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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by All Done on April 2, 2004, at 17:39:28
I’ve been talking to my T for a little while now about going back on AD’s. I’ve been hesitant because I’ve only been on two. Paxil made me feel suicidal and Zoloft (which I stayed on for quite sometime) left me feeling not depressed but not much of anything else either. I hate that feeling. Anyway, I’m also in the process of finding a new pdoc (probably not looking as hard as I should), so my T suggested I go to my GP to get an rx for Zoloft until I find a new pdoc. (Enough abbreviations for you in that sentence?) So, I finally went, and my GP asked a few questions and said perhaps I’m bipolar and need a mood stabilizer, but he would like to try a different AD (Lexapro) for eight weeks first. If after that point I am feeling like I did on Zoloft, he wants to switch to a mood stabilizer.
Ugh. This probably sounds like it should be on the med board, but my thoughts aren’t really about the medications. I’m wondering about the dx. My husband and I saw our couple’s therapist yesterday and we told her what my GP said. She seemed surprised at the dx and a bit frustrated that he was trying anything different with me at all. She wants me to get to a pdoc.
Obviously, I’m going to talk to my T about this tomorrow, but I’m just wondering what you guys think. Was he too quick to throw out a dx? I’ve done a little more reading on bipolar since then and I don’t know that I fit the characteristics all that well. I have plenty of ups and downs, but I’ve never considered myself manic at any point (although my GP says some bipolars don’t experience the manic episodes as strong as others but may fall deeper into depression). I guess I just don't know. Well, enough rambling. I’m not looking for you all to diagnose me, I just wonder what you think about my GP trying to do it at one 15 minute visit.
Thanks, in advance, for your thoughts.
All Done
Posted by Fallen4myT on April 2, 2004, at 17:57:55
In reply to Quick to dx?, posted by All Done on April 2, 2004, at 17:39:28
IN MY OPINION,,,,,WAY TO QUICK TO DX....AND TO ME, A GP HAS NO BUSINESS GIVING OUT M/S's UNLESS he had a PET scan....and I bet he doesnt..see your T and worry not ..Too many GP's are giving psyche meds out on a dime..Once I was given an AD didnt take it I KNOW I was sick...and sure enough I ended up with pneumonia
Posted by Racer on April 2, 2004, at 17:59:07
In reply to Quick to dx?, posted by All Done on April 2, 2004, at 17:39:28
Oh, for heaven's sake! You're so lucky -- to have a psychic GP -- and you're not jumping up and down? You should call a paranormal researcher to go check this dude out!
Now, this is only one viewpoint, but since it's mine I'll tell you all about it. That sounds so invalidating, and really unhelpful. I don't blame you for having your doubts about this guy -- he's decided that your report about your trouble is inaccurate, he's decided what the treatment plan will be without regard for your needs, and he's telling you that your perceptions of your expiences are just plain wrong. Gee, let me think about this for a few minutes -- Yep, you've got every reason in the world to mistrust him. Can you talk to your T about this experience? What about talking to him? Can you say something like, "Listen, I think you mean well, but I've had Major Depression for [x] years now, and have never had any signs of bipolar. It worries me that you're choosing a dx without regard for that history, and it worries me even more that you're already planning what to do *when* the single antidepressant you've chosen fails, rather than considering how to make an antidepressant work. Can we rethink this whole picture?"
Mind you, I can't have conversations with my pdoc like that one, so I more than understand if your answer is, "No, I can't have that conversation with him..." (I could be wrong, but I think the ability to have that conversation would be a sign that the depression is cured...)
What a distressing thing to have happen. I hope hearing someone else say that it doesn't sound right helps you accept your self-validation.
Posted by Dinah on April 2, 2004, at 20:33:12
In reply to Quick to dx?, posted by All Done on April 2, 2004, at 17:39:28
Just a thought. Could it be your reaction to Paxil that he was reacting to? My new psychiatrist added a mood stabilizer really quickly upon hearing of my suicidal reaction to Wellbutrin, and it turns out to have been a really wise call.
Posted by terrics on April 3, 2004, at 10:05:16
In reply to Quick to dx?, posted by All Done on April 2, 2004, at 17:39:28
Find a pdoc. Gps do not see enough psych pts. to get a real feel for a diagnosis. terrics
Posted by All Done on April 4, 2004, at 0:31:54
In reply to Re: Quick to dx? » All Done, posted by Fallen4myT on April 2, 2004, at 17:57:55
Hi, Fallen. I did talk to my T today and I am going to get a new pdoc lined up. Generally, I like my GP and I think he is honestly trying to help, but this time, I think I'd feel better with an expert's opinion.
Sorry you had a bad experience :(, but good for you for knowing yourself best :).
Take care,
All Done
Posted by Fallen4myT on April 4, 2004, at 0:36:44
In reply to Re: Quick to dx? » Fallen4myT, posted by All Done on April 4, 2004, at 0:31:54
Youre welcome and thank you. Oddly my old doc who made the error moved away and we remain friends..calls, visits...odd how things shake out..docs can be wrong and to dx one so fast is not right. I am glad youre gonna see someone
hugs
Posted by All Done on April 4, 2004, at 0:44:42
In reply to Re: Quick to dx?, posted by Racer on April 2, 2004, at 17:59:07
Racer,
I was able to talk to my T about all of this today. He didn't really agree or disagree with the dx (although he said he's never seen a manic episode). He suggested that perhaps my GP was trying to dx through prescribing different medications and when we find what works, that will give us an "official" dx. I don't really feel comfortable with this method, especially after hearing that some SSRIs induce manic episodes in bipolars. If that is the case, I feel like he's playing with fire if he truly believes I'm bipolar.
Anyway, while I do believe my GP was genuinely trying to help (maybe I'm a bit too trusting?), I'm going to find a pdoc that will spend a little more time with me and we'll go from there.
Thanks for your post,
All Done
Posted by All Done on April 4, 2004, at 0:50:32
In reply to Re: Quick to dx? » All Done, posted by Dinah on April 2, 2004, at 20:33:12
> Just a thought. Could it be your reaction to Paxil that he was reacting to? My new psychiatrist added a mood stabilizer really quickly upon hearing of my suicidal reaction to Wellbutrin, and it turns out to have been a really wise call.
Dinah,
Well, I'm not sure. He threw bipolar out there pretty quickly. It may have even been prior to me reminding him about my experience on Paxil. And he never suggested being on both.
I'm going to keep this in mind, though. I'm really glad to hear it helped you!
Thanks,
All Done
Posted by All Done on April 4, 2004, at 0:52:37
In reply to Re: Quick to dx? » All Done, posted by terrics on April 3, 2004, at 10:05:16
> Find a pdoc. Gps do not see enough psych pts. to get a real feel for a diagnosis. terrics
terrics,
That is exactly what I've decided to do. Thanks for the advice!
All Done
Posted by karen_kay on April 4, 2004, at 10:00:19
In reply to Re: Quick to dx? » terrics, posted by All Done on April 4, 2004, at 0:52:37
i'm thinking about you dear...
Posted by gardenergirl on April 4, 2004, at 14:49:23
In reply to Quick to dx?, posted by All Done on April 2, 2004, at 17:39:28
I'm glad you are planning to see a pdoc. Given your reaction to the other meds, it's definitely worth it to get a more specialized opinion. I have to admit, I see my GP for meds, but since last fall, I have been telling him my dx and suggesting what to try. This is under the guidance of my T, who finally provided the dx that fits me: atypical depression. Once I got the right dx, the med to take was obvious, an MAOI, which has the best track record for this.
But I certainly wouldn't recommend this approach to everyone. Most GP's are not push-over's like mine, and he knows that I am in training to be a clinical psychologist, so I think he trusts my input and that of my T. Many GP's, I think, are too quick to prescribe whatever the drug reps are hyping the most, and are less likely to develop a dx first.
Good luck. Sorry for rambling about me.
gg
Posted by All Done on April 5, 2004, at 13:51:15
In reply to (((all done)))), posted by karen_kay on April 4, 2004, at 10:00:19
Thank you, Karen. Right backatcha. (Is that how you spell it? ;))
Posted by All Done on April 5, 2004, at 14:03:30
In reply to Re: Quick to dx?, posted by gardenergirl on April 4, 2004, at 14:49:23
gg,
Thanks for your response. Don't worry about rambling. I am always looking to hear others' experiences because I truly appreciate learning from everyone here.
One of my friends made the same comment about the meds and drug reps. It makes me a bit scared to think my GP might be so cavalier with my mental health and well being. Just another reason to play it safe and get a pdoc, I guess.
Thanks again,
All Done
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