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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by holymama on April 23, 2004, at 12:23:35
Does anyone have thoughts on how bad a person's depression has to be before hospitalization or what I should do at this point. I've been dealing with a month long depression, a breakthrough depression in my bipolar treatment. I hesitated to even call my doctor about this one, as I feel there is a valid external reason for me to be depressed and was even feeling too down to call him and get healthy. Finally I gave in and called him too days ago. He suggested to up my lexapro from 10 to 15 mg at night (I'm also taking trileptal 900 mg/day). Now, two days later I must be having a mixed episode, as I am not feeling my dark mood lift, and I am still weepy and on edge, but I am having some of the other manic symptoms I get like unable to sleep, fidgety, anable to focus, feeling like I will jump out of my skin. I'm at home trying to care for my three young children and I'm yelling and weeping and having horrible dark thoughts like thinking through suicide attempts, even though I don't think I could ever do that with children, it scares me when I think that way and I think that when I want to do it it is more of a way to explain to everyone how unbearable I feel and also because I know that would put me in a hospital and I would get a rest.
My pdoc is going away next week (maybe leaving as early as tomorrow), so if I call him I would have to do it tonight, I've been thinking about trying a new pdoc anyway, so maybe this is the chance to do it, I also have a therapist I could call.
There are too many factors and I'm feeling too unfocused to even make a decision. Any advice?
THank you.
Posted by pegasus on April 23, 2004, at 13:22:04
In reply to How sick do you have to be before hospitalization?, posted by holymama on April 23, 2004, at 12:23:35
Hi Holymama,
I'm so sorry you're going through all of this. I would suggest that you do call your pdoc back, and explain how upping your Lexapro has made you feel.
I'm really glad to hear that you wouldn't commit suicide because of your kids. It's really concerning, though, to hear that that's the only thing keeping you going. So, let me ask you: If you didn't have kids, would you seriously be considering it? If so, definitely get help. Call your T. Call your pdoc. If you can't get ahold of them, call a crisis hotline, or call 911 or go to the emergency room. You don't want to end up any further down that path.
If you wouldn't consider it, I'd still call my T if I were you. They would probably want to know how bad you are. They might be able to help you make some decisions, or at least some ways to cope.
I wish you much luck. Please keep posting here, and let us know how you're doing. I'm really concerned about you, and what you're saying.
pegasus
Posted by pegasus on April 23, 2004, at 15:00:24
In reply to How sick do you have to be before hospitalization?, posted by holymama on April 23, 2004, at 12:23:35
One other thought. I remember reading that SSRI antidepressants (like Lexapro) often cause manic episodes in people who are bipolar. The fact that upping your Lexapro seems to be leading to manic aspects mixed with your depression seems to go along with that expectation. I definitely think you should talk to your pdoc about this, if you can. There may be other meds that work better for treating depression within bipolar, which is caused by different biological factors than unipolar depression.
pegasus
Posted by rainyday on April 23, 2004, at 15:48:10
In reply to Re: How sick do you have to be before hospitalization?, posted by pegasus on April 23, 2004, at 15:00:24
Please keep in touch with us this weekend, and as pegasus said, put a call in to your T and p-doc. The last time I was in crisis and didn't call my T, she was upset with me. I'm bipolar2 with panic attacks.
Definitely look into the medication thing. I personally am on effexor xr 75mg and wellbutrin 300mg and am generally doing a lot better. Not today, mind you, but much better than I was.
There's a boatload of people here you care how you are doing!
Posted by holymama on April 23, 2004, at 16:19:36
In reply to Re: How sick do you have to be before hospitalization?, posted by rainyday on April 23, 2004, at 15:48:10
Thank you both for responding. Support boards are good things for times like this. I got my husband home and he saw what a mess I was and luckily (???) he is unemployed and not working at all next week so he's going to be with me until I figure this one out. I haven't been this bad for over a year. I tried really hard to get through to my therapist, but the phone system there isn't working so I couldn't talk with her!! I decided against talking with my pdoc since he's like an ice cube and was the last person I wanted to talk with when I was having a breakdown. I have been researching other pdocs anyway so I decided with my husband to choose a new one and get in next week.
I was really close to calling a hotline or 911. I've never been that panicked before, and it's pretty annoying/comical (depending on how you look at it) that my therapist was not reachable at the only moment in the last year that I have been seeing her that I needed her outside of my therapy time.
I've calmed down, thank you for the support. I'm still feeling down, but as long as my husband is here to help with the kids I'll be o.k. if I can rest. I'll keep you updated. :) :) :)
Posted by shadows721 on April 23, 2004, at 17:32:07
In reply to How sick do you have to be before hospitalization?, posted by holymama on April 23, 2004, at 12:23:35
It depends on your safety. If you aren't safe, then hospitalize yourself.
Posted by noa on April 24, 2004, at 8:17:23
In reply to Re: How sick do you have to be before hospitalization?, posted by holymama on April 23, 2004, at 16:19:36
Glad your husband is there to help you through this, and that you are feeling calmer. Take care.
Posted by holymama on April 27, 2004, at 12:59:47
In reply to Re: How sick do you have to be before hospitalization? » holymama, posted by noa on April 24, 2004, at 8:17:23
I've been having a hard time for the last month with breakthrough depression, and despite an increase in my AD last week, I'm just spiraling down. I finally lost it yesterday while watching my three kids and packed my bags, so that when my husband came home I was ready to leave for a few days, just drive north, stay in a hotel alone and rest , weep and ruminate on why I am depressed. Really stupid idea, but a really desperate attempt to just survive. He talked me into having my parents take the kids for a few days and go to the hospital. My pdoc has been on vacation, and my therapist too -- and neither will be back until next monday. My husband and i did try talking to the emergency doctor on call at the office, and she recommended the emergency room. I also tried calling other pdocs on my insurance list, but of course it's impossible to get in anywhere quickly. I just want medication changes so I can survive the week and function, and take care of my children!!! We were at the ER for 4 1/2 hours last night (6:30 - 11:00), stayed to talk to a 'crisis' person, and after all that, noone could help us. Apparantly noone else can prescribe meds except my own pdoc. So it is now 2 pm and I have been sitting by the phone all day wiating for my pdoc to call back from his vacation, to either prescribe meds over the phone or give up his care to another doctor. I am frustrated to say the least. I can't believe it took 4 hours to talk to a 'crisis' person and they sent a severly depressed person away without giving any help.
Posted by gardenergirl on April 27, 2004, at 14:07:34
In reply to My husband took me to the hospital last night, posted by holymama on April 27, 2004, at 12:59:47
holymama,
I'm so sorry you had to go through that only to leave unhelped. It sounded like a good idea to go, but how upsetting that you couldn't get what you needed. I hope your pdoc calls soon. In the meantime, hang in there and post more if it helps.(((holymama)))
gg
Posted by Fallen4MyT on April 27, 2004, at 18:16:46
In reply to My husband took me to the hospital last night, posted by holymama on April 27, 2004, at 12:59:47
Maybe you need to get away and NOT just to a hospital a good rest....away from kids even while you adjust to any med change would be nice...even you and hubby minus kids...Sounds like your hands are too full...Many prayers for you
Posted by Dinah on April 28, 2004, at 9:58:18
In reply to My husband took me to the hospital last night, posted by holymama on April 27, 2004, at 12:59:47
It seems like a silly rule. :(
Posted by holymama on April 28, 2004, at 12:17:18
In reply to Re: Did you hear from your pdoc? » holymama, posted by Dinah on April 28, 2004, at 9:58:18
I've been sitting at home waiting for a call from my pdoc and now my PCP. It's 1:00, I called my pdoc almost 48 hours ago, and I know he got the message because his secretary said she spoke with him about me. He knows I've been trying to reach him, he knows I've been to the ER, and the best guess that my husband have is that he's pissed that he has to call me back on vacation. I just made an appointment with a new pdoc for next week to replace him (yay!!) but in the meantime, I am trying to get someone (anyone!!!( to adjust/change my current meds for me so I can function better until my appointment. I think I fell through a crack in the system.
Posted by Dinah on April 28, 2004, at 21:09:01
In reply to No!!! » Dinah, posted by holymama on April 28, 2004, at 12:17:18
It's fine to go on vacation, but you need to leave someone with the power to do what's needed for your patients when you're gone. I think it's ridiculous that no one else can prescribe for you. :( I guess an appointment with a new pdoc is a good idea. Has it been in the works for long? I've found it very easy to get a quick appointment with a therapist, but pdocs seem to take months to have openings for new patients where I am.
Posted by holymama on April 28, 2004, at 21:18:36
In reply to Re: Totally unacceptable » holymama, posted by Dinah on April 28, 2004, at 21:09:01
My husband and I have learned a lot about the mental health community around here in the last two days. Because my parents took my kids for two nights and because I had reached a point of breaking down, we decided to spend our free time getting me in somewhere. We literally spent two whole days making phone calls, getting advice, making more phone calls...we have talked to multiple doctors' offices, 3 hospitals, my PCP, my pdoc's secretary...trying to figure out how I can get an appointment before next week, with anyone, ANYWHERE. My PCP is actually away on vacation (HA! With my Pdoc? And my therapist?) but I spoke with his nurse practitioner who was finally the one awesome person I encountered and was on the phone with me multiple times and calling around, trying to help me. I figured out that if I took my medical records from my pdoc and gave them to a new pdoc, the process moves faster and I can then be considered for 'emergency care' under my new pdoc. So I got an appointment for saturday. My old (as of a few hours ago) pdoc still hasn't called me...2 1/2 days now. It would be funny if it weren't so damn annoying. Thanks for asking Dinah. Thanks for reading my long saga. Autumn
Posted by Camille Dumont on April 29, 2004, at 13:19:27
In reply to Re: Totally unacceptable » Dinah, posted by holymama on April 28, 2004, at 21:18:36
Well, if you're really really really desperate, there is one thing you can do and its pretty simple :
- Go the the ER
- Walk up to the reception desk and say : I am depressed, I think about suicide all the time, I have a plan and I do not know how much longer I can resist the urge to go ahead with it.Believe me you WILL get admitte and pretty quickly although you might also end up staying at the hospital for a while but at least you'd get to see someone who could change your meds.
Its so insane that sometimes you have to lie to get help but what else can you do?
Posted by holymama on April 29, 2004, at 17:24:17
In reply to Re: Totally unacceptable ... drastic alternative, posted by Camille Dumont on April 29, 2004, at 13:19:27
Hi Camille,
Yes, that is also the same conclusion that my husband and I came to. That is, if I really need care I should go into the hospital and lie and tell them I am suicidal. Then I would get help.Also, another issue that has come out of all of this is, that a couple of people recommended complaining about my pdoc. In fact, one friend I have whose husband is a therapist called me today and both she and her husbnad spoke with me on the phone and told me who to get in touch with to complain. Although I feel angry about what happened and don't want it to happen to anyone else or me again, I feel like I should speak to him to find out what happened first before I complain. I was considereing keeping my appointment next week with him to ask him about it, but my husband reminded me that I have a $30 copay. I could cancel the appointment but call him next week to speak with him about it. Or do you all think that whatever his excuse it; it is unacceptable and I should just complain about him anyway?
Posted by Camille Dumont on April 30, 2004, at 8:03:40
In reply to Re: Totally unacceptable ... drastic alternative, posted by holymama on April 29, 2004, at 17:24:17
I'd talk to him over the phone first. Sometimes bad communication can lead to total hell ... and if you're still not satisfied, by all means do complain ... you will be doign the rest of the population a great service. If there are some crappy docs out there and nobody complains, then they will never stop being crappy.
Hang in there
Posted by judy1 on April 30, 2004, at 11:34:53
In reply to Re: Totally unacceptable ... drastic alternative, posted by holymama on April 29, 2004, at 17:24:17
I agree with the other posters that you should keep your appt with your pdoc to hear his excuse and then determine your course of action. I have been in your situation several times, and one of the times my pdoc was enraged and fired his answering service. so let us know what happens and what you decide.
re: lying about suicidal feelings. Once you are labeled a suicide risk you get into the legal system (or if I'm wrong, please let me know- this happened to me after a suicide attempt). Is this something that will haunt you later? After a car accident, I was sued and the attorney requested my records trying for a 'suicidal' spin on my part (all I did was go through a yellow light that turned red, I most definitely was not suicidal) I write this because while I firmly believe everyone should get help if they are actively suicidal, I do feel if your pdoc was at fault- you should make sure you have a pdoc who is available at all times so you don't ever have to go through this again.
I completely sympathize with how overwhelmed you must have felt, I have done the same thing you did- waited for my husband to get home to take care of the kids so I could get away. And you know what? doing that really helped, I was so stressed and depressed I just needed some alone time.
I truly hope everything works out for you and you feel better.
take care, judy
Posted by mair on May 2, 2004, at 9:49:56
In reply to Re: Totally unacceptable ... drastic alternative » holymama, posted by judy1 on April 30, 2004, at 11:34:53
Like everyone else here, I can't believe your pdoc left without making arrangements for coverage in his absence. My last pdoc sent me a letter every time he went away. My current pdoc isn't that conscientious, but I only see her a few times a year, and she knows I'm pretty stable.
You probably should talk to your pdoc before complaining. I'd probably just write him a letter but that's me and my avoidance of potentially unpleasant encounters. You can complain, but I think you should only do this if you think it'll make you feel better or bring closure to this whole experience. Sometimes the whole complaining process is more traumatic than it's worth.
Keep us posted on how it goes with the new doc.
Mair
Posted by holymama on May 2, 2004, at 10:04:38
In reply to Re: Totally unacceptable ... drastic alternative, posted by mair on May 2, 2004, at 9:49:56
Hi everyone, how nice of you to keep posting! I did see my 'new' pdoc yesterday (saturday office hours!) and she's a bit old, and odd, slow, not very warm...but we'll see if her approach works. She wants to take me off my current drug combo completely (lexapro and trileptal) and try me on wellbutrin and lamictal. So I have an intense drug schedule for the next 6 weeks, weaning off of my current drugs and starting new ones slowly. I wonder if I'll be a complete nutcase for the next 6 weeks? I sure won't make any important plans...And I 'm pretty sure I still have an appointment with Dr. Dufus (my new pet name for my old pdoc)on Tuesday. I'll probably call tomorrow to cancel, but I definately will talk with him on the phone at minimum. I want to confront him in person or by phone, not by letter, since I feel so angered by the situation he put me in, I want to let him know. I'm not ususally a confrontational person, but in some cases when I feel sure I am right I do like to say it face to face.
This is the end of the thread.
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