I realize this is a thread about statsman’s question, but does anyone have any advice for post #19?
Never mind , others already covered it and better than I.
Are you your niece’s guardian? If so, do you get to choose her doctors, or is there a referral etc. etc. needed?
I’d start with a call to the existing doc to ask about the things you mentioned. I’d probably also phone the therapist to get more details on the “might be making her manic” thing. If the answers aren’t satisfying, if you can, I’d look for another doc for your niece. There do exist practicing incompetent doctors (and practicing overworked and therefore sloppy doctors), and your niece might or might not have one. At this point all you have are good questions.
Yes. My husband and I were given guardianship of her last fall, when she came to live with us.
I think the therapist may be right about the mania, but she’s basing it on some reckless behavior and poor judgement which could be due to teenage-ness and not bipolar. It’s kind of hard to tell.
Thank you for your answer. This makes the second bad experience I’ve had with a psychiatrist in this area; apparently it’s very difficult to find a good one.
Sorry, I must have skipped this.
First off, there are two different types of “not recommended.” There are medicines out there that are not supposed to be given to children, and there are medicines that have just not been tested, and are only “not recommended” for that reason.
But doctors often will prescribe medicines for older teenagers that is good for adults.
Second, I’m confused why the therapist and psychiatrist are not working together. If the therapist believes that the medication is causing mania (a common side effect of giving antidepressants to a bipolar person), then said therapist should document the information that led to that conclusion, and tell you to get another psych appointment ASAP.
And if the therapist thought she was bipolar in the first place, the psychiatrist should have been given the diagnosis from the therapist. And they should have warned you that the medication might cause mania and how to deal with it.
You should absolutely not be working with a psychiatrist and therapist that have an antagonistic relationship. You should not have to be wondering whether to do what the psychiatrist or the therapist says.
I’m hoping the psychiatrist doesn’t know about the recent problem, and would be willing to try another medication based on what the therapist says. I’d try that route first.
Thanks BigT.
We started first with the therapist - I’ll call her Jane - last fall. This spring, Jane said that she thought the girl needed to see a psycihatrist so that she could be recieving some med for depression.
I took her to the regional mental health place, where they did an intake session with *their *therapist. Her appointment with the p-Doc was set a month from that intake. We had told their therapist all about the possibility of bipolar, and about a host of other things such as PTSD we thought she was suffering from. I don’t know if the p-Doc ignored that, or discounted it, or wasn’t told that. Their therapist, incidentally, is available to talk to niece at the high school and it was my impression that he was going to be doing that.
I am going to try to get a message to the p-Doc regarding this issue with the med.
Well, I thought I’d give an update in case anyone was curious. I saw the psychiatrist I was bitching about in the OP today. It was my second post-intake med check appointment. On the advice of several of the posters here, I started checking out other doctors in the interim. I found one that can see me in August. I thought I could make it until then.
Now, I’m not so sure. I’ve still been having periods of crippling, damn near paralyzing depression, and along with those, thoughts of suicide. I’m not actually thinking of going through with it–I couldn’t do that to the few people that care about me. But I thought that any thoughts of suicide were a sure indicator that things aren’t going well upstairs.
I told the psych about my thoughts of suicide (I told him I feel this way about half the time), and he said that “well, those thoughts are something your therapist has to help you with. The medication won’t take those away completely.” He also said that I have to learn to distract myself from those thoughts.
What?? So antidepressants can **cause **suicidal thoughts in children, teens, and young adults, but they can’t get rid of them? Aren’t suicidal thoughts an alarm that says “Hey, Doc! This regimen ain’t workin’?” Apparently not for this guy. I even asked him (sarcastically) “So, how often do normal people think about suicide?” He said, “Everyone does from time to time. They just don’t dwell on it.”
The only option I see now is to contact my PCP, the guy who originally referred me to my current psych, and tell him “it ain’t workin’ out.”
Sometimes, thoughts of suicide are an indication that you’re feeling better, of all things, because now you’ve got a bit of motivation back. Yes, you can actually be too depressed to even care enough about your depression to think about suicide. (IANAD/N, however, I have dealt with periods of serious depression on and off over the years.)
That being said, if you feel like you need to call another doctor, please do so.
Unfortunately, yeah, sometimes it is the way they are. I went to a shrink exactly like this, for 5+ years. All he did was dole out drugs (and incidentally, he overprescribed benzodiazepines, and I got hooked on them; had to go a different [better] addiction specialist psych to get off of them!). Appointments were no more than about 10 mins., and if I ever wanted to talk, he told me I should start seeing one of his firm’s therapists.
I’m SOOOO glad that I’m getting both meds and talk therapy from my current psychiatrist. She also got me off benzos. (Yay!)
Find another shrink. You won’t regret it.
So you go in and you tell him you’re having suicidal thoughts and he tells you to talk it out with your therapist? That sounds reasonable. Unless you told him you started to have suicidal thoughts after you took the drugs he prescribed. Then I would worry that he kept you on those drugs.
Other than the suicidal thoughts, did you tell him the drugs you’re taking were not working? What was his response to that?
He told me that there’s no magic pill that can take away the suicidal thoughts. He told me to try not to dwell on them. He said to come back in a month, after which we’ll see if he needs to up the dosage of Lexapro.
Do you have a decent therapist? If not, can you get one (and get in to see them in a reasonable amount of time, i.e., much much sooner than freakin’ August)?
I have to say, while it is on the face of it true that suicidal thoughts might best be dealt with by a therapist, and while there is no magic pill to banish them, I have never heard of a shrink dismissing them so cavalierly. I’ve had most of my psych meds handled by my general practitioners, though. Mentioning suicidal thoughts to them, as I’ve had to do a few times, has brought instant action, including med adjustments AND urgent therapist referrals.
Until you get this provider clusterfuck straightened out, please please do hold onto your rational rejection of those suicidal thoughts, hard as it may be in the middle of the night or other dark times. Nurture it, remind yourself of it, think of it as a sacred duty, whatever it takes. I might not be alive today if I hadn’t had a similar idea, sort of compartmentalized and protected from however I was feeling emotionally, during the worst times. I would take it out to look at like a favorite shiny beach pebble, or something. (Does that make sense?) IT WAS WORTH IT.
Good luck.
I know I strongly recommend a psychiatrist for psychiatric issues, but it may be worth it to ask your therapist and/or your GP for a referral to another GP or internist who is skilled/experienced in prescribing these meds for the near term. There are GPs/internists out there who are better than others in this area, and would very likely be able to see you sooner than August.
In the meantime, make sure you are taking care of the basics: good sleep, good food, fresh air and exercise. You need, also, to be very very open with your therapist about your suidical thoughts.
This, too, shall pass. You are doing the right thing in being diligent and standing up for your care. Clearly, you believe on some level that you deserve better, and that is a sure sign of belief in yourself, a core of self-esteem. These are good things. The suicidal thoughts are The Beast. Fuck The Beast, that fucker. He is not the boss of you!!
I had been seeing a therapist for a while, but about three weeks ago, she told me that she was taking a leave of absence from the clinic and that I would be seeing someone new. The new person is still getting to know me, so we haven’t really done much yet. I only see her once per week; I wish it was more.
I just left a message for my GP about getting another referral. He’s pretty good about calling me back. I’m crossing my fingers!
ETA: I have another thread going somewhere about exercise and diet. I’m not eating as well as I should because, being me, knowing that I’m overweight has led me to go on this radical diet of 1000-1200 calories a day. Not healthy, I know, but it’s hard to eat sometimes. I’m also exercising, but I hate that. I’ve been doing it since January, but I really, really dislike it. I don’t feel good afterward, I don’t feel an endorphin rush, I don’t feel energized. I just feel hot and sweaty and disgusting and miserable for the entire time. But I’m still doing it.
Well, that sounds a little harsh, my friend. It’s not about whipping yourself, it’s about self-care. Gentleness, gentleness. Water the plant and talk to it in gentle, soothing tones.
IMO, telling a mentally ill patient to just not to dwell on their thoughts is extremely stupid advice. Even though he can’t deal with your thoughts as well as a therapist can, I would still hope he could come up with something smarter than “don’t dwell on it.”
Get someone new. My advice is to cancel your next appointment with this guy and instead set up an appointment with someone else. You have nothing to lose by doing this. You’ll just tell your new doctor about all the medication you’ve taken and you can continue from where you left off with your old doctor.
This could be affecting your mental health. I know that, when my diet changes at Passover and I’m eating less carbohydrates than normal, I feel much more depressed and irritable than I normally do. The brain makes serotonin from carbohydrates, and serotonin is one of the neurotransmitters that’s often out of whack in depressed people.
If you have any guns in your house, you should get rid of them now. Guns are not for people with suicidal thoughts.
Find another doc. You have zero obligation to this one.
It’s not like you void the warranty if you go see another psychiatrist.
No guns in the house (really, even though I live in Texas, I don’t have any guns in the house! ;))