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    living better through chemistry

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  1. I've noticed this about my doctor's office too. For me it is sad but not surprising - I live in one of the most segregated cities in the US. Try looking at the makeup of the neighbourhood the office is in. Unfortunately, poorer areas, inner city areas, and so on are more likely to be more diverse, at least from the aspect of the patient population, but also people like to work with patients like them. I think you're more likely to find asian practitioners in chinatown, for example. Also, if there is a medical school or a teaching hospital near you, try clinics served by them. You'll get a more diverse group of practitioners there because they're students being drawn from a larger area.
  2. My pdoc did genetic testing through Millenium Health and it was in-network lab work for my United Healthcare insurance plan. The cash price was around $2300, my insurance brought the cost down to around $1500. It was still quite expensive because it went against my (high) deductible. My doctor had been told the out of pocket cost was $200 for people with no insurance (which was what convinced me to try it). When I got the bill for $1500+ I shared it with her. Her office got the cost negotiated down for me so my out of pocket cost ended up being around $250. So my takeaway is it's worth asking your insurance company about if this stuff is covered, because it might be. Also your provider can be a useful advocate for you, don't be afraid to ask them for help. Negotiating health insurance and coverage and stuff is hard.
  3. I also choose relative sanity over potential physical illness. I do monitor my weight and my BP. I have risk factors for diabetes, high BP and heart problems. Not all meds with a side effect of weight gain will cause you to gain weight, so make your decisions based on how you're responding. Frankly, I'm hoping that if I can find the right meds to help me feel better then I will be able to do other things to more proactively protect my physical health (e.g. lose weight, exercise, eat less prepared/processed food).
  4. Mostly it's boring. I've been IP at two different hospitals, admitted through the ER. They take away your clothes, shoes, phone, etc. and make you wear paper scrubs initially. You can "earn" back your clothing (minus any strings, like shoelaces or drawstrings in sweats/hoodies) usually within a day or so. Other belongings are kept locked up. I was allowed to keep a book and a journal (no pen though, had to use pencils in the dayroom). The journal was gluebound, not wirebound. My friends/family brought me clothing after I was admitted, if you're planning to go you could bring a bag. Bring three days of clothes and keep it simple. There's laundry facilities for if you're there longer. I've had several stays ranging from 2-10 days. You can have visitors for short periods of time, how long and how often varies. There are patient phones for making calls in/out, though it takes special permission to make long distance calls. The phones are usually available most of the day, something like 7am-11pm. They're in public areas where you can be easily observed. You'll be under constant supervision. The two hospitals I stayed at everyone was checked on at least every 15 minutes and their location/activity recorded. If you're considered more of a danger to yourself you could be put on one-to-one where there's someone essentially by your side all the time. This is done rarely. You'll see a pdoc every day. The nurses and aids will take your temperature and BP twice a day. Your meds will be doled out and you will be watched to ensure you take them. During the week there is an attempt at group therapy during the day but it's not very intense/deep. Evenings and weekends/holidays are usually "free time" which has meant for me pacing the halls, staring out the windows, and watching the shared tv in the day room (never anything good on though). There's usually paper and stuff for colouring. One hospital I've been at has an art therapy room and everyone makes beaded bracelets (not necklaces though). No sharps. One hospital I was at didn't even let us have plastic knives with our meals. I've met good people while IP. I've met good people in post-hospitalization day programs. People like you find here - normal folk who happen to have mental illness and are having a bad spell. One hospital I went to offers ECT, and I was able to start receiving ECT treatments while there. The restrictions and treatment from the staff varies depending on your level of safety and how you treat them. There is some looking down on the patients of the ward for being there that seems to be universal, but if you're polite and kind and friendly they will be to you too. Mostly it's boring. There's not much therapeutically to be gained from it. If you want therapy you'd be better off in a day/IOP program (where you'll be monitored by a pdoc). It's a safe place to wait out a bad spell of your depression. It's unlikely any medication changes they make while you're there will change your situation, meds for depression just don't work that way (unlike if you were there for psychosis or mania, for example). My pdoc says any impact from med changes while in hospital is placebo effect. If that works, I say take it.
  5. Thanks for sharing, I didn't know Ducky well but I'm sorry to hear she's doing so poorly.
  6. I keep a spreadsheet list of psych meds I've tried. I list stuff like dates I took it, max dose, prescribing doctor, and effects (both positive and negative). I organize it by intended impact because I take meds for multiple reasons, so anti-depressants, sleep, ADHD, anxiety PRNs, etc. I am a bit of a geek (surprise!), but maybe something similar would be useful for you? You and your doctor could start one together based on what you remember. (I also keep info on dates/locations of psych IP stays, and how many and when my ECT treatments were). This info makes it easy to get second opinions. My experience with Remeron has been largely kind of 'meh'. It stopped making me sleepy about 2-3 days after each dose change. My appetite is heavily suppressed by other meds I take. I get weird vivid dreams about food though.
  7. You won't forget big things like how to change diapers or what behaviours are normal in children of that age. You might forget parent names or the locations of items that are rarely used. Nothing that can't be brushed off as having a bad memory and making a joke. It might impact work because if it helps you could be more genuine in your happiness, have more energy to chase the kiddos and feel more optimistic about everything. If it helps, you won't have that voice in the back of your head sighing at every little task. This is all based on my experience, of course. Your mileage may vary.
  8. Hi Hermione, welcome to CB. First let me say I totally understand your fears. ECT is terrifying and how it has been portrayed in our culture doesn't help. You must be feeling pretty terrible if your doctor has recommended you consider ECT. I'll tell you that my pdoc pushed ECT for a year before I tried it. I was so scared even after I agreed to do it. I was almost crying when they took me to the procedure room for the first time. A kind nurse came in and held my hand while they put me out. I had a total of 31 treatments over the course of about 5 months. The first several were 2-3 times a week but after a couple of weeks we backed off to once a week. I used FMLA to take short term disability leave from my job as a mechanical engineer for 2.5 months. After that I worked 4 days a week and got ECT on Fridays (and I did not work those days). I stayed with friends for the first half of my treatments, but moved back home (where I live alone) for the last approx. 3 months. If you're interested I documented my experience here. The side effects that I experienced were fatigue, headache, nausea and memory loss/foggy cognition. The doctors gave me medicine in my IV for the headache and nausea. The fatigue was pretty much only on the day I received treatment. I slept most of that day, usually. Now, about the side effect you're probably most worried about: the memory loss. I understand. As I said above, I am an engineer so you can understand that having a clear mind is important to me. That said, the depression was making my cognition & memory pretty foggy on its own. I found my memory and cognition was pretty bad on the treatment days (when I just wanted to sleep anyway) and when I was getting more treatments close together. It was not so bad I couldn't function though. I think I acclimated to it somewhat too as I was able to work almost full time (32 hours/week) while receiving weekly maintenance treatments. There is a lot I don't remember. Pretty much anything that happened while I was receiving treatment I can't remember. Foods I've tried, movies I saw, and visits from friends/family. I was able to work, though I kept meticulous notes. I don't remember stuff from that period without some prompts, and often not even then. It's been better since I stopped ECT treatment. Beyond the treatment period, I can't tell how much other memory loss is due to ECT and how much just from severe depression. Some of both. Prompts, notes, etc. make a big difference. I've reread journal entries, chat transcripts, etc. as memory aids. It helps. I really do recommend ECT. It is not as scary or as damaging as it seems. It didn't help enough for me but I would try it again if I could get enough time off work to give bilateral ECT a fair shot. I only had 4 bilateral treatments and they were all a week apart. If you have any questions at all this forum is a great place to start/ask, but feel free to PM me too.
  9. I had formal testing done for learning disabilities while trying not to acknowledge that my depression was out of control. I was referred to a local university's psychological assessment program by my gdoc. At the time I was not seeing a pdoc. Over the course of about 6-8 hours they did really thorough interviews, a lot of different kinds of testing, and reviewed what (meager) records I had. I came out with a dx of ADHD, depression, general and social anxiety, scores on various tests including IQ and a recommendation of ways that my university could help me improve my performance. I took the paperwork with their recommendations to get accommodations at school, which helped me. My gdoc changed her approach to my psych/MI care and also added a stimulant.
  10. Haven't seen you posting recently. Hope you're okay.

  11. Count me as another with a dx that stuck. I've been pretty clearly depressed, anxious and socially phobic/anxious since I was a teenager. In college I got ADHD added when I did a formal psychological assessment (which included discussion of my childhood behaviours).
  12. I've been taking Singulair for several years. I have experienced a few of those side effects (depression, anxiousness, suicidal thoughts, restlessness), but I can't say if they're from the Singulair or just my illness. I don't recall any marked change in psych symptoms coinciding with starting or stopping Singulair (I have stopped and restarted because my asthma is primarily allergy-based and the allergies are primarily seasonal, or at least that's been my justification when I couldn't or didn't want to afford the copay. Mostly these days I take it all the time though.)
  13. People do get diagnosed with both bipolar disorder (BP) and borderline personality disorder (BPD). BP is classified as a mood disorder while BPD is, a "personality disorder." The defining traits of BP (depression and mania) last for four days to months to years. That is, you are manic or depressed for a long period of time. The traits of BPD that get confused for mania, mostly, are emotional dysregulation and can be much more fleeting and unpredictable. I've read arguments that cases of rapid or ultra-rapid cycling bipolar disorder are actually mis-diagnosed BPD. I really like this blog post from The Last Psychiatrist for understanding what many psychiatrists mean when they give a diagnosis of BPD. BPD has become shorthand for "difficult patient". Be wary. This is an interesting blog post in Psychology Today discussing the diagnostic similarities and differences between BPD and BP. The author argues that "Ironically, a patient who is actively manic and one who is acting out from borderline personality disorder look nothing alike if seen when symptoms are present. The difference is not subtle at all! Furthermore, if psychiatrists know the tricks of the trade (and most do not), they can get a patient with BPD to turn many of their symptoms off and on like a faucet. Manic patients stay manic no matter what the doctor does in the short term - short of knocking them out with sedating drugs" This article in Current Psychiatry discusses the diagnosis of Borderline Personality Disorder with Bipolar Disorder. The intended audience for the article is psychiatrists, not lay-public like us, but the gist of it is that the two do co-occur and are often confused for each other. According to that article: Bipolar disorder is generally considered a clinical disorder or brain disease that can be understood as a broken mood “thermostat.” Borderline personality disorder is characterized by an enduring and inflexible pattern of thoughts, feelings, and behaviors that impairs an individual’s psychosocial or vocational function. BPD and bipolar disorder often co-occur. Evidence indicates ≤20% of patients with BPD have comorbid bipolar disorder and 15% of patients with bipolar disorder have comorbid BPD. The confusion between bipolar disorder and BPD may be particularly problematic for patients with bipolar II disorder or subthreshold bipolar disorders. In your position, particularly given your current BP2 diagnosis, my questions to the diagnostician would be: Which criteria for BPD do I meet? What makes you sure those are not just symptoms of (possibly more severe) BP? How would a diagnosis of BPD change my treatment plan? Would those changes be beneficial even if I do not have BPD?
  14. BPD is way over-diagnosed and nowhere near as easy to dx as many suggest. BPD is almost exclusively dx'd in women. BPD is often used as a way for doctors to tell each other about difficult patients. Given how much time you've spent in hospital, I'm frankly surprised no one has brought up BPD/traits with you before. Particularly from hospital pdocs. I'm not a diagnostician, but I think any diagnosis of BPD or BPD traits should be taken with an extremely large handful of salt. Talk to your primary pdoc. He knows you better than the hospital pdocs, having seen you both in crisis and while relatively stable. The hospital pdocs only ever see you (oddly enough) in crisis, so their experience of you is skewed. Edit: Here's an interesting blog post on what borderline is defined to mean and what it has come to mean to psychiatrists in general.
  15. I'm an engineer. I work for a small company in an open office layout surrounded by my colleagues. I think the most important thing is that the job is something you enjoy. Life is hard enough without dreading work. Remember that most of us spend more time with our colleagues than our families. Figure out what excites you, what turns you on, and figure out how to do that. The next most important thing is structure. For me that means not working at home. I need the structure, routine and forced interaction that comes from working at an office. Even the open layout is probably better for me than having a private office because I'm likely to hole up alone and not interact with people, given the option. Isolating like that just makes my MI worse though. Not to say I'm particularly close to any of my coworkers, but there's something about having people to shoot the shit with before a holiday or after a weekend.