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So When I started posting here this was my story brieflys

"I have been suffering with severe depression and anxiety for over 3 years. Its getting to the point where I just need a break. I have tried every SSRI out there, I have tried SNRI, Mood stabilizers, BenzoDiazapene's, and anti-psychotics. They all help, but dont do the trick. Things just keep getting worse. I have been to three different psychiatrists, and have religiously been in therapy for years. My newest Dr has started the use of stimulants, showing promise, but not fully effective. Now she is out of ideas, and wants me to see another Dr. I feel like I just keep playing medication roulette. No one knows what to do, This is hopeless. Has anyone else experienced this? I dont even know where to turn. Every where i look only, just says to consult a healthcare provider! "

I also got rid of my therapist and got a psychologist, he thinks i may have cyclothymia, which i dont buy because the depression is bad

But after 8 weeks of hell, I get to the new PDoc today, who has good reviews on www.healthgrades.com. He rushes me through his assessment, doesnt let me explain things. Gives me a new diagnosis of BP2, disagrees on the cylcothymia. Decides to quite 2mg of klonopin cold turkey as im sitting there in tears balling my eyes out saying i cant function without it right now, and even now i need more, my anxiety is too bad. He ignored me and didnt even reply. Then says your on 2 AD, which works better, i said i have only been on welbutrin for 3 weeks but my insurance is tough covering trintellix, he says ok stop trintellix. then says ok start seroquel, keep welbutrin, stop klonopin, stop caffeine now. i said i dont sleep i cant function without caffeine. Again no reply. Then he tells me he can see me in a month, but if we do that this will be a long process, and that i need to see a doctor more regularly, and that in a month he goes out of town for a month. WTF!!! so he sends me over to the psych hospital for 4 hours to get into an IOP program. He didnt listen to anything, nothing with my anxiety, nothing with med concerns with seroquel, didnt let me explain symptoms, nothing! I said to him, im gonna have to take off work, I am up for a big promotion, im gonna lose it, . He said it didnt sound like things were going well anyways. Then looked up in the database of controlled substances and said you got klonopin filled on this date, you should have some left if you absolutely need it. I tried to talk again about how i spend half my day at work in a bathroom quivering, he ignored me and asked me to write him a check. Then nicenly said hed see me when i got done with IOP. Said if that didnt work wed do ECT or TMS. HE saw me for 20min!!!!!

 

ive been going through hell , waiting months for this! I give up.........

Heres my plan

1)Just go do an IOP i probably need it

2) call me old Pdoc run by her what he said, and see what she says about seroquel and possibly upping the klonopin until i see the IOP pdoc. 

3)NOT GO BACK TO HIM-I cant find a good Pdoc

4) I dunno what to do about the seroquel its gonna make me tired, kill sex drive, and put on weight, and the one thing i look forward to and hand my hat on is bodybuilding.

5) when i asked why seroquel and not lithium or the like he said "this is for bipolar depression" it has to be this

 

im so angry, sad drained, hopeless

 

sorry needed to vent

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Could you just work with the IOP to get meds where u want until u find a new doc. He sounds terrible. I would have walked out.

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he was very nice until the end, but just kept saying "focus" stay on what im asking if i tried to explain. I need to get into the IOP first. so i need to get ahold of old pdoc and hope she suggests something in the interim.......but the anxiety is insane

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called my old pdoc, who told me they couldnt see me anymore becasue they didnt know what to do, I was told they "left the practice" and probably cant call me back..........this just keeps getting better and better. THis is why people with mental health issues get worse

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Honestly, looking for answers, I don't see the problem with your new pdoc. Perhaps he should have listened more, but his treatment plan is pretty standard for someone with Bipolar 2. The only thing I would question is whether Wellbutrin is the best antidepressant for someone with anxiety.

Are you mainly upset because the Klonopin was discontinued? As for Seroquel, it is not written in stone that you will gain weight nor is it written in stone that you will not be able to do body building. Seroquel is effective against anxiety as well as bipolar depression. It will also help you sleep at night. Yes, it can make you tired, but the sedation should improve once you get used to the medication. There are a lot of people on these boards who swear by Seroquel. What is your Seroquel dose?

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he didn't let me talk, discontinued meds, asked

me what Ad works better i didn't even finish and he stopped one, didn't even listen to why we started wellbutrin prior. then told me he was going away for a month and to go to the hospital.

 

as i sat there crying. he ignores me and asks for a check.

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I'm sorry that he ignored you. That is never good in a pdoc.

But what would you have had him done differently in regards to your treatment plan?

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1) not being me in to tell

me he can't follow up for teo

 months when he knew uo front what the issues we're. 

2) address my anxiety

3) let me explain symptoms

and causes. he never let me give life events, or back story to anything

4) not rush me through an eval

because he's behind

5) not ask for a check while

im crying asking questions

6) not just say go to the hospital

7) address any questions i had about meds.

8) not just dump me

9) actually listen to what the rationale for AD i was in

and dosing  not stop the klonopin and an AD cold turkey just because and the plan was to up the dose in the

welbutrin but he didn't like coming in, in the middle of another treatment plan

 

 

we spoke three times prior to this appointment he knew it all

 

 

 

 

 

 

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I think he did address your anxiety with the Seroquel. What is your Seroquel dose?

As I said, he should have listened to you. That's inexcusable and it's also inexcusable that he asked for a check. I don't know how his office is run, but everywhere I've been, the front desk takes care of billing.

Unfortunately, the rest of it is pretty common with regard to pdocs. Many pdocs will only see you once a month, and it's bad that yours is going to be away the next month. My pdoc spends only 10 minutes with me and I think the initial visit was something like 20 minutes. I've had pdocs tell me before that they will not prescribe anything on the initial visit until they got to know me and my issues better. Also, with the current anti-benzo climate, you always run the risk of getting a pdoc who will not prescribe benzos. That, unfortunately, is becoming more and more common.

However, your pdoc's treatment plan is pretty standard for bipolar II. The belief of a lot of pdocs is that antidepressants aren't effective in bipolar. Hence, he traded out the antidepressant and the Klonopin for Seroquel which is believed to be more effective for bipolar depression and also helps with anxiety. You remain on the Wellbutrin which is one AD that is often prescribed to people with bipolar who need an antidepressant.

What I am trying to get you to see is that all is not lost and that even though your pdoc ignored you and was generally not the best in patient-doctor interpersonal skills, you are still getting good treatment. 

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he wrote an article on the underprescribig of benzos and how they r needed, so that makes sense

25mg 3 days, 59mg 3days then 100 for three weeks at least seems loooow

Edited by looking for answers

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also correct me if i'm wrong you shouldn't just stop an AD and 2 mg klonopin cold turkey

regardless i'm goin iop, even went to psych hospital and they told me to no do his rec till i talk to iop pdoc. gotta get pcp to manage meds for now

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2 hours ago, looking for answers said:

also correct me if i'm wrong you shouldn't just stop an AD and 2 mg klonopin cold turkey

regardless i'm goin iop, even went to psych hospital and they told me to no do his rec till i talk to iop pdoc. gotta get pcp to manage meds for now

Yep, stopping Klonopin abruptly can trigger seizures. 

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If you didn't feel listened to and heard then it might be Better to keep looking for a different doc long term but you could stay with him and follow his recommendations while you wait for a new pdoc appointment with a different one. iOP could be useful. I wouldn't write off Seroquel if you've not tried it. It has a lot of evidence for use in all phases of BP and side effects only happen to some people, not all. You can still lift weights and won't necessarily get fat. Sometimes changing many things at once is a bad idea but sometimes there needs to be a start from scratch/overhaul. Is being treated inpatient an option for you? 

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I went through my personal version of all of this insanity about 15 years ago. The way my illness was going through the process of evolving, the entire medical support staff was left trying to catch a passing comet with a butterfly net. 

I had no idea what was going on. I sat there and answered all of the questions honestly and, as they reviewed my file, I couldn't explain why the answers were constantly changing. My symptoms were all over the place. Everything contradicted everything. 

I had a lot of stress conspiring to melt my brain.. and the confusion of it all turned an innocent spark into an explosion. After a couple inpatient visits for manic psychosis leading me to believe I could fly like Superman, all the puzzle pieces finally started coming together. 

Medication was its own nightmare for me. I tried for years to go that route. The side effects screwed with my head in ways that I found intolerable. Physically, I could not function at anywhere near the level I was formerly at. All of my relationships turned into everybody basing my thoughts, actions, decisions, progress, setbacks, and accomplishments on whether or not my medication was disappearing daily as prescribed. My identity as a human being was somehow contained in whatever orange and white plastic bottles were in my bathroom cabinet that month. The meds became the strings that everybody in my life dangled me from. I was paying strangers a couple thousand bucks a month for fulfilling the role of providing job security or becoming a puppet put on the planet solely to entertain with my insanity. No longer human. That delusion became my reality.

Overall, regardless of medication tweaks, there was no improvement in my quality of life. Everything in my life evaporated. I had 2 advanced degrees, a full resume of professional accomplisments, a lengthy occupational position of being in a supervisory role.. and then, I couldn't even trust myself to complete a single rational thought. I blamed the meds as much as the illness.

Eventually, I flushed it all.. and got hit with the mental tsunami of cold turkey medication withdrawals. I found strength in knowing that different crazy feeling was actually 'real'. If medication couldn't glue me back together, I had to accept that, admit defeat, figure out what went wrong that led to that point.. and start over. 

After years of losing my identity, I had to find myself again. Not only that, I had to learn from my ordeal and make a conscious effort to avoid retracing the same footsteps that led to the cliff edge of madness.  

The illness forced me to sacrifice everything. Family. Job. Friends. Life. Goals. Plans. Dreams. The more I tried to fight it, the harder the illness grabbed me by the neck. I trusted nobody. The world had betrayed me. So, I adapted. I found the connection and realized my mental episodes are induced by stress. I simply can't handle pressure to comply, conform, and fit neatly into the path of least resistance for the convenience of everybody around me. I am an overly generous person.. yet, my future survival demanded an incredible amount of selfishness. Mental illness is beyond maddening.

Sure, maybe if I stayed on the Medicoaster, I might have eventually found the perfect physician who finally understood me enough to prescribe a magical bottle of patience with a chaser of tolerance and an occasional emergency dose of temporary amnesia that allows me to sleep at night. 

Instead, I made the sacrifices and avoid everything that provokes a negative reaction.

15 years after my last inpatient visit, I am now self employed, self reliant, self sufficient and living a completely sober existence in my own isolated little bubble that very rarely overlaps with society. There is a very long list of normal, happy things I accept that I will likely never have in my life. I can write online (anonymous), but.. I have not had a face to face conversation with anybody that lasted more than a minute in over a decade. I am just fine with that.

In spite of my own past experience, I am not against medication at all, however.. I now know it was not a viable option for me. I am certainly not saying anybody should thumb their nose at their support system and burn that bridge.

All of those variables within the seesaw of balancing therapeutic benefits vs. unwanted side effects kept fueling the anxiety that kept me on the proverbial wheel in the hamster cage. 

I hopped off that wheel. 

Moral of the story? We are all individuals. My solution will not be your solution. Figure out what motivates you. Figure out what you want for your future. Figure out what provokes (and inspires) you. Figure out what your options are. If you can't see the fork in the road, create one. Find the courage to never stay stuck. Learn to trust the people who stayed by your side when the rest of the world ran and hid. The old cliches.. Today is the first day of the rest of your life. Find what matters and embrace it.. It's your life to live and your story to write. You hold the pen. Dig deep into your soul.. and start scribbling. 

The illness is a master at sucking motivation and leaving us to be frozen in indecision, then, forcing us to second guess every aspect of everything. 

After reading through what you have written in the thread, I think it might be helpful to put your options on paper and untangle the knot. Prioritize things. Outsmart the disgustingly jaded us vs. them game. The process is overwhelming because there are layers of money to be made by adding confusing obstacles. Maybe they are trying to test how committed you are to your own future wellbeing? Your illness is their job security. Its a cruel world.

Work with a treatment counselor to make a step-by-step list of the order that everything has to be completed in. Establish everybody's role and purpose. Educate yourself of the options, symptoms, and side effects. Speak their doctor lingo language. By showing them you are proactive in your own treatment, you will make a positive impression and stand out among the usual crowd in the waiting room. Communication matters. If you have 'professionals' in your circle that can't tolerate being questioned about their ideas or recommendations, they are probably not looking out for your best interest.

Last thing I noticed in your post. Inpatient is always an option. Always. Hospitals are open 24 hours for a reason. A chemical imbalance can be just as dangerous as a broken neck. As a last resort, an unplanned hospital visit always beats the alternative of not going - especially when your life depends on it. I have been hospitalized 3 times for mental illness/medication related psychosis. About half of the people in there with me were working their way through supervised medication adjustments. That wing of the hospital is not what the movies portray it to be. 

Sorry for the novel. :)

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10 hours ago, Lms-Kaz said:

I went through my personal version of all of this insanity about 15 years ago. The way my illness was going through the process of evolving, the entire medical support staff was left trying to catch a passing comet with a butterfly net. 

I had no idea what was going on. I sat there and answered all of the questions honestly and, as they reviewed my file, I couldn't explain why the answers were constantly changing. My symptoms were all over the place. Everything contradicted everything. 

I had a lot of stress conspiring to melt my brain.. and the confusion of it all turned an innocent spark into an explosion. After a couple inpatient visits for manic psychosis leading me to believe I could fly like Superman, all the puzzle pieces finally started coming together. 

Medication was its own nightmare for me. I tried for years to go that route. The side effects screwed with my head in ways that I found intolerable. Physically, I could not function at anywhere near the level I was formerly at. All of my relationships turned into everybody basing my thoughts, actions, decisions, progress, setbacks, and accomplishments on whether or not my medication was disappearing daily as prescribed. My identity as a human being was somehow contained in whatever orange and white plastic bottles were in my bathroom cabinet that month. The meds became the strings that everybody in my life dangled me from. I was paying strangers a couple thousand bucks a month for fulfilling the role of providing job security or becoming a puppet put on the planet solely to entertain with my insanity. No longer human. That delusion became my reality.

Overall, regardless of medication tweaks, there was no improvement in my quality of life. Everything in my life evaporated. I had 2 advanced degrees, a full resume of professional accomplisments, a lengthy occupational position of being in a supervisory role.. and then, I couldn't even trust myself to complete a single rational thought. I blamed the meds as much as the illness.

Eventually, I flushed it all.. and got hit with the mental tsunami of cold turkey medication withdrawals. I found strength in knowing that different crazy feeling was actually 'real'. If medication couldn't glue me back together, I had to accept that, admit defeat, figure out what went wrong that led to that point.. and start over. 

After years of losing my identity, I had to find myself again. Not only that, I had to learn from my ordeal and make a conscious effort to avoid retracing the same footsteps that led to the cliff edge of madness.  

The illness forced me to sacrifice everything. Family. Job. Friends. Life. Goals. Plans. Dreams. The more I tried to fight it, the harder the illness grabbed me by the neck. I trusted nobody. The world had betrayed me. So, I adapted. I found the connection and realized my mental episodes are induced by stress. I simply can't handle pressure to comply, conform, and fit neatly into the path of least resistance for the convenience of everybody around me. I am an overly generous person.. yet, my future survival demanded an incredible amount of selfishness. Mental illness is beyond maddening.

Sure, maybe if I stayed on the Medicoaster, I might have eventually found the perfect physician who finally understood me enough to prescribe a magical bottle of patience with a chaser of tolerance and an occasional emergency dose of temporary amnesia that allows me to sleep at night. 

Instead, I made the sacrifices and avoid everything that provokes a negative reaction.

15 years after my last inpatient visit, I am now self employed, self reliant, self sufficient and living a completely sober existence in my own isolated little bubble that very rarely overlaps with society. There is a very long list of normal, happy things I accept that I will likely never have in my life. I can write online (anonymous), but.. I have not had a face to face conversation with anybody that lasted more than a minute in over a decade. I am just fine with that.

In spite of my own past experience, I am not against medication at all, however.. I now know it was not a viable option for me. I am certainly not saying anybody should thumb their nose at their support system and burn that bridge.

All of those variables within the seesaw of balancing therapeutic benefits vs. unwanted side effects kept fueling the anxiety that kept me on the proverbial wheel in the hamster cage. 

I hopped off that wheel. 

Moral of the story? We are all individuals. My solution will not be your solution. Figure out what motivates you. Figure out what you want for your future. Figure out what provokes (and inspires) you. Figure out what your options are. If you can't see the fork in the road, create one. Find the courage to never stay stuck. Learn to trust the people who stayed by your side when the rest of the world ran and hid. The old cliches.. Today is the first day of the rest of your life. Find what matters and embrace it.. It's your life to live and your story to write. You hold the pen. Dig deep into your soul.. and start scribbling. 

The illness is a master at sucking motivation and leaving us to be frozen in indecision, then, forcing us to second guess every aspect of everything. 

After reading through what you have written in the thread, I think it might be helpful to put your options on paper and untangle the knot. Prioritize things. Outsmart the disgustingly jaded us vs. them game. The process is overwhelming because there are layers of money to be made by adding confusing obstacles. Maybe they are trying to test how committed you are to your own future wellbeing? Your illness is their job security. Its a cruel world.

Work with a treatment counselor to make a step-by-step list of the order that everything has to be completed in. Establish everybody's role and purpose. Educate yourself of the options, symptoms, and side effects. Speak their doctor lingo language. By showing them you are proactive in your own treatment, you will make a positive impression and stand out among the usual crowd in the waiting room. Communication matters. If you have 'professionals' in your circle that can't tolerate being questioned about their ideas or recommendations, they are probably not looking out for your best interest.

Last thing I noticed in your post. Inpatient is always an option. Always. Hospitals are open 24 hours for a reason. A chemical imbalance can be just as dangerous as a broken neck. As a last resort, an unplanned hospital visit always beats the alternative of not going - especially when your life depends on it. I have been hospitalized 3 times for mental illness/medication related psychosis. About half of the people in there with me were working their way through supervised medication adjustments. That wing of the hospital is not what the movies portray it to be. 

Sorry for the novel. :)

that's a hell of a story! i'm def going through some withdrawal now as i up the seroquel. it's not cool. and i'm hungover from the seroquel. but i'm going to do the IOP program. of course there's a short waiting list. i will beat this. the meds help at times. i refuse to believe there isn't a med that will work. i just think we have not had the righ diagnosis and combination yet.

 

i refuse to give up my dreams of professional

accomolishments. i will have meaningful relationships, and i enjoy social interactions-just not now. 

right now it all just sucks horribly and i can't stand life. 

but im fighting

 

 

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The manifestation of symptoms at onset, or as the illness progresses, is especially maddening. 

Everything is new, and different, and scary, and intimidating, and frustrating. 

Don't know what to say. Don't know how to say things. Don't know who to tell. The fear of judgement. Or ridicule. Or being labeled. Or discriminated against. 

How does a person learn to trust a professional who has only researched a symptom without ever personally experiencing it? What is their basis for relating to any of it? 

It is beyond overwhelming. Who can you trust when you can no longer trust yourself? 

Places like this are excellent for filling that void. Although every person is a unique individual, a lot of us have been in similar situations. 

You will find what works for you. Keep pushing forward and finding new things to grasp.

The illness is a master of manipulation that cons people into doubting themselves and their ability to persevere. It is a steep mountain. An obstacle course to overcome. 

Stability is sitting there at the peak waiting for us to navigate our own maze and solve our own riddles.

At least that's how I often picture it. Yes, I get distracted. Yes, I lose motivation. Yes, I slip backwards.. a lot.

But, I am stubborn. And, I enjoy a worthy challenge. So, I have learned to shake it off. Keep learning. Keep adapting. Keep climbing. 

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