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Lose Confidence in My PDoc After 2 Years?

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I'm BP 2, was diagnosed in September of 2004. Had lovely periods of hypomania where I could accomplish everything, then I had dark depressive periods. Always had severe anxiety during depressive periods, moderate social anxiety all other times. Periods of hypomania and depression were spaced out months aparts and would last for months with months of fine time between them.

After convincing myself to not leave the house because the FBI was out to get me and was going to crash the house any moment, I saw two psych docs. One was an idiot that gave me paxil. Symptoms got worse, gave me more paxil. Second doc was my wonderful pdoc.

He gave me his personal cell phone. I can call him anytime. He gives me advice on on-stop medication adjustments when I'm really "out there". I love the guy, respect him tremendously. He understands where I'm coming from, fills out notes for work for me right on time, even gives me tons of samples since I'm broke.

But here's the catch to this fairy tale: I'm almost worse now that when I've started treatment. I've been on so many different combinations of medications, some of which have make me fall asleep at work, forget periods of days, get akathesia, get agorophobia, and the really nice couple of times when I OD'd on my pills and tried to cut myself because I don't feel like myself anymore and it's been two f'cking years, and have basically COSTANT anxiety.

I'm going to be demoted this week from my job I fought hard to get because I take "too" much time off work. I got into a car wreck and almost totalled my car (with my kids in the car, and the wreck was my fault) and I can't figure out why I did what I did. Doc turned down the lithium after that episode.

So I made an appointment with another doc on October 11. Am I doing the right thing? In my lifetime, I've seen 5 psych docs - all except for this one were a flake and a total idiot. Most were assholes as well. When do you say enough is enough? Or am I getting as good as it gets?

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Hi, Gizmo,

There is absolutely nothing wrong with getting a second opinion. It doesn't mean you have to ditch your current pdoc. The new guy may have some new insight into what might work for you. It's always worth trying to find out.

Have you made a comprehensive list of all meds taken, doses, and duration? You need to do that to get any kind of decent information from #2 pdoc.

Apart from that, you may find that you want to stay with your current doc after all. You seem to be extremely articulate. Have you spoken (or written) about all of this to your current doc? If someone else is better, then great. But, it seems a shame to give up on a doc you've got a good rapport with, especially if you haven't shared all the downsides of your side effects.


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yeah, as greeny said, you didn't share a lot with us about your RX or DX, so we can't, in our non-pdoc, only other crazy people way point out what may look weird. if you're bipolar and on 60mg paxil with no mood stabilizer, for example, we might suggest talking to your pdoc about it! it would raise a red flag to us.

that being said, i'm with greeny in that you should get a second opinion. a lot of what happens is that things do get worse before they get better. i know i've been through a lot in my medication adjustments and various pdocs in finding the right meds and treatment professionals. sometimes i change treatment professionals and meds, and sometimes just doses or have a talk with the people treating me. i've also had car accidents since being on meds. as you can see, i'm BP1, ADD, and PTSD. i'm also on a pharmacy. i've been on different drugs that induced different side effects, like seroquel, that turned me into a walking zombie, or geodon, that made me homocidal (in the hospital, and they ripped me off of it really quick, don't worry!).

with a second opinion, you may even need to go back a couple of times to be re-evaluated for another DX and then another revision of what your RX would be under this new pdoc. think things over carefully. changing treatment teams frequently isn't something to take lightly, but neither is staying with ones who aren't doing you any good.

you may need to have a talk with your current one about the status of your treatment, what your thoughts and ideas are, and what you want to see in the future. maybe he doesn't know where to go wtih all of this. maybe he needs more testing. volunteer for the mmpi or more tests if you have to. you need the most accurate DX you can get so you can get the best treatment possible. just throwing drugs at it isn't working.

does that make any sense, or am i blabbing to the wind as usual?


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I can understand being doubtful of your doctor when things get worse.

I went from originally being dx'd major depressive with panic disorder 5 years ago, and now they're thinking bipolar with psychotic symptoms. A lot of it began after a new wave of 'treatment.' Each time added something more to the mix. That's quite a lot worse than I started. But I'm glad I stuck with it, because now I'm doing so much better than I could have hoped.

I think you need to trust in your doctor. If he was good for you before, I'm sure he's still good for you now. If you don't feel your doctor has the clearest picture, tell him/her what you think he's missing. It might mean some med changes, and perhaps things will get better for you.

Good luck, I hope your decision is the right one

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