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Doctors do not listen to me!

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I'm new to the boards here. *waves hi*

Okay, now that I've gotten that out of the way.... ^_^

I'm not really sure where to start. Hopefully this won't sound like I'm rambling, but I want to give a little background info in order to give the big picture. I apologize in advance for the long post.

I have multiple physical ailments (swollen/aching joints, back pain, migraines, malaise, possible heart issues?, SEVERE allergies, chronic stomach pain, etc....) I've had most the painful problems since I was about 13 or so, and I'm 25 now...so....at least 12 years. I've had the same doctor for about maybe 9 years off and on. He's a bright guy and does what he sincerely thinks is best. I used to trust his judgement until this year.

Why? Because he is essentially telling me everything is in my head. Or, rather, a symptom of what is in my head. Now while I believe some of it is caused by the constant stress I feel, other things should NOT be bypassed, but he just attributes them to my mental state. For the record, all I've ever told him is that I get depressed and I feel hyper/stressed a lot.

The most recent travesty occurred the other week when I was calmly sitting at my desk here at work. I felt an emptiness in my chest, then a sharp, searing pain in my heart while it beat about 5 times extremely hard. My vision then started to fade out for about 2 or 3 seconds at the most.

I tell him this, and he says I'm having a panic attack. Bull. Shit. Since when does ONE symptom make a diagnosis? I've had P.A.s before. Yet he argued with me that even though I've had them, and I know what they're like, and there was NO sign of panic in the LEAST when this occurred, that it was still a panic attack. I'm half wishing my heart would just give out so that I can prove him wrong. But then again, I'm just a stubborn bastard. :P

Anyway, he FINALLY (after, oh, a decade?) referred me to go see a psychiatrist. This cold woman barely looked at me once, asked me a series of questions (not really even background info...just how I currently feel), talked over me, then sent me out the door with a prescription for Effexor. I do not intend on taking it for reasons I'll discuss in the next paragraph. I don't know what to do now though because I'd like to see someone different, and I don't want my insurance to think I'm doctor shopping or something. I've never dealt with the MH side of the system, so I have no idea what I'm doing.... I'm completely green!!

I do not want to take the Effexor because when my regular doctor prescribed me Zoloft to try and ward off my migraines, it made me feel absolutely miserable/insane/awful/etc. Since Effexor is in the same sort of SSRI group with the same kind of contraindications, wouldn't Effexor have the same shitty effects on me as the Zoloft?? I mentioned this to both doctors, and they just kind of, well, ignored my concerns. Big surprise there.... Ugh.

So in a nutshell, here are the concerns:

a) None of my doctors listen to me. Like I have no idea what is going on with my own body or my own head. Like because sometimes I feel "off", I must be a COMPLETE f-ing moron and couldn't POSSIBLY contribute anything to my own care. Christ.

b) None of my symptoms line up with GAD or anxiety disorder or anything.... I mean, the first prerequisite for GAD is that there is persistent overwhelming WORRY. I'm not a worrisome person at all. If anything, sometimes I'm too laid back. While I have had issues with depression throughout my life, and my symptoms DO line up with that diagnosis at times, the anxiety side just does not fit. The symptoms I do have include the following:

- Unless I'm sick or exhausted, I generally always feel like I have imbibed WAY too much coffee. Like I want to jump out of my skin. I fidget. I can't think straight. I can't concentrate. Sometimes my heart pounds in my chest. Brain fog is a SERIOUS impedement sometimes. (I'm an impeccable speller, and when in the fog, I can't rememeber how to spell simple words. It's disturbing.) I can't sit still. I sometimes become what I guess you could call hypervigalant? What doesn't make sense with that though is that I'm almost impossible to startle. ADD runs in my family and several teachers throughout my history have referred my parents to have me evaluated. (I was never hyper or unruly, I just couldn't concentrate on anything to save my life. ...and still can't. It's a wonder I was an honor roll student for 10 years! ha)

Because I feel stressed out most the times when things are calm, I go out of my way to avoid stressful situations and it affects my life negatively. I recently went back to school and did great for two semesters. I lasted 3 weeks this semester and had to drop the classes. I completely shut down from the stress. I can't handle it. I'm a wimp.

So then at the same time as I feel completely wired, I'm usually extremely tired. Makes sense, right? Bah.

And then when it IS time for bed, I can't sleep. Irony sucks.

- Sometimes I feel compulsions to shop or completely change what I look like. I can usually resist it, as I've learned that bounced checks and debt aren't exactly conducive to happiness. Neither is a dye job and haircut that you don't like 5 days later.

Even without the aid of a little pot-smoking, I still feel a compulsion to eat. I'm normally 5'4" and around 145 pounds, but this year I've lost control. I had a serious illness which caused me to lose 20 pounds in only a few weeks last year, and once I recovered from that, I ballooned from 125 pounds to nearly 200 pounds. I've NEVER been this big. Ever! It's incredibly frustrating. If not for my very awesome significant other, I'd probably feel completely worthless right now. I was thinner when we met, and he still loves me in all my gross pudginess. <3

I'll probably proofread this post at least 15 times before I actually post it too. Ugh.

- There was a long period where I "didn't feel real". Like I was just a pair of eyes and a brain and that neither were connected to my body. I'd look at myself in the mirror, and while I knew it was me I was staring at, I still kind of felt like I was stuck in a body looking at the host. Like it wasn't me I was looking at.

- When I get exceptionally stressed, either for real reasons or for no good damned reason at all, I do a lot of repetitive stuff, like rubbing my fingers down my thumb on the same hand (if that makes sense) over and over again, or repeating expletives. It's like...calming. Kind of like rocking back and forth is soothing. Sometimes I hit myself. In the past, I would cut myself, but as I've gotten older, that behavior has nearly diminished. When I was in high school and still living with my parents, I exhibited a lot of the symptoms of Borderline PD. :) Once I moved out of that hellhole, I started to do a LOT better. So yeah, I had a shitty childhood. Some physical abuse, but mostly psychological. Constantly walking on eggshells for fear of being beaten by the bad parent or making life more difficult for the parent that DIDN'T make my life hell. The bad parent didn't really beat me up often; it was exceptionally rare, but the fear of setting this person off kept me constantly stressed out. I think the asshole rewired my brain to be the intolerable way I am now. Jerk.

So baring in mind my behaviors and the fact that Zoloft made me go a bit mad, I would think that I should look into if I am bipolar or cyclothymic. But since none of the doctors I've seen will f&#@ing listen to me, I don't know how to even start. I'm so goddamned sick of going nowhere in life. I do well for a while, and then for no good reason, everything falls apart and I become neurotic. How am I supposed to get better if no one listens to me? I'm so frustrated. I don't want to become a lonely, poor, old cat lady. :) Especially since I'm incredibly allergic to cats. ;)

So here I am. Posting my stupid story on some random internet board for a bunch of strangers to read. Great.

Any little bit of help or advice would be greatly appreciated!

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first of all- there is no stupid post here- welcome -

Wow you sound stressed. So much to think about.

You worried about "doctor shopping" and I believe shopping for the the right fit - especially for a therapist (tdoc) or psychiatrist-(pdoc) is essential. If someone is talking over you and you don't feel heard then this is a bad fit and i'd say go elsewhere. You have to have at least some trust in the people you work with. and if you've been seeing the same doctor for 9 yrs and you are no longer satisfied, maybe this is the time for some new eyes and minds to look at you, where there are no assumptions based on past experience, but someone who will treat you in the here and now.

The scary thing is that many ailments are physically real but do have a component of our mental health- even heart attacks. but things like migraines , IBS, back pain ( I have had all these)are really common for those like us.

I was recently filling out many questionairres for some psych research. So much of your description of feeling in a fog,and not real etc were all things they asked about. ( I also have these- usually a symptom of PTSD-and then you spoke of abuse and it made sense to me anyway. these are dissociative symptoms which helped us with the threats in childhood but now they get in our way.

You sound on the right track about BP- like the impulsivness and getting yourself into debt.

Unfortunately as you'll find here- no one med works the same for everyone-most of us, after years, are still trying out new combinations of meds to get the right "cocktail"

I hope you've found a glimmer of help and/or hope here.

again welcome, mrs l

just an fyi- you may in the future want to post more shorter posts than a really long one- I've found that if i write a long one i don't get as many responses- see many of us have short attention spans too! ;)

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Thanks for the replies! ;)

And to the poster above me (Kazuma), the reason I don't feel I have anxiety is because I'm not anxious. Dictionary.com defines the psych variety of anxiety as the following:

Psychiatry A state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threatening event or situation, often impairing physical and psychological functioning.

I don't have apprehension. I don't have uncertainty. I don't have fear. I have no preoccupation with anything in the future aside from maybe worrying about paying bills, but most people my age have that same issue.

So how on earth would I have anxiety???

I've known three people that had severe anxiety and I have very little, if anything, in common with them. I say stress because what I feel is the same as feeling stressed, but without any thought or external stimulus contributing to the stress. It's just like I said...I feel like I drank a bunch of coffee. The DSM says that the conditions you listed MUST BE MET. If I don't meet several of the criteria, then I don't see how it would make sense to label me as such. That would be like labeling someone as schizoaffective when they have no hallucinations.

It's like if the average person's PHYSICAL, (*NOT* mental) resting stress level is 5 out of 10, then mine's at a constant state of, oh, 7 or 8. So in the event there actually IS something to worry about or be stressed over, then I'm at a 10 when your average person is at a 7 or 8. It is NOT caused by anything I'm thinking about (the vast majority of the time, anyway) When I have racing thoughts, they're usually neither positive OR negative. It's more like normal thought process ("gee, I should probably re-tie my shoe", "oh look a sweet-ass car!", "I wonder what I'll have for lunch", etc etc etc) only sped up.

The reason bi-polar was brought up is because at one time I was seeing a Licensed Counselor and through meeting with me mostly weekly for about a year, she believed that it may be an issue due to how I get so amped up sometimes (and the obvious depression issues). I actually feel like I've taken amphetamines or something. It's like an overglorified caffeinated feeling, but I feel HIGH too. It's really odd.

The woman I recently saw spoke to me for less than ten minutes (after making me wait for over an hour while I was clocked out at work. I missed 2.5 hours of work for a damned 7 minute interview. She "forgot" she had an appointment with me. Infuriating!!) and a lot of stuff didn't even get discussed. I will definitely not be seeing her again. Ugh.

Maybe caffeinated isnt quite the right term... It's kind of like feeling a subdued rage, but without any actual anger. Stressed and angered. I'm a rather patient most the time, so that generally keeps me out of trouble as far as a temper is concerned..... The only exclusion being that nothing pisses me off more than loud noises (like kids. god, I hate kids.) or barking dogs. I snap when things are chaotic around me, but since I try to be a non-violent person, I usually just try to escape the chaos. My right hand is scarred up from punching so many walls. Right now a piece of skin is missing on one of the knuckles from this morning.... I've never punched a person.

As far as the ADD is concerned, I have every single symptom for it and always have. Apparently the people my parents took me to as a kid diagnosed me (I was asking my mother about this last night), but my parents chose to do nothing about it.

My gut tells me that there's probably no single thing horribly, excruciatingly wrong with me, but there are several big things that are kind of wrong with me. When you add them all together, it equates to something that very impedes my life and any successes I may have.

Two months ago I was bouncing off the walls and staying up until 2 in the morning. Two weeks ago I was staring at my set of knives contemplating jabbing one of them into a major artery and could barely motivate myself to get out of bed. Today I'm more or less "fine". I'm still all fidgety and caffeinated feeling, and I feel that subdued rage, but I don't feel like running circles around my workspace or jumping out a window, so it's a more or less good day aside from being pissed off about a traffic incident that happened 5 hours ago..... So everything irritating just makes me more irritated than it normally would... but aside from that, today isn't half bad.

It's like every morning I wake up, and I have no idea what to expect. I can't plan things. I can't finish anything. I can't succeed in anything I do even though I'm a bright individual. I never know what mood I'm going to be in. And it's ruining my life.

Maybe it's supposed to be ruined. Maybe I should just stop caring that it is. It would be less irritating that way.

Oh, and as far as the back pain goes, it probably has something to do with surgery I had 11 years ago.

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The symptoms you mentioned could indicate a few different things. If I were you, I would consider finding a new psychiatrist. There are good ones out there! I promise! (I love my psychiatrist - I would recommend him to just about anyone)

Now, you mentioned that you have depression. Does this depression fit the criteria for MDD? If it does, that leaves you with BP 1, BP II, BP NOS, MDD, and Dysthymia (possibly). This rules out Cyclothymia.

If your depression does not fit the criteria, that leaves you with Depression NOS, Cyclothymia, and Dysthymia.

Eating compulsions might be part of the depression. They could also indicate an eating disorder (most likely categorized as EDNOS).

You mentioned that you have had panic attacks and depersonalization. This could indicate Panic Disorder.

And Kazuma is right, you could have an anxiety disorder (Panic Disorder is categorized as an anxiety disorder in the DSM). Anxiety isn't necessarily full-blown fear. You mentioned that you feel stressed without an external stressor. That could indicate an anxiety disorder. Also, persons with anxiety disorders can feel distressed over the same things that everyone does - bills, job, family, etc. The difference is that the distress significantly impacts your "social, occupational, or other important areas of functioning". My husband and I both have generalized anxiety, but we tend to display our symptoms in different ways (Sometimes it feels like my anxiety has come out of no where, and my husband can usually pin point his). So you could have an issue with anxiety but have different symptoms than the persons that you know. Also, you could fit the criteria for Panic Disorder and Generalized Anxiety Disorder at the same time. Woo hoo!

Have you been checked for Fibromyalgia? It could be one explanation for the mix of "physical" and "mental" issues you have. (I used quotes because I do not necessarily differentiate the two)

Bipolar Disorder shouldn't be ruled out until you have received an adequate screening. Bipolar Disorder is a bitch to diagnose, so you might consider hunting down a mental health professional that has a lot of experience dealing with that sort of thing.

You said that you've been diagnosed with AD/HD. That could explain a lot of your symptoms.

In short, you could have damn near anything. Make an appointment with a psychiatrist, pronto!

There's a chance that you were given a prescription for Effexor because it is an SNRI. The serotonin works on mood and anxiety, and the norepinephrine (aka noradrenaline) works on mood and attention. Effexor is also used off-label for some pain-related issues. The drug could potentially knock out a lot of your symptoms. Or it could induce hypo/mania if you are predisposed.

I've had some crappy reactions to antidepressants, but I haven't had any problems with Effexor so far. I had a mild headache and some brain fog the first week that I took it. I have some crazy ass dreams as well. That's it. No weight gain, no sex problems, no heart problems, na da, zip zilch. Depression is in remission! It rocks.

You never know how something is going to work until you give it a shot.

Take care and keep us updated!

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Do you have a therapist that you see on a regular basis? If not- this could be at least if not more helpful than meds alone.

Its clear you have a lot of concerns- diagnosis is a tricky buisiness and often is irrelevant as long as you are getting proper care for your symptoms and concerns.

more and more adults are being treated for degrees of ADHD- so discussing this would be important.

my biggest concern from your last post was about hurting your hand because you are punching walls in rage-- this is a sign that managing emotions- anger at least- is getting away from you. I would lead with that in meeting a tdoc or pdoc. Punching walls is NOT a good way to manage-and there ARE ways you could learn in therapy so you don't walk around with skin hanging off you knuckles.

and just a personal note- I was probably in therapy for a good 6 or 7 years before I had any definative diagnosis. That was 15 years ago and since then, the diagnoses have changed, been elaborated added new ones- its not exact at all- and it can take years to fully evaluate- don't let this stop you from seeking treatment! In my opinion its the best way to help yourself.

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Thanks, you two. Your words have been helpful. ;)

I was seeing a counselor/therapist up until about 6 or 8 months ago, but she got all babied up (damned newlyweds! ha) and had to leave. I liked her, she was a really sweet lady, but it was at a Lutheran counseling center and I didn't feel like I could really let loose and talk about how I really feel. F words and C words and all, heh. Plus being a nontheist.... the tie in with Lutherans always made me feel uncomfortable. She did help me though with some things. At first, she'd ask me questions, and I could not, for the life of me, answer them. I was so out of touch with my emotions that I couldn't put anything into words. I'm still kind of like that, but not as bad. I really hate talking to people because it's so difficult for me. And it brings up issues that bother me. So then I'd leave and be really irritated and drive too fast and other stupid slightly reckless shit. (I wouldn't even have been able to be open enough to type this paragraph before I started counseling)

I really DO need to see one again though. It would be fine and dandy if I just had [insert whatever brain disorder here], but I have a history with a lot of really shitty life experiences in it that I'm not going to get over just by popping some pill. *sigh* If only it were that easy, eh?

What it really comes down to is that I can't afford it. I'd grudgingly go again if it was free. After the whole ordeal I went through with hospitals and insurance and collections and all that shit, I don't trust insurance companies in the least. I'm terrified that I'll try to do things right and see someone, and then I'll get a giant bill from my insurance because they decided they don't want to cover my visits. I mean, they sent me a letter when I went to the allergist, saying I had a "pre-existing condition". No shit! I have allergies! And they won't even cover my allergy meds. Bitches.

So between the fact that I can't even afford to live on my own (and never have) and the fact that I don't have the emotional energy to talk to therapist after therapist to find one that I like, I'm not sure what I can do.

Maybe I should just move to Canada.

And this lady I saw the other day... I'm taking the Effexor she prescribed for me-- started last night (I'm also taking Propanolol (not sure if that one's contraindicated), Imitrex as needed and Trazodone as a sleep aid as needed... And all the literature says not to take those together, yet she still prescribed it... Should I be worried?? I don't want my heart to get screwed up or to get Serotonin sickness. That'd suck! I'm not going to stop taking anything, but I am concerned.)

Heh...I just got the weirdest feelings in my head while I was typing this. Weeeeeiiird. I think the effexor just busted down my blood-brain barrier lol. It takes like 4 weeks for this stuff to really start working, right? (assuming it agrees with me)

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I'm taking the Effexor she prescribed for me-- started last night (I'm also taking Propanolol (not sure if that one's contraindicated), Imitrex as needed and Trazodone as a sleep aid as needed... And all the literature says not to take those together, yet she still prescribed it... Should I be worried?? I don't want my heart to get screwed up or to get Serotonin sickness. That'd suck! I'm not going to stop taking anything, but I am concerned.)

The Effexor, trazodone, and propanolol should be fine together. I'm not sure about the Imitrex, though. Maybe someone could chime in? One can be on multiple serotoninergic medications - you just need to be mindful of any symptoms that could indicate Serotonin Syndrome. (I was on Lexapro, Cymbalta, and trazodone at one time. I didn't have any problems - well, besides the drugs not doing anything for my depression.)

Heh...I just got the weirdest feelings in my head while I was typing this. Weeeeeiiird. I think the effexor just busted down my blood-brain barrier lol. It takes like 4 weeks for this stuff to really start working, right? (assuming it agrees with me)

The first few days of a new drug or a drug increase can be trippy. It should pass. It may take at least 4 weeks for you to notice an improvement on your affect. Side effects can start kicking in much sooner, as I see you noticed. ;) Why does it have to be that way?

You definitely need to give the medication a chance to work. If you have any concerns, let a doctor know. They should let you know whether or not it's OK to keep taking the medication.

What it really comes down to is that I can't afford it. I'd grudgingly go again if it was free.

You health is incredibly important. If you had a broken leg, you would have it set, right? You need to take care of your brain like you take care of the rest of your body. MI can kill a person if it isn't treated.

I'm guessing based on your move to Canada comment that you're in the U.S. Check out this website:


Also, a lot of psychology, counseling, and medical school programs have mental health clinics that work with people on payment options. For example, a university close to my home has a large counseling program. They have a clinic that offers counseling on a sliding scale. The highest fee is $30. That's less than my insurance copay! You could look into hospital outpatient clinics as well. The one I go to has a program for those with a low-income and are underinsured/uninsured. Visits are $3, plus they hook you up with samples.

I was very reluctant to go to therapy, in part because of the expense. But it's worth not feeling so awful all of the time.

Take care now! :)

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I'm not totally sure- but my guess would be that the propranolol and imitrex might interact as the first is primarily for high blood pressure and the second as far as I know is primarily for migraines ( which I'd think would also have some effect on blood pressure).

I've taken effexor and trazedone together with no problems or warnings of any sort ( though it was years ago). I'd think you'd need to be careful if you took a propranolol with your trazedone since both will make you drowsy.

I'd reccomend call ing the doctor for clarification- so you feel more comfortable with what you are taking.

And no, you are right, no pill can take away the traumas of our past and this is really where the therapy helps to learn to cope in better ( and safer) ways.

I wonder if since you say you have no apprehension or fear, but that you point to some self destructive behaviors ( punching walls, driving too fast), that you have learned to not conciously feel the apprehension and fear. This does not mean they are not there- they are for everyone but for those of us with difficult pasts and childhoods, and MI those fears and apprehensions are definately there under all the maladaptive coping skills we've developed- becuase maybe the were adaptive when we were little kids- just not any more.

If you don't find ways to express your emotions- they have a way of seeping out that is beyond your control. thats when the self destructive things happen and we sy they are really no big deal. The problem becomes that if you don't get treatment these behaviors may escalate- not a good thing.

Research as much as you can- this ( you) are really important, and not to be left without the proper care. keep us posted.

Sounds like a good idea to look into anything you can like other suggestions of universities and sliding scale clinics. sometimes joining a therapy group is less costly than individual.

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  • 1 month later...

Alrighty, a couple people said to keep them updated, so here's where I am right now, like 6 weeks or so after starting my prescription for Effexor (Is that all? It seems like so much longer!)--

So my mood ended up stabilizing a LOT during the first 4 weeks or so, but then during th 5th week, for no good reason, I woke up one day and found it extremely difficult to get out of bed. I ended up dragging myself to work that Monday, but then I missed the next two days of work because I was feeling so miserable (mostly psychological misery. On the second day I had a killer migraine too, but I probably would have stayed home anyway 'cause I still felt really awful mood-wise) It's like even walking required all the strength I could muster. I was really crabby. And depressed. This occurred around the time of my monthly pain-in-the-ass, but I don't attribute it to that, as menstruation has never had an effect on my mood. (Though it does make me feel physically awful sometimes, heh. Yuck.)

I worry my employer thinks I don't care about my job, or that I'm just a shitty person overall. I'm late to work a lot because I can't wake up in the morning (my alarm went off for 25 whole minutes on full blast this morning without even waking me. Luckily I was only like 12 minutes late.... ugh) I don't have any diagnosis, so I can't explain to him what is wrong with me. He knows that I go to the doctor a lot and is okay with that, as long as it's at the end or very beginning of the day, but he is NOT okay with me being late (and who could blame him?) I've lost jobs before because I have such a hard time getting out of bed in the morning and I can't afford to have that happen again. I don't know what to do. I'm so tired all the f-ing time. I hate it so much. I slept for 12 hours the other day and was ready to pass out asleep 8 hours later.

I've been dealing with this crap for too many years. I'm so sick of it. I've had my thyroid tested twice and it's fine. I'm never ever ever going to find out what's wrong with me. I'd like to give up, but I'm so sick of feeling sick that I can't.

So after a nice weekend with my S.O., I'm feeling better now. But not as good as before the whole five-day+ crash I had. I'm feeling more "anxious". My moods are still pretty even (for me, anyway), but not like they were 2 weeks ago. Last night I punched the crap out of my dashboard because someone made me wait for a half hour and didn't call me to let me know they'd be late. I'm a lot shorter now. I don't have the patience I had when I first started taking it.

I took Lexapro once before several years ago, and that too started working very quickly on me. I don't remember how long it worked for though, as I was too young and retarded to keep track of such things.

I keep getting migraines. They're driving me crazy. But at least they're only mild to moderate and not severe like they can be this week

So my regular doc thought my multitude of pains were caused by all the stress I felt even though I told him it wasn't. Well, the stress was greatly ameliorated for about a month, with no effect on my pain levels. As a matter of fact, my back actually hurts MORE now.


This sucks.

On a positive note, I had a follow-up appt with the psychiatrist and she seems like maybe she could be an okay doctor. She wasn't nearly as evil and horrible as the first visit. Not sure if I like her though. Don't really think I do. We'll see.

Oh, yeah, and this Effexor is KILLING my sex drive. I'm a horny, perverted gal normally. Now I feel like a stereotypical "not now, I have a headache" woman. This is NOT fun. And I'm now finding it nearly impossible to, uh, come to fruition...if ya know what I mean. And the Effexor is making my eyesight blurry too. I told all this to the p-doc and she still has me taking it.... bleh.

Why must antidepressants ruin the joy of humping? ;) I hate it!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Oh, and mrsloony-- The propanolol is a beta blocker. It's used to reduce blood pressure, but it's also supposedly very useful in preventing migraines. It seems to be making mine less severe, but they're still just as frequent. Meh.

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What's your dosage on Effexor? The last major depression I took meds for, the first med the pdoc gave me was Effexor. I had never heard of it at that point. So, I bring it home and start looking up info on the internet and get kind of worried about the stuff I read. But I start taking the Effexor anyway and the next time I saw the Pdoc I asked him why he chose that med to be the first one to try. He said that when someone is as depressed as I was and needs quick results, you almost can't beat Effexor.

I have to say, it really worked for me and I did stay with it for a long time. I did eventually work my way up to the higher end of dosing which if I can remember, I think was 375mg. But then like you say, the side effects suck! I had the sexual dysfunction too. It's the damn serotonin component in Effexor.

You might need to increase you dosage, depending on what you are at now. As we increased my dosage, I started feeling a little better. Next time I saw my pdoc I told him: I'm feeling a little better but I wonder if I could feel a lot better if we increased the dose. He just kind of looked at me with a half smirk and said OK.

So, when the sexual dysfunction and other assorted side effects just go to be too much I had a pdoc start playing around with Strattera and Zoloft, trying to mimick the effects of Effexor but in a way that you had control over how much you tweaked the serotonin and norepinephrine. We were working on it and trying to strike the right balance when I lost my health benefits. So much for that. But maybe it's something you can keep in mind.

Hang in there.

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Good to hear from you again! It's also good to hear that you had some relief, even if it was short-lived. Hang on to those moments. They will happen again!

You are going to need to have a talk with your employer. Mental illnesses are covered under the Americans with Disabilities Act. You do not need to disclose your diagnosis. All you need to say is, "I have recently been diagnosed with a medical condition which causes me to do A, B, and C. I require accommodations X, Y, and Z in order to perform my job in an efficient manner. I appreciate that you are working with me on this." I think your employer can request a note from a physician, but the note doesn't need to say anything specific. It would just reiterate what you told your employer. You should really consider asking for a little flex time. A lot of people with MI have abnormal sleeping patterns. Asking for a few extra minutes in order to get to work is not a lot to ask, and it will alleviate a lot of stress for both you and your boss. Being direct about health issues can be a little scary, but you would be surprised how understanding some people can be. No one is exempt from suffering, you know? Keep in mind that failure to provide accommodations for you can result in your employer winding up in some deep legal shit. Contact your local Legal Aid society if your employer causes any problems.

You mentioned that you had a follow-up visit with your psychiatrist. I'm glad to hear that you found someone that you think you will be able to work with. Does she know that the Effexor is not as effective as it was? You may just need your dosage adjusted. The irritability thing could be concerning, as it might be an indication of an underlying problem that is now starting to rear it's ugly head. Or Effexor could just be too activating for you. Is there anything going on in your life that would make you abnormally irritable?

If your GP can't find a cause for your pain, than there's a good chance that you need to see someone who works with pain patients. Rheumatologists are especially knowledgeable.

An anticonvulsant might help out with the migraines and some of the body pain. I know that Topamax is approved for treating migraines. Maybe one of our more drug savvy folks could chime in? Would your psychiatrist consider prescribing an anticonvulsant to you?

It sucks that your having sexual side effects. They're so hard to deal with. Ask your psychiatrist if she can recommend something. A lot of people have had success with Wellbutrin, and some women have had success with using a bit of testosterone cream (you can get this at a compounding pharmacy for cheap).

One last thing - Lexapro works very quickly in a lot of people. The physician who prescribed Lexapro to me (before I started seeing my pdoc) said that she has had some patients respond to it in about a week. Quick response is not uncommon - I think there was a study on this. Quick response is not true of all medications, so definitely keep a record of how you're reacting to the drugs from now on.

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and my 2 cents worth! also look into ocd. i agree with the others....find a tdoc...look into clinics etc. have you been tested for epstein-barr? that's chronic fatigue syndrome. also, monthlies can be a cause for migraines and anxiety. thank the gawds for menopause! lol. keep keepin' on! you can do it. just keeping looking and trying and posting here. i would encourage you, at least you havent totally given up..please dont! i've been thru a lot of what you talk about. it Can get better with the right group of drs and meds.

i have a "remedy", when you get really tired...try to drink a large (i think it's 8 oz.) of v8 juice. it's gotta be the brand name and very cold and drink the whole thing quickly (like within 5 minutes). i've had Some luck with it boosting my energy level without a crash. i cant do it consistantly because i have a stomach condition that wont allow me to have much acid. but it really works. a work-friend told me about it and she had cfs really bad.


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have you been tested for epstein-barr? that's chronic fatigue syndrome.

Was tested for it a while back and they found nothing

I notice my migraines have worsened after I got hit with Mono in Nov '06, so could be worth looking into. Thanks.

Just out of curiosity, what in my post(s) made you think of OCD?

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