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diagnosis and new meds questions

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hi, i'm new to these forums and hoping to find them helpful with the new information i have gotton from my PDoc. anyhoo, this is a brief history....

i was committed when i was 15 for oding on aspirin and was in a psych-ward for a week and diagnosed with ocd and was given luvox, this was in 94. the luvox did not work so i stopped taking it and did not see another pdoc. over the next few years i got progressively worse, not sleeping, doing stupid things (random sex, drinking, drugs) and then i crashed and got severly depressed, again. this time i sought treatment through my family doc and was put on prozac, zoloft, buspar and paxil. all others failed the paxil i took for 7 years. during this time i was in and out of major depressive states, high anxiety, tremendous amounts of fear, and high periods of irritability. so i stopped taking the paxil, without telling my regular doc. i stopped cold turkey....mistake as i was ill for weeks. go backwards to last year and i started seeing a therapist as things where starting to get progressivley worse again. she recommended that i get medication from a pdoc to help with the behavioural therapy she wanted to address. fine, it couldn't hurt i thought but i got it through my regular doc, 75mg effexor which quickly turned into 175mg of effexor and .5mg - 1mg of xanac when needed. this helped and like an idiot i stopped seeing the therapist. this last year has been getting worse again, more boughts of major mood cycling, going from happy to a ragging bitch ever the sound of someone breathing loudly or the crunching of an apple. i decided that it would be in my best interest that i see a pdoc so i did, 3 weeks ago. he mentioned 2 options as possible diagnosis, mild bipolar with rapid cycling or borderline personality disorder....make sense. before putting me on a mood stabilizer we tried one more anti-depressant, lexapro 10mg in the morning. well my world came crashing down within a week while i was on that. i was near the end of my rope and the thoughts of harming myself came back very strongly. i saw him last week and was given a script for abilify 2mg with the hope that within a week we can move it up to 4mg as long as my body will tolerate any possible side effects.

my question is this, how long should a normal pdoc visit be? how does one get a finaly diagnosis for something, because it would seem now, based on treatment and what he has said, is that we are going to assume this bipolar with rapid cycling mood changes; all within an hour.

is that normal? or have most of you spent time in therapy or in hospitals where therapists works together to find the problem.

i see my therapist this coming froday, the same day as my pdoc to talk about up my abilify dosage to 4mg.

so i was just wondering it was was common. i didn't have many insurance options with the pdocs so i picked the only one that was covered under my insurance. fortunately i love my therapist and she's covered under my husbands insurance company.

based on your experiences with the pdocs, do you think we are heading in the right direction with this bipolar thing?


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I'm not sure I can be of much help, but I wanted to say welcome. Sounds like things are pretty sucky for you right now.

unfortunately, a pdoc appt is usually 20-30 minutes.( with an innitial visit sometimes longer) I'd think they would go with a "working" diagnoses, or a "rule out" one because obviously you don't have time to tell them everything about you and your life history- and it can take a long time to really make a diagnoses.

I always request that my tdoc speak with my pdoc- after all, they have known you longer and have more info to add. ( make sure you sign consent forms so they are allowed to talk to each other about you)

I like to think that when a pdoc meets you the first time that they prescribe what they do based on the symptoms you describe and that they want to make you more comfortable. some pdoc will give you a pile of presriptions, personally i like the idea of one at a time so you know whats working (or not) for you.

I hope the abilify helps though from experience its good to have some patience- it often takes some trial and error before finding what works best.

Sounds like you are on the right path-please make sure you stay in touch with tdoc and pdoc- especially if you are feeling selfdestructive again- when in doubt, get to an ER.

let us know how you are doing and if the abilify is helping. welcome, mrsl

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thanks. yeah, the initial visit was an hour but how much can you really tell someone in an hour? i think what is more telling is how i tell the story and how my throughts don't seem to come out in a way that makes sense to other people.

my therapy sessions go an hour or more but i think i'll only be able to go once a month, it's so expensive - even with co-pays

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