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Every time I try to talk about this I always end up just deleting it. Just one more case of not knowing what to say...

I started seeing a therapist after my daughter died in August 2009. In October 2010 I was diagnosed with PTSD. I didn't start seeing a psychiatrist for meds until May 2010.

At first I liked her but now I'm starting to have doubts about us being a good fit. First of all she doesn't seem to recognize the PTSD diagnosis. She only ever seems to want to talk about my depression (which isn't nearly as bad as my nightmares, fear of strangers, flashbacks, or dissociations).

She also doesn't seem to remember my extreme sensitivity to medication. I just feel like she wants to move faster then I do.

Now suddenly she's decided I'm Bipolar. Maybe I am, but I can't help wondering if the one manic episode I've had in my life was drug induced.

I also try to explain to her that things start to look strange right before a panic attack. The best way I can describe it is it looks like I put on someone else's glasses. Everything is just not focused right and slightly out of proportion. She says it's just dissociation. I always thought I was dissociating when people touch me and I suddenly feel outside myself watching. Or when I suddenly realize I'm happy and it feels like I'm watching a movie.

I know she has the degree, but I've lived in my body for more then 40 years.

How does one go about changing psychiatrists? How long am I supposed to give it before I know for sure?

She spends 15 minutes a month with me, how does she really know whats going on?

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Hi, welcome.

How do you find a new pdoc? You find a new doc and give your old one the courtesy of at least telling are leaving and why would be nice as well.

Relationships with pdocs and therapists are no different than other relationships. They sometimes/oft require some work.

When you h ave a problem with one, you need to bring up the problems and discuss them. Not surprisingly there are often different perceptions and expectations. I have had to do this on numerous occasions, especially dsturing the first year or two, when i wasn't really stable and my emotions were raw and sometimes askew.

To be honest your pdoc doesn't sound off base...

-We are ALL "sensitive to medications". :) Pdocs probably hear this from every patient. Med changes aren't fun, do your best to roll with it and keep talking with the pdoc.

-A sense of visual distance or distortion can certainly be a symptom of Depersonalization/Derealization. Neither it or any other related symptoms require 'being touched' as a trigger.

-While PTSD is no picnic and requires action to stabilize, it does make sense to put a priority in getting control of a comorbid mood disorder, since that is the underlying foundation. Once mood is stabilized, it is likely that the PTSD related symptoms may relent making that treatment more successful.

It sounds like you want and need more support all around from your pdoc and therapist. Again this is something you need to discuss with them.

Bottom line: Don't let your worries and frustrations about treatment and your docs fester in silence. Talk them out.

Have a great week. :) a.m.

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I think things looking strange could be part of anxiety, are you worried it's something else unrelated?

I changed pdocs once for similar reasons, 15 min appointments and didn't really address the key symptoms that were bothering me. I do think getting medication for depression did help the PTSD symptoms, it gave me that leg up to functionality that meant I could start addressing things in therapy.

How hard is it for you to find a new pdoc? If you want to change I recommend continuing to see your old one until you find a new pdoc - getting caught without one at all would suck.

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cyclothymia is a part of PTSD. If your doc isnt familiar with it, its entirely possible they are mistaking that part of the illness for bipolar cycling.

I still have some symptoms but zoloft has been really good for me. I tried medicating the PTSD symptoms directly with mood stabilizers but the side effects were too much to bear. Everyone is different though, maybe thats the key to getting a grasp on your anxieties?

I find that I cant connect to my real feelings of trauma and thus I cant deal with them correctly. I have intellectualization and dissociative defenses that come up and seal it all off. Inter family systems therapy was the closest Ive come to getting around that but it was really slow going.

What other antidepressants have you tried? My doc tried to put me on cymbalta but I passed on it. It does tend to work better in women, supposedly. If you have pain you could always add a TCA in there instead.

Have you ever gone manic or mixed on an AD? celexa and especially prozac did that to me. Mixed and re-experiencing like crazy.

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cyclothymia is a part of PTSD

Cyclothymia is a mood disorder separate from PTSD. It consists of cycling between hypomania and dysthymia. People with PTSD can have Cyclothymia, but just because you have PTSD doesn't mean you have Cyclothymia - and vice versa.

I agree with AM - talk to your pdoc about your concerns. Don't stay quiet. Make an extra appointment this month if you need to. I also agree that the mood disorder will probably be the focus of the doc - you're not going to be able to work on your trauma until your other symptoms are under control. Of course, teasing out what is the trauma and what is the mood disorder is going to take some doing. That's where you and your therapist come in.

As for the dx, just roll with it for now. See if it helps you find the right meds. If you've had a drug-induced mania, it may not mean you have BP, but you may need to avoid a class of medication (Though some may argue that mania with medication use means there's a BP element - I don't know enough to form an opinion). Also, ask your doc about the dx if you don't agree - see what the rationale is. There may be something she's seeing that you're not.

Do you mood chart? That might be helpful for both you and your doc.

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I my Pdoc this morning and we talked about meds. Now I'm trying Trileptal. I tried to bring up some of my psychological issues but she said that was my therapists job.

She now sees that my anxiety is a bigger problem then my depression.

Ive been kind of charting for my therapist, but now the pdoc wants me to officially start so she can see.

The only AD I've tried is Zoloft. That worked really well almost immediately and then dwindled fast. She said that was a symptom of BP.

I'm also wondering if maybe I'm rejecting her for my own made up reasons and not anything really legit. I was planning on talking to my therapist about it.

Right now with everything all out of wack I just feel like I can't trust myself at all.

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