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Preparing a first Pdoc appt


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Hi dear readers (ok, I just really suck at starting posts... )

 

So, after one year in Canada, where a pdoc suggested a BP2 diagnosis (or Depression with phases of hypomania/euphoria and added weirdness), I am back in my home country and I wanted :

- a second opinion before starting meds, because I am really afraid of medication

- some help with my current depressed (or sth close) state. I basically randomly cry for hours, feel worthless 24/7 and keep struggling with SI and suicidal ideations (especially this week... )

 

But, the thing is, I present very well. As soon as I am with someone (and for less than 2 hours) I am the epitome of cheerfulness (maybe a bit too much, even: my affect is always euthymic, even if I am saying "life is hell" I say it joyfully, because... I was told that sounding sad was wrong). So when I see a doc, I generally end up thinking "actually, it's not worth saying, I am fine, I am just lazy", not saying anything/minimizing a lot, and being back to trying for hours to decide whether jumping out of the window actually makes sense or might be a mistake. Right now, I have kept the damages quite low (no "dangerous" SI, and I just messed up my academic life. And possibly personal life, oh and I regularly stop eating for 3 days because the kitchen is shared and I am scared of meeting people). But physically, I am quite fine.

 

However... I'd really like it if a) I could have a way to prevent it from worsening even more, b) make sure the suicidal plans stay just ideas and not facts, c) be better.

 

But, I guess that all this might include "being efficient with the new pdoc". So... could you help me prepare the session? What kind of things are "worth saying" ? I have been taught all my life that if I was physically able to look fine, then it meant I was actually faking/attention-seeking if I said otherwise, so... I don't know which things are worth saying, and which things are not. What have I the right to say?

 

example: "feeling I am a failure/I should not exist" : it's actually not directly dangerous, it's just a feeling. So it's just whining. And same with pretty much everything.

 

I am guessing that my reasoning is not 100% accurate because it prevents any actual communication, but... do have any advice/list of things important to mention in a first session?

 

Thank you for reading this far too long post.

Edited by inabook
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It's not too long, and all of those concerns are pretty normal. It's highly likely for the first session that the pdoc will do an intake assessment. Basically, they'll have a lot of questions for you, and it's your job to answer as truthfully as possible.So don't worry too much about bringing up the right topics, they are very good at covering the topics that they want answered.  The pdoc is likely to ask you how you feel about yourself (then you could elaborate on the negative thinking), you social interactions / life skills (you would describe your difficulty interacting with others) and will ask if you've been on psychotropic medication before (then you could describe your hesitation). Try and not stress so much, the first session always seems so daunting but I think it's really helpful to have a professional help you. If you've got any points that you feel are vital feel free to write them down so you remember, and if you have to I assume they won't mind reading the piece of paper. Let us know how it goes.

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Write out something similar to what you just posted here. It can be a list, or you can just print out the whole post. That way, you'll have a reminder with you. You have the right to say whatever you want - and believe me, pdocs have heard depressed people say, "I wonder if I'm just whining or being lazy," all the time - I know I've said that to mine. (Spoiler: she told me I wasn't lazy and such thinking was typical for depressed people). 

 

Suicidal ideation, messing up your academics, temptation to self-injure, and fear of interacting with others in your own kitchen definitely sound like depression to me. Your new pdoc needs to hear about those things, and if s/he is competent, will not take how you present at face value. 

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I have always typed out a brief, but still detailed, history. And all of the symptoms that are preventing me from living life to it's fullest. I also type out my current and previous meds, and the reasons I quit taking my previous meds.

 

And I just hand the pdoc the paper after saying "hi", and they can go through it and I don't have to remember anything. All of my pdocs have appreciated that, because it makes it easy for them, too.

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I'd start with what you have posted here.  Write a list of medications you are on for any condition (including vitamans and suplements), and any meds that you might have tried in Cannada the duration and dosage. Also a history consise could help a lot. My first pdoc visit was underwelming and I psyched myself out (granted he was not a great pdoc). But then with my nurse pratitoner she asked me a ton of questions and was able to prescribe a good course of medication. So try to just go with it and write down any questions you have now becuse if your like me you will forget in the moment. Best Wishes!

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Thank you for all your answers. I will definitely try to write something down before going, but I don't think I will dare to give it to her, so I will try to use it as a reminder, and hopefully, she'll ask questions. Since it's almost the only pdoc in my town (with another one who is over-medicating my dad, so not an option) I really hope it will 'work'.

 

Thank you.

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She will ask questions, but if she doesn't cover one of *your* questions, you should refer to your notes, and tell her. You need for her to know *everything* that is going on, and she can't read your mind. Don't worry that something you tell her may be too minor, or too silly, they are not.

 

My pdoc really likes that I bring in a list of topics, so there is no dead time. I know when you do intake, you usually have a longer appt., but after that, you won't have a lot of time at your pdoc appts.

 

ETA: Having notes will also save you in case of the, "Well, so what's going on?" open question approach, that makes at least *my* brain freeze up. Some pdocs may approach it that way. Fortunately for me, only my first.

Edited by crtclms
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I once told my pdoc, while depressed, "I think I'm just faking it," and she said that's typical depression talking. 

 

I agree with printing out this post, and print out some of your blogs, and maybe read them to your pdoc? I know they're very personal though, but it's a good way for a pdoc to get an idea of whats going on in your head. 

 

Bring a family history of mental illness too, even physical illness so they can rule out physical causes. If you only suspect mental illness in your family, still tell them that. 

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But, the thing is, I present very well. As soon as I am with someone (and for less than 2 hours) I am the epitome of cheerfulness (maybe a bit too much, even: my affect is always euthymic, even if I am saying "life is hell" I say it joyfully, because... I was told that sounding sad was wrong).

This is me, completely. But fortunately, every pdoc I've been to (several, I move a lot for work) has seen right through it, and asked something to the effect of, "So other than today when you're up and dressed and look fine, how are the rest of your days?" Even the bad pdocs have figured out that part, at least the ones I've seen.

Hopefully you have a good doctor that will be able to help you feel better.

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And you'll be happy to know that I wasn't able to talk about any of the above things, thanks to my really helpful "It doesn't matter"-Self. Still... I'll have a second appt, and I hope she accepts to read written things, because, seeing how efficiently I avoid any USEFUL answers (but she didn't ask questions, just "so, tell me what's important", and of course nothing is ever enough to be considered as "important"........ ). 

 

Please give me a wall against which I can now bang my head in repentance for my utter uselessness.

 

Thanks to you all, I guess I should have handed her the paper on which I had written the things, instead of hoping I would not think "it's not important enough" and not mention it..........

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And you'll be happy to know that I wasn't able to talk about any of the above things, thanks to my really helpful "It doesn't matter"-Self. Still... I'll have a second appt, and I hope she accepts to read written things, because, seeing how efficiently I avoid any USEFUL answers (but she didn't ask questions, just "so, tell me what's important", and of course nothing is ever enough to be considered as "important"........ ). 

 

Please give me a wall against which I can now bang my head in repentance for my utter uselessness.

 

Thanks to you all, I guess I should have handed her the paper on which I had written the things, instead of hoping I would not think "it's not important enough" and not mention it..........

 

OK, try not to beat yourself up over this! You are not useless! You are a good person deserving of help.

 

I know just how difficult it can be to bring things up to a pdoc, let alone a new pdoc at that!

The good part is you have another appointment and have another chance to get it all out there in the open. And if she for whatever silly reason doesn't accept written things (I can't fathom why she wouldn't) then I say read the paper out loud to her! But I hope she will just look at the darn paper! She probably has seen this a million times. Lots of people have difficulty bringing things up to their drs. And it's not just to pdocs either. Non MI people do it all the time to their GP's too. So you are most certainly not alone!

 

So no banging your head against a wall!

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I'm sorry your first appointment didn't go as well as you'd hoped. There are always follow up appointments to make changes and add information.

 

I'm currently waiting for a first pdoc appointment and making a list of things I need to talk about. I'm hoping it works out, because that list is getting long!

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"inabook", I am literally in the same exact situation as you. I had my first appointment with my new pdoc last week and I did the same thing you did; I also present very well because I'm a pro at hiding things. I had a list of things I wanted to bring up but wound up only bringing up things he directly asked about. Conveniently didn't mention my recent suicide attempts that nobody knows about along with other things that, viewing as a nursing student myself, are important. However, I did write down some stuff in a document and I'm hoping when I have my 2nd appointment on Friday that I muster up the courage to hand him the freakin' paper! I'm diagnosed with MDD and also pretty sure it's more bipolar (2) than unipolar... Let's do this!!! It's important and we are important. 

 

Also, thanks to everyone else who responded to this - all your responses put my mind a little more at ease and were very helpful. 

Edited by DontLookAway
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