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Question on Where to Begin


Guest Anthony Patch

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Guest Anthony Patch

I've been suffering from major depression for several years now, with severe anxiety/panic attacks and mild agoraphobia.  Otherwise, I'm tip top (fit, functioning, employed, all that fine stuff).  I've been to tdocs and was taking ritalin with a pdoc's scrip for about a 8-months until I stopped last summer.  I've tried to get through this on my own because I'm not especially comfortable with doctors and have had some bad experiences with them. 

I'm tired of spending time and money with pdocs who want me to blame my parents or others and don't seem interested in helping me get better. I need some advice on finding the right doctor, getting into his/her office, being honest with them and hopefully start feeling better.

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AP,

Sorry you're not feeling well. 

I have an idea for you;

Do you live anywhere near a medical school/teaching hospital with a psych department?  If so, I would consider making an appointment for a complete, 'start at the beginning' evaluation of your condition, and I'll tell you why:

Universities are on the cutting edge of treatments for mental illness, and IMHO are an excellent place to be evaluated (and often charge ona sliding scale!).  When I was evaluated at a university many years ago, they diagnosed me there and then referred me to a pdoc that had recently graduated from the school and was starting his practice.  I was able to tell the folks at the school about my concerns about pdocs/tdocs, and they referred me to someone perfect for me.  In fact, he has remained my pdoc for the last 15 years.

The reason that I think you should get a complete evaluation is because In my opinion, the conditions you described don't seem to jibe with the med you were prescribed, but as I am not a doctor or any other kind of medical professional, that's all I would say about that.

Good Luck,

-- Abby

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Heya Anthony,

I'm with AbbyNormal.

As a former med student and resident.

You *would* get the most thorough, back-to-basics, assessment from a trainee.  Plus they would have to review it with their supervisor.

There are times when trainees are useful.  ;)

If you can't take advantage of med schools, keep looking. Is there an EAP where you work?

When seeing a psych or therapist (I wish I could have told *myself* this when I started looking for help) ask questions as if you're interviewing them for a job (which, really, you are).  Be a smart consumer, know what you want.

--ncc--

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I think Abby has given you some excellent advice. Especially on the meds. And where to find a good doctor. Why are you taking ritalin? Do you have ADD or ADHD?

I really know little or nothing on the subject, but I know that much.

If your Psychiatrist or Psychologist is bringing your family into it in a strong way, they may be of the Freudian <sp> persuasion. A little Freud is ok, but you need a good pdoc for your meds and a tdoc that uses CBT, Cognitive Behavioral Therapy as well so you can talk about what's bothering you "now."

"Not whether your mother breast fed you or whether you were picked on at school."

I know I'm being a little tongue in cheek about this.

Family history is very important in finding mental disease trends in the family and possible hereditory factors, to help him/her prescribe meds, (meds that worked well for another family member perhaps), just as a starting point, and to help define what your problems might be "right now.."

How old are you? Is there some sort of situational problem going on at home? Or are you independant and on your own?

There are just so many questions to be answered.

Good luck to you my friend

John

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Anthony -

You sound like the sort of person who wants to take responsibility for his own well-being and improvement, and that's a very, very positive sign for someone struggling with mental health issues.  Remember, you are under no obligation to continue seeing any doctor.  You employ them.  If one doesn't work for you, shop around.  I just changed pdocs and am delighted with my latest choice.

It sounds as though your diagnosis has a little time behind it

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While it might not be inappropriate at some time to go into your family history, etc, I think it would work better if you took the right meds to relieve your depression and anxiety first. After that, I'm not sure. I got a lot out of that sort of thing way back when, but it was very slow. Perhaps CBT would be faster, but I know meds work a lot faster, and leave you better able to cope. Some combination is probably best.

I agree that you should shop for a doctor. The toughie is that MI effects our judgement sometimes. But if you feel some rapport with the doc and proposed treatment seems reasonable and appropriate, those are good signs. Fortunately, it seems you may be with it enough to do your homework and communicate well. Patients who can do this, it seems to me, are served better by the medical system. That's kinda rough on those whose medical problems interfere with their thinking or communication, such as people in severe pain or psychosis. I think a lot of medical types will be very skeptical of any patient who allows more than a little bit of emotion to seep into their voice.

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I'm tired of spending time and money with pdocs who want me to blame my parents or others and don't seem interested in helping me get better. I need some advice on finding the right doctor, getting into his/her office, being honest with them and hopefully start feeling better.

<{POST_SNAPBACK}>

I would add that you can set limits in terms of therapy -- I once told a therapist that my relationship with my mother, especially as a kid, was not an available topic for discussion and pointed out the more urgent matters I needed help with.

Or perhaps you need someone who'll deal with medications but not do therapy? If you're not interested, willing to work with it, and so forth than there's no reason to try therapy -- other than therapy and meds being the most effective treatment.

There's some information about finding and communicating with a doctor pinned at the top of the 'health care' board.

Fiona

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