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Davo1962

Major Anxiety + Depression is back

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I've always been rather high strung but suddenly the anxiety has hit me.  Very hard.  Can't concentrate.  Can't study.  Plus my depression has returned.  I'm trying to study to get back into IT (computer programming of some sort or CISCO networking)  but the anxiety is to the point where that is not happening.  I'd like to take a bootcamp course but need this fixed first.  Spending $13,000 for 12 weeks of VERY intense learning means that I've got to be able to both handle the pressure and not have my memory drugged into a stupor!

I'm not sure where to look for help.  I switched health insurance companies and my old GP is not in network!  Only University of KY Doctors are in my plan.  They have many offices in town but work as a group, come in at appointment time and get whichever doc is free when your number is called.  But I am allowed to go straight to a specialist (psychologist or psychiatrist).  Prescribed by my former GP I was on Effexor (and eventually also Wellbutrin) at very high doses for a few years, kept pooping out and the dose kept going up.  I went to a psychiatrist to get weaned off them and felt MUCH better with out any meds for about three years now.  I'm leery of getting anti-depressants from a GP, especially a "new every time" GP.

I'm looking for advice as to what kind of Doctor to start with.  Should I make an appointment to see a GP,  or go straight to a psychologist who can steer me to a psychiatrist for meds or go straight to the psychiatrist then go to a psychologist?  I'm NOT taking any mental meds without some serious therapy.  Specialists cost more out of pocket, but if the GP will work with a psychologist I could save some money there.

I'm interested in ACT therapy.  Would it be bad to go to an out of network sliding scale place I could afford to get this kind of therapy or should I go with whatever they recommend, most likely some form of CBT.  I don't want to waste my family's money, but we've got enough in the bank that I can mostly afford to pay for treatment.

What does anybody think of over the internet therapy?  I've found one ACT place I could go to or my health insurance is pushing tele-med for both therapy AND psychiatry!  Yes, I could actually not meet with the person who prescribes my mental meds -- scary.  I've also stumbled upon http://portlandmindful.com  which has a sliding payment scale and an ACT practitioner associated with a university that works in town on nights and weekends.  I need to call and see about his costs.

Thanks to all who wade through this post.  I hope it is somewhat clear what I'm asking as I'm sort of asking what do I need to ask and to who.  Any help is appreciated.

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I would say go straight to a psychiatrist because brain meds are their specialty but my husband just goes to a GP for his and seems to do okay. I guess it depends on how complex your cocktail is... the more complex it gets the more it falls into psychiatrist territory.

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I would go straight to a psychiatrist so they can devote the full appointment to your mental health. I don't find psychologists to be a good source for finding a psychiatrist. Psychologists are not medically trained, you would do better getting referrals from your GP. There is a conflict of interest on the part of the psychologists as both psychiatrists and psychologists are angling for the same patients and psychology in general has lost a lot of patients to psychiatry. After all most mental illness has a biological underpinning so I consult with medically trained persons. 

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Many thanks and yes, I'm going straight to a psychiatrist. 

Well as straight as the insurance company will allow. 

I spent too much time Thursday trying to navigate phone trees, picking the right place to call in the first place, and getting signed into their web site.  I found that where I had in mind to set up with a GP also has psychiatrists and psychologists, but you have to be a patient first.  I didn't find out until my call had been transferred that I had to actually have an appointment with a GP to establish myself as a patient.  Only then would a psychiatrist would see me, or maybe the physician would make a referral.  So I made an appointment to see a GP.    First available is November the 8th.  Since that is so far out and I need a yearly checkup and a renewal on my statin and allergy meds I'll take it; however, I need to see somebody else first.  Actually I'll have to reschedule since I work all day on Fridays.   [Random curse words have been redacted.]

Meanwhile I found the other group of psychiatrists which will directly accept new patients.  Leave a message & somebody will call to setup an appointment.  No callback Friday, yesterday.  I'll give them a few days next week then try again.  [More redaction.]

I'm also looking for a psychologist, or trained counselor to get some sort of talk therapy.  And a support group could be helpful.  As the old crazymeds site said, "If it is serious enough for you to be taking brain meds then you need a counselor and a support group." 

I'm looking into finding someone who uses acceptance and commitment therapy. 

Oh, God it has taken me most of the day to write this.

Thanks again for your replies.

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I was feeling really well when I went in to establish care and get my yearly physical.  Almost scary good.  On the PHQ-9 I scored 14, mildly depressed, 15 would have been severely depressed.  Resident doctor so no temazepam for me, just a handouts about sleep hygene and talk about trazodone, if I should need it call the office.  Poor sleep and I'm crashing now.  Awake for a couple of hours last night with really bad thoughts and worries.  I had called for the trazodone refill Friday afternoon, hopefully by Tuesday...  They made me an appointment to see a psychologist. I only work part time and am done by 10am so of course to was during my work hours.  Rescheduling put it off by an entire week.

So here I am just waiting for December the third.  I know these dark periods will pass.  I wonder how I'll be feeling then?

 

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