Posted by Racer on October 26, 2000, at 13:35:02
In reply to Re: How sane is my insanity? now what? please help., posted by stjames on October 23, 2000, at 19:37:59
Hey, there, Pullmarine, you sound a bit better than you did last week. I hope that's the case. I didn't respond sooner to this because I wanted to wait until I had enough time to do it justice, and I'm glad I did, because I see something now which I didn't at first reading.
That said, let's get on to the wisdom of a fool:
I agree with everyone who said that it's worth discussing the letter with your doctor as a therapeutic tool.
The other suggestion I have is a variation on stjames' suggestions: can you make a spreadsheet of your symptoms, the meds you've been on, the results -- good and bad -- of those drugs, and the suggestions you might have about what to do about them? I did this, and had good luck with it. The doctor I saw had heard that I was a troublesom patient, was ready and willing to believe it, and didn't start out willing to hear me out. I told her, sobbing just this side of hysteria, that I had this list to use as a starting point for the discussion, and she got that 'wow, they do get crazier' look on her face, but let me start. By the end of my little rant, she was willing to work with me, and even gave me the drug I'd suggested.
The list I made, if it helps, included the drugs I'd taken, their side effects, their effect on my depression, and another list expressing my specific dissatisfactions with my recent care. That care, fortunately for me, had been through a county system which was starting to get a lot of flack for its failures. In fact, a few months later, they repeated their handling of my problem: they saw a young man whose family brought him in because he was acting crazy, hadn't been sleeping, etc. Pretty much the same state I'd been in. They said there wasn't anything they could do, he seemed normal enough to them, and sent him home. Three hours later everyone in the house was dead at his hands.
Anyway, the doctor listened to me, I had a reasonable suggestion: the Effexor had few side effects, worked on my anxiety but didn't fix the depression. SSRIs had fixed my depression with horrible side effects. How about adding a low dose SSRI to the Effexor? She thought that made sense, did it, and it worked.
I'm torn about stjames' suggestion to bring these things up as though a friend had had good luck. On the one hand, I think it's a lot less agressive and lets the doctor decide to do it or not, but on the other, I think part of your problem may have to do with autonomy and assertiveness. It sounds as though you feel helpless, and that's not good. Of course, if you walk in and say something like, "Gee, Doc, I'm not stupid, I've done the research, I think more Dex and some Trazadone would help me" he's likely to get defensive. Maybe it's better to take the safe road, get your meds fixed, and then work out the independence issues?
Ah, what do I know anyway? I'm just a crazy chick myself! Whatever you do, here's wishing you strength and success. You have my best, warmest wishes for you.
poster:Racer
thread:47132
URL: http://www.dr-bob.org/babble/20001022/msgs/47413.html