Posted by Bill LL on August 12, 2004, at 9:22:33
In reply to P-docs--more sophisticated diagnoses PLEASE, posted by robot on August 12, 2004, at 1:02:47
On issue #1, that's a problem with too many docs. Too many tend to be obnoxious whether they are p-docs, internists, or any other specialty. I have even had that problem with the pediatrician for my kids.
For #2, trial and error is unfortunately necessary. Antidepressants oftentimes work one way for 1 person and a different way for another. They are very hard to predict and scientists don't really know how they work.
In #3, I get the impression that since you are still depressed after 5 months, you may need a dose increase. That usually works. As for fuzzy thinking, that is an ADD symptom. You may also need an ADD drug. Wellbutrin is also used for ADD so that might help both the sexual side effects and the fuzzy thinking. If it doesn't help with fuzzy thinking, you may need an ADD drug such as Strattera or Ritalin. Ritalin is also an antidepressant to some extent.
For #4, there is no hard core evidence for taking supplements to help with depression. And even the anecdotal evidence seems to be weak. But diet can help. Eating a relatively high protein diet should help with mood.
> Here's what Ive learned this year--the first year Ive ever even had a psychiatrist:
>
> 1) As far as he is concerned, the less I know the better. The more interest I show in what my problems might be or what meds I might try, the less apt he is consider it. (At least this is the impression I get.)
>
> 2) Reliance on trialanderror too much. Yes its true, we dont know much about how these ADs work. BUT--we do know what neurotransmitters they target. If my doc had listened to my specific list of symptoms, he could have decided to try something more than just an SSRI sooner.
> I thought with a psychiatrist, and mine is reportedly admired in his field SPECIFICALLY as a diagnostician, I would be getting a walking talking encyclopedia who would try to pinpoint as much as possible the problem and match it up with approaches we could try.
> Instead he slipped me the latest, most expensive SSRI. Whether my problem was with seretonin or not didnt seem to be an issue.
> Depressions DO slightly differ according to what NTs are messed up. So why dont they pay attention?
>
> 3) "Keep taking it..." When I told him Im better but still depressed (after 5 months), that my thinking is still fuzzy, and that I still struggle to enjoy anything, his response was that if I feel better, the best thing to do would be to keep taking it. The only way I got him to add anything was by telling him about the extreme dissappointment with the sexual sideeffects. He suggested Wellbutrin and I said yes.
> I think something like Wellbutrin would be the first choice, or at least considered as an adjunct, for someone with pronounced anhedonia such as I.
>
> 4) Virtually no discussion of diet or essential nutrients.
>
> I admit, my perception may change abit in the future if I get better, but right now Im a little disillusioned about psychiatrists.
poster:Bill LL
thread:376707
URL: http://www.dr-bob.org/babble/20040811/msgs/376808.html