Wednesday, April 25, 2012

New Psychiatrist

I went to see a new psychiatrist, as my "old" psychiatrist is too far away since I have moved. And also, because I want another perspective. It is still going to be a medication perspective, I am not going alternative- but I want suggestions that go beyond adding something else to augment what I am on. I think I am on enough drugs. 

But I am depressed enough that I feel like I do need to do something with meds. At least in the short term. Yes, I can pull myself out of it for a couple of hours, which is kind of strange, but then I fall back into the abyss. The worst part is the fatigue. I feel so tired, so weak, it is like I can't move. I don't think my legs will hold me up. 

I think I like the new guy. Of course there was the diagnosis part. Am I "really" bipolar, or is it all med-induced? Do I really have a seizure disorder, or was it just the medication? I am not really into labels- but I do identify with being "depressed." And by this, I don't necessarily mean major depression, clinical depression, or anything technical- I am not even thinking in those terms. I am just depressed. Severely depressed. Way too much of the time, and it keeps coming back. 

One hour is not enough time to tell the story of your life. It is not enough time to tell why you think you are this depressed right now, at this point in your life. There would be too much to explain. And a whole adult lifetime in the psychiatric system to explain as well. This was all reduced to an excel spreadsheet I had of all the meds I had been on, with dosages, effects, and side effects.

I think I came off as less depressed than I am. I had my couple of good hours when I pull myself together. But still, he did have two suggestions. One is to raise the Wellbutrin to 200mg, as 300mg is making me too anxious. And the other is to switch the Effexor to something like Lexapro. 

I like these suggestions. They don't involve more medication. In fact, I had been thinking about switching the Effexor to Lexapro myself. I'm just very scared about doing it. I'm afraid I can't do it while working. I asked him how easy it would be to change antidepressants. He made a joke, he said it would be very easy, he would just write the prescription. I didn't laugh. But then he said he would cross taper. But first, we are trying the Wellbutrin, which is likely to be less disruptive.

I also like the fact that he actually bothered to tell me the side effects of Zyprexa, and did a screen for movement disorders- he is the first doctor to ever test me for this. 

What he didn't ask me: what is my diet like (terrible at the moment), am I exercising (no energy), how is my therapy going, how is my life going. Maybe he felt he didn't have to ask- it's all terrible. I'm depressed.

That is the trap of depression. I eat badly when depressed, because I get too overwhelmed going into a grocery store. I feel too exhausted to move, let alone exercise. I isolate. I cancel therapy appointments because, it is hard enough to get myself to work, to get myself to therapy after a day of work is just too much. How do you break the cycle?

I try to do little things. Get a few extra steps in. Do a few stretches. Grab a salad at the drive thru if I am going to get fast food. But mostly, try to keep going, and hope that things will eventually get better. 


ashmc2 said...

I don't know what you should be on for your depression but I do have a thought. One thing to think about is the overall therapudic level of the meds in your system. Although fatigue and mental lethargy are definitely symptoms of depression, many meds have those side-effects also. So my point. If a certain pill, while helping overall, is also giving downish, sluggish side-effects, it still may be possible to get the benefit of the pill without the difficulty thinking at work. If you take 600mg of said med - 400mg morning and 200mg at night. Switching to 200mg in morning and the 400mg at night when the side-effects my actually help you fall asleep, while not feeling tired mentally and physically in the day. And better yet, if you could take all 600mg at night and still retain a theraputic level of the drug that is helping your depression, but you would sleep-off most of the negative side-effects, leaving you sharper for work. Sorry if this sounded stupid and obviously ask your doc before listening to my idea. He may already know this won't work.

ashmc2 said...