Wednesday, December 7, 2011

Time to rethink this

I have an appointment with my psychiatrist on Friday, just a regular appointment. But I have a lot to discuss with him.
Some of you have shared your experiences with OCD on this blog, and we have found how many connections we have in the way the disorder affects us and manifests itself.
You have talked about cognitive behavioral therapy and exposure and response prevention therapy, and the successes that you have shared have me rethinking my own treatment plan.
I have been seeing my current psychiatrist for nearly two and a half years. Prior to that, it had been many years since I saw a psychiatrist. I relied on my family doctor to treat my depression and OCD.
Depression was my biggest concern. I feared it. I was haunted by the reality that even with medication, it could return.
My OCD was, I thought, less of an issue. If the antidepressant I was on happened to help the OCD, then that was fine. Otherwise, I thought I could handle the symptoms of OCD on my own. I thought getting older and wiser about the disorder had made it less of a threat and more of a nuisance.
About four years ago, I seemed to slide into a period of depression that was the worst I’d had for a while. I was on medication at the time and had been since I was 27. I sought help from my family doctor.
My doctor said he thought I might be bipolar, and started me on different medications. I really can’t remember if the new symptoms started before or during the time my doctor tried different drug combinations with me. I can’t say for sure if some of the medications I was on exacerbated certain tendencies towards anxiety.
I do know that I thought I was going to lose my mind.
I had taken a new job in a city an hour’s drive away. I started dreading the drive more and more. I felt like I didn’t have complete control over my driving and feared having a wreck.
I felt afraid. I didn’t know what I was afraid of. I remember lying in bed at night whispering to myself, I’m so afraid.
I was extremely tense and anxious. It was hard to focus and settle down on anything—hard to read, to work on the computer, hard to write out a sentence by hand, to keep my mind on any one thing.
I felt like I was watching what was going on around me, not participating in it.
I reached the point where I was too afraid to keep driving to and from work and quit my job to try to find something closer to my home. My husband did all the driving.
My doctor worked with me closely, and gradually the anxiety lessened enough to begin to feel comfortable driving again and go about daily activities. But I still didn’t feel on track.
A close friend urged me to see a psychiatrist. She even recommended one that she had met socially. I appreciated her concerns, but I didn’t think I needed a specialist, and I thought she was probably understandably biased towards psychiatrists because her father was one.
My family doctor had suggested it too. He said I might need to be on lithium, and he would want a specialist to do that. I resisted.
Finally, though, I realized that I needed help that maybe a specialist would know how to give me. My family doctor recommended a psychiatrist, and it was the same one my friend had urged me to see.
It was the best choice I could have made.
When I first met with the psychiatrist, he asked me a lot of questions, of course, including what medications I had been on. I couldn’t even remember all the ones I’d been on through the years. He had to name different ones, which jogged my memory.
As he took notes, he shook his head every now and then and said I should have never been on some of the meds.
He said he saw no signs at all that I was bipolar.
I was relieved, but also upset because I had been treated for nearly 18 months for a disease that I did not have.
He diagnosed me with depression and OCD—no surprise there. But he also diagnosed me with general anxiety disorder.
He made changes in my medications and, most importantly, gave me hope. He said I would start feeling better in a few weeks and a lot better in about 12 weeks.
And he was right.
It took a while to get the medications well balanced. In addition to the medication therapy, he offered insight and advice on dealing with my disorders in other ways.
My OCD started becoming an issue again, and he suggested setting me up with a therapist for cognitive behavioral therapy.
I told him no. I felt like I had had enough therapy over the years, and I just didn’t want to take the time or spend the money to do it.
However, I’m going to reevaluate my response and discuss my options with him Friday. I don’t want to be resistant again to change that I might need.
I’ll tell you what he says.

3 comments:

  1. Great post. Thanks for sharing. I'm one of the "cheerleaders" for ERP Therapy so I really hope you decide to pursue it!

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  2. I can relate to some of what you said about how some symptoms were exacerbated on certain meds. This summer I was having such a terrible time that my doctor raised my dosage of one medication. I began to have panic attacks and was so anxious and not able to sleep. I felt like a failure. Come to find out, it was the medication's fault and not mine.

    Good luck and please update us,
    ELizabeth-

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  3. Hi Tina. I applaud you for facing change. I was so afraid of CBT & ERP that I put it off for over a dozen years. I sure wish I had not done that, but hey, the past is the past. I am glad that I finally did it. CBT is very hard, but really worth it. If I may, I'd also like to encourage you to find a psychologist who really has lots of experience with CBT, so you don't waste your time or $. I found my doc through a big teaching hospital. I drive over an hour away to my appts. Sounds crazy, I know, but I feel her expertise is worth it. Don't know if that's an option for you, but just throwing it out there. If you don't mind - I'd like to pray for you tomorrow about your appt. I hope it goes well. Take care.

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