Psych consult and what not

[lewisr]

Hi everyone,



It's been a while. It's been an extremely difficult month for me.



To make a very long story short, I've been saddled with some of the
hardest emetophobia of my life. I've had a chest, then nose, then ear
cold (the WHOLE office) so I had to face yet another phobia of visiting
a doctor's office.


As my emet has been getting scary worse, I finally went to a psychologist who was very nice and understanding but
immediately insisted I go on Zoloft. I do NOT want to do that. I don't
want to "go" on anything. But he said he couldn't treat me until I
visited an MD to evaluate possible drug therapy.



So this morning I made an appointment with a psychiatrist. I am very scared because he is an MD.



For those of you who have been, what should I expect? Is it just like
the psychologist except he's an MD - e.g. will we just talk, etc? Or is
it like going to the doctor's office where I will have to get a
physical exam, or have blood drawn, or wear a gown, etc?



I am really nervous about this and would greatly appreciate any
feedback. I do NOT want to be on drug therapy but my emet has worsened
to the point where I feel some sort of intervention is necessary.



Thanks,

Lewis


Edited by: lewisr

[lewisr]

Anyone?[img]smileys/smilies_09.gif[/img]



Thanks,

Lewis

[kel12347]

For a psychiatrist, you guys will just talk. He or she may recommend that you have bloodwork done by a family doctor, to make sure you don't have a thyroid problems, etc. But the psychiatrist won't do any blood drawing or anything like that.

[mjewell]

Don't psychiatrists generally prescribe meds as well? I thnk most of the time they do. Lewis, going on meds and getting therapy at the same time isn't a bad idea. if your anxiety is that high, therapy would probably be difficult for you to get through without the help of meds. You don't have to be on meds forever if you take them.


Just my 2 cents, you know what is best for you of course!

[tayda]

Yup, the I believe a psychiatrist has a medical degree, where a psychologist may have their masters or even doctrate. Before I went on any medication, I had blood work to check the health of my liver, and other stuff in my blood. I went on prozac and the other prescription I can't spell for the life of me. My psychologist talks to me, but not as long as the therapy sessions. I think that you will find you feel a little better after seeing someone. Goodluck.

[shiva]

I think that if you are aprehensive about taking medication, then you will be sure to not stay on them long term. I am very much anti medication if it means the person is going to look only to pills for help and not continue to challenge themselves. I don't see that in you at all. I really think that meds have their place in helping people like us to face our problems, and for some people they prove to be very helpfull in doing so. If you really feel that you could go on the meds for a while and continue to work on yourself really hard while on them, then go for it. Maybe you could get off of them by summer then


There's nothing wrong with help when trying to face this thing head on. The most important thing is that you do something to take your life back, and you are.


I would however be reluctant if you get someone who prescribes you one medication and then keeps adding different kinds to it in order to get their desired effect. For instance, say you get put on zoloft to help with your anxiety and six weeks go by. You go in and say that you are feeling a little better, but have trouble sleeping. So, then they prescribe trazadone on top of this. You also tell them about panic attacks you still have, so then they say, "wonderful, try some klonopin" but, wait.. you also tell them that you are still somewhat obsessive compulsive when it comes to washing your hands so they put you on seroquel or another anti psychotic. This would be a bad sign. (and, i have been there.. hence the bad tast in my mouth about meds However, taking something to take the edge off is not a bad idea. (but in my oppinion, a glass of wine works just as well, if not better

[lewisr]

Thank you everyone for your responses.



Shiva, I am with you in terms of not using meds as a crutch. While I
would not mind a prescription-strength "Rescue Remedy" for use during
acute panic attacks, I do not want to "go" on anything. I have resigned
myself to the fact that I am going to be "scared" most of the time,
until my psychotherapy and behavior modification works. I can live with
that. I cannot, however, tolerate the acute panic attacks. They are
brutal.



My primary concern is the psychiatrist's office. I called ahead
and expressed my fears and the receptionist said "we don't have any
needles in this office" so that made me feel a little better. I am just
frightened that I am going to walk in and instead of a couch and
leather chairs, it will be an exam table and medical equipment. THAT, I
am not ready for.



Not yet.



Best,

Lewis

[pianolover]

Dear Lewis,


I am going to a psychologist, and just this morning we were kind of discussing this medication issue. I have been on Celexa (citalopram) for almost six months; I started off on 20mg, they raised it to 30, and I am going to talk to my doctor tomorrow about possibly raising it again. I was kind of apprehensive about taking yet a higher dosage (more meds!! ack!).However, although my psychologist is not a medical doctor,he says that from what he knows from research, therapy plus medication tends to bring about the best results; ie, therapy is less effective without medication, and medication is less effective without therapy. Just thought that kind of tied in to your questions.


Hope it goes well!

[bexcelica]

Lewis, I know you don't want to go on anything, but I thought the same
thing. But let me tell you - I am on 100 mg of Zoloft and WHAT A
DIFFERENCE. I do not worry hardly as much as I used to. You might as
well try it. It couldn't hurt. I agree though, I mean I wouldn't want
to be on meds for the rest of my life. But to start out, it may be a
good idea.

[shiva]

Lewis,


I really wish there were better "as needed" meds out there that we could pop during an anxiety attack and not have to take everyday or worry about getting addicted. Maybe they can give you some zanax or something though rather than put you on something daily. However, it really can help when starting therapy... that is being on a little something in order to help you address the issue with less anxiety. Whatever you decide, I know you will make the right choice for YOU and that's all that matters. Everyone is different. Good luck!

[2jo2]

Lewis,


I'm on Zoloft, 100mg, and I'm in therapy. My therapist (PhD) gives me talk therapy, and I go and see a nurse practitioner in a mental health clinic. She talked to me to find out the extent of my fear/OCD, and we tweaked my meds for about 6 months til we found something that made me feel ok while I go through talk therapy. Most people like us go on meds without the intent to stay on them forever. The meds lower the threshold of the anxiety so that you can work through it and learn how to keep your anxiety low on your own. I think it will be beneficial for you to try what your doctor suggests. Don't worry, the psychiatrist's office is like a therapist's office. If they want blood work done, they'll send you to the regular lab to have it done. I just don't think it's feasible for them to have their own lab people to test blood every once in a while. Just because he's an MD doesn't mean he's like a general practitioner. He is just a therapist that can prescribe medication. I hope you find what you need and that you can get some help. I've been in that desperate place before where you need an intervention. Most likely you have OCD, especially if you're obsessing about germs and what you've touched, what you're breathing in, etc. I've been there. Zoloft is a dream for me. I hope whatever you try works for you as well. Please keep in touch.

[kel12347]

I'm currently on Prozac and Klonopin. Let me tell you, before the meds, I was in no condition to start exposure therapy...I could hardly even leave the house. Now, a month later, I'm just starting step 2 on my exposure hierarchy. My psychiatrist is going to leave me on Klonopin until the Prozac dosage gets adjusted (I think we're almost there), and then taper me off the Klonopin. Hopefully then I will only need the benzos for rough situations, like flying, the dentist, etc. But the only way I could have started exposure therapy in the shape I was in was with medication. I don't intend to stay on the meds forever, but right now they've got me functioning, and pretty well, too...something that was not happening without the meds.

[bexcelica]

yea lewis, when i said that zoloft helped me, i wasnt trying to get you
to go on it. i was just giving you my honest opnion on it. i would
rather see you do what would help you the most than press a med on you.
as shiva said, youll find what helps you. good luck, and you know what
to do if you get stressed out. im here

[lewisr]

yea lewis, when i said that zoloft helped me, i wasnt trying to get you
to go on it. i was just giving you my honest opnion on it. i would
rather see you do what would help you the most than press a med on you.
as shiva said, youll find what helps you. good luck, and you know what
to do if you get stressed out. im here

Thank you, and thank you everyone. I feel NO PRESSURE from anyone here
regarding meds or anything else. This is my safe place - it almost
feels like a real room that I can go in to and not be judged or "it's
all in your head."



As frightened as I am about the appointment, perhaps this is the right step to be taking?

[bexcelica]

It is DEFINITELY the right step to be taking. Even if it doesn't work out, you are trying to do somethign about it, which is always a big step. I'm so proud of Lewis!!!

[mjewell]

That's right...nothing worth having is ever easy to get!

[lewisr]

OK, so as saturday approaches and I have the "meds" conversation with this new guy....



Here's MY big question.



Do ANY of the anti-anxiety meds you have taken cause nausea, v* or even a twinge of queasiness?



Because if so, no way, no how, no chance will I go on them. I don't need the cure to be worse than the symptoms LOL!



Thanks,

Lewis

[mjewell]

Benzos like Xanax or Ativan have virtually no side effects except drowsiness. There is a chance that some anti-depressants cause nausea in the beginning, but I think benzos would be the best route for you, especially since you just take them as needed and not every day. Good luck!

[tayda]

I've never tried xanax, but I was given ativan... and it knocked me out. I usually don't experience many side effects from medications, but it seems that benzos just knock me out. I'm on prozac right now and I've been good. I still get the night time anxiety... but it has been better.. (except last night)... however, I agree w/ MJ.. if you don't have a problem w/ anxiety and so forth every day, then a benzo may be the way to fly. They work almost immediately, but may make you tired. Just be careful b/c they do have the potential to be addicting.