![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by robot on August 12, 2004, at 1:02:47
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.
Posted by woolav on August 12, 2004, at 8:43:40
In reply to P-docs--more sophisticated diagnoses PLEASE, posted by robot on August 12, 2004, at 1:02:47
I know how you feel. I have never got a straigt up diagnoses from my pdoc. I only found out, by what she marked on my bill code. Which was panic disorder. But I have asked her in the past is she thought i had BP2, she wasnt sure..I feel like they just guess and give meds based on what symptoms you have at that particular time. I have come to find that i have to do my own research and then tell her what I have discovered and what I think would work for me etc..its amazing how pdocs think. I have been to 3 in my life. Only 1 was i really impressed with and she is in another state...:(
But at this point I have decided to add therapy so i can finally figure out what caused my panic disorder and what my real problems are. We can not keep masking the *real* problem by sedating ourselves with medications.
Thats just my opinion.
S
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.
Posted by robot on August 12, 2004, at 16:40:42
In reply to Re: P-docs--more sophisticated diagnoses PLEASE, posted by Bill LL on August 12, 2004, at 9:22:33
thanks bill.
I actually want to continue the lex plus the wellbutrin--give it at least a year or so. I dont want to be switching meds.
What frustrates me: I recently found some info on sepcific symptoms that come from particular NTs being deficient. My complaints fit more in with the dopamine, and norepinephrine list. Once it was diagnosed as chronic/major depression, he didnt seem to go any further. I find it highly dubious in this light that the AD I started on should be just the latest SSRI out there.
yeah, Ive complained to him about my mental functioning alot. They are obviously ADD symptoms, but not extreme. To his credit, the fact that I was in the middle of a dark depreesion made it impossible to diagnose whether I was ADD or not.
I have always been kind of a daydreamer, found it difficult to absorb information when being spoke to, not good at thinking on my feet, and had a bad memory. I think thats why I escaped into books and writing, where I could deliberate and take my time. As Ive gotten older it seems that these attributes have crossed the line to symptoms. THough I wont know where I am exactly until I get this depression under control; its complicated by the fact that the ADD has contriubuted to the depression. Catch 22.
Yeah, I do hope that Wellbutrin can help me, since its supposed to boost norepinephrine action too. Strattera appeals to me to.
Posted by Waki on August 16, 2004, at 0:10:07
In reply to Re: P-docs--more sophisticated diagnoses PLEASE, posted by Bill LL on August 12, 2004, at 9:22:33
I think this statment is way off "doctors are obnoxious whether they are p-docs, internists, or any other specialty. I have even had that problem with the pediatrician for my kids".
Do you realize how many people are obnoxious? Obnoxious people are bartenders, auto mechanics, next door neighbors, message boardposter's, Fast food service clerks, spouses, siblings, children, diverse groups of people etc....
I don't believe one specific profession has more obnoxious people then another.
I say shame on the obnoxious person once (first time) and shame on the so called victims from then on.
This is what the free market is all about.
People who are truely obnoxious will be out of business because customers will move on.
There is a world best seller book you might want to read called "who moved my cheese".
It's compares mice to people, through a cheese pile. Mice continuely look for new cheese, hence when their cheese runs out they already found new cheese. The people who stayed near the cheese pile until it dissapeared almost died.
My point is this. A person who is the recipient of obnoxious behavior needs to intiate a chnage in behavior.
You have three simple choices, #1) Advise the person being obnoxious it is not acceptable and force a change in behavior.
#2) "Change your cheese" meaning find another "who ever" and move on down the road.
#3) Stay with them continue to be victimized and then say and accept the results.
People either drive systems or allow systems to drive them.
When the system drives a person and they complain, and stereotype it only perpuates negitiveness and insults the good people who do not fall in the "general clasification".
Inversly how would you feel if doctors read different postings on here and said" Message posters" are obnoxious....
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.