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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by jealibeanz on June 29, 2006, at 14:35:43
How do you do it? I can't seem to manage the nerve to bring up the topic, even though I love my family doctor and have seen him twice withing the last few months.
He's treating me for anxiety/ADHD/insomnia. You'd think I'd be comfortable bringing up depression since I deal with other mental/emotional problems with him, but I chicken out. I always feel bad for coming in with complaints! To me, adding depression to the list makes me feel like I'm saying, my life is broken, I'm miserable and want to whine to you... you must fix me. I know this is not true, but it's what I go through.
I've tried Paxil, Wellbutrin, Buspar, and Effexor. I quit all because of side effects of lack of symptom relief. So I'm not even sure what kind approach he'd go after anyway. I feel like it's pointless since I don't want an SSRI, so I should just keep my mouth shut and dig deeper into unhappiness.
If I don't say something, he wouldn't diagnose me, since I'm nothing but politeness and smiles in the office. He realizes I have major anxiety, but appear to be very ambitious and otherwise fairly happy, he doesn't see the depression. (I'm sure he recognizes that anxiety deminishes life quality, so I may not be super happy unless it's controlled. He think it's somewhat well controlled right now, so I'm probably pretty happy about not be as anxious.)
In reality, I could care less about life right now and want to drop out of school just because I don't care!!! But paste on my happy smile and wonderful laughing joking attitude and face each dreadful day.
I have a physical in August. I have until then to think about this. I could try to sort of hint at it when talking about my other meds and small talk about life, but I think I'd have to really spell it out if I need help... Any advice on how to bring it up? Or if I should?
Posted by Phillipa on June 29, 2006, at 16:21:36
In reply to Approaching doc about Depression, posted by jealibeanz on June 29, 2006, at 14:35:43
You should bring it up. Pretending is no fun I do it everyday. It's tiring. So your anxiety is controlled and you're still depressed? My theory was that anxiety created depresseion guess I was wrong. So what you need to left find a med to augment the antianxiety med. Love Phillipa
Posted by nickguy on June 29, 2006, at 18:27:32
In reply to Re: Approaching doc about Depression » jealibeanz, posted by Phillipa on June 29, 2006, at 16:21:36
FIll out this
http://psychcentral.com/cgi-bin/depression.cgi
and show it to him. Tell him it's been bothering you for a while and you werent sure what to say. Your paying him, you can complain to him all you want. If he doesnt take you seriously, ask him for a refferal to a psychiatrist.
Posted by cecilia on June 29, 2006, at 18:34:56
In reply to Approaching doc about Depression, posted by jealibeanz on June 29, 2006, at 14:35:43
It doesn't sound like the anxiety is controlled either if this is so difficult to discuss. (Believe me I understand, all doctors terrify me). If you've already had 4 unsuccessful meds from your GP, I'd get a pdoc. If you know one you're willing to see just make an appointment without telling your GP, otherwise E-mail your GP to ask for a referral, or if he doesn't do E-mail, write down exactly what you want to say and read off the message to his office answering machine in the middle of the night. Then when you get to the pdoc, have everything you want to say written down in advance. Good luck. (And remember, no doctor can read your mind, since you clearly want to try Emsam despite the many bad effects reported here, tell the pdoc that, the worst he can say is no, and then you can decide whether to go with whatever he/she does want or look for another pdoc.) Cecilia
Posted by Jost on June 29, 2006, at 19:09:01
In reply to Re: Approaching doc about Depression, posted by cecilia on June 29, 2006, at 18:34:56
Could you say more, jellibeanz, about what seems to get in the way? I know you've been really concerned about this for quite a while, and going back and forth about how to describe/categorize what's troubling you, and how to tell your GP.
If you GP is as caring as you say, I'm sure he would be more than happy to help. And if you've taken other ADs, it would certainly inform his decision about meds if you told him your prior good or bad experiences.
Did you see a Pdoc? Is s/he available, or at least available for a referral? How about someone where you're in school? I honestly feel it makes sense to take the plunge and get something--emsam, for example-- to help.
If the first thing isn't right, you can try something else. But if you never get the first thing, you'll never start the recovery process.
Again, maybe if you talk it through a bit more, you can move to greater comfort with bringing it up.
Jost
Posted by jealibeanz on June 29, 2006, at 20:43:05
In reply to Re: Approaching doc about Depression, posted by Jost on June 29, 2006, at 19:09:01
No, the anxiety isn't controlled at all, but at least it's being treated and somewhat deminished by the 3 x .25 mg Xanax daily. I went to a pdoc without a referral... horrible experience. He sent me on my way with no meds saying I will respond to nothing since I don't like SSRI's and that I don't have anxiety or depression.
My doc is wonderfully caring and more than happy to help, I'm just afraid of bringing up the subject. I'm also afraid that I'll try a med and not get better(you can't fail unless you try... holding back gives one a small sense of hope), or that he'll want to try another SSRI, or nothing at all. He and the entire office want me to succeed and do well.
I'm at PA school right now, and they're all thrilled about it, hence the extreeeeeme anxiety on top of my already normally high levels, and the urgency to control depression. I won't be a good provider with huge anxiety and depression, and the toll it takes on my confidence. I do fear that I won't be certified or hired if I have a history of anxiety/depression, psych treatment, and currently using Xanax. That's seen as baaaad! There's no need for review boards or employers to take that on from the beginning. Medical professionals are held to a different standard, fair or not.
I have to call in a week for the Xanax prescription refill. I may ask for it to be increased, since he already indicated this is a tiny tiny dose and he'd be willing to do so. I don't plan on actually going in until my physical, 6 weeks away. At that point I'll tell him the Xanax helps, but not to the degree that I need. I may add that it makes me at least a little happier, despite lack of total relief of anxiety. Maybe that will open the door if I mention happiness and indicate that I'm not! (btw, I haaaate the word depression. It's almost like a pop culture catch phrase now. I avoid it at all costs.)
Posted by Emily Elizabeth on June 29, 2006, at 22:22:22
In reply to Re: Approaching doc about Depression, posted by jealibeanz on June 29, 2006, at 20:43:05
Some thoughts:
1. Perhaps you could mention it in the context of side effects. "Gee. I like the Xanax, but I also seem to be struggling with depression. Is it possible that the Xanax is making it worse?" Benzos do often make depression worse, so it is a reasonable ? and it opens the door to a depression discussion.
2. If you are getting a Xanax rx regularly, then don't you already have a record of an anxiety diagnosis? Also, perhaps you could talk to a PA at your doc's office about what is expected in terms of mental health for a PA. My hope is that you aren't totally right (I wouldn't know though)
3. Perhaps your level of depression doesn't require meds and would respond to psychotherapy instead (no s/e's!) I guess I just say that b/c you are okay waiting 6 weeks to see your doc abt this. That's not wrong, that's good(!), but it does indicate a more mild depression. I know that waiting 6 weeks would put me over the edge. Just food for thought. (BTW, the literature is mixed about whether mild depression is best treated w/ therapy or meds. Therapy is my own bias).
Please keep us posted. We are all pulling for you!
Best,
EE
Posted by jealibeanz on June 29, 2006, at 23:25:43
In reply to Re: Approaching doc about Depression, posted by Emily Elizabeth on June 29, 2006, at 22:22:22
I was pulled off Klonopin last fall by his PA who was treating me since it induced crying spells and maaajor depression. That's when I began Effexor.
I don't believe Xanax aggrevates depression like Klonopin does for me. Xanax feels cleaner. Besides, it reduces my general and social anxiety enough where I can be outgoing and assertive in classes and with peers. If I lost this ability, I'd be even morrrre depressed. I don't want my Xanax taken away.
Well, perfect mental health is required obviously. I can tell that based on my classmates and my instructors. We all seem to have issues and insecurities. I think it goes along with a more driven and perfectionist attitude that the general population. Docs/PA's/ect just eventually learn to cover it for the mostpart I think while in practice.
My depression is severe in my opinion. The last few months have been absolute hell. Yet, when you get deep enough, it's hard to find the strength to get help and talk about it. That's why I can get myself to go to a physical appointment that's already scheduled, but wouldn't want to make a separate appointment for this. I can struggle and fake my way through the rest of the summer. I wouldn't last much longer just gutting it out. Don't have the emotional energy....
This is the end of the thread.
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