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Thread : I Think I Need a New Psychiatrist  
14 Oct 2008 @ 7:03 PM
dalton&miranda's mom Join Date: Thu 25th Sep 2008
Threads: 2 Posts: 6
I Think I Need a New Psychiatrist

I've been seeing my current Psychiatrist for a little over 3 months now, ever since I was diagnosed with Adult ADHD. On my first visit she stated that she had several adult patients and all were on Strattera and doing well, I thought this sounded encouraging so that is the medication she decided to try with me.

Before being properly diagnosed, my family doctor had me on Effexor XR to relieve some of my depression symptoms until I could get a proper diagnosis. My test results showed that besides ADHD I had signs of mild depression, social anxiety disorder, and something similar to being slightly bi-polar(not sure of the exact wording of my results). My Psych. told me I would have to choose which disorder to treat, that I couldn't treat my depressive issues and ADHD at the same time. Since most of the anti-depressants I had tried either didn't work or only worked for a few months, I thought the ADHD may be more severe than my depression or maybe even causing some of it, so I chose to treat my ADHD.

I started on 25mg for two weeks, then moved to 40mg for two weeks, and then to my current dose of 60mg. There was a noticeable difference within a few weeks, I could actually focus on the speaker when someone was talking to me and I could read a short newspaper article without my mind wandering all over the place. Within a couple of weeks of starting on the 60mg, I started to notice I was losing my newfound ability to focus and concentrate. It was almost like I wasn't even on the Strattera anymore. I tried to communicate this to her in my last visit, her reply was that "the medication won't make you more intelligent" and she left it at that. She told me to continue with my current dose and come back in 4 weeks.

Today marked my 4 week visit (actually 5 weeks my baby was sick last week and I had to reschedule) I tried once again to explain to her that I had very little ability to focus or concentrate, that I was becoming more moody and irritable than ever, more so than before I was on any type of medication at all, and that the increased dose of Strattera was making me extremely tired all day long and extremely sick for the first few hours after taking it. I ask her about other medications that may be available. She said that the only other medications were classified as class 2 narcotics and that if I was already depressed they would only make me worse.

She then insisted that the Strattera wouldn't work the way I had described that it was doing with me. She said it wasn't designed to work for awhile and then not work, that she felt that it was probably working the way it should. But, that my depressive issues were overriding the benefits of the Strattera. Since I'm no psychiatrist I thought she may be right, so I ask her what were my alternatives, since she had told me in my first visit that I couldn't treat both depression and ADHD at the same time. She said she could give me Lexapro for my depression and I could take it with the Strattera but to take one in the morning and one in the evening, but the ultimate decision would be up to me.

I ask if the Lexapro would relieve my symptoms enough to allow the Strattera to work, but she became very defensive and insisted that the Strattera was working, but I may have some other psychological issues that were causing my problems. She has been reasonably nice until today, but since I brought forth the notion that maybe the same medication that's working for everybody else isn't working for me, she has been very defensive and kinda cold toward me. She kept saying well, you can either take the Strattera or come off the Strattera and you're always entitled to get a second opinion, but if I get a second opinion I have to let her know.

I think I'll be getting another Dr. not a 2nd opinion. Has anybody else ever encountered a Dr. like this? Or do you guys think I'm being over sensitive? I just feel like she's very closed minded to anything other than Strattera. Am I wrong in my thinking that all medications don't work the same for all people? She thinks that Strattera should work for me because it's working for her other patients.

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14 Oct 2008 @ 7:18 PM Reply # 1
ADD RN Join Date: Wed 21st Nov 2007
Threads: 11 Posts: 358
I think I would change her

The first thing I noticed is your psychiatris tttally disregarded everything you told her. I think that is proably the worst thing a psychatrist is negate your real felling ; they have to give insight but totally disregard your complaints makes me wonder. I am also ADD/ADHD and I have been taking Ritalin la 20 mgs and Welbutin XL 150 mgs one is a stimualnt the other is an anti depressive so both of these disorders are treatable at the same time. There si agreat book about the different ypes of ADD and the common treatment that work. If very hyper called the ring of fire for example you would not give a stimulant. The book is Healing ADD : The Breakthrough Program That allows you to See and Heal the 6 types of ADD By Daniel G Amen, M.D. Also my first psychaiatrist was a child psychaitrist this may be the best place to start with one of them and them move over a adult psychaiatrist

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15 Oct 2008 @ 3:46 PM Reply # 2
EAM Join Date: Wed 15th Oct 2008
Threads: 0 Posts: 2
You need a new psychiatrist.

You're not being overly sensitive, I think she's clearly been disrespectful of you and dismissive. The comment that Strattera 'won't make you more intelligent' is downright patronizing and rude. As someone that's been to numerous psychiatrists I can tell you they aren't always as impartial and objective towards their patients as they should be. Some of them express negative personal opinions and judgments of their patients. Maybe you remind her of someone she dislikes, maybe she's having a bad month, who knows. The important thing is, it's completely not your fault and it's inappropriate for her to take this attitude with you when she's suppose to be helping you with your mental health. Even if it is in your head (which I don't think it is) you shouldn't have to meet with someone about your mental health or any personal health issues if you don't feel comfortable around them or don't feel they're respecting you.

She also clearly sounds as if she's afraid to prescribe stimulant medication (she refers to them as level 2 narcotics rather than by their name?), and for me that's a warning sign with any doctor. A good doctor doesn't promote their own agenda or try to cover their own ass above administering patient care. It's not you, it's her. Definitely find someone else.

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Last edited by EAM : 15 Oct 2008 @ 3:50 PM. Reason:
15 Oct 2008 @ 6:37 PM Reply # 3
dalton&miranda's mom Join Date: Thu 25th Sep 2008
Threads: 2 Posts: 6
I'm going to start my search tomorrow

Thanks for your responses and support. I'm going to call around to a few Dr.'s tomorrow and see if I can find someone who has worked with ADHD Adults and who isn't afraid to try something different.

I'm not asking for a miracle cure, I just want to feel better. I know a good diet and a proper amount of exercise are essential to feeling your best, I also know these are things I'm going to have to implement on my own. But, I just can't stay focused long enough to start a plan. I go over it in my head each night before I go to bed and I think, Ok tomorrow's the day, I'm really going to do this. But then tomorrow comes, and I just can't get my mind around what I'm trying to do.

I have taken some steps though, I have ordered a book on the Zone Diet, which was suggested by my family Dr. I also am insulin resistant so I have to cut out carbs and sugars, which I'm sure I don't need anyway being ADHD. And I have ordered Dr. Amen's book on Healing ADD, thanks to ADD RN's suggestion.

It means alot hearing that I'm not just being too sensitive, I've spent most of my life being too sensitive, and sometimes it's hard for me to evaluate my own actions. And I love my husband, but he's no help, his response to everything(and I mean everything) if it's not working change it, he's very blunt. Maybe he has something. LOL

I'm really glad to have found this forum, it's been of enormous help, not only for the resources, but also to know that I'm not the only one with problems and emotions attached to having ADHD and other disorders.

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16 Oct 2008 @ 5:20 AM Reply # 4
KatzMeow Join Date: Sat 3rd May 2008
Threads: 2 Posts: 15
ADHD and comorbid disorders

Wow, sounds like it's time to find a new pdoc. I spent years being primarily treated for major depression and anxiety although I have had many other diagnoses along the way--bipolar, borderline personality, OCD, social phobia and even had one say all my problems stemmed from moral and character flaws. I tried medication after medication, but nothing really helped. The only med I ever found useful was Wellbutrin; it wasn't the answer, but did help keep me from sinking as far into the quicksand of depression as I would without it. BTW, I've never had a pdoc tell me I had to inform them if I was going to get a 2nd opinion. Don't know what that's about.

It was just luck I found a pdoc who, when I joked about having ADHD because a friend had laughed when I told her how many windows/programs I had open on my computer (not just one window of Firefox with multiple tabs--several windows of Firefox with multiple tabs, MS Money, chat program, etc), took me seriously and discussed the idea. I spent years researching depression, even minored in psych (almost had enough psych classes for a double major), but never once even remotely considered I could have ADHD. My pdoc sent me home with a script for generic Adderall and I swear, from the first dose, my entire view of the world and myself changed.

Adjusting to the changes from the meds and diagnosis has been a very difficult processes, but for the first time in my life, I have hope. I'm no longer clinically depressed; I can still get depressed, but it doesn't last very long.

The amphetamines have also been crucial in alleviating my anxiety. Since childhood I found social interactions very stressful, now I understand why. In interacting with people there is a lot to keep track of and pay attention to. Missing social cues repeatedly will cause others to find you odd, weird, and they'll usually dislike and avoid you. Rejection by peers will 'validate' the view of social interaction as stressful and helps set up a cycle of anxiety, stress and rejection. With the meds I see many of the social cues I didn't before. Although I'm still not as socially adept as most people, I find I enjoy interacting with others and seek out opportunities without having to force myself through a wall of anxiety.

The meds have helped my overall anxiety and worry by allowing me to prioritize and compartmentalize problems. It's also curbed my perfectionism; now, there's a 'good enough' point. Without the need to find a way to do something perfectly I no longer feel as stressed about it and can tackle the problem. This has reigned in many of my struggles with procrastination.

Without my schedule II 'narcotics' I'd be the hopeless, depressed wreck of a person I was before.

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16 Oct 2008 @ 9:15 PM Reply # 5
dalton&miranda's mom Join Date: Thu 25th Sep 2008
Threads: 2 Posts: 6
Finding a New Dr. Nearly Impossible

I have been on the search for a new Dr. I know I've called every one within 2 hours of my house, most are so overworked that they aren't accepting any new patients at this time.

I think I may go back to my initial Psych. He seemed to be a good Dr, the few times I saw him, but he doesn't start seeing patients at his private practice until 4:30pm. He is the only local Psych. and he is so overworked, he provides all of the Psych. services at 2 area hospitals, comp care in 3 counties, and also has his private practice here local.

He has a couple of psychologists that conduct nightly group therapy sessions for recovering drug and alcohol users, but he still has to do interviews with each of them so many times a week. This is all done during the time of his private practice hours, so when group session lets out, he just kinda works the ones he needs to see in between patients that are already scheduled. I ended up waiting 3 hours beyond my scheduled appointment the last time and finally left before seeing him because it was nearly 8pm.

But the combo of meds he had me on for depression seemed to be working pretty well. At the time I wasn't aware that I had ADHD, so I wasn't on any type of ADHD meds, so I still had concentration and focus issues and some others that are associated with ADHD. But I guess all I can do is make an appointment and see what he tells me. If I have to endure a little inconvenience every once in a while to feel better, then I'll just have to suck it up and deal with it.

I think I'm going to go back to school and get a degree in Psychiatry, maybe even specialize in ADHD in Adults. It seems there is a great shortage of them in my neck of the woods. Plus, who better to understand and ADHD adult than an ADHD adult. LOL

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17 Oct 2008 @ 11:37 PM Reply # 6
Elaine20 Join Date: Sat 10th Nov 2007
Threads: 5 Posts: 265
Definitely a new psychiatrist

For a psychiatrist to tell you that you can't treat depression and ADHD and that you have to choose which one to treat, makes me wonder how she got a degree. That is one of the most ridiculous things I've heard.

I know quite a few individuals with multiple disorders who are being treated for all of their disorders, and successfully, I might add. One woman has ADHD, bipolar and borderline disorder and she is treated for each of them. My neighbor's daughter has ADHD, OCPD, depression and borderline personality disorder.

Sometimes you may find a doctor who is knowledgeable about ADHD who is not a psychiatrist. We have a general practitioner who is brilliant and knows more than the vast majority of psychiatrists. Psychiatrists have sent some of their patients to him!! People with multiple disorders have come from all over the world to see him.

After being diagnosed and treated for my inattentive ADD this year, I told my doctor that I would love to go back to school to become a neuropsychiatrist if I had the time and money (I'm 48 and I don't see that happening at this point unless I win the lottery or something).

By the way, was the "mild bipolar" diagnosis called cyclothymia?

My husband has the classic ADHD and borderline personality disorder. My son, daughter and I all have the inattentive ADD, my daughter and I both have GAD. My sister has had clinical depression for years, and since my diagnosis of ADD, we came to realize she had it as well. My sister graduated valedictorian of her high school class and she is a pharmacist, so I've learned a lot about medication from her as well.

I've read a number of books on ADHD and borderline personality as well, and have had a lot of experience in my family with both disorders. There is still a lot of misinformation out there regarding both disorders--that's one of the reasons I'd love to become a neuropsychiatrist.

Good luck with your search for a new psychiatrist. Good ones are in short supply.

Elaine

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