Need Advice About Psychiatrist

[EvenStrongerNow]

He put me on Risperdal in February. I noticed it was really helping me and helped my depressed mood. I was getting out of the house. Then, about three weeks ago, I started getting even more depressed than ever. I even told him that my breast was lactating.

I went into him yesterday to tell him of these things and he asked what I would like for him to do for me. I told him I would like to not feel depressed anymore and I needed him to tell me what to do to not feel this way.

He increased my Risperdal. I asked him why and told him that I've never been this depressed and asked him how he knows that Risperdal isn't the issue. He said that Risperdal is not the issue because it really helped me at first and now it has only been the last three weeks that it hasn't so it must be the ptsd that's making me feel this depressed. So, he increased it and asked me to come back this Friday.

I don't understand why he isn't giving me an antidepressant. I told him how I used to be optimistic, extraverted, I was functional and productive, and had a zest for life. He said, "Well, how do you know that you didn't have an idealized version of yourself since you've been through childhood trauma too?" I was upset that he said that. I liked who I was before depression and ptsd. I didn't have ptsd my entire life--only since I was with a psychopath. I don't want to be a depressed person, but I didn't know how to say that to him. It caught me off guard when he said that. I liked who I was before that experience.

I'm really afraid to stay on this Risperdal. I haven't had a period since last September and I'm worried about how this medication will affect that. My endocrinologist already said my prolactin levels are 47...and they should be below and up to 20. She isn't sure if the Risperdal is causing it specifically but she says that this med is notorious for raising prolactin levels. There are some other hormone levels that are off and she worries about a pituitary tumor and wants me to have an MRI to rule it out.

So how does my Psych know that this depression isn't a hormonal imbalance? I took the increased dose of Risperdal last night, passed out really early and slept til noon today.

What should I do? Friday, I have an appointment with him where my husband is going to come in with me.

 

[Deleted member 1860]

I'm concerned about the lactating. Have you googled to see if this is a serious side effect? I would be quite concerned if a med made me lactate!

I know that doctors say things such as "this med can't give you a side effect after this long" but this is not the truth. I have had side effects kick in after a year! Sometimes our body chemistry changes and then bam! you get a side effect. I use Geodon, and if I'm on it too long it gives me depression. I only take it as needed now.

 

[EvenStrongerNow]

This from nami.org:

"Rare Side Effects

Risperidone may increase the blood levels of a hormone called prolactin. Side effects of increased prolactin levels include females losing their period, production of breast milk and males losing their sex drive or possibly experiencing erectile problems. Long term (months or years) of elevated prolactin can lead to osteoporosis, or increased risk of bone fractures. "

The Psych said my breast lactating concerns him as well so then why did he increase the dosage? I don't know why I'm not a better advocate for myself when I'm in there. I just didn't want him to see my frustration and I'm unsure why I was so afraid to show myself with him.

 

[Justmehere]

I had some other tough side effects myself with this med. For some people it's a great medication. For others, not so much. It is common for a negative side effect to build up over time. He should know that...

One option is to call him an tell him you would like to not take the increased amount yet, and just not take it. It's ok to say no to that treatment option and insist on another option other than increasing this medication.

He sounds like he is seriously lacking in people skills, and not explaining his reasons well... some of his reasoning and things he has told you sounds really crap too. I'd consider the possibility of a second opinion. I've had to do that myself and it's been really helpful.

Do you think your husband can help advocate for you when you go in? It's easy to feel intimated by some docs. Maybe writing out questions or goals or simply what you are and are not ok with before hand could help.

 

[Meadowsweet]

I don't know anything about medication, but from what you've said, I think you are right to be questioning. I would certainly seek a second opinion if you can.

 

[Laura 2]

@EvenStrongerNow
This guy sounds like a right mind-gamer who's in deep denial himself.

I wouldn't go back to him at any cost 1if it were me.

 

[EvenStrongerNow]

I just sent him this email. Screw him. I'm coming off of this antipsychotic.

Hi,

I woke up feeling worse than I've ever felt this morning. The increase in Risperdal just isn't going to work for me. I can't even drive that's how detached I feel.

I'll give it credit that it has reduced the anxiety that I used to experience with ptsd but this depression is bad. It has to be from the medication because I didn't feel this way prior to taking it. It happens all of the time, it takes medication awhile to build up to cause a bad side effect and I'm experiencing some. Blunted emotions, depression, feeling detached, spacing out, and breast lactation.

I want to get off of the risperdal and get on an antidepressant and something mild like Buspar for anxiety. I took those in 2010 and I did really well. I was functioning and had a job. Also, my hormone levels are off. I got the results back from the Endocrinologist. My prolactin levels are elevated--some other stuff and she wants me to get an MRI because she suspects a pituitary tumor.

Please tell me what dose to take tonight to start coming off of the risperdal. I'm not taking it anymore. I was too afraid to tell you all of this when I was in there because you didn't seem to be listening to what I was saying. You said "how do you know that who you were before isn't some idealized version of yourself since you've been through childhood trauma?" Well, that upset me. I liked that person. I liked who I was before risperdal.

Sure, I was mildly depressed and experienced some intense anxiety, but I was functioning and I could actually feel my feelings. I did not experience this numbing before risperdal. I was cleaning my house, running errands, and making dinner at least. Now, I'm not doing anything at all because I'm so down and feeling completely lifeless. I can't even drive or feel any good feelings. My reflexes are completely gone and I feel like a zombie.

And the reason you keep getting conflicting information from me is because when you make me talk about my feelings and when you make me talk about what happened to me in the past, I can't do it without being reminded of the horror that I went through and it makes me completely lose what I've initially come in there for.

That's why I'm having my husband come in there on Friday. Because you don't have a clear perspective of me and when I'm reminded of trauma, I don't have a clear perspective of me.

 

[Laura 2]

@EvenStrongerNow Wow, that's a good strong email. Good for you.

FWIW- this idealized self business is a real mind twister; yet we all have some idealist notions about ourselves, we have to otherwise you just can't survive.

 

[EvenStrongerNow]

Do you think so? I just don't want him to think that I'm worse off than I actually am, especially pre-medication. When I first went into him, symptoms were spiking but I've done three years of therapy and had been managing my ptsd okay for the most part. I just wanted something to assist with the depression and anxiety, especially since I have a hormone imbalance. Do you think it was okay to ask him for exactly what I want?

I find it so hard to do when I'm in his office and I don't know why. I think it's because he is a man and I have a hard time trusting people. I've told him that before and he said, "We need help and we sometimes have a hard time reaching out and asking for help, but when we do and help is offered, we have an internal saboteur that wants to stay sick".

I really had no idea how to respond to that. I'm not a self saboteur. I've never been that way. I'm the most proactive person that I know but the depression is keeping me from enjoying life or doing what I used to do.

 

[EvenStrongerNow]

Here is another email I just sent to him. I want him to get me.....more than anything....I want him to understand what I've been experiencing during our visits...

I find it so hard to speak to you when I'm in your office and I don't really know why. I think it's because you are a man and I have a hard time trusting people. I've told you that before and you said, "We need help and we sometimes have a hard time reaching out and asking for help, but when we do and help is offered, we have an internal saboteur that wants to stay sick".

I really had no idea how to respond to that. It hurt my feelings (and the only reason I can think of why you said such a thing is because you don't know me well). I'm not a self saboteur. I've never been that way. I'm the most proactive person that I know but the depression is keeping me from enjoying life or doing what I used to do.

For some reason, when I'm in your office with you, I lose track of myself and suddenly, I have no self-confidence and the only reason I can think of why that's happening is because I'm being triggered. Your name is Dan, his name was Dan. You have blue eyes, so did he. You are a man and I don't trust men aside from my husband and I don't trust people that I barely know. And you also ask me to talk about things that are difficult for me to discuss because I'm reminded of trauma.

When I'm in there with you, you say things about me that just aren't true about who I am and I don't know how to tell you that in the moment. I realize you don't like discussing this stuff outside of appointments but it would really mean a lot to me if you just read it and go into our next appointment taking what I've said here as to be meaningful because it is.

This is who I am, in these emails.

 

[Justmehere]

Wow, he would drive me nuts!

Your emails sound excellent! Way to go!

In the US, psychiatrists are trained in how to handle meds, not therapy or psychoanalysis, and some of what he says seems like he is going in those directions. Who knows, he could be projecting his inner sabatour onto you!

Do you have a past or present therapist that could talk to him as well and give another clinical perspective other than his own limited one? Or can you have records about the past medications you have been on sent to him? (If not done already?).

I think your emails are very well reasoned and your requests are very appropriate.

 

[Deleted member 1860]

I think its great that you are able to bring these issues up with your doctor! So many of us just go by what they say and question nothing.

However, I am concerned that this doctor is not listening to you and that he is triggering you because of his name and looks (and gender?). Is it possible to find another doctor, or is he usually a good doctor and this happened to be a bad appointment? I am all for working through our triggers, however, I don't think it is good to have a doctor or therapist who triggers us. That is, our health providers should feel safe to us so that we can freely discuss issues with them and then work on our triggers/problems outside of the office. If it isn't a safe place/person, then I wouldn't expect much healing to happen.