A Plea For Help
I am almost 34, and I was diagnosed with depression in my early 20s. The doctor I visited was just a random name I chose from my insurance booklet, and after reviewing a 4-page questionnaire I filled out pronounced me a “textbook” case, prescribed Zoloft and Ambien, and presented me with my bill.
About a year later, I visited a GP that my mother worked for and admired, and he actually spent some time listening to me talk about how I was feeling and the affects I was experiencing from the Zoloft. I told him about the dead calm, empty, floating feelings that clouded my days, my antipathy about everything from the death of a loved one to a promotion and raise at work. My sex drive was a dream long dead and what’s worse, I didn’t care. I just wanted to FEEL something again. He suggested that I continue with the Ambien when I felt like I needed it, and changed my prescription to Wellbutrin XL. This change made everything better, and I could feel happy and sad and angry and content and sexy, all those emotions that had been missing while I was on the Zoloft.
I moved to another state, and that doctor stopped practicing, and I don’t have contact with him any more. I have been off meds for about 3 years, and my depression is reaching a level that I haven’t before experienced. All the old symptoms are back, with some crazy new ones that scare me just a little. I’m not suicidal and I don’t feel like I’m going to hurt myself or anyone else, but I need medication, and I need to talk to someone.
But how? How do I find a doctor to help me? Do I start with a GP and demand a prescription for what helped me before? Do I close my eyes and point to a name under “Mental Health” in my insurance booklet? I don’t have many friends here, so I can’t even ask around for referrals. I don’t even know if I need to start with a psychologist, or a psychiatrist, or a GP. My insurance is good and I can go anywhere without a medical referral, but I don’t know how to start or where to turn. I want to help myself, but I don’t know how. Any advice or guidance you can offer would be so much appreciated.
January 10th, 2008 at 2:14 am
In my experience and in my opinion,start with a psychiatrist. GPs mean well, but are clueless when it comes to psych meds.
My GP had me on antidepressants for over 10 years. I kept feeling worse and worse with each one we tried.
When I finally went to see a psychiatrist(just this summer), I was properly diagnosed as Bipolar II, received appropriate medication & have entered a whole new world.
Sometimes I want to kick myself for not seeing a psychiatrist sooner. You may not find the “right” psychiatrist for you right away, but it is (I feel) the best place to start.
I am changing psych docs, but that is just because we have very different personalities. I am going to see someone I feel will be a better fit for me.
Even so, I am forever greatful to Dr.D for a correct diagnosis & course of treatment.
January 10th, 2008 at 8:05 am
Don’t use an ob/gyn or gp. They don’t have the expertise or finesse needed to monitor/change psych meds.
New-ish to the area, I didn’t know how to pick a doctor either, so just picked my therapist and my psychiatrist because they use my insurance. The former I’ve been with for nine years and the latter eight. Perhaps I lucked out, I don’t know, but I am happy with what I have.
Another route would be to get a therapist or psychiatrist and ask for their recommendations for the opposite. Or if you already have a gp or ob/gyn, ask them for recommendations.
January 10th, 2008 at 11:53 am
In terms of finding friends and a particular psychiatrist- the Depression and Bipolar Support Alliance http://www.dbsalliance.org and NAMI, nami.org have links to support groups by state. You might try a support group, and see who the members recommend. You could also try calling the nearest hospital(s) to see if they have depression support groups. Finally, my HMO has lists of both support groups and local shrinks– calling yours might yield a little information to narrow the search.
Good luck.
January 10th, 2008 at 11:59 am
I agree with Mandy. I am in a similar boat as you are right now, only I’ve continued to take meds it’s just that they aren’t effective anymore. I made an appointment with a therapist before I got myself an appointment with a psychiatrist and I am regretting it. It’s really important if you are in need of the support of meds to get that first, it will make the time you spend in a therapists office more worthwhile.
finding a good one? I got a recommendation from my GP, but if you can’t get a recommendation from someone I would look through the phone book, call a few different psychiatrists and get them on the phone so you can briefly chat with them and get a feeling about what kind of people they are. Go with your gut.
Like Mandy says, you may have to go to more than one before you find a good fit. Just be sure that if the first one you see doesn’t feel like a good fit for you- try a different one.
You deserve to get the best care possible and it sounds like you are going to have to be your own best advocate right now until you find a good psychiatrist.
January 10th, 2008 at 12:53 pm
You can start with a GP, but they will likely give you a conservative dose of whatever they prescribe. My psychiatrist doubled the dose of antidepressant the GP had given me. He also knew what medication to give me with the antidepressant to make it work better for me. A GP likely wouldn’t have done that.
If Wellbutrin XL has worked for you in the past, you can certainly tell the doctor you’d like to start there. Do let your new doctor know why you didn’t like Zoloft.
Be prepared going to a psychiatrist. It’s typically not the lying-on-the-couch talk therapy most of us think of. Appointments are usually brief and all about the medicine. I have a therapist for the talking a psychiatrist for the meds.
January 10th, 2008 at 4:27 pm
i have a suggestion. in most cities there are local free magazines that list many different “groups” (for example, weight watchers, aa, al-anon, writers, etc.)
if you are up to it and find a group that applies to your needs, it is a good way to find out the better doctors/therapists/etc that can help.
i wish you the best, know that you are not alone.
January 10th, 2008 at 11:25 pm
I know it is hard, especially when you are not feeling your best, but you have got to advocate for yourself. Meaning, call drs from your insurance, set up appts to meet them. If they don’t seem right for you, don’t go back. Like the others, I’d recommend a psychiatrist, not a gp or gyno. I’d also find a therapist. I’ve done it both ways- pointed to a name in the insurance book or asked for recommendations. Either way, they may or may not be a good fit for you. You’re worth it- finding the person who is just right for you is so worth it.
January 11th, 2008 at 9:49 am
I’ve been in your situation and it is a frustrating one. If you can’t get a positive referral for a psychiatrist and/or psychologist, I’d go through your insurance. See who’s covered and who is taking new patients. You might be lucky and “click” with the first person you see; otherwise, you might need to “interview” a couple of doctors. It’s frustrating, but worth it to have a psychiatrist with whom you feel comfortable discussing hour health, thoughts, feelings. Another option is to look at local hospitals, particularly those affiliated with universities. They often have a physician’s network, listing the doctors who have private practices. Research based university affiliated hospitals tend to have excellent physicians working for them.
I would suggest choosing a psychiatrist over a gp or an ob/gyn. The latter two simply don’t have the training or experience to effectively prescribe and monitor psychiatric medication.
Keep in mind that it may take a couple before you find the right fit – but it’s absolutely worth it in the long run. You are worth it, and you deserve the “best fit” doctor for you.
Good luck.
January 11th, 2008 at 12:46 pm
I’m completely new to my little town too and didn’t know where to start to find a new doctor either. My employer offers an Employee Assistance Program that includes a couple of free therapy visits. I decided to start with the free guy, talk about my symptoms, and get a referral to a psychiatrist from there. I hated the first guy I saw, so I went back and asked for another referral. I haven’t seen new guy, but he sounds like a better fit than the first P-doc I saw.
Wishing us both luck with the hunt for new care providers.
January 11th, 2008 at 2:35 pm
You might want to consider a GP until you can get in to see a good psychiatrist. At the very least, a GP can get you on something that might help you feel better quickly so you can have some relief. If your town is like mine, it can take a month or more just to see a psychiatrist.
If you need to talk you can email me- amanda at veryzen dot com.