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ADHD to Bipolar 2 to Generalized Anxiety to OCD traits to Social Phobia
suzy930rn posted:
Hi there. I am a 39 year old mom, wife, and professional. 12 years ago I was diagnosed with Generalized Anxiety Disorder and began Paxil 10mg. The anxiety got better but I needed to increase my Paxil to 20mg. Ok, several years went by, I moved, my mom passed away and I began a new job. I was still on Paxil 20mg. I was again having severe agoraphobia and panic attacks. My house was my best friend. I found a psychiatrist close to home. He also told me I had GAD. He changed my Paxil to 30mg, added Ativan and Klonopin. This helped. I felt great. I was slowly weaned off my Ativan and Klonopin by his request. I would only take Ativan if I had a "break through" panic attack. Ok, life was pretty much ok for the next 8 years. I was on "med management". Then, he moved out of state. Ok, time to find a new psychiatrist. That was a struggle because of either my insurance or those not accepting new patients. Being I felt stable, I decided to have my primary doctor simply follow me with my "med management". Then, about 6 months later, I "crashed". I became agoraphobic again, constant panic attacks, felt helpless. I found a new psychiatrist, 1 hour away. He completed a full assessment on me. He told me that as a child I had untreated Inattentive ADHD which by body compensated for by developing a mood disorder (Bipolar 2) which I was never treated for so my body compensated for by developing GAD, OCD traits and Social Phobia. Ok, sounds like I found my diagnosis and my Prince that was going to help me. He said the Paxil was the worse medicine I was on. So, he needed to wean me. He is in the process of weaning me, week by week. ( I am down to 2.5mg every third day) Although he says at this point that it is simply a placebo. While weaning me, he put me on Valium 2mg, three times daily. He also put me on Lamictal 25mg, twice daily, eventually increasing it to 200mg once daily. As I am still weaning the Paxil, he has also had to increase my Valiium to 5mg, 4 times daily, with 2.5mg additions during periods of panic/agoraphobia. One day I feel "normal", the next-panicky/agoraphobic. I notice I become panicky and agoraphobic whenever I have a change in my routine. It becomes a chore to simply run a routine errand. Lately, I feel I am becoming worse. I see my doc on a weekly/bi weekly basis. Although,it is difficult to get there sometimes because he is one hour away. He says I have to desensitize myself and force myself to do the things I am afraid to do when I have a change in my routine. He said I have to rewire my brain. He makes it sound so easy. I am finding it so hard. I am trying. I tell myself I can do it , I can do it...However, sometimes I can and other times I can't. I call him a lot. He is great with communication. He said for me to keep forcing myself. When I force myself, I feel like my body is going to combust. Regardless of if I force myself and actually succeed by going to the places I am fearful of, or "give up" and avoid them, I become extremely depressed the remainder of the day and the days to follow I cry often, I can't eat, and all I want to do is sleep and cry. I am not suicidal, but sometimes wish the world would end, not on my own account. He tells me to keep trying to desensitize myself...Does anyone have any words of advice or encouragement?
Patricia Farrell, PhD responded:
You are correct; it's easy to tell someone to "desensitize" but not so easy to do on your own. I'm surprised, frankly, that a psychiatrist is seeing you weekly/biweekly for med management and hasn't referred you for cognitive therapy with a decrease in med management sessions.

I'm not an MD, but a psychologist and I think you need a bit more professional help. I don't know what literature would have provided his indication of your undiagnosed childhood ADHD compensating into bipolar, change into GAD, OCD traits and social phobia. It might be interesting to read it.

You did very well for quite some time and you can do well again, but you may need more support. Give it some thought.
suzy930rn replied to Patricia Farrell, PhD's response:
Thank you for your response. My psychiatrist is going to start me on Cognitive Behavioral Therapy. I have also restarted Paxil 10mg. He said it will only act as a Placebo, but, my feeling is that a Placebo will tell my brain to feel less anxious.

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