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After 10+ years - what is it??
An_255179 posted:
Dr. G - I need some guidance. I was seeing a Psychiatrist for a combination of talk and Rx therapy for depression and anxiety. I am so talked out...and my doc retired/stopped practicing with little/no notice. It was a habit, honestly, not much was being accomplished and the meds, for the most part weren't working -
Here I am 2 years without a doc, being treated off/on by my PCP, but without success, obviously. I'm 53, and so very tired. She recommended a new Psychiatrist, but he's statistician - I can't get a word in - and I feel like he really didn't spend any time in the last 4 months helping me to figure out what it really is that I'm suffering from - and I am suffering. Ups and downs - sometimes just fine - othertimes tears that won't stop - I've picked up what I think of as old habits - cutting - just to ground myself in reality. Nothing severe, but enough to cause lasting pain so I can attach myself to it. I go through times of spending ridiculous amounts of money - nearly 9,000 in 5 months - to incredible fear because of the debt - spending like that is way out of my lifestyle. I've alienated friends an co-workers and go from not giving a damn, to being very upset and guilty about it. I really need help. The latest drug - Wellbutrin - is something I was on two years ago and suffered a seizure that came on with no notice. At the time it was thought to be a reaction to the switch from SR to regular due to a change in my insurance. I just stopped taking it myself because I was having ridiculous dizzy spells, and was feeling a bit concerned that the dizziness was a warning of another seizure or bad reaction. Prior to that was Pristiq but in the course of a few months I gained 12 pounds....which is making me SO upset and depressed. My question, I guess, is what can I do to insure an actual diagnosis. Friends, and I know I can't/shouldn't rely on them think it's more bipolar than depression....I just can't seem to get a doc to truly evaluate what's going on, am I'm a bit tired of being a guinea pig and suffering from it all. Ideas?
thank you - Suzanne
Joseph F Goldberg, MD responded:
Dear Suzanne,

Treatment recommendations hinge on a thorough initial evaluation to make as clear a diagnosis as possible, and some of the symptoms you describe, such as cutting and mood swings, could suggest any possible number of diagnoses, some of which may be treatable with medicines and some of which may not be so clearly medicine-treatable. It may be worth trying to find a local or regional expert in mood disorders for a formal second opinion about diagnosis/diagnoses and treatment recommendations (both pharmacologic and nonpharmacologic). WebMD isn't set up to assist with making formal referrals but, apart from Googling or contacting a University medical center, you could try the websites for the American Psychiatric Association ( ) or the American Society for Clinical Psychopharmacology ( ) as well as Castle-Connolly Top Doctors ( ).

Good luck -

Dr G

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Joseph F. Goldberg, MD, is a Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. He also maintains a private prac...More

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