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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by deerock on August 11, 2009, at 14:06:36
i have had 2 psychopharm docs in a row tell me that medicine is likely not going to help my condition. this most recent one said "there is no pharmacological intervention that will help the symptoms that you are experiencing. you need to continue in therapy, that is your best bet at getting the issues with your personality under control."
has anyone had this happen to them? i am wondering what this means other than the fact that he has tried and tried with meds and nothing has worked. i feel like there may be some other meaning to glean from it.
Posted by SLS on August 11, 2009, at 14:32:49
In reply to 2 pdoc's told me meds will not help me, posted by deerock on August 11, 2009, at 14:06:36
What exactly are you experiencing?
What is the condition that you are being treated for?
- Scott
Posted by deerock on August 11, 2009, at 14:36:50
In reply to Re: 2 pdoc's told me meds will not help me, posted by SLS on August 11, 2009, at 14:32:49
i become enraged and really anxious all the time.
everyone i see calls it soemthing different. most common thing ive heard is panic disorder and generalized anxiety disorder.
ive heard it called major depression, organic mood disorder (because it started after using lots of marijuana) and hallucinogen disorder not otherwise specified.
Posted by SLS on August 11, 2009, at 15:01:38
In reply to Re: 2 pdoc's told me meds will not help me » SLS, posted by deerock on August 11, 2009, at 14:36:50
> i become enraged and really anxious all the time.
>
> everyone i see calls it soemthing different. most common thing ive heard is panic disorder and generalized anxiety disorder.
>
> ive heard it called major depression, organic mood disorder (because it started after using lots of marijuana) and hallucinogen disorder not otherwise specified.It is rare that major depression, panic disorder, or generalized anxiety disorder are intractable such that medical science can predict with certainty that drug treatment is futile.
How did you feel when you were on a combination of Trileptal and Zyprexa?
It is possible that some of the doctors you have seen concluded that you have an personality disorder for which psychotherapy is better suited to treat.
- Scott
Posted by deerock on August 11, 2009, at 15:04:51
In reply to Re: 2 pdoc's told me meds will not help me, posted by SLS on August 11, 2009, at 15:01:38
i think the personality disorder thing is right, altough my therapist denies that i have one. i mean i think its right in the sense that they concluded it.
i would not put zyprexa in my body again. i never took trileptal with an antipsychotic. i only took it by itself.
Posted by deerock on August 11, 2009, at 15:26:41
In reply to Re: 2 pdoc's told me meds will not help me, posted by SLS on August 11, 2009, at 14:32:49
is there a specific kind of therapy that works best for personality disorders?
Posted by SLS on August 11, 2009, at 16:15:16
In reply to Re: 2 pdoc's told me meds will not help me » SLS, posted by deerock on August 11, 2009, at 15:26:41
> is there a specific kind of therapy that works best for personality disorders?
I guess that depends on the disorder. I really don't know very much about them, except to say that medication can be helpful for some of them. Trileptal helps with impulse control, anger, and aggressiveness. Zoloft can also help with aggressiveness and anger. I think Trileptal is also helpful for treating borderline personality disorder when combined with an antipsychotic. One woman I know with BPD did very well with Zyprexa. Because her body weight increased so much, she was switched over to Risperdal and seems to be doing ok. I don't know what her dosage is.
- Scott
Posted by Sigismund on August 11, 2009, at 16:23:05
In reply to Re: 2 pdoc's told me meds will not help me » SLS, posted by deerock on August 11, 2009, at 14:36:50
The anxiety makes sense for a hallucinogen precipitated state, but the rage is a puzzle.
Years ago I insisted that our world had the equivalent of clergy for the mind, which I duly found in therapy, after first trying to shoehorn the psychiatric profession into that space.
Now I can see the benefit of being able to accept the limitations of pharmacological help.
Posted by deerock on August 11, 2009, at 16:30:48
In reply to Re: 2 pdoc's told me meds will not help me, posted by Sigismund on August 11, 2009, at 16:23:05
Hi, can you restate that? It went over my head. I don't speak shakespearian.
Posted by Sigismund on August 11, 2009, at 17:11:04
In reply to Re: 2 pdoc's told me meds will not help me » Sigismund, posted by deerock on August 11, 2009, at 16:30:48
OK.
How much help can we really expect?
Posted by deerock on August 11, 2009, at 18:00:18
In reply to Re: 2 pdoc's told me meds will not help me  » deerock, posted by Sigismund on August 11, 2009, at 17:11:04
Sigh....the truth comes out.
Sadly, therapists are not honest about this it seems. Or deluded?There is help but its up to us. That I know.
How much help do you think we can expect?
Posted by Sigismund on August 11, 2009, at 18:24:30
In reply to Re: 2 pdoc's told me meds will not help me Ãâ » Sigismund, posted by deerock on August 11, 2009, at 18:00:18
>How much help do you think we can expect?
Not much, but some.
It is sometimes said that people who leave here have had success with meds. It is a comforting assumption. It might also be the case that people just become resigned to their fates.
Like my psych said about ECT.....it certainly cuts down on the complaints.Rage? Hmmm. If someone asked me for a pharmacological treatment for rage, I'd wonder whether pot would help.
Since the rage was precipitated by pot (or the absence/withdrawal of it) I wonder if there could be a connection as you suggest.On the Alternative Board some time back someone wrote about smoking pot for years at a high dose without great or obvious ill effect and then stopping.
This precipitated something like a bipolar state.
Does that make sense to you?
In which case, could mood stabilisers help?
I don't know anything about those drugs.
Posted by Sigismund on August 11, 2009, at 18:27:15
In reply to Re: 2 pdoc's told me meds will not help me Ãâ » Sigismund, posted by deerock on August 11, 2009, at 18:00:18
>Sadly, therapists are not honest about this it seems.
Maybe. Psychodynamic therapists are in it for the long haul. I went for 15 years. Looking back I can see that I needed parenting.
Posted by Phillipa on August 11, 2009, at 19:10:29
In reply to Re: 2 pdoc's told me meds will not help me Ãâ Â, posted by Sigismund on August 11, 2009, at 18:27:15
Personality disorder what about DBT or for anxiety CBT? Phillipa
Posted by Garnet71 on August 11, 2009, at 19:56:52
In reply to 2 pdoc's told me meds will not help me, posted by deerock on August 11, 2009, at 14:06:36
Hey Deerock,
Just a quick note to let you know -I've been reading a lot of the psychodynamic/psychoanalytic journals lately and found many of these types of therapists are opposed to medications while a client undergoes therapy-personality disorder or not.
What I grasp from what I've read - and I'm not an expert or educated in this sort of thing; just my personal conclusions - is that many believe psychotropic drugs will diminish the emotional cathartheis, dynamics, and recovery involved with the type of therapy you are undertaking. Some won't even consider patients taking antidepressants, etc.
The issue I have with these types of therapists is that I perceive, just opinion, is that some are not straight up or honest. They won't talk to you using any type of diagnostic or medical terms, and often distract from the truth in a game of manipulation- manipulation that is designed to reach your core issues in the most effective way possible.
It seems you just have to decide if the benefits outweigh the risks. I think psychodynamic therapy is extremely beneficial-there is just a lot you must put up with in the process; and if that includes anxiety and rage-than so be it. It might be more helpful than harmful in your recovery-but that is for you to decide, of course.
Put it this way - how can a person recover from depression or anxiety if they can't identify the source and the triggers if they are numb or immune to these affective reactions blocked from medications? The emotional effects you are experiencing could indicate that psychotherapy is working for you. It will give you the awareness and identification necessary to change your thought or behavioral patterns. It's the job of your therapist to bring this all to your attention so that you can learn from it.
: )
Posted by floatingbridge on August 11, 2009, at 23:03:51
In reply to Re: 2 pdoc's told me meds will not help me » SLS, posted by deerock on August 11, 2009, at 14:36:50
Deerock,
Have you ever had any kind of bipolar diagnosis? Seems anger and rage are tough emotions / symptoms for some docs to treat and recognize as symptoms. I put this out there because I know of a number of people who presented with rage and irritability and were actually in a mixed state. Personally, I don't understand why you may not benefit from some sort of med intervention--esp. since feeling a bit better helps therapy progress. (I'm not failiar w/ the pychodynamic therapy mentioned by Garnet.)
I would think, maybe, try doc number three--unless you have tried many, many drug trials--I don't know your history.
Hang in there,
fb
Posted by yxibow on August 11, 2009, at 23:54:46
In reply to Re: 2 pdoc's told me meds will not help me » SLS, posted by deerock on August 11, 2009, at 14:36:50
> i become enraged and really anxious all the time.
What is the rage about... anger is a stage of trying to come to terms with some condition ?
> everyone i see calls it soemthing different. most common thing ive heard is panic disorder and generalized anxiety disorder.
GAD and panic disorder usually respond best (initially) to things like klonopin, and SSRIs like paxil, lets say.
>
> ive heard it called major depression, organic mood disorder (because it started after using lots of marijuana) and hallucinogen disorder not otherwise specified.Major depression is another story.. that goes down the road of various medical (and psychological) interventions.
HPPD (in your case HPPD NOS) ironically does not always respond to things like Zyprexa or other atypicals -- its counter intuitive. A lot of things have been tried for this.
But maybe there is a clue that I find very hard to accept with my condition, that until something radically different than I've already tried comes along, psychodynamic therapy, doing things through accomplishing steps and exploring the depths of what is the core of what is really making you anxious and have spells of rage, is actually a genuine way of getting some relief.
But this is just my experience and I'm not saying its easy or always has worked -- for me its hard to come to terms with what I have in the Here and Now, and how to work with and around it......because medical interventions have had their consequences and trials of new interventions.... well my doctor has his reservations because of what has happened in the past... anyhow this isn't really about me, I'm just giving an example.
-- hope that helps-- Jay
Posted by floatingbridge on August 12, 2009, at 10:36:35
In reply to Re: 2 pdoc's told me meds will not help me » deerock, posted by yxibow on August 11, 2009, at 23:54:46
Hi Jay, what's HPPD?
fb
Posted by floatingbridge on August 12, 2009, at 10:48:28
In reply to Re: 2 pdoc's told me meds will not help me » yxibow, posted by floatingbridge on August 12, 2009, at 10:36:35
Never mind, Jay--I reread and figured out.
fb
Posted by deerock on August 12, 2009, at 10:50:48
In reply to Re: 2 pdoc's told me meds will not help me Ãâ Â, posted by Sigismund on August 11, 2009, at 18:27:15
parenting is something you got from your therapist?
or did you get therapy and realize it was parenting that you need?
or is good parenting and successful therapy the same thing, in many ways, based on your experience?
what i am trying to say, is did you get the good parenting results from good therapy?
Posted by deerock on August 12, 2009, at 10:51:53
In reply to Re: 2 pdoc's told me meds will not help me, posted by Garnet71 on August 11, 2009, at 19:56:52
garnet, thanks. i found your post very helpful.
Posted by deerock on August 12, 2009, at 11:04:28
In reply to Re: 2 pdoc's told me meds will not help me » yxibow, posted by floatingbridge on August 12, 2009, at 10:36:35
thanks fb.
Posted by deerock on August 12, 2009, at 11:07:22
In reply to Re: 2 pdoc's told me meds will not help me » deerock, posted by yxibow on August 11, 2009, at 23:54:46
jay, i think youre going down the right path.
the docs wont give me meds because even the ones that have helped have harmed me in some way. even if its just because i say so. so they know not to go down the road because it likely wont end well. they also know i can function, though not well, so they feel that the therapist can work with it.and i like what you said about trying something different. thats what im trying to do.
so how do you come to terms with your here and now? what has been working for you lately?
Posted by floatingbridge on August 12, 2009, at 14:42:24
In reply to Re: 2 pdoc's told me meds will not help me » floatingbridge, posted by deerock on August 12, 2009, at 11:04:28
You're more than welcome, Deerock--good luck to you and best wishes!
fb
Posted by Sigismund on August 12, 2009, at 15:22:23
In reply to Re: 2 pdoc's told me meds will not help me Ãâ Â » Sigismund, posted by deerock on August 12, 2009, at 10:50:48
>so how do you come to terms with your here and now?
That's the fun question. Not very well, with a lot of resentment, vitamins and so on.
As for
> parenting is something you got from your therapist?
In retrospect I can see this
> or did you get therapy and realize it was parenting that you need?I didn't realise it at the time.
The only paradigm I had that had been of any use up to that point had been religion, specifically the Communion Service, so I wanted something along those lines perhaps.> or is good parenting and successful therapy the same thing, in many ways, based on your experience?
I think they are similar, though which parent could act like a psychodynamic therapist and get away with it?
> what i am trying to say, is did you get the good parenting results from good therapy?
The process could have been more efficient.
It made it easier for me to be a passable parent, certainly.
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