I took the first step today towards regaining my self confidence and mental well being. I had my first appointment with a psychiatrist! I have been in a state of depression since age 17, and I am 28 years old now. In the 11 years that I have been experiencing mental meltdowns, I have never had any of my doctors suggest I see a psychiatrist!
You would think that I would come to the conclusion on my own and take it upon myself to see a psychiatrist, however, when you have numerous health conditions which can cause depression, you tend to trust the one treating you for those conditions. Lupus and fibromyalgia can both cause depression, so I always left my treatment options for depression up to my rheumatologist. I have so many different specialists that I figured one of them had to know about treating depression.
My depression has always come and gone on a regular basis. I have been able to control my depression to the extent that those around me would not know what I was feeling inside of me. I have been prescribed Lexapro, Citalopram and Prozac in the past to aid in the treatment of my depression. The Lexapro helped for a bit, but the dosage needed to be increased within the first year of taking it. After about 5 years of being on Lexapro, I had asked to be switched to something less expensive and was switched to the Citalopram, which is generic for Celexa. The Citalopram is supposed to be a medication very similar to Lexapro, so I felt comfortable jumping right into this medication.
The Citalopram seemed to make no more of a difference than the Lexapro had made. Yes, the medication helped and was less expensive than the Lexapro, but it did not seem as if it helped as well as it should have. With all of the other health issues I have, depression was one issue that I would yet again put on the back burner and just pray that the medication would work better or that I would miraculously heal from the horrible mental instability I felt brewing from within each and every day.
Lets fast forward, seeing as though I am a very long winded person and could tell you my life story before even realizing I’ve done so! ………….
Finally, I switched to a new rheumatologist in September 2009. I felt that the treatment I was receiving from my rheumatologist at the time for my lupus and fibromyalgia was less than adequate, but that is a whole other story all together. The new rheumatologist has been extremely thorough with my care and concerns. He tried me on Prozac for my depression, which had actually caused me additional depression and anxiety. The next medication he tried me on was Cymbalta to combat both fibromyalgia and depression. The Cymbalta has helped slightly for the fibromyalgia, however has not touched upon the depression. To top it all off, I am on such a high dosage of Prednisone (80 mg) that can also cause depression. I am being hit with a double whammy at the moment. Due to my many medical conditions, my rheumatologist tells me that he would like me to see a psychiatrist for additional help with my depression.
I went to the psychiatrist today for the first time. When I arrived at the office, I filled out the usual paperwork with my contact information and insurance information. I was also given a questionnaire to fill out with questions such as: history of physical, mental and sexual abuse; drug use; childhood. I filled out the paperwork and was called back to see the psychiatrist, Dr. G, shortly after. While in the psychiatrist office, Dr. G went over the same information that I had filled out and had also gone over my medications, medical history, and had asked me to describe what depression felt like to me. My answer: I cry and sometimes I am not sure why. Other times I cry over things that most people would not find upsetting.
While sitting on the couch in Dr. G’s office, I suddenly felt like I was going to cry, and then I got angry. I cannot explain why I suddenly felt a rage and just wanted to scream at Dr. G. He did not do anything but ask me how I felt and asked me to describe my feelings. I started letting him know that if things are not exactly the way I want them, at times I just get so upset and angry and my mouth gets the best of me. I will practically bite heads off. I don’t know why I can be fine one minute, and then in an instant turn into a monster. He asked me if I had ever hurt anyone, and I said no. He asked me more questions about my rage, and I answered them. In the end he came to the conclusion that yes, the Prednisone has increased this rage, however that because of having Lupus and Fibromyalgia he believes that I have a mood disorder on top of depression.
Dr. G asked me if I had ever taken any other medications besides the Lexapro, Citalopram, Prozac and Cymbalta. I said no. He double checked with me by naming off about 10 different medications used to treat depression and mood disorders, and all answers were no. So, he gave me options and let me know what he thought would be best for me. We decided upon starting Abilify 2.5 mg (pending results on my white blood count, as this is not recommended if one has a low white blood count) and increasing my Cymbalta (pending my creatine level and other kidney function levels he wants to check first). Dr. G also stated that he wants to do a Homocysteine (specific B12) test, thyroid test, and several other tests, along with requesting my medical records so that he may delve deeper into my mood disorder.
All in all, the visit to the psychiatrist was well worth it. I return to see Dr. G in 1 month and he will let me know in the meantime when I have the go ahead to start Abilify and to increase my dosage of Cymbalta. Of course, when I left his office, I felt sad and I could only assume it is because of having to sit and tell someone all of my downfalls.
No comments:
Post a Comment