Is this typical?

And what do you all think I should do?

If you scroll down a few posts you'll get the backstory on why I'm here. (I'm doing better since I last posted, by the way.) About two weeks ago I had an initial visit with the psychiatrist's intake therapist. I was told that the first appointment the doctor had was in mid-July, but that if I wanted, could be put on the "next available" call list, which I thought meant that I would get a call when a cancellation came up. I've not heard anything from the office and I'm afraid that if I would call now, I won't be able to see the doc until late July, early August at this date. A part of me wants to say the hell with it and try to gut this out as best I can, but maybe that's not the wisest thing to do.

Is this typical of psychiatrists' offices? I find it astounding, and not a little outrageous that the mental health system is like this.

Sorry to vent; this is brand new territory to me. But I'm really not happy that I was not at least offered a chance to make a July appointment with the option of moving it up if something opened up sooner. In the meantime I guess all I can do is hope that I can maintain as well as I have been, but there are days when it's still hard.

how that list is coming!

I can wait up to two weeks to see my doctor. So far, it's never been longer than that.

The more I think about it, the more pissed I get. If something hasn't opened up by now, they should call and offer me an appointment. By this time, I imagine that it will be August before I see the doc. My fault, I guess, for not following up, but they did say they would call me.

i live in chicago, where there is a psychologist on every corner, it seems. but when my bp daughter was first dx'ed, we had a hell of a time getting her treated. after one pdoc that was senile, which was pretty much how she ended up in the psych ward, then the 2 minute rx roulette guys from the hospital, we waited 3 months to get her into a university program. they did tell us, tho, that if things got really bad, we should bring her to the er, and she would get into the program that way.
therapists are plentiful, psychiatrists are hard to find, it seems.

curious, tho- who diagnosed you?

This seems to be a pretty big practice, and the therapist lays the groundwork for the initial meeting with the pyschiatrist. We talked for about an hour, and she came up with the diagnosis of dysthymia.

I called the office today and politely explained that it is going on three weeks since I had my first consult, and that I was told I was on a call list. If there were no cancellations, I wanted an appointment. They came back and said they had a cancellation for Thursday morning. So I go then.

Not particularly looking forward to it, but I think it's something I have to do.

that first step is pretty tough. just keep putting one foot in front of the other. it's all any of us can do.
glad you followed up, and glad they got you in.

:hi:

I met with the doc briefly. She gave me a handful of Lexipro samples and sent me to the lab for a blood test. I see her again in August, and also her therapist. I told her what works best with me in terms of therapy and she seems to think that this woman will be helpful.

I'm kind of bothered by the fact that without really even knowing me, she gave me the Lexipro. I would think that before meds they would try straight counseling for awhile. Because of that, I'm not going to take the meds until I can talk with these people a little more. If this can be handled through talking things through, I'd rather do that than get on a regimen of pills.

Does anyone have any experience with Lexipro?

I've never met a p-doc that didn't hand me a script at the end of our first 45 minute session. I don't know what your insurance issues are but in general an insurance company needs a diagnosis out of the DMS-IV before the insurance co. will approve to pay for ongoing treatments. Once a medical doctor gives you a diagnosis he/she treats you for your diagnosed problem. For M.D.'s, the treatment almost always consists of medication.

That's pretty much been my experience with it.

It seems to be based on a medical model that is much less complicated than the field of psychology deserves. It's not like a diagnosis of say, high blood pressure where it's pretty cut and dried and you can trust that the prescription he writes will most likely help the problem.

My experience is that I've found doctors in the mental health industry to be quite confident of their diagnosis, to the degree that my own input about my diagnosis and treatment course was treated as though it was insignificant and ultimately invalid. Like they just want me to follow their orders and not question whether there might be a more effective course of treatment for me.

I think you're smart in wanting to know more before you do something that you're not comfortable with right now.

It seems like the medicine would only be effective if there was some physiological problem, which I'm assuming the blood test would show. (They did a CBC as well as check a number of other things, such as hormone levels, etc.) It's been about two weeks, and unless the lab is notoriously slow, guess things all checked out normal.

Especially with hormones. I think they have to take a series of blood draws and look at how your levels fluctuate (or not) over time.

What I'm learning from this book I'm reading is that even though your levels may be normal, the way your body responds to hormones is more important. For example, a woman may have testosterone levels checked and they come back normal but her body is sensitive to testerone so even a level that falls in the normal range may be too high for her and thus she develops acne or experiences hair loss.

It's probably reasonable to think that medicine would only be effective if there was some physiological problem. However, and I'm speaking in general terms, it's usually also true that when people experience mood related disorders that there is an underlying physiological problem. For example, depression is often associated with low serotonin levels.

You mentioned disthymia (sp?) in an earlier post. If you haven't already, I would probably start by trying to understand the diagnosis as outlined in the DSM-IV-TR because that's the criteria that the intake therapist uses to make the diagnosis. You can go to any Borders or Barnes and Nobel and just go look it up. You could probably even find it online. Then I would look to find research studies that have examined the effectiveness of various treatment methods for that particular diagnosis. I'm guessing here but I wouldn't be surprised if the best method was a combination of treatments such as drugs and cognitive therapy.

If nothing else, I think there is NO downside to arming yourself with information. Just be careful that you use credible sources for the information. Discussion boards and forums wouldn't qualify under that category; however, they have been enlightening for me in their own ways. I've used them to help connect with other people going through similar problems. To me, that's kind of therapeutic in and of itself. But I'm especially cautious of the discussions involving medications. Most of the people who post about their experiences with meds tend to be the people who had negative experiences. But as long as you're cautious and don't let the worst-case-scenario's freak you out, it can be helpful to know if this or that side effect happens to others too. For example, one side effect of Effexor was that I experienced terrible disturbances in sleep cycles. My doctor wasn't aware of that side effects and blew it off when I told her about them, like "well, I've never heard of that". By searching online I discovered that I wasn't alone, and that many other people had the same problems. It was nice to be validated.

I'm going off on tangents here....sorry. Anyway, even though they didn't call you about the blood test if you just want to be sure it certainly wouldn't hurt anything for you to give them a call and just make sure they got them back and that everything checked out ok.

Lexapro and all the former years put together. I take five meds and was v-e-r-y s-l-o-w-l-y getting better and better (it's been since 89). But now that I'm on the Lexapro, I feel better than I've ever felt in my life! Lexapro is also good for generalized anxiety disorder. I don't know if they're marketing it for that, but it is.

You know, you may not need to take the meds forever. The meds could help you with the talk therapy, too. They'll just help you get better faster. Then once you're back in control of your life, the doctor will probably let you go off them.

Good luck!