I could use some help regarding how to deal with psych

[Baroness]

This will be long, but I want to give a decent history of my situation, so apologies in advance for the long-winded post. :\

Basically, I don't have a lot of choices in my city for good psychiatrists. I have been with my psychiatric nurse practitioner for close to seven years.

I have bipolar NOS with GAD, social anxiety and panic. Anxiety runs rampant throughout my family and in addition, I'm noticing that the week before my period intensifies the anxiety to extreme levels. Now for some peculiar reason, my entire family can take .025 mg of Xanax and get fast relief from anxiety, but I started out resistant to benzos. The very first time I took .025 mg of Xanax, I felt nothing. 10 mg of Valium was like a sugar pill. Nothing short of 2 mg of Klonopin works.

Lamictal was a life saver for years and got rid of my panic, but it returned this year with a vengeance.

The problem is this: my psych n/p's case load has obviously increased and she has always been a bulldozer of a woman. She has a very strong personality and for an anxious weakling like myself, I am easily shushed up and ushered out of her office. It wasn't much of a problem until recently.

While I had been on Klonopin only as needed, once the panic returned, my psych n/p started me back on 2 mg of Klonopin per day, something that also worked very well in addition to Lamictal.

But...she plays this game with me. She writes on the script to take 2 mg per day, but doesn't give me enough to get to the next appointment. She forced me to wait two months to make another appointment with her (long story there due to weaning off another medication), and didn't give me the right amount of Klonopin to get through two months. I tried to tell her that in my last appointment and she mumbled some non-answer and that was that.

I struggled and somehow managed to stretch the Klonopin out to last me until the next appt. (which is next Saturday), but my quality of life has been terrible. I don't go out nearly as much because I just don't have enough medication to do it, and going out without it isn't an option. I know some people have managed to do yoga or meditation and get past it, but I'm not at that point. I can't even go to my parents' house without taking something first. Food is a huge trigger and wherever I have to eat or see food, that's a sure sign that panic will appear. And of course, most people want to share a meal together. Klonopin makes it possible for me, and even then I can only pick at the food.

That is one of my triggers, and to eat, I need to be alone. I can't even eat at the table with my husband.

Anyway, I know she will do the same thing to me again next Saturday. She'll give me the script saying take two per day and not give me enough and I do not know how to get through to her that it's not enough. I've always used it only as directed and have never once called her office for more no matter what. I don't doctor shop and I've used the same pharmacy for years.

My question is, how can I get through to this woman that I need X amount of pills to get to the next appointment (whenever that will be)? She thinks I have some stash left over when I don't. The only thing I can think of is to take the empty bottle to her and say, "Look, there's nothing left."

Changing isn't an option yet. I do have someone else I may seek a second opinion from, but it's not something I can do just yet.

Any advice? I don't want to appear like some kind of abuser, but I just want to not have anxiety over a prescription. One day I hope to be free again and only use it as needed, but for right now, I'm still in a very precarious state and taking it daily stabilizes me.

TIA for reading this and for any advice you might have.

[eke]

I realize it sounds too simple but you simply need to be honest and direct! Tell her that she is prescribing a specific amount but not providing a prescription for that amount! If you feel the need you can tell her that this situation troubles you somewhat and this issue is causing you a bit of stress. I don't think that would be a lie as you are asking others for advice so it must trouble you on some level. Maybe she is not playing a game and an actual misunderstanding exists. The only way to get to the heart of the issue is to address it directly! I've found in life that simply being honest and direct with people is often the most beneficial approach! Good luck! Sincerely!

[billyboy1965]

Anyway, I know she will do the same thing to me again next Saturday. She'll give me the script saying take two per day and not give me enough and I do not know how to get through to her that it's not enough.

My shrink can't write an accurate prescription the first time around to save her life. I've learned to review them carefully because the pharmacy was always needing to call because something wasn't right. It was not intentional.

Have you ever considered reviewing the script, stopping to think and looking confused, and hand it back and tell her it doesn't add up?

I am mild bipolar II and also take Lamictal in combination with Wellbutrin. Maybe it's worth a shot.

[hrtguy]

I hate to say it but you've just got a bad prescribing doctor. I can definitely understand not wanting to switch doc's, but if they aren't doing what you need them to do it's time to find a new one. Here's my example of how I had one.....

I had surgery done on my chest. I told the doctor that pain meds don't work for me and that I needed Valium for the pain instead. Of course he didn't listen and prescribed me 40 or so Vicodin 5 mg for recovery. I woke up in the afternoon after surgery, went home and started taking the pain meds like he told me. Thing is, I get all the side effects and none of the relief. Two days after the surgery I hadn't slept, not one minutes, was covered in sweat, itching, etc so I went back in his office. I told him what was going on and asked for the Valium again, where he told me no, here's a script for 5 Ambien. Again, keeping my mouth shut, I went and filled the prescription not knowing they were $15 a pill. Took the first one, two hours later, still awake. Took another, 4 hours later still awake. So I pretty much stormed his office with the leftover Ambien and Vicodin, handed them to him and said, 'Look a**hole, I'm not trying to get meds out of you, these things don't work for me. Why are we experimenting with $15 dollar pills when I know that a $.10 Valium works.' His answer? 'I don't like prescribing them.'

He was willing to let me squirm in pain for 3 days after surgery not getting a minute of sleep just on principal. I really don't see how pain meds like Vicodin are so much less taboo then Valium, but to him they were and nothing I could say was going to change his mind.

You should always try to confront the problem first but be ready for them to basically look you in the eyes and let you know that they don't care what you know works, they will always know better. If you are in that much anxiety you need to find someone willing to pull their head out of their *** and try and help. It may take some shopping around, but after your next visit get copies of your medical records. If she isn't willing to help then that's a psychiatrist I wouldn't want to visit.

[billyboy1965]

@hrtguy

I don't think she has many choices.

Medical records. Every single time I see a doctor I always request a copy of the medical records that have been placed in my file since my last visit.

I always ask (I believe they do anyway) that other doctors forward their report to my primary care physician as well.

When I go for my annual physical I take the results from my last physical with me and we compare item for item and I also make a list of new "old age" crap problems. My doctor respects that.

Can't recommend it enough.

[Baroness]

hrtguy, that sounds awful. I'm so sorry you had to go through that.

Yeah, my husband agrees with the direct approach. I'm going to have to sit there and do some fast math when she tells me when my next appointment will be and then have to confront her then about it. The woman is so stinking hard to get through to. She hears what she wants to hear and if she wants to just shush you up, she just dodges the question and gets you out of the office quickly. She has gotten much worse since her caseload has apparently increased. And I have a real problem with asserting myself, especially when it might make me look like one of those numbskulls who are just there to get pills from her to get high.

I'd agree with the idea that she's a bad prescribing doctor except for the fact that she gets everything else right. In fact, she gives me scripts for Lamictal and Nortryptiline (that I'm currently weaning off of) that I don't need because I usually have a refill or two left.

She is very weird about benzos, as most doctors are nowadays. I think maybe my state is cracking down on the physicians who prescribe them too. One time I did say, "But the bottle says take two per day." She told me she meant as needed. This was before the panic returned this year, however. She does this little thing where she writes the scripts, opens her office door and tells me "Stay right there!", photocopies the scripts and then gives them to me. I'm thinking WTH? I think I know by now to sit in the office and wait until she's done.

I briefly left her to see a psychiatrist earlier this year and after three appointments with him, he had me running back to my psych n/p. His medication of choice was Ativan in combination with the Lamictal, which worked alright, but the man was a real piece of work and it got to the point where going to see him became a stressful thing and I had a panic attack right in his office. He stood there and half-laughed and said, "And here we are, supposed to be making you better!" Funny.

One time I wound up in the hospital with a panic attack. The psychiatrist there was a nice man who had an extremely thick Indian accent, but an interesting approach to things - he wanted me to take Ativan for panic only, and Klonopin as needed for days when I just had generalized anxiety. He didn't want me combining the two on the same day, but to use them for different purposes. I know his name, but I couldn't understand the guy to save my life and if he didn't have a woman with him (maybe a student?) who sort of translated things for me, I'd be lost. I've considered going to him, but that accent would be a problem.

Billyboy, I wonder if my primary care has my records from the psych, because that would enable me to see a couple of people for second opinions without letting on to the psych that I'm searching for someone else. Maybe I'll call my primary care and ask.

Oh, regarding Wellbutrin - that is the one SNRI I haven't tried. I've tried pretty much all of the SSRIs and SNRIs and my psych n/p refuses to use any more of them with me. My problems started up again last summer because I felt like the Prozac I'd been on was pooping out and asked to try Lexapro. She gave it to me, but it caused GI issues and she weaned me off. That started causing panic attacks, but they went away until February of this year, when the doctor attempted to start me on Prozac again (at a measly 10 mg!). That was enough to really ruin things and I've had a hard time recovering from it. I worry about what these meds do to us. After taking 20 mg of Prozac for seven years, stopping for awhile and restarting at 10 mg, it can cause a complete panic relapse? That's pretty frightening.

Anyway, thank you all for reading and listening to my rambling. It just feels good to get it out and talk to people who understand.

ETA: I almost forgot to mention she was going to let me try BuSpar again (had tried it very briefly many years ago), which is something I really wanted to do. She said "Let's try Nortryptiline first" but when it didn't help, I asked her for the BuSpar and she wouldn't even allow it. I don't get her.

[Cmac]

All I can do is express how very sorry I am for you. I cant imagine how frustrating it must be to rely on a doctor to keep everything in balance and have that doctor fail you....over and over again. In your situation, I do not think there is anything wrong with doctor shopping, you are not seeking meds for receation, you have a legitimate need. I would guess your husband suffers too because he has a loss of companionship when your meds are not right. Maybe he should go with you next time and speak up on your behalf!

[PEACHPLUMPEAR]

hrtguy, that sounds awful. I'm so sorry you had to go through that.

Yeah, my husband agrees with the direct approach. I'm going to have to sit there and do some fast math when she tells me when my next appointment will be and then have to confront her then about it. The woman is so stinking hard to get through to. She hears what she wants to hear and if she wants to just shush you up, she just dodges the question and gets you out of the office quickly. She has gotten much worse since her caseload has apparently increased. And I have a real problem with asserting myself, especially when it might make me look like one of those numbskulls who are just there to get pills from her to get high.

I'd agree with the idea that she's a bad prescribing doctor except for the fact that she gets everything else right. In fact, she gives me scripts for Lamictal and Nortryptiline (that I'm currently weaning off of) that I don't need because I usually have a refill or two left.

She is very weird about benzos, as most doctors are nowadays. I think maybe my state is cracking down on the physicians who prescribe them too. One time I did say, "But the bottle says take two per day." She told me she meant as needed. This was before the panic returned this year, however. She does this little thing where she writes the scripts, opens her office door and tells me "Stay right there!", photocopies the scripts and then gives them to me. I'm thinking WTH? I think I know by now to sit in the office and wait until she's done.

I briefly left her to see a psychiatrist earlier this year and after three appointments with him, he had me running back to my psych n/p. His medication of choice was Ativan in combination with the Lamictal, which worked alright, but the man was a real piece of work and it got to the point where going to see him became a stressful thing and I had a panic attack right in his office. He stood there and half-laughed and said, "And here we are, supposed to be making you better!" Funny.

One time I wound up in the hospital with a panic attack. The psychiatrist there was a nice man who had an extremely thick Indian accent, but an interesting approach to things - he wanted me to take Ativan for panic only, and Klonopin as needed for days when I just had generalized anxiety. He didn't want me combining the two on the same day, but to use them for different purposes. I know his name, but I couldn't understand the guy to save my life and if he didn't have a woman with him (maybe a student?) who sort of translated things for me, I'd be lost. I've considered going to him, but that accent would be a problem.

Billyboy, I wonder if my primary care has my records from the psych, because that would enable me to see a couple of people for second opinions without letting on to the psych that I'm searching for someone else. Maybe I'll call my primary care and ask.

Oh, regarding Wellbutrin - that is the one SNRI I haven't tried. I've tried pretty much all of the SSRIs and SNRIs and my psych n/p refuses to use any more of them with me. My problems started up again last summer because I felt like the Prozac I'd been on was pooping out and asked to try Lexapro. She gave it to me, but it caused GI issues and she weaned me off. That started causing panic attacks, but they went away until February of this year, when the doctor attempted to start me on Prozac again (at a measly 10 mg!). That was enough to really ruin things and I've had a hard time recovering from it. I worry about what these meds do to us. After taking 20 mg of Prozac for seven years, stopping for awhile and restarting at 10 mg, it can cause a complete panic relapse? That's pretty frightening.

Anyway, thank you all for reading and listening to my rambling. It just feels good to get it out and talk to people who understand.

ETA: I almost forgot to mention she was going to let me try BuSpar again (had tried it very briefly many years ago), which is something I really wanted to do. She said "Let's try Nortryptiline first" but when it didn't help, I asked her for the BuSpar and she wouldn't even allow it. I don't get her.

Is the accent the only reason you wont go back to the indian fella? I'd hang on to him. Im my personal experience its super hard to find a doctor that understands anxiety and prescribes accordingly. If I had him I'd hang on to him. Where I am though all the doctors have crazy accents

[queentresa]

I have bipolar NOS with GAD, social anxiety and panic. Anxiety runs rampant throughout my family and in addition, I'm noticing that the week before my period intensifies the anxiety to extreme levels.

Lamictal was a life saver for years and got rid of my panic, but it returned this year with a vengeance.

Food is a huge trigger and wherever I have to eat or see food, that's a sure sign that panic will appear. And of course, most people want to share a meal together.



I can personally feel your frustration dealing with your situation. After re-reading your post multiple times I felt like It could have written by me.
When I read your description of your symptoms, triggers etc. it screams Hormone imbalance.
I was wondering if you have ever had your blood tested for all your hormone levels, also thyroid? Timing in these test would be crucial so having a Endocrinologist who specializes in Women Health would be beneficial.
Trying to understand the connections that trigger your anxiety may help relieve and eliminate your anxiety.

As to your problem with your Prescriber it may help to carry a larger wall calendar with you on appt. days. That way your Prescriber can have a visual aide and together you count the number of days until your next appt. Also never leave office until you have checked and re-checked yourself the number of pills prescribed. After a few times of you standing your ground I'm sure your prescriber will pay closer attention to your counts. Good Luck

[LilRageKitty]

@Baroness I'm sorry you have to go through all of this. I know exactly how you feel about the food/anxiety as well. And as of right now, I don't leave the house... at all.

I do think that you have to be as direct as you can with her. Make sure she really knows that your anxiety is not under control. That you can't leave the house without the medication.

Try to keep your head up and we're here to help in any way we can. I've suffered from anxiety and PTSD for years and have been bounced all over the place to different doctors, etc. It's really frustrating when you reach out for help and you feel like the person isn't really hearing you.

@queentresa
What did I just come across? I feel like you two are my long lost symptom sisters and I'm very sorry you have to go through life with struggles very similiar to my own, but this is the very first time I've ever heard of other women having issues similiar to my own. And i really appreciate you both for sharing your stories.

I've actually had my hormone levels tested and they didn't notice a difference. But I notice a difference a week before my period. I feel like I'm completely nuts and sometimes shortly after my period ends as well. I've also been diagnosed bipolar and am prescribed lamictal, wel-butren and klonopin.

I could talk about my anxiety, issues with food, my avoidance behavoirs, etc.

But I will stop blabbering on. It's just good to hear I am not the only one.

Good luck to the both of you and know that I am here if either of you ever want to talk.

[TreasureGirl]

Baroness, Hi there Im new to this forum but I am also diagnosed with the same things as you and LittleRageKitty minues the PTSD. --- Ive been on a search for a doctor who really listens to me and encourages me for over 10 years-- thankgoodness i have finally found one, if it wasnt for him i never would have gotten my bipolar diagnosis. Iwould still be searching. Yars ago, i went to a couple doctors who are like the woman you are describing, and they either saw me for 5 minutes or didnt really believe me. so i gave up until last year, granted now i did move to another state. where previously lived there was a shortage of phychiatrists so i can certainly sympathize with having no options. I know you said that you have no other options, but if your mental health isnt being taken care you must be feeling miserable. maybe it wouldnt hurt to try to do some research for nearby towns. At some point you need to stand your ground with this woman- you are the patient and you are paying for her help. Just try to push past your anxiety in those 2 minutes. I know its hard, but being frustrated sometimes helps you forget about being anxious.

[queentresa]

@queentresa
What did I just come across? I feel like you two are my long lost symptom sisters and I'm very sorry you have to go through life with struggles very similiar to my own, but this is the very first time I've ever heard of other women having issues similiar to my own. And i really appreciate you both for sharing your stories.

I've actually had my hormone levels tested and they didn't notice a difference. But I notice a difference a week before my period. I feel like I'm completely nuts and sometimes shortly after my period ends as well. I've also been diagnosed bipolar and am prescribed lamictal, wel-butren and klonopin.

I could talk about my anxiety, issues with food, my avoidance behavoirs, etc.

But I will stop blabbering on. It's just good to hear I am not the only one.

Good luck to the both of you and know that I am here if either of you ever want to talk.[/QUOTE]

@LilRageKitty
Since being on this forum for only a few weeks, my eyes have opened a little more, my heart continues to swell, I feel like I can breathe a little lighter. Reading the thoughts from so many.
The realization that behind each post there is a person who understands whats its like to be me. I'm also here to lend an ear and thankful for your offer of yours.

[Gman]

@queentresa
What did I just come across? I feel like you two are my long lost symptom sisters and I'm very sorry you have to go through life with struggles very similiar to my own, but this is the very first time I've ever heard of other women having issues similiar to my own. And i really appreciate you both for sharing your stories.

I've actually had my hormone levels tested and they didn't notice a difference. But I notice a difference a week before my period. I feel like I'm completely nuts and sometimes shortly after my period ends as well. I've also been diagnosed bipolar and am prescribed lamictal, wel-butren and klonopin.

I could talk about my anxiety, issues with food, my avoidance behavoirs, etc.

But I will stop blabbering on. It's just good to hear I am not the only one.

Good luck to the both of you and know that I am here if either of you ever want to talk.

@LilRageKitty
Since being on this forum for only a few weeks, my eyes have opened a little more, my heart continues to swell, I feel like I can breathe a little lighter. Reading the thoughts from so many.
The realization that behind each post there is a person who understands whats its like to be me. I'm also here to lend an ear and thankful for your offer of yours. [/QUOTE]

Et all,
very inspiring posts,
Stay well.
Gman

[Baroness]

@LilRageKitty, @TreasureGirl, @queentresa and @Gman, please share your stories here if you feel like it. I would love to hear them and I don't care if it's not on-topic in this thread. I feel bad that all of you are going through this garbage, but also a little relieved to know I'm not alone. So share as much as you like!

@queentresa, it's funny you mentioned the endocrinologist. I've thought something is off with my hormones and told my primary care. She did bloodwork and gave me the name of an endo to call (they're also in short supply here), and the woman who answered refused to give me an appointment because I didn't have a "real problem" like thyroid issues or whatever. My bloodwork came back normal, but I know that hormone testing is sensitive and bloodwork doesn't always show everything.

I have considered saliva and urine testing, but am not at the point yet where I want to spend $400 on it. My old boss is a nurse practitioner and worked at a combination traditional/holistic medication practice and gave me two kits. One would have been $250 and the other $150. It just seems like a huge gamble to spend that kind of money and then maybe find out nothing's wrong at all.

Anyway, my psych n/p has been good for something, because she recommended another endocrinologist in town and I'm going to call him and see about an appointment. I have nothing to lose.

@PEACHPLUMPEAR, I am hesitant about the Indian doctor mostly because of the accent, but I also Googled him and his Health Grade ratings weren't great. I wonder why because he was very pleasant with me and seemed understanding (from what I could tell from one time seeing him).

My husband has offered to go with me, but he thinks what I need to do is make a list of my issues and prepare answers for her rebuttals. I am absolutely paranoid that she is seeing me as a junkie of some kind. There's no basis for that sort of thinking, but I am having it anyway (I have a bit of OCD as well).

The thing is, years ago she told me I was the last person she'd ever worry about getting hooked on benzos. What has changed? Yes, I've needed to take them daily for periods of time, but certainly not the entire seven years I've been going to her. My husband said that maybe I should ask her if she thinks I have a problem and that's why she's shortchanging me, but that seems really risky.

All I want is the correct amount to get me to the next appointment and the ability to take 2 mg/day if needed. That's all. I can't even understand why people take these for pleasure. Being sleepy is fun? But I am a teetotaler. I've never been drunk or even smoked a joint. I don't even have a sip of anything alcoholic now because of the meds I take.

I'm going to wait until next Saturday, see what she does, and if it's the usual shenanigans, I will seek out the second opinion I was talking about in my first post. It's a tricky situation. The woman is a psych n/p as well, but works with my mom, and my mom would prefer to keep my issues private from the other girls in her office.

This psych n/p she works with has another office that I could go to, but my mom still doesn't want me mentioning that I'm her daughter. I'm not sure if it's because she's ashamed or if she just doesn't want to worry about the woman telling other people in the office about my issues.

Anyway, I've written a huge post again. Thank you to each and every one of you who has responded. I have also breathed a huge sigh of relief after reading your responses. This is one of the best forums I've found in a long time.

[PEACHPLUMPEAR]

@Baroness I understand where you're coming from, I had a psychiatrist suggest I was trying to show him my cleavage or something in order for me to get on his good side, he implied I was being suggestive in order to get good drugs right while I was in the middle of pouring out my life story. He's the reason I'm scared to go back to any doctors and why I've ended up here again. I've posted a short story of the incident in another thread I will copy paste it for you if you're interested.

"Not as bad as some people here but I went to a psych to get yet again another evaluation and some more meds, he gave me a little sheet in the beginning to mark off any health problems and a hearing disability was one of them. He was late and when I got in the room to talk he spent a lot of time making a big deal about being comfortable and he talked so low I could barely hear him so I was leaning in with a hand behind my ear trying to listen to him ask questions and in the middle of me trying to rush through my life story he made a comment about how my tits were making him uncomfortable and he said he thought I was trying to "get friendly" with him or some such nonsense and he was acting all disgusted. Meanwhile I was wearing sneakers, long jeans, and a long sleeve tshirt with a tanktop underneath, in the middle of spring in florida and I am not a suggestive or flirty person by any means. I was in complete shock and couldn't really take in what happened until I got to the parking lot and just cried and cried. And what made it worse was that I tried to explain why I was leaning in (hard of hearing) and he said I was full of shit basically and it didn't even occur to me to tell him to look at the little medical sheet he gave me until the next day. I'm pretty much scarred and haven't really been able to go to the doctor since."


So I totally get where you're coming from and I don't think your fears are that irrational. It's so hard to find a good doc and they're all crazier than shit where I live so I've given up. And you have every right to seek out a second opinion. I really hope you find a doc willing to work with you and not against you. Sending some good luck, good feelings, and e hugs your way. Hang in there.

I myself have even given up on the IOPs for now since the payment thing is giving me added stress. I was trying to avoid asking a neighbor for help because I don't want to be a bother, I phoned him up out of desperation and he gave me ten bars and wouldn't take a donation. I was in tears when I got home, it meant the world to me because I'm having such a hard time right now and coming down from a gigantic alcohol bender. Tryna kick that shit to the curb hard.

[slick76]

I have a similar problem with my pdoc except she's old and doesn't remember stuff. When I tell her what I need she's always in awe like "oh really"? no shi* lady...yes, REALLY! It took me a while to overcome my shyness and become more direct and assertive with her but I suggest you do the same. I'd take Wellbutrin or Adderall before I went in to see her cause that'd pump some adrenaline into my veins.

Be nice but be firm, it's the only way to deal with people like this. Good luck!

[TreasureGirl]

Peachplumppear- My heart truly goes out to you about your story with that doctor- but you cant let that one incident control you anymore. At least reach out to a female doctor to get some help. That way you dont have to deal with that issue at all. and you can move onto why you came for help in the first place.


Also, its really nice to see that are others on here with Bipolar--- ive just recently been diagnosed, so now im kinda going through this with a new pair of glasses on. Until then I always thought i was really a b*tch. Or I couldnt understand why i was fine one day and then next I could barely stand to be in a room with anyone because of anxiety. But I too have had my hormones check which was a very smart thing to do by the way Queentresa - cuz there are so many different hormones and if one is out of whack it will throw your whole body off-- I went thru meno really early in life -34 -so now I wear an estrogen patch and use progesterone cream ---and man......that by itself was like heaven. I use the biodentical ones and it gave me back a lot of my energy. among a tons of other stuff. i could go on but...... bla bla bla.

[Baroness]

@PEACHPLUMPEAR - oh my gosh, that is revolting. What kind of pervert doctor would do something like that?

I am really sorry you had such an awful experience and don't blame you for being skittish about doctors now.

I spoke with my primary care yesterday and she recommended another endocrinologist. I have an appointment, but it's for January 31. Not exactly what I was hoping for, but the endo has good ratings and I always trust whoever my PCP recommends.

I wish to heavens that my PCP could prescribe my psych meds, but she is very upfront about the fact that she's just not well-versed enough to be prescribing anything other than an anti-depressant or occasional benzo. She is just about the only doctor I've had who truly understands me and doesn't patronize me for being a little screwed up. She's been my doc for 18 years now. I went straight from my pediatrician to her and that was it!

Psychs, on the other hand, seem to be in a world of their own. Tell me, is it me or are they either:

1. Patronizing because they know you are messed up
2. Arrogant, or...
3. Spaced out themselves

Because I've had all three types. My first psych was a Russian who gave me samples of Effexor. I told her I was worried about taking it because high blood pressure runs in my family. She said something to the effect of, "Are you questioning my judgment?" Just pure arrogance. I didn't go back.

The second doled out pills like a human vending machine. She convinced me to try Effexor, and I relented, which was a bad decision. It spiked my blood pressure so high that I had to start a bp med and have never been able to get off them since. That was 10 years ago. She also *really* screwed me up badly because I didn't know that you couldn't just switch psych meds around like aspirin or something, and this woman was just giving me something new to try every month I saw her.

She left the practice and I found a wonderful psychiatrist. He was the one who diagnosed me with bipolar NOS and gave me Lamictal, Prozac and Klonopin, which was the combo that got the panic under control. He also left - to go work in a prison! He was the best because while he didn't have a ton of personality, he wasn't a jackass and was extremely matter-of-fact and clear in what we should do.

After he left, I was transferred to an old guy who was barely aware of things. He wound up retiring shortly after I decided to look elsewhere.

This is how I ended up with my current discombobulated psych n/p. She's better than some of the other bozos I saw, but is far from perfect.

My PCP agreed that there is a shortage of specialists in this city. It is about 400 miles away from a very large city, and my theory is that most doctors would rather practice in a huge metropolis than a depressed city with a crummy economy.

[Baroness]

I just wanted to let you all know I saw my psych n/p on Saturday and went in with my list of issues and summoned every ounce of assertiveness I had. She prescribed me enough medication for a change! My next appointment is in six weeks and she wrote the script for 90 tablets rather than 60. That's enough to allow me to take the 2 mg Klonopin/day that she prescribes without running out. Whew.

She's also raising my Lamictal to 250 mg like I had asked. I'm hoping this will help get the anxiety under control and I can go back to the days where I just took Klonopin when I needed it and not daily. Maybe my memory would improve. Lamictal was the drug that got rid of the panic back in 2005, so I figured maybe an increase would help matters.

She did say the disorder tends to morph with time and this could be why I'm having problems again. The panic attacks this past year are different from the ones I got back in 2002-2005. My mom had panic when I was a child, it went away, and now it's returned again all of these years later. So maybe it does "morph".

Another thing that surprised me was that she told me not to blame myself for requesting to get off Prozac and try Lexapro last year. That seemed to be the catalyst for my panic returning and it's something my mother keeps shoving in my face. "If only you hadn't changed your medications..." That's when my psych explained her morphing theory.

Anyway, what did surprise me was my psych gave me a paper to give to my primary care listing all of my issues and on it was depressive disorder NOS rather than bipolar. I didn't notice this until after I'd gotten home. It's odd because she's always talked about me being bipolar this and bipolar that. So why wasn't it on the sheet? I'm puzzled and will have to ask her next time.

Oh, one more thing - do you guys find that other anxious people tend to make you more anxious? When I met with a group of people who suffered with anxiety and depression, I found they comforted me, but being around my mother, who understands what it feels like, is very much anxiety-inducing. My psych said this is because anxious people tend to feed off each other. If that's the case, why did the group therapy feel so comfortable?

Thanks to all of you for your support, advice and encouragement. It really helped.

[Revert]

@Baroness - yes, I cannot be around anxious or hypo-manic people they propel me into a state of anxiety. I also LOVE the three item list of the characteristics of psychiatrists. I totally agree.

I am happy that you have sorted things out with your practioner. I always check my scripts for accuracy before leaving the physcian's office. In fact, I check every transaction I make such as paying the water bill or picking up my dry cleaning. This isn't because I am OCD, it is because historically I have had too many mistakes happen, many people are just sloppy, have their mind on other things or are just plain incompetent. For example, years ago I had my electricity disconnected because the clerk applied my payment to my Father's account since we had the same address and last name, although I had my own apartment in the building he owned.

I also have anxiety and it runs in my family. I do think some of the anxiety is "learned" when you grow up in a family where anxiety is rampant. Sometimes, I find myself a acting exactly like my Mother, which is part learned and part genetic.

Yoga and meditation are impossible for me. But, exercise does wonders! Especially if you can find an activity you like doing, such as swimming or walking or dancing.

Best of luck to you