Antidepressants Finally Increased

For many months I’ve been trying to get my pdoc to do something about my depression. Every month it was the same thing, I would practically beg him to adjust my meds and every month he would respond in the same manner – NO. My husband Maurice has been concerned, my therapist has been concerned and I have been frustrated beyond belief. All I wanted was an increase in my antidepressants. Not much, just enough to get me out of my funk that stayed with me at all times.

Over a year ago I went to my usual appointment and I was definitely in a manic state. It was the first time I had been manic in a very, very long time, but he was overly concerned, in my opinion, and immediately adjusted my meds. it wasn’t long before I started to be regularly depressed. Not severely, but enough that I pretty much maintained this level of depression that felt like it was circulating under my skin. He had lowered my antidepressants and it had too great of an impact. Don’t get me wrong, he would tell me that medications aren’t the cure all for everything and I would nod in agreement, however, I would point out that the regular depression came on at the exact same time he lowered my antidepressants. Most frustrating of all was when I would try to discuss this with him he would not discuss the DAY that I was manic, but would refer to the PERIOD that I was manic. He sure remembers it differently than I do.

I received a lot of suggestions that I should request a new doctor. I do go to a county health clinic and there are forms to fill out to request a new doctor. Sounds like an easy solution, right? Well, not so much in my case. The clinic I go to is part of a hospital that is a teaching hospital. As a result, the vast majority of doctors are actually resident doctors. Who do they all report to? The head of the department, of course. Who’s the head of the department? Do I really need to say it? Yeah, the head of the department, the man who makes all final decisions regarding meds, is, of course, my pdoc.

This past week was horrible. I could barely get out of bed, I kept the shades closed and it took every bit of energy I had to shower and brush my teeth. I would cry for no reason and while I didn’t want to die, I did want to slowly drift away somehow. My husband, Maurice decided he had enough and made the decision that he was coming with me. That’s all it took. It still wasn’t easy. My pdoc brought up again that meds aren’t always the solution and each time Maurice continued to stand his ground. As a result of this standoff, my appointment on Friday took over 30 minutes. Can you believe it? A psychiatrist actually spending more than ten minutes with a patient? Miracles do happen.

We struck gold. Maurice stood his ground and my pdoc finally caved. He increased the dosage of my antidepressants. I’m fully aware that meds are kind of tricky. I may find that the increase won’t help at all. Perhaps I’ll become too manic. Who knows? At least I’m trying to do something differently. I am angry it took having to bring Maurice in to resolve the problem. Why couldn’t the man believe me?

If you take meds, do you have problems like this? Do you feel like your pdoc listens to you or do they brush you off like had been happening to me over this past year? I’m curious how many of you experience the same frustrations that I had.

16 comments on Antidepressants Finally Increased

  1. Hi Bradley. My Pdoc used to just listen to me and then make his own choices even if I desired a different course of action. He always explained why he was making certain decisions. After 5-1/2 years I now know it was that I didn’t understand enough about the meds and how they affected my cycles. Over the last couple of years he lets me help make the choices. If I insist on something and explain why (I’ve studied a lot) he will work with me and we will carefully plan it out. We’ve come to trust each other and he spends time with me. Lately, I’ve been wanting to eliminate a certain drug that I feel isn’t working as well, if at all, from the mix. We’ve already reduced a different one. He’s suggested a wait and see what happens with the reduction–the two meds have a drug interaction so the reduction may help that other drug start working better. I’m disappointed because I hate all the drugs, but I know scientifically his approach makes sense, so I agreed. We’ll give it some time. I rarely stop cycling. We’ve slowed the process down to every week or two, but I don’t see “normal” for more than a week or two in-between. It used to be far worse so I am thankful but my Pdoc and I are working towards something better. Right now coping skills are what keep me going. It’s a stubborn case of bipolar.

    Thanks for being open and sharing your experiences. It helps to know we aren’t going through this alone.

    1. I have the same experience as this commenter. My doctor and I work together in making the choices but only after having a relationship of going on 7 years now. Also, I rarely stop cycling, never seeing normal for more than a week; coping skills are what keep me going, etc. It is nice to know I am not alone in this matter, although I do tend to stay on the depressed side of the spectrum more often than not.

      I asked my doctor recently about increasing my Adderall to help combat the fatigue that comes along with the depression and she said no because we decreased it about 6 months ago because it was causing me to become hypomanic. She said if the depression persisted she would up my mood stabilizer before increasing my antidepressant or any other med that may cause me to cycle into hypomania.

    2. When I originally started going to this clinic I had a resident who was wonderful. She would pull out her book of meds, read the description including any possible side effects, and we worked as a team deciding what my best options were. Unfortunately for me she graduated and moved on and I was assigned to the doctor I currently have.

      I’m glad you have a pdoc that works with you. Hold on to him tight and don’t let him go. Btw, Journey,you don’t have a link to your blog from your Gravatar account and I’d like to check it out.

      Thank you for stopping in and commenting.

      Wil, as I said above to Journey, I’m very happy you have a pdoc that works with you. I’ve heard many horror stories worse than mine, so consider yourself lucky.

  2. Hey Bradley–I’m actually having a little of the opposite trouble. My pdoc is talking about cutting one of my mood stabilizers back and I am balking. I’ve been stable for a while now and I’m really in the “if it ain’t broke, don’t fix it” mode. But we work well together and I do trust him. We shall see. Thanks for the blog. I always read it even if I don’t always comment.

    1. I’m with you, Teri, I wouldn’t want to change either. I’m happy to hear that you’re reading, please feel free to comment more often.

  3. I am lucky enough to have a pdoc that listens and who, I believe, is very wise. In the past, any use of an antidepressant has me shooting toward mania. And I do mean any. When I was very depressed last year, he prescribed Ritalin, and that helped a great deal. Now I am back to being depressed and agitated and cycling. This time, he put me on Abilify and is decreasing my Geodon. So far, it seems to be helping. A lot of mood stabilizers are known for keeping either depression or mania at bay, so if upping your antidepressant doesn’t work, maybe you can take a look at a mood stabilizer that has a similar effect. It is sad that it took Maurice going in and not taking no for an answer for something to be done. I can understand it would be difficult to switch pdocs based upon the politics of the situation, but if he doesn’t listen, you may have to end up taking that into account. I’m glad you’ve had the med change and hope for you that it is a good one. Best always, Rose

    1. Rose, I’m so happy you’ve come and posted, I know it’s a challenge right now. It is sad that I had to bring Maurice, but I know my pdoc respects so I was mostly confident he’d listen…and he finally did.

  4. I hope that the med change helps you out of your current slump. It sucks that it took Maurice to go in to advocate for you to get the doc to make the change, but thank God you have someone like Maurice to do that for you. Many people don’t. I have a wonderful husband that has made a handful of trips to my psychiatrist visits with me when I was doing poorly and couldn’t even drive myself there. We are fortunate to have such supportive partners, aren’t we? 🙂 Hang in there. ((Hugs))

    1. “We are fortunate to have such supportive partners, aren’t we? ”
      Yes we are. Very fortunate.

  5. I take my husband to all my appointments to back me up, and to fill in gaps I might have missed. So far, once I actually got my diagnosis, things have been well. But I also found out that I lucked into two published experts in Bipolar II and its underdiagnosis, so that helped a LOT. My pdoc retired and I have a new person now who seems a bit wary of me (I speak too fast for Indian/English doctors ’cause I’m an American and they sometimes mistake it for pressured speech), but for the most part, has been happy to work with me. We’ll see how it goes now that the baby is born, but I’ll certainly have to remember to point out the speech-speed thing (her boss, the one responsible for my diagnosis, loves to use me for student teaching because of that exact thing).

    Anyways, I hope the re-up helps! <3

    1. First, Raeyn, I want to let you know that I saw the pics on your blog of you and your new baby, however, I failed to comment. You look like one very proud Mama. Congratulations.

      When I was first diagnosed Maurice was always there for me and I don’t think I could have done it without him. I’m glad he’s still around when I need him to be. .

  6. I’m very lucky. My doc is extremely responsive to what I have to say and we are always on the same page. We are in the beginning stages of doing a complete med overhaul because what I’m on just isn’t working. My partner also went to my last appointment just in case my doc wasn’t on the same train of thought but this wasn’t necessary…he could see for himself I wasn’t improving.

    Good luck with the med increase!

    1. Thank you, Michele. I’m confident the increase will make a difference. Consider yourself very lucky, indeed.

  7. ya i think this kind of problem is endemic, esp when most of the pdocs think they are the ‘rational’ ones, and we are (obvioiusly) not rational, by definition…thus, theirs is the only reality that counts, and so we do not get medicated appropriately. it is too bad indeed that it takes having a family member or friend to advocate for you that your condition is indeed ‘bad’ enough to treat/change meds for. i have often wished medicare/medicaid would pay for me to have a companion on the days i have appointments, so they could advocate from what they see of me and from their opinion on my behalf to the docs who don’t see or don’t listen to me, but alas, there is no such person for me to have. guess i’ll just start carrying a big stick.

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