Why can't anyone give me a correct diganoses?

[dallasm78]

I have been on depression medication since october 2001 and in july 2007 I was also put on xanax for panic attacks.
I have been having alot of problems with getting a correct answer to exactly what I am one the meds for and what it is I am being treated for for all these years.
I got really down after I had my first child and I started having episodes of extreme anger and sadness often in the same time even hour. I never got mad at my children however my husband got alot of the anger against him for no reason.
I learned to control those episodes and in july 2007 two days after I had by second child I started to have severe panic attacks.
Since then I have been having trouble controlling the mood swings and the panic again. I have gained almost 100 pounds since starting the meds in 2001 and have been having memory loss, lack of concentrstion, I am extremely tired all the time, i shake alot when i wake up and i go from a ok mood to extremely anger to very sad and lonely to self pity. And I can have all this moods and more within hours of each other.
I have asked the doctors here for advice but I live in a very small remote town and we have no full time pyschotrist here and the only doctor i have seen for this since september last year was my family practioner doctor.

I guess my question is , is there anyone out there who may be able to start leading me in the right direction for a correct diganoses and proper meds for it.

Thank You.
Dallasm78

[azalea82]

Below I have copied and pasted a letter from the website of Dr. Phelps.  Perhaps you could bring this to your family doctor to help explain your situation.

From the desk of James Phelps, M.D.
PsychEducation.org
Corvallis, Oregon

Dear Doctor:

Believe it or not,  I'm not doing this to make money.  You'll have to read on a bit to see why. Your patient has brought you this because he/she thinks you can help, knowing:

• You each have the same goal: for him/her to feel better and function better.

• Some forms of depression can be made worse with antidepressants.1

• Bipolar disorder has multiple variant forms that can be difficult to recognize.2

• Patients with bipolar disorder go an average of 7.5 yrs before being correctly diagnosed.3

Your patient has been looking around the Internet and found my site on Bipolar variants.  This site includes only data-based, rigorously referenced, widely accepted medical viewpoints — no hocus pocus, no fuzzy thinking, no wild opinions.  There’s no big money in this for me. I’m just trying to help you and your patient reach your goals (if you find that hard to believe, please see the explanation on my site: www.psycheducation.org).

By bringing you this letter, your patient is saying "I think I might have a Bipolar variant", or that it needs very cautious "ruling out".  Bipolar Disorder has recently been recognized as having complex variations. It’s not just "manic-depressive" anymore.  Patients who have depression, but who also have profound anxiety, or severe insomnia, or marked irritability, may have "Bipolar II": a variant which does not maintain responses to antidepressants (e.g. "Prozac poop-out"), can be made worse by antidepressants, and can respond well to "mood stabilizer" medications.

Please consider my guide to bipolar variations for clinicians (hx, dx, rx, px), which may help you with this patient, found at www.psycheducation.org.  I wish you well with your further efforts at treating patients with mood disorders, knowing that "at least half of patients with psychiatric disorders make their only contact with the health care delivery system through the general medical sector."4

Sincerely,
James R. Phelps, M.D.



References        (on the website you can access the actual references with a click)

1.  Kilzieh N, Akiskal HS Rapid-cycling bipolar disorder. An overview of research and clinical experience. Psychiatr Clin North Am 1999 Sep;22(3):585-607  
2. Fawcett J Bipolar Disorder: On the Edge of DSM-IV. American Psychiatric Association meeting, 1997
3. Ghaemi SN, Sachs GS, Chiou AM, Pandurangi AK and Goodwin FK. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? J Affect Disord 1999 Jan-Mar;52(1-3):135-44
4. Wells KB: Depression in general medical settings. Psychosomatics 35:279-296, 1994.

[Justin88]

I dont feel like reading all that today, dont have the time, sorry about that.

But I tottally agree with you dallasm78.. I read later... great topic...

[Starlight1287]

I agree that trying to find someone who can treat you long-distance is probably the best option.  I go to my psychiatrist in person usually, but when I go away for extended times he'll do phone sessions with me, and I've had previous psychiatrists do the same.  I know it's not quite the same situation, but perhaps if you could get in touch with a good doctor and explain your situation you could find one who would be willing to do all phone sessions.  I know sometimes they want to see you in person to be able monitor your health, but if you got the psychiatrist and GP in touch, that might solve that problem.

I'm not positive this would work, but I'd say it's worth a shot.

[Donna149]

I myself beleive you have nerve problems. You need something to relax you. Being under alot of  pressure, & stress with the children and husband is enough to get on anyones nerves. I am not that good at spelling so maybe you can make my words out. I am on xanaxs, somas, lortabs 7.5 Lyrica, Effexor xr, Celebrex, Blood pressure pills, & nexiums. See if your small town doctor will put you on Effexor xr 37.5. That seem to help me control my temper alot, but i have read alot of bad things about coming off of it. It seems like i can handle everyday problems alot better. I am 50 yrs old and taking care of my oldest grandson that is 11, plus watching my youngest grandson that is 18 m onths old, plus having a husband that is home everyday due to heart problems. So i know what your going through.

[gettingwierder]

I have all of the same symtome you have, and probably since 2001 as well.. Iv been on so many meds for depression.  I think Zoloft or Paxil worked, but I also remember gaining over 30 pounds.  THAT made me even more depressed.  I went on Wellbutrin, and lost the weight but was an irritable *****, so I stopped.  Well whatdoyaknow? 5-6 years later, what am I back on again? Wellbutrin.  It *****.  I think its making me waaaay more anxious and irritable, paranoid.. restless.. but Im afraid to take anything else cuz I might gain weight, but Im afraid to stop because Im afraid Im going to get seriously depressed again.  Im not even doing all that well while on it!  I just frickin quit my job yesterday cuz I cant get out of bed!  And I have 2 kids to take care ofand no child support!  Im so stupid..

Im sorry.. this is about you being stuck out in the middle of no where and cant get any help.  I was tryng to make a point that I am near 100's of pshciatrists, and I went to one and he was a complete *******.  I need to swee another.. Im not even making sence.. Sorry..
Where are you anyway?  

[azalea82]

I guess web addresses do not appear in the comments section.  Consider google-ing "bipolar spectrum disorder."  See if the symptoms are similar to those you experience.  Antidepressants can make bipolar disorder worse.  Mood stabilizers such as Lamictal or Lithium may provide more of a benefit.  

[Bob_D]

This is kind of a long shot. There are certain services that provide counseling over the telephone or email. You can find them if you type "online psychiatrist" into a search engine. I have no experience with them, personally. At least the first one I checked out said on its site it will not prescribe over the web. However, it is conceivable that you might - I say might - work out an arrangement between the service and your local physician whereby they could diagnose you and send the dispensing instructions to him to give to you.
Just a thought.

[dallasm78]

I understand how everyone is saying I need to find a good board certified psychiatrist to get evaulated however the problem with that is that the closes town to me is 600km away over a very severely run down dirt road and even at that hospital there they have no one to help me either.
The only other option I have is to pay a little over $900.00 to fly to the nearest city to get in to see someone, but there is where the problem is, because even if I could fly out of this small town I would have to be on a doctors waiting list just to get into see someone.

You All have to understand the terrible situation our little town is in without the correct doctors and facilitlies here. We can not get anything done in this town. My daughter had to fly outside to get her tonsils removed. This cost us a whopping $1500.00 this past summer, and I am still trying to recover from those expenses.
Maybe if we had a better hospital facility and more doctors and specialists here I wouldn't be so sick as I am and then maybe I can get treated by someone who knows what they are doing.

[therese83]

Listen to Hensley 258

With correct treatment you would not be suffering like this

[Hensley258]

I uderstand that given your in a small town that there is not many good Psychiatrist that you can see for evaluation.

Regardless, You need to find one and drive a long way if need be.

TRUST ME when I tell you that a GP doctor CAN NOT effectivly treat your condition.
They have not the skills or experience to even prescribe psycotropic medications. They will if you let them, but often times (due to lack of understanding) the results are much less than satisfactory.

The good news is that your symptoms are very treatable (if you get the right help)

I guarentee if you find a Psychiatrist that can get you on the correct medications for your condition that you will feel 100% better.

Life is too short to feel like **** all the time. Find a good Board Certified Psychiatrist and get evaluated. Please stop wasting your time with your GP on matters of mental health treatment.

If you have to drive 100 Miles to get the right help then so be it.

Good luck.

[azalea82]

From your description, it sounds like you could have a variant of bipolar disorder.  Check out www.****.*** for more information about diagnosis and treatment options.