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Avatar universal

mental health issues - serious

I am going to have a hard time writing this.  But here it is.  My therapist cleared me for tx.  I have an appt. with Dr. Gish's team on Wen. the 11th.  So far so good but not good at all.

I have taken benzos since 1998 for anxiety.  In late 2009 I was switched to Clonazepam (Klonopin) for panic attacks caused by xanax interdose withdrawal.  Then my therapist decided I was BPII.  I never believed it - until I saw her boss, the psychiatrist, who REALLY pushed it.  So I was given Lamotrigine (generic Lamictal).  This was in March 2011.  I have slowly gone into depression, and now I've almost destroyed my long-term marriage - because of ~ prescription drugs.

Therapist cleared me for tx but... I am NOT mentally stable.  I cannot lie to the doctors in.Vegas (Gish team).  It would be setting me up for disaster during tx.  Yet, it seems that my hep c is quite advanced - bridging fibrosis, moderate to severe piecemeal necrosis (2+/3+).  And them some.  All I wanted to do was get started with tx.  

Now - I realize that I am mentally not stable.  Today, TODAY, my mother-in-law called me out of the blue.  She is a straight shooter and very wise.  An Elder.  She told me that she has seen me change into a depressed, moody, crying, whining mess and wanted me to know it from her before I saw the Vegas doctor.  She told me that I had better be honest with them about how the meds are working because... they have made me a lot worse.  My husband has told me this for years, just about the benzos.  He has no concept of what BPII is.   I didn't listen to him, but I did listen to her.  She's right.

I have told my therapist I'm basically fine but have depression so she UPPED my dosage of Lamotrigine.  Oh, so much worse.  I never experienced depression like I have with Lamictal.  I do NOT believe I am BiPolar.  But I wanted that clearance.

Now what?  I cannot bluff my way with the treating doctors in Vegas.  I have to tell them the whole truth about these meds.  I have to.  To give me Riba and PegInt would most likely l exacerbate the already out of whack symptoms I have.  It could have devastating results - either I have to quit treatment or - even worse - become suicidal big time.

I know it takes a LONG time to taper off Clonazepam.  Lamotrigine, maybe not so long but long enough.  This may mean - probably will - that my tx will have to be postponed.  And that means that my liver is just going to get worse.  I know that we never know how fast we are going to progress.  But I do know that in 10 years I went from 1/0 to whatever I am now.  FAR advanced.  It may have to do with my age, 65, and the fact that I've had this virus for 43 years.  My GI couldn't even interpret the bx results except to say I'm cirrhotic because that scary word was somewhere in parentheses.  Most of you know this part.

I was going to just fake my way through all this because, after all, I do have a mental health clearance.  But now I fully realize that the drugs have done a number on me.  I have made my husband sick - I am driving him crazy.  He has PTSD which he won't treat.  Why did my clear me?  She's incompetent.  There is one other psychiatrist in town but only sees outpatients once a MONTH.

I should just wait until I see the docs Wed, but I wanted to throw this out on here first.

Advice?  Ideas?  Help?   I am listening now, believe me.
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Avatar universal
Catmagic stated.........."I don't want to see another post on this.  Please respect that.  Please just drop it.  The docs and I will handle all this crap.  Okay? "

Maybe her wish should be granted???    Best to you
Helpful - 0
Avatar universal
   Yes, and LookingForward is right: the anemia was what caused many of my side effects, both mental and physical.
   It may be a good idea, when you do go into Tx, to have your Triple Tx meds lined up, and have a perscription for Procrit lined up also, before you begin your Tx.
   That way, if you end up with early onset anemia, you wont have to battle the Pharmacy,when youare already experiencing the uncomfortable side effects.
    Once you achieve Undetected,  your Doctor can opt for riba-reduction also, or instead of the Procrit. And if Procrit is used, you will want to line up which lab is closest to your house, to have your labs drawn at, etc.
  
Helpful - 0
1995824 tn?1330379049
Trust your doctors. See someone else about your BP diagnosis.

It is always difficult to look I'm the mirror.

I refused to take antidepressants on this treatment. I'm like OH...dont like them and have more issues with anxietymt an depression. Overall, I did just fine...the only anxiety and slight depression I felt were when I had extreme anemia and when I was trying to deal with my hard headed doctor about my rash issues.

Have faith that you can beat this.
Helpful - 0
Avatar universal
  My Doctor is smart the way she sets up our Tx:  we have to attend a weekly support group, and we all go around, and speak, in front of 'the group", in a format similar to the A.A. model, only we talk about our Hep C experience.
     I see our Doctor watching us: she is checking the color of our cheeks/complexion, our energy level, and most likely, our sanity level.
If we cant do the simple requirment, of making the weekly meeting, and speaking in turn, then she knows something is up. And it is almost impossible for people to practice "b.s., or "games", in a large group like that, with 40 people all listening~
  I remember one time, a woman who had been Txing, who had cirrhosis, sounded very confused, and "out of it' when she spoke. It turned out she had an ammonia problem, having to do with her brain, and so one of her Doctors' caught it.
    
    
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Avatar universal
Well, if my Medicare and TriCare won't pay for all of that, then we'll just pay for it ourselves.  One day at a time now.
Helpful - 0
163305 tn?1333668571
Your comments about anti-depressents underscore why I refused to use them during tx, despite my craziness. Sometimes they are more of a problem than the 'problem.'

I personally think there are indeed people who are mentally and chemically unbalanced. However, I also believe drugs can mask whatever is the root of a problem and can become it's own problem, as seems to have happened in your case.

It's normal to feel down sometimes.
Our modern  lifestyle contributes to the problem.They've found many mental problems are related to stress.

In Thailand, they taught kids who were hyperactive to meditate instead of giving them ridalin and they calmed down.

I truly believe in going with one's instincts. You do what you know deep inside is the right thing, for you.
Helpful - 0
Avatar universal
  Good luck on wednesday, Cat~  Psych meds are an incredible challenge, to get just right. I find the Doctors seem to be able to cure Hep C alot easier, then they can "cure" depression and mood swings. There is so much the medical profession just doesnt know, about brain chemistry.
   I know many people who have Txed, who suffer from depression, and they made it thru, without suicidal ideation, etc. You just never know how you will react, psychologically, until you begin Tx.
   It may be a good idea for you to visit with your therapist once a week, while on Tx~ is this a possibility that your medical insurance will allow for?
    Also, I know many people who have successfully tapered off benzos and
other perscription drugs, during a 30 day inpatient stay, at a hospital rehab program.  Many hospitals have these kinds of programs, and you would be staying in a hospital, with Doctors and Nurses there, and then there are these support groups thru-out the day, and you get to explore your "issues", etc.
    I am not sure if your Medical Insurance would cover a program like this, but many times, scholarships are also given, especially if the director knows youhave Hep C, and need Treatrment very soon!
  
  
Helpful - 0
Avatar universal
Oh ~ something else.  Even my therapist sees patients only once a week.  Small town - LOTS of mental illness.  If she won't work with me on this then I have to wait until August to see the "ex" psych - one Sat. a month for out patients.  Can tx wait until September?  Well, I'll find out on Wed.  But I have this feeling about that.  Just like four years or so ago I knew the virus was replicating fast.  And once again, a doctor who didn't believe me - my feelings.
Helpful - 0
Avatar universal
I really do believe very strongly that the BPII dx and the subsequent use of Lamictal has caused this problem.  The depression stated soon after I started taking it - slowly, stealthily, it has taken me down into despair - crying a lot, sad, can't find any joy, fearing that I am going to die (from cirrhosis), so tired.  This is so not the real me.  

That said, yes, I was cleared for tx.  And I know that I have a tremendous amount of inner strength.  Nothing can take that from me.  I want to slay this dragon.  I will find out Wed. about what to do.  I'm in the best hands there.
Helpful - 0
Avatar universal
LF12 - you give me hope.  It's good to know that this has happened to someone else - and that they finally found relief.  My "ex" shrink told me several years ago that I was not BP and to beware of anyone who tried to label me as such.  Smart man.  Me - not so smart.  I am just like your neighbor was - depressed, lethargic (and I thought all of that was the HepC), and yes, agoraphobic.  My first instinct when I got that dx of BP was - NO WAY.  And then I gave in.

I wish that was all I had to contend with.  I so wish I had be pro-active about my feelings before now.  I am sure that I need to start tx right away.  Not sure how long it takes to safely taper off Lamictal or if, after I tell the doc. about this, that tx can be done right now because of the interferon depression.  I just pray I can go ahead with tx now instead of having to wait to clear this crap.  I really feel that time is of the essence re. tx.

I am sure it's the Lamictal that has messed me up.  My moods swing like a chandelier in an earthquake.  Lamictal is the cause of that - no doubt in my mind.  
Helpful - 0
1995824 tn?1330379049
I just want to add that my neighbor was diagnosed with BP uears ago and has run through several types of drugs to help. She just became more and more depressed, lethargic, almost agoraphobic. She recently went to a different doctor who believes she is not BP after all, and she is in the process of weaning off all drugs. She looks and feels better than I have seen her in years. She is getting out in public and doing things she has not done in years as well.
Helpful - 0
Avatar universal
BRILLANT!  I will do just that.  Now I'm thinking what I want to edit out.  lol
Helpful - 0
Avatar universal
I ~ also wanted to say that although Lamictal is supposed to be a mood stabilizer, it really made my "moods" a lot more severe - depression came along.  I presented as hypomanic, and yes, all those things on the BPII list applied to me, well most of them.  I question though, whether all that was my "normal" - reckless, risky behavior, fast talker, impulse spending, etc.  All I know is that when I started Lamictal I knew what depression, clinical depression, was for the first time in my life.  Like you, I'm sure I presented as BPII.  Hypomanic predominant.  And I'm also sure that I would not present that way now.  I've "grown up" a bit and the recent bx was frightening.  I freaked out, but I think that too is normal.  Did Lamictal ease that one bit?  Nope.

It sure as heck didn't stabilize my moods EVER.  What worked for me was Clonazepam.  No panic, no anxiety (no depression) ~ smoothed me out.  

Yes, dealing with my husband's 70% VA rated PTSD certainly has affected me and always will.  That puts a lot on my plate as far as not pushing his buttons.  Lately I've been not just pushing them but pressing them.  Yes, the recent dx and fear have certainly changed the dynamics as far as what I've conditioned myself for for many years.

And this, that you wrote - oh so true:   It seems like the difference might be that the meds you are currently taking may not be addressing what you are feeling.

I will try to work on this with my current therapist. I see her on the 18th.   She seems resistant to changing the meds combo at all.  I've tried it with her.  Again, she just ups the Lamo. and ... I get worse.  The "old" psychiatrist I have total confidence in to help me do that.  I'll make an appt. for August with his office tomorrow.

Your post - again, wow.  You have really written a masterpiece here for me.  Thanks so much.

You hit every single issue I am facing.  You may bill me if you wish. lol
Helpful - 0
163305 tn?1333668571
Why don't you make a copy of your post here and bring it with you to your appointment with Dr. GIsh ?
He is very experienced and can help you. I'm sure he's had patients with various other kinds of  health issues besides hep C. many times before.

Go to the appointment, and be honest and straightforward. Write down things before hand.

That's all I can add other than to wish you good luck in going FORWARD !
Helpful - 0
Avatar universal
Wow, what an incredible post from you!  I mean  - whew!  I'm glad I did start this thread even though for a while there I thought "Well, duh, Dr. Gish or team will know."  But the information you gave me is SO helpful.  I am going to see a really good psychiatrist in early August   ~ who I used to see and I sure couldn't bluff him.  He had my number and would catch me fast when I'd start to play games.  Too bad he only has the one day a month for out-patients, but his wisdom will get me through - and fix anything that's broken.  Ha - I stopped seeing him when he told me he was going to taper me off and then STOP giving my Xanax scripts.  So of course I went to another dr. who would give it to me.  Doctor shopping for sure.

Today was the day that a light came on and I realized that I REALLY want to beat this dragon and make a commitment to do it no matter what.  But I also realized that my head meds just aren't right.  I should not have used the word "incompetent" - my bad.  I do think that a psychiatrist as opposed to a therapist, PAC is what I need.  THANK YOU TONS~!!!

I will read it over and over and over.

THANK YOU SO MUCH!
Helpful - 0
Avatar universal
I tend to see the glass half empty obviously.  I have waited SO long (3 months) for a definitive diagnosis from a doctor that I've driven myself up then off the wall - that could be where this junk today came from.  Wed. is the day.  I will tell docs. everything and they'll do what's best.
Helpful - 0
766573 tn?1365166466
Lamictal is basically a mood stabiliser. It works in conjunction with other meds off label to help treat depression but not necessarily solely to treat depression per se. I mistakenly walked around with a Bipolar dx for a while myself. Like you, at the time I may have presented in such a manner but that is not the case anymore. I responded well to the few anti-seizure meds I took all those years ago. However as I have changed there is no way I would respond to solely those meds anymore.

You do not sound as if you have bluffed your way into anything. I can tell from the beginning of your posts how much you have changed as you have learned. Every time you encounter an obstacle you put it out there and view it from every angle. You listen to many different perspectives and confirm or correct them or explain why a particular perspective would not be accurate or apply to you.

That could be what is happening here. To me, being cleared for treatment means your doctor thinks you can handle the psychological component of treatment. Nothing changes that. It seems like the difference might be that the meds you are currently taking may not be addressing what you are feeling.

The Pro is that if you stay on Lamictal you will have gotten a huge obstacle out of the way. As you know the titration period for Lamictal is lengthy given the potential for the rash (Stevens–Johnson syndrome, and/or DRESS). All that is out of the way.

Another Pro is that Lamictal is a great adjunct to other psychotropic drugs and the case could be is you made to re-evaluate your current medication regimen.  I say this because a Con for Lamictal is that it does zero by way of addressing anxiety.

There could simply be another dimension to your persona that is not apparent to your doctor. This does not make your doctor incompetent; rather it could just mean that your doctor does not see this aspect yet. I can't say whether it is anxiety or depression or what but it is obvious that you do not feel confident in your current medication regimen.

This does not mean you have to totally go back to the drawing board. It just means you need to express these things to your doctor. I realize it may take a little brain storming and creativity on your doctor's behalf given what you have shared about your history of benzos.  There are many meds that work in tandem with Lamictal (or besides the Lamictal).

There is still a way for all this to work. I think if meet with your doctor and address your current misgivings that together you will be able to come up with something that will work. If this is the case - and I say "if" because I could be off base. I mean the only one who knows for sure is you. But if it is the case then the way I see it if there is a delay then it could be  just the short time it takes you to become regulated on another med.

The other thing I am hearing is you are worried about how all this will work. It can be scary when we see what our relationship is like when the other person cannot function at 100%. The imbalance can become overwhelming. The sad fact is that while you treat there will be times you have to put yourself first. As a solid, steadfast person who is already carrying quite a load this may not be as easy as it sounds. Perhaps it conflicts with what you have conditioned yourself for and adjusted to with your husband's condition. I mean who knows. It could be a combination of many things.

It just sounds as if you could address these particular things and come up with a few alternatives then it would go a long way to easing your concerns. I won't lie, being on week 26/48 even when things are fine I can let myself feel incredibly overwhelmed. The frustration at not being able to function is unreal. Watching certain things fall be the way side really gets to me. Seeing how incredibly lonely my husband gets sometimes because I just do not feel like doing certain things sickens me with guilt.

I am not saying this will happen to you, what I am saying is that you want every tool available in your arsenal to be mentally prepared for these feelings. What I am hearing is that you do not quite feel it yet. You have a lot of internal strength and you will not go through this alone. I think if you can assess how you feel about some of the things I mentioned then there may not be a huge delay to start treatment.
Helpful - 0
Avatar universal
It's always best to be honest with your doctor.  They can't help if they don't have all of the information.  You may find they react differently than what you expect, and things may not be as bad as you think they are. That happens to me a lot.  Good luck to you, I hope you are able to start and finish treatment!
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Avatar universal
Oh - no I don't think all doctors are incompetent.  I think my therapist may be.  She is NOT a psychiatrist.

I shouldn't have posted this.  Let's just let it drop.  Dr. Gish will know what to do about it.  

EVERYONE ~ let this one drop away.  can-do is right - no one here can advise me on this.  I am seeing the best of the best as far as hepatologists.  
Helpful - 0
Avatar universal
You really just need to see Dr gish, let him know everything. As for all of your doctors being incompetent, well I don't know about that... Dr gish is one of the best, nobody here can advise you like he will be able to. Good luck.
Helpful - 0
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