1st post...this might get lengthy

[mamatoady]

I was sexually abused when I was 4. I have had PTSD for as long as I can remember. It was the not talked about thing growing up and I finally broke my silence when I was 19 and in college. I had severe problems with coping -- I cut, had lots of unsafe sex, did drugs etc. My therapy didn't make me better. I quit therapy and found a new therapist. We used EMDR and it truly saved my life. I was in therapy for that and dealing with life for about 8 years. Then I had to move, but I was feeling closure on my memories and even forgave the person who hurt me. So I didn't have access to my therapist--my lifelink anymore (Although we emailed ocasionally).

Then a few months ago stuff started coming up really bad and I tried to find an in-town therapist and it was a horrible experience. I called my old therapist and now I drive 2 hours once a month and work with him.

Here's where my problems lie. I am realizing and connecting the dots more than ever. I can see now what my triggers are and what happens to me. I have learned to be able to USUALLY tell when I'm having a dissociative reaction to the triggers. It's getting to be a lot again. I've been really close to risky behavior, way too close for comfort. I'm in my bad blace. I'm trying to get off my zoloft because I'm having horrible memory problems and I have fears that the zoloft caused it (although no one believes me) I'm actually getting an EEG done because I will sometimes forget where I am and what I'm doing...my therapist believes it's flashback/dissociation related and I have no reason to disbelieve or discredit that.

My depression is getting worse because my doctor doesn't know how to handle my meds. I don't know who else to ask. I get suicidal thoughts and I'm just done. I know everyone with PTSD gets that way and just wants it all over with...I've been feeling that more so lately. I just want to be better. I want it all to go away.

-Sarah

 

[GDPR]

Hi Sarah.Welcome to Psychlinks.

 

[rdw]

Welcome to Psychlinks Sarah! . It sounds like you have a great relationship with your therapist.

 

[MHealthJo]

Sorry to hear such difficult things to deal with.

Glad that you have a therapist you are comfortable working with though.

With regard to the ins and outs of medication, have you considered the possibility of seeing a psychiatrist to help you with that? I am not sure how good each type of professional is with medication; that probably varies from place to place. But at some point I decided to see a psychiatrist for the meds side of things - a bit more of a 'medication pro' maybe. I found it helpful...

 

[Retired]

My depression is getting worse because my doctor doesn't know how to handle my meds

This situation may require that you proactively advocate on your own behalf.

Most doctors have sufficient understanding of psychotropic medications (such as those used to treat mood and personality disorders) however, depending on the doctor's specialty and clinical experience, you may reach a point where that particular doctor's treatment armamentarium is exhausted while your symptoms persist.

The logical and ethical next step would be for your doctor to provide you with a referral to a specialist colleague with the necessary clinical experience to treat your symptoms.

Depressive symptoms are treatable, but require specialized protocols of trial and error of available relevant compounds, while modifying dose and compound choice in a rational manner to adapt to your particular medical history and symptoms.

You need to ask your doctor to provide you with a referral to a specialist, most likely a psychiatrist or other local specialist in psychiatric disorders.

 

[mamatoady]

Hi, thanks Steve,
My doctor is out for a while because his wife is having a baby and the other doctor has switched me to Cymbalta. I know nothing about it, but am picking it up tomorrow. I've been on Zoloft for 7 years, so I've got the night to do a little research. I'm supposed to follow up with MY doctor in 3 weeks.

 

[texasgirl]

Welcome to psychlinks . This is a warm and loving community. I hope you are able to move into a better place and agree that maybe a psychiatrist would be a good adjunct to your therapist to evaluate if medication would help to assist in your growing process. Much luck to you.

TG

 

[Retired]

It sounds to me like your current doctor, who took the initiative to prescribe Cymbalta, a dual action SNRI in the hopes of relieving your symptoms of depression that, by your own admission do not appear to be controlled by the Zoloft you have been taking for the last seven years, has demonstrated some initiative to try to help you.

On what do you base your opinion your doctor doesn't know how to manage your medications, Sarah?

 

[mamatoady]

There are two doctors, MY doctor who is currently on leave and the doctor and the other doctor who over the phone perscribed Cymbalta. MY doctor has never said anything about alternative medicines to zoloft and has pretty much allowed me to determine how much I take and when and how I wean off of it. We finally together started weaning me off zoloft because I told him I couldn't think (it was REALLY BAD) and I had heard that zoloft can cause memory and cognition problems. So weaning off was my idea. I thought I'd be good to wean off, but my depression/anger got horrible so I called to see what he wanted to do and he wasn't there so they sent my info to a different doctor and he perscribed Cymbalta.

THe reason I said he can't handle my meds is because I have gone in with issues about it in the past and he never seemed to know anything different to do and didn't offer up alternatives. Even at my last appointment with him I asked what I'd do if I still needed to be on something and while he agreed that we needed to figure out something, left it up in the air.

With that said--he's great in every other way. I'm not meaning to trash him.

 

[Retired]

If I understand correctly, the substitute doctor who has access to your medical history, prescribed Cymbalta because you reported your symptoms were not being relieved with your current prescription.

If that's the case, considering it's a substitute physician, who has your medical history, it sounds like a rational approach.

My concern about your situation involves your comments:

MY doctor has never said anything about alternative medicines to zoloft and has pretty much allowed me to determine how much I take and when and how I wean off of it. We finally together started weaning me off zoloft because I told him I couldn't think (it was REALLY BAD) and I had heard that zoloft can cause memory and cognition problems. So weaning off was my idea.

Are you a trained medical professional, Sarah?

Physicians who do have training do not treat themselves, nor their own families, because they cannot be objective about their own circumstances.

Even though I strongly believe each of us should be in a partnership with our doctors for our own health care, by being informed, I also believe we need to rely on the expertise and clinical judgement of the physician we consult.

We can collect information about our condition and medications, but the sources of information must be reliable, scientifically based and credible. The internet is filled with self serving malicious sites whose only goal is to denigrate every treatment and medical intervention that's available.

Even if you are a trained and qualified medical professional, Sarah, you do yourself a disservice by making unilateral judgements and decisions about how and when to take your prescribed medications.

If your doctor is allowing you to make your own therapeutic decisions, I would respectfully submit your doctor is doing you a disservice and not providing you with the quality of care you deserve.

My advice would be to find another doctor who can advise you of your options, and work with you to develop a strategy to control your symptoms, so you can regain control of your life and enjoy the quality of life you deserve.