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Offline brendab1223

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First psychiatrist appointment this coming Tuesday
« on: November 29, 2013, 06:11:51 PM »
Hi everyone. I'm new to this forum. Did a search for my question because I know it's extremely annoying for people to ask the same question over and over lol. Anyway, I'm not only new to the forum but new to anxiety. I guess I have been anxious for most of my life but for the past year or so it has gotten so bad that my work performance has suffered, I get constant panic attacks over irrational things that make absolutely no sense and the irrational thoughts wouldn't stop so I couldn't sleep. I went to see my primary care doctor and he stated I have anxiety and gave me a two week supply of Valium 5mg to be taken twice a day. He did blood work to rule out anything else. I went back for a follow up and there was nothing wrong with my blood test results. The Valium had helped but it had only been two weeks and I still was feeling anxious and having trouble sleeping. He gave me a month's prescription of the same dosage and quantity and sent a referral to see a local psychiatrist. I have an appointment this coming Tuesday. Now that I've been on Valium for about a month, I can tell the difference. I sleep better, not perfect, but better, and I don't have irrational worries or thoughts. I haven't had a full fledged panic attack and my work performance has improved so much that my boss said "Can I have what you're having?" lol (jokingly of course).

Ok so my question is this. I just learned that a psychiatrist is not a therapist and they basically only prescribe medications. Since I didn't find this psychiatrist on my own and it was an official referral through my doctor, do you think I will continue to receive Valium being that is what my PCP recommends? But since PCP's are not psychiatrist is there a chance the psychiatrist will have me try something else? I'm scared of that but I know the psychiatrist knows best. I've never ever been on any medications in my 43 years in this world so I really don't know anything about this.

Also, I was told I'm supposed to bring the bottle of Valium on the day of my appointment which has me a little freaked out. You see, the bottle says the date it was filled which was 11/4/13 Diazepam 5mg twice a day with a quantity of 60. I have forgotten to take it a couple of times being that I'm a mom of four and sometimes I'm running around in the morning getting kids off to school then have to rush to work. I then started obsessing about counting the days and the pills and now I do this every morning. According to my calculations, the day of the appointment is day 30 and I should have one pill left in the bottle after taking one that morning (my appointment is at 2pm) but there will be three pills in the bottle that day. I know this sounds stupid but will I get in trouble for forgetting to take the pill a couple of times? Will he think I don't need the medication because there are more pills than there should be in the bottle? Not taking it was an honest mistake and it was in the beginning (like I said, this is my first time taking medication ever). I'd say that happened maybe the first week. After that I keep the bottle in my purse and have taken it every day twice a day as prescribed. I'm so scared. I'm going to be honest and apologize for forgetting but don't want him to think my anxiety just happens once in a while. It had been every single day, thankfully much less often now.

Thank you all in advance for your input and sorry if this question has been asked before and I just didn't see it and also sorry if this sounds like a completely ridiculous question  :happy0151:
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Offline Abraham2007

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Re: First psychiatrist appointment this coming Tuesday
« Reply #1 on: November 29, 2013, 10:09:46 PM »
Sounds like you have a good GP who knows his limits with treating mental health, and directed you to a decent psych doctor who has a better understanding of anxiety disorders.

Although you have an obsessive compulsion to worry about what seems like small things - psych doctor dates, fears he may not think you really have an anxiety disorder, etc. - I wouldn't try to fight the obsessive worrying and fix it on my own.  Instead my focus would be on your psych doctor visit, Tuesday.

More than likely your psych doctor will presribe you a SSRI in addition to a refill prescription on Valium.  After you stabilized on the SSRI, which may take two to three months, a lot of your obsessive worrying will be under control. 

Later your boss will probably ask again, "Can I have what you're having?"  :laugh3:
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Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #2 on: November 29, 2013, 11:04:04 PM »
Thank you Abraham2007. I don't know what SSRI is but I'll google it or look it up on here. I've never had any obsessive compulsive issues that I know of. Or maybe I'm in complete denial. This is all so new to me. I've always thought I was just an overprotective mom and maybe a bit of a perfectionist when it comes to my job. But yes I have found myself counting pills every day and counting the days, obsessing over the pills I have left and what I'm supposed to have on my appointment. I'm just going to keep on keeping on and if my PCP directed me to a good psychiatrist then he will know what's best for me. I appreciate your comment very much. LOL at my boss' comment. It was pretty funny  ;D
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Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #3 on: November 29, 2013, 11:24:42 PM »
So I goggled SSRI's and they seem to be anti depressants. I'm not depressed. I have a pretty good life. I have great kids (well, sometimes), a job, a home, a car, friends and family. I don't feel hopeless nor do I feel like my life is horrible. This is why I was wondering why on earth am I having these anxiety attacks. People have it worse than me and they seem to be fine and dandy. So I was at a loss as to why am I so anxious about everything without any reason. I guess both meds combined will help. I will know on Tuesday if I don't get chewed out for not taking my Valium as prescribed. And you know what, this is a tough condition to deal with. I have heard about it in the past and never understood the effects until now. How horrible it is to feel anxiety all the time, warranted or not. Hopefully I'm on my way to get this all straightened out. I will post how my psychiatrist appointment went.
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Offline e77

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Re: First psychiatrist appointment this coming Tuesday
« Reply #4 on: November 29, 2013, 11:33:48 PM »
Not a problem.  Many take medications like valium only as needed to relieve anxiety.  Its not like taking an antibiotic for an infection so I don't think the doc will get on your case for it.  Good luck with the appointment
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Offline insights

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Re: First psychiatrist appointment this coming Tuesday
« Reply #5 on: November 30, 2013, 12:05:33 AM »
But since PCP's are not psychiatrist is there a chance the psychiatrist will have me try something else? I'm scared of that but I know the psychiatrist knows best.

Welcome to AnxietyZone, Brenda.

Many doctors and psychiatrists are reluctant to prescribe benzodiazepine drugs like Valium because of the perceived dependence issue, so the psychiatrist may want to switch you to an antidepressant. Antidepressants can be very effective anti anxiety meds, however, they may worsen anxiety initially, so hopefully you will be allowed to continue taking Valium until the antidepressant begins working which can take 3-12 weeks.

Quote
I know this sounds stupid but will I get in trouble for forgetting to take the pill a couple of times?

No, it would have been of far greater concern if you'd had far fewer tablets remaining than you should have. Valium has a very long half-life, up to 200 hours, so missing the odd daily dose usually makes little if any difference.

Quote
I've always thought I was just an overprotective mom and maybe a bit of a perfectionist when it comes to my job.

Which makes you a prime candidate for an anxiety disorder, unfortunately. This may be something you should work on.

Quote
This is why I was wondering why on earth am I having these anxiety attacks.

This is the question that haunts most of us. While anxiety disorders (and depression) most often begin within a year or so of a significant life event such as a bereavement, relationship break-up, job loss, moving house, serious illness or injury, etc, often there is no discernible cause. It may just come down to genetic susceptibility (which can be more than DNA, Google: epigenetics) and the slow drip of normal day to day stress gradually destroying brain cells (see: Depression, antidepressants, and the shrinking hippocampus - this applies equally to anxiety which shares the same biology).

BTW-knowing what caused an anxiety disorder doesn't necessarily improve recovery. Many with PTSD, for example, know exactly what triggered it, often in great detail, but this doesn't help, just the opposite in fact. The cause is mostly irrelevant, it is how you react to it which counts. The cognitive and/or behavioural and/or mindfulness therapies can teach you how to reframe anxiety. They can be very effective, though they do require time and effort to get the best outcomes. You may also learn how to ease up on the perfectionism which while an admirable trait can sometimes become emotionally destructive.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #6 on: November 30, 2013, 03:25:58 PM »
Thank you so much for your replies. Very very helpful. I counted the pills only once today which is better than 3-4 times a day. And yes Ian, I am quite the perfectionist at work. I want to do the best that I can do because my job has a lot of liability. With the anxiety and panic attacks I cannot be 100% sure that I will perform my job appropriately. With that being said I have decided to accept another position with less liability. It is a slight pay cut and now I'm anxious about being able to financially continue to provide for my children. I mean the pay cut is really slight (roughly $50 a week less a check) but I find myself worrying constantly about that. I just accepted the position this past Wednesday. Oh and another thing. Now that I will start a new job in three weeks, I will lose my health insurance for three months until the new one kicks in. If I'm put on medications I be able to fill them for the month but after that I'm royally screwed. And I cannot afford Cobra. Ugh, I'm telling ya it's never ending. I leave my job which is possibly a part of my anxiety disorder in order to get better but now other things come up which causes more anxiety. I just want this to be over already.
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Offline insights

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Re: First psychiatrist appointment this coming Tuesday
« Reply #7 on: November 30, 2013, 04:27:10 PM »
I just want this to be over already.

Unfortunately, there are no quick fixes, especially when there is an element of OCD as it can be the hardest of the anxiety disorders to treat. But they are treatable and it is possible to get your life back.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #8 on: November 30, 2013, 04:45:57 PM »
I'm hoping Ian. I'm so new to all this but trusting my new psychiatrist will know how to treat this. I was nervous about my appointment but Tuesday can't come fast enough! Instead of having the case of the Mondays I'm actually looking forward to it so I can begin being treated for this the day after. I'm trying to stay positive and will follow the psychiatrist's instructions. I've also been looking into some relaxation techniques that I will ask the psych about to see if it will help. Thank you very much again. I don't feel alone anymore.
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Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #9 on: December 03, 2013, 05:57:01 PM »
Ok so I went to my first psych appt. Of course I cried a lot while describing what I was going through. He says I have Generalized Anxiety Disorder and panic attacks. He told me to stop taking the Valium and gave me Klonopin .5 mg 3x per day and also gave me Paxil 20 mg to take every morning. He wants to see me in four weeks to see how that's working. Now off to search the forums for info on GAD and these new medications.
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Offline Abraham2007

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Re: First psychiatrist appointment this coming Tuesday
« Reply #10 on: December 03, 2013, 06:25:52 PM »
Ok so I went to my first psych appt. Of course I cried a lot while describing what I was going through. He says I have Generalized Anxiety Disorder and panic attacks. He told me to stop taking the Valium and gave me Klonopin .5 mg 3x per day and also gave me Paxil 20 mg to take every morning. He wants to see me in four weeks to see how that's working. Now off to search the forums for info on GAD and these new medications.

Hi Brendab,

Don't feel insecure for having cried in front of your psychiatrist.  Psychiatrists work in the field of mental health, and believe me, these people have heard it ALL.   Nothing discussed should be off limits, because it is the psychiatrist's job to not judge you for your mental health condition, but to help you manage it.  I tell my psychiatrist everything, without the nagging fear he might think differently of me. We pay our psychiatrist to not judge our character, but to only review our bodily symptoms, and prescribe our necessary psychotropic medications.

20mg is the starting dose for Paxil, however, if you experience heightened anxiety, you may want to call your psychiatrist about starting a little bit lower on the dose range. However, since you're also taking the Klonopin for reducing your anxiety, this may not be necessary.

Only time will tell if your body and your brain are a match for Paxil (Paroxetine).  If you experience uncomfortable side effects - and you may experience more anxiety in the first few weeks, which will die down, so know that is normal - but if the side effects get too much, know your doctor can always switch you to another SSRI.

The best you can do now is to allow yourself to feel comfortable taking antidepressants. 

Taking them does not devalue your Spirit in how you handle stressful situations.  Neither does it mean you are chemically dependent on a pill to make you feel better.  Know you are a human being who has developed an actual health condition, where your brain does not produce enough neurons to handle psychological stress, and the medication helps your brain to produce these neurons on its own.

Like all anxiety disorder sufferers, you have a neurological problem that needs medical intervention.  It would be a shame to not take advantage of today's medical science to help you manage it.

 


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Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #11 on: December 04, 2013, 01:56:18 PM »
Well I took one Klonopin last night and it knocked me out. I felt so foggy this morning that I didn't take it because I started the Paxil and it also can cause drowsiness. My job requires me to be alert to the max so I really can't be sleepy all day. I had some Valium left so I took one this morning and I'm "ok". There is no way I can take Klonopin 3x a day like the doctor prescribed. I'd be asleep all day! Valium works better for me but he wanted me off it so I don't know. Guess give it some time and see if it helps.
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Offline Abraham2007

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Re: First psychiatrist appointment this coming Tuesday
« Reply #12 on: December 04, 2013, 03:53:45 PM »
Paxil (Paroxetine) is deemed the most sedating SSRI (Selective Serotonin Reuptake Inhibitor).   

On the opposite end of the SSRI spectrum, Prozac(Fluoxetine)/ Effexor(Venlafaxine) are deemed the most stimulating.  (Effexor is generally considered a SSRI until the user exceeds over 150mg.) In the middle for SSRI tolerance comparison are Citalopram (Celexa) and Lexapro (Escitalopram).

I would call your psychiatrist, as soon as possible, about your side effects.

1) Mention you were more alert on Valium (Diazepam), versus your current use of Klonopin (Clonazepam).

2) Mention the possibility of halving the pill, or taking a dose at 10mg versus 20mg, possibly before bed, as a way for your body to better adapt to the medication, and gradually move your way back up.

3) Mention if the sedation becomes too hazardous, there is the possibility of switching to another SSRI.

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Offline brendab1223

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Re: First psychiatrist appointment this coming Tuesday
« Reply #13 on: December 04, 2013, 04:17:33 PM »
Thank you Abraham. One good thing is I didn't feel anxious at all today. I'm going to take the Klonopin in a little while and see how I feel in the morning. If I feel the same as today I will call the doctor about the side effects. I can't see how anyone functions taking Klonopin 3x a day. Well I guess everyone is different. And even taking the Valium one time today still didn't quite take away the foggy feeling. I took Paxil for the first time this morning so it was definitely the Klonopin that gave me that feeling. We shall see. Thanks so much for your continued help and sorry for all the noob questions.
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Offline Abraham2007

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Re: First psychiatrist appointment this coming Tuesday
« Reply #14 on: December 04, 2013, 04:26:26 PM »
Hey Brendab1223 ,

Don't ever feel sorry for asking questions about your anxiety disorder.  The people who post here can all share their own personal horror stories on how their anxiety disorder has crippled them at some point in their life.  Knowing we can change that makes living life worthwhile.

For all of us, education and asking questions about this medical disorder is the key for a better life. :)

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