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Author Topic: A Confession. Desperately need advice/help.  (Read 346 times)

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Offline anothereveryman

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A Confession. Desperately need advice/help.
« on: January 28, 2014, 02:39:15 AM »
Before I begin, let me say that I'm currently on disability. It has allowed me to escape a very difficult living arrangement due to having income of my own (I could fill paragraphs describing what a health and psychological hazard it was living there but I'll abstain), but that's where a lot of this present anxiety comes from: I feel in grave danger of losing it, and not because of my anxiety/depression attacks getting any better. In fact they're getting worse. I think it's time to explain.

I hated the side effects of my medications, and even with my anxiety present (punctuated with constant fights with friends and roommates, many of them my fault, erosion of ties with family, inability to focus or maintain concentration on even simple tasks like chores and especially organization difficulties), I hated the side effects worse than the small relief they seemed to give. So I tapered myself down, of course not telling my psychiatrist. I kept getting the prescriptions, but I gradually in the past stopped taking them.

During a very recent visit, when I mentioned a lot of my current symptoms (nothing new to her, just re-stating what haunts me), she asked if I had a blood lab done recently. She was taking out some forms. I mentioned, truthfully, that I had a blood lab done to screen for diabetes, kidney problems, and a few other things a few months before that. She said that is good and she'd like a copy of those lab results. I'll be heading to the doctor's office in a few weeks where those things were done, so getting the paperwork isn't the issue.

This is the issue, and the conceptual anxiety I have about it is making my hands tremble, making me cringe with guilt, setting me near a panic attack: That blood work wasn't looking for medications or density of medications, instead it was looking for health problems due to inheritance (it found nothing bad, which is good). She had what I thought was a Freudian slip when she asked me for the blood work results: "I want to know if you're taking - er - what your vitals are and need yearly blood work for your file."

At this point, I both probably need the medications that I've been reluctant to take, because of the escalating personal problems and functioning failures I've had for a while now, gradually getting worse. So getting on it is not as much the issue. My question is: Would health/vitals blood work also indicate my history of shying away from medication?

Am I at risk of losing my disability benefits in an upcoming review (perhaps in a half year or a little more)? Please believe me when I say I'm aware of what a mistake I've made, and I know I need to get back on those medications. I'm afraid of telling the psychiatrist about any of this due to fear of punishment, and I'm more vulnerable than I've been to before to the psychological stress that this situation is making for me.

I guess I don't even know where to begin when asking for help/advice. If anyone knows how this whole process works please tell me. I'd be willing to try new medications that would have less disturbing effects if I could request somehow a new psychiatrist, but that might not be in the cards and I don't even know how to begin the process.

Please go easy on me in your answer. I'm about on the verge to check into a mental hospital.
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Offline eva12

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Re: A Confession. Desperately need advice/help.
« Reply #1 on: January 28, 2014, 03:25:58 AM »
Hey there

Ok firstly you are not going to be punished for not taking meds.they are prescribed to you not ordered and If you choose not to take them that is up to you. You must, however, be honest with your doctor.he or she needs to know what meds work for you and currently it seems what you've been prescribed is working..as no one knows you've not been taking it. Explain why to the doc and it may be that something else can be prescribed or at the least the side effects discussed.

Also, when ordering blood tests, there are thousands of things that can be looked for.therefore you need to be very specific in what you're checking the blood for.so in other words the doctor will only be looking at that specific thing and not anything else such as levels of chemical in the blood

Hope that makes sense and eases you a little

Big hugs
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Offline insights

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Re: A Confession. Desperately need advice/help.
« Reply #2 on: January 28, 2014, 06:01:47 AM »
Would health/vitals blood work also indicate my history of shying away from medication?

Regular blood tests do not look for what meds you're on. It is unusual for doctors to test for med compliance, except maybe for benzodiazepines and prescribed narcotics if they suspect they are being sold. Or possibly if the med might cause physical harm if plasma levels became too high. In some 26 years of taking psych drugs, I've only been tested for a med once because my psychiatrist wanted to see how an antidepressant I was having issues with was being metabolized.

Quote
Am I at risk of losing my disability benefits in an upcoming review (perhaps in a half year or a little more)?

I have no idea what demands the U.S. government makes of benefits recipients, but I think it would be unlikely that they stipulate the treatment you must be on.

Quote
I'm afraid of telling the psychiatrist about any of this due to fear of punishment,

Your psychiatrist is not your master, just someone you pay, directly or indirectly, to give you advice. Whether you follow that advice is entirely your decision, not hers, as is what you put in your body.

But you should have been straight with her from the beginning that the meds weren't working well for you. She probably would have prescribed something else which might have worked. So I suggest you be honest with her the next time you see her and tell her everything that has happened. The worst she could do is suggest you see another doctor, but that is unlikely. You won't be the first of her patients to have stopped taking meds. Unfortunately, when it comes to psych meds, far more patients stop taking their meds within a few months than continue to take them because the side-effects can be so unpleasant, especially at the beginning.

Quote
If anyone knows how this whole process works please tell me. I'd be willing to try new medications that would have less disturbing effects if I could request somehow a new psychiatrist, but that might not be in the cards and I don't even know how to begin the process.

How did you find this psychiatrist? Were you referred by your family doctor?

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #3 on: January 28, 2014, 06:04:30 AM »
Hey there

Ok firstly you are not going to be punished for not taking meds.they are prescribed to you not ordered and If you choose not to take them that is up to you. You must, however, be honest with your doctor.he or she needs to know what meds work for you and currently it seems what you've been prescribed is working..as no one knows you've not been taking it. Explain why to the doc and it may be that something else can be prescribed or at the least the side effects discussed.

Also, when ordering blood tests, there are thousands of things that can be looked for.therefore you need to be very specific in what you're checking the blood for.so in other words the doctor will only be looking at that specific thing and not anything else such as levels of chemical in the blood

Hope that makes sense and eases you a little

Big hugs

Thank you for your response.

The blood test I already took that I intended to give her because I already had it done (and hate needles and labs and doctor's offices for that matter), was directly to look for organ problems in the kidneys, liver, and heart. It didn't have a medication/drug detection intention at all. I'm presuming from that if my psychiatrist wanted that additional information she'd have to request another blood drawing.

I am going to return to medication and start small, effective tomorrow probably. I will come clean with her next time I see her, this time with at least the sincerity of showing "check my blood, I tried again, I really don't like the stuff you put me on but I'm willing to try something else."

I am very tense and jittery, and you may have no idea how happy I was to see a reply here after waiting a while. I suppose I just need minds outside of my own to get some perspective. I'm terrified of losing my disability coverage and even going homeless which may be catastrophizing, since I don't abuse any substances, don't drink for that matter, and the only dishonest thing I've done is been noncompliant with medications (even though I bought them anyway). As I said I intend to be compliant soon, though I dread the return of the side effects.

Thank you again for replying!
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Offline anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #4 on: January 28, 2014, 06:06:27 AM »
Would health/vitals blood work also indicate my history of shying away from medication?

Regular blood tests do not look for what meds you're on. It is unusual for doctors to test for med compliance, except maybe for benzodiazepines and prescribed narcotics if they suspect they are being sold. Or possibly if the med might cause physical harm if plasma levels became too high. In some 26 years of taking psych drugs, I've only been tested for a med once because my psychiatrist wanted to see how an antidepressant I was having issues with was being metabolized.

Quote
Am I at risk of losing my disability benefits in an upcoming review (perhaps in a half year or a little more)?

I have no idea what demands the U.S. government makes of benefits recipients, but I think it would be unlikely that they stipulate the treatment you must be on.

Quote
I'm afraid of telling the psychiatrist about any of this due to fear of punishment,

Your psychiatrist is not your master, just someone you pay, directly or indirectly, to give you advice. Whether you follow that advice is entirely your decision, not hers, as is what you put in your body.

But you should have been straight with her from the beginning that the meds weren't working well for you. She probably would have prescribed something else which might have worked. So I suggest you be honest with her the next time you see her and tell her everything that has happened. The worst she could do is suggest you see another doctor, but that is unlikely. You won't be the first of her patients to have stopped taking meds. Unfortunately, when it comes to psych meds, far more patients stop taking their meds within a few months than continue to take them because the side-effects can be so unpleasant, especially at the beginning.

Quote
If anyone knows how this whole process works please tell me. I'd be willing to try new medications that would have less disturbing effects if I could request somehow a new psychiatrist, but that might not be in the cards and I don't even know how to begin the process.

How did you find this psychiatrist? Were you referred by your family doctor?

Ian

I don't have a family doctor, and unfortunately one of the medications I have been prescribed (and dread taking) is a benzo. I see how some might suspect that those not taking them are selling them or something. I don't. I just look at the bottle and get tense.

As I said the blood work I had done before that I need to get a copy of was for health screening, not drug compliance. I think I may have to be honest with the psych anyway, though I won't be seeing her for a number of months.
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Offline insights

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Re: A Confession. Desperately need advice/help.
« Reply #5 on: January 28, 2014, 06:21:33 AM »
unfortunately one of the medications I have been prescribed (and dread taking) is a benzo. ...I just look at the bottle and get tense.

Why? Have you had a bad reaction, or is there something about benzodiazepines that you don't like? Also, which one is it.

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #6 on: January 28, 2014, 01:28:17 PM »
unfortunately one of the medications I have been prescribed (and dread taking) is a benzo. ...I just look at the bottle and get tense.

Why? Have you had a bad reaction, or is there something about benzodiazepines that you don't like? Also, which one is it.

Ian

I don't like the backlash of anxiety that often kicks in when benzos wear out (during my hospitalizations this was apparently apparent with the short-acting ones like Xanax), am all-too-familiar with how dependency-causing and addicting they can become, and am afraid of my psych's "use short term solution indefinitely" approach.

My prescription is for clonezepam. I know it's one of the longer-acting ones.
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Offline insights

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Re: A Confession. Desperately need advice/help.
« Reply #7 on: January 28, 2014, 03:54:51 PM »
and am afraid of my psych's "use short term solution indefinitely" approach

Then tell her that and ask for an antidepressant. Unless she has a very good reason why they wouldn't be right for you, don't take no for an answer. Celexa (citalopram) would be a good first choice.

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #8 on: January 28, 2014, 04:00:39 PM »
and am afraid of my psych's "use short term solution indefinitely" approach

Then tell her that and ask for an antidepressant. Unless she has a very good reason why they wouldn't be right for you, don't take no for an answer. Celexa (citalopram) would be a good first choice.

Ian
I have a prescription for sertraline (generic Zoloft). I intend to take it before I see her again and give it a sincere chance to work, though last time I had chattering teeth I simply couldn't stop, especially when trying to sleep, peripheral tingling and even problems using the restroom.

If I have to suffer these things for a small chance of improvement someday and more importantly so I can retain the semblance of safety and security that Disability has provided me, I will. It can be an all-day act of will to get around to doing paperwork/filing anything/making appointments, let alone getting through errands.
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Offline insights

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Re: A Confession. Desperately need advice/help.
« Reply #9 on: January 28, 2014, 06:37:25 PM »
I have a prescription for sertraline (generic Zoloft). I intend to take it before I see her again and give it a sincere chance to work, though last time I had chattering teeth I simply couldn't stop, especially when trying to sleep, peripheral tingling and even problems using the restroom.

Unfortunately, SSRIs can produce a range of unpleasant side-effects in the first few weeks. I'm guessing your prescription is for 50mg tablets. If so, buy a pill-cutter at the pharmacy and only take half a tablet daily for the first week or two. If half tablets still trigger too many side-effects you could drop back to a quarter tablet and increase the dose by a quarter every week or so to the prescribed dose.

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #10 on: January 29, 2014, 03:12:29 AM »
I have a prescription for sertraline (generic Zoloft). I intend to take it before I see her again and give it a sincere chance to work, though last time I had chattering teeth I simply couldn't stop, especially when trying to sleep, peripheral tingling and even problems using the restroom.

Unfortunately, SSRIs can produce a range of unpleasant side-effects in the first few weeks. I'm guessing your prescription is for 50mg tablets. If so, buy a pill-cutter at the pharmacy and only take half a tablet daily for the first week or two. If half tablets still trigger too many side-effects you could drop back to a quarter tablet and increase the dose by a quarter every week or so to the prescribed dose.

Ian

This psychiatrist is pretty brutal. My prescription is for 200mg! I could attempt to quarter one of the two 100mg tablets I'm supposed to take, messy as that might be...

With that in mind I'll take your advice. Thank you for responding. Not sure what to do about the benzos, though. I may need to take them simply for compliance purposes.
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Offline insights

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Re: A Confession. Desperately need advice/help.
« Reply #11 on: January 29, 2014, 05:50:58 AM »
This psychiatrist is pretty brutal. My prescription is for 200mg! I could attempt to quarter one of the two 100mg tablets I'm supposed to take, messy as that might be...

I hope that you were started on a lower dose that this originally and gradually had the dose increased over time.

Quote
Not sure what to do about the benzos, though. I may need to take them simply for compliance purposes.

Again, you don't have to take anything you don't want to. You are the one in charge. However, I suggest you don't have the prescriptions filled if you're not taken the benzodiazepines lest someone starts wondering where they are going if you're not taking them.

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #12 on: January 29, 2014, 06:27:29 AM »
This psychiatrist is pretty brutal. My prescription is for 200mg! I could attempt to quarter one of the two 100mg tablets I'm supposed to take, messy as that might be...

I hope that you were started on a lower dose that this originally and gradually had the dose increased over time.

Quote
Not sure what to do about the benzos, though. I may need to take them simply for compliance purposes.

Again, you don't have to take anything you don't want to. You are the one in charge. However, I suggest you don't have the prescriptions filled if you're not taken the benzodiazepines lest someone starts wondering where they are going if you're not taking them.

Ian

I do have to take them, so I hear, to stay on disability. I do have problems, very real ones, and even if I feel the meds havent helped in the past, I heard noncompliance could disqualify me.
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Re: A Confession. Desperately need advice/help.
« Reply #13 on: January 29, 2014, 07:11:12 AM »
I do have to take them, so I hear, to stay on disability. I do have problems, very real ones, and even if I feel the meds havent helped in the past, I heard noncompliance could disqualify me.

I'm not an American so have no understanding of the laws that may apply, however, I would be surprised if the government dictated a person's medical treatment.

Hopefully, someone with an understanding of how the disability system works will be able to shed some light on this.

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 anothereveryman

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Re: A Confession. Desperately need advice/help.
« Reply #14 on: January 29, 2014, 08:10:50 PM »
I do have to take them, so I hear, to stay on disability. I do have problems, very real ones, and even if I feel the meds havent helped in the past, I heard noncompliance could disqualify me.

I'm not an American so have no understanding of the laws that may apply, however, I would be surprised if the government dictated a person's medical treatment.

Hopefully, someone with an understanding of how the disability system works will be able to shed some light on this.

Ian

I hope so too.

I'm going to see my therapist tomorrow, and because she's part of the same service that my psychiatrist belongs to, she might know more about this. I'll come clean with her, and almost certainly re-start my medication regimen then. I'm very deeply afraid of losing my coverage that I'm willing to endure a lot.
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