update- went to 1st pdoc appt.
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| Wed, 02-28-2007 - 5:55pm |
Well, I went. I was diagnosed as Bipolar II with rapid cycling, generalized anxiety, panick disorder, agoraphobia, and social anxiety.
He wanted to put me on meds and tranquilizers, but I wigged out and started crying. Its the 'wanting to have a baby' thing. He said I would have to use contraception and NOT get pregnant.
He said that in his opinion I need to 'get stable' before TTC. I said I thought I was stable because I'm not trying to kill myself and I'm not having the unwanted and overwhelming suicidal thoughts anymore...and I'm alive, so.. but apparently that is not what it is to be 'stable'.
So I was told to go home, talk to my husband about the TTC thing, and decide if I want to go ahead and try now or wait. If we try now, I need to actively TTC and see the OBGYN about what medication I can take while TTC and pregnant because I have to start taking medications. If I decide to use contraceptions and postpone TTC, then I'll get meds when I go to my next appointment in 5 weeks w/ the Pdoc. He also wants me to start therapy but I don't want to pay the $$ for it.
We're thinking of putting it off. *cry* I KNOW it would be best to wait until I have a JOB and meds. I just have been avoiding taking more medications (besides my Lexapro) for SO LONG because I wanted to TTC.
I dont know. I guess we will talk about it. I just have such a hard time making decisions. I want to have a baby, it breaks my heart having to postpone AGAIN. We keep putting it off year after year for different reasons. Then even though we arent using contraceptions, I still have been sabatoging it by avoiding intimacy especially around the time of ovulation.
Anyways, I need to 'get stable' and I NEED to get an income. Maybe getting stable will lead to my getting a job.
I just got a letter from the state offering me an interview. Perhaps I could take that job, switch to night classes to finish up the program I'm doing for the medical transcription job where I can work from home, start the medications, and then in a few months TTC! I dont' see it happening, but I wish.

Wow...that's a lot of dx out of one appointment. Did you go in with a dx or set of dx's that he was just confirming? I'm curious because it took me a year to get a dx other than "yeah, you're medically depressed right now." I have one friend that got a bipolar dx in a week, but that week was inpatient after a manic crisis.
And please, please, please reconsider going into ttc without a better understanding of what's going on with you and what works for you. I've seen posts from lots of women who had one or more pregnancies without being diagnosed and treated with whatever mental illness they deal with. I'm one. It's less than fun and pregnancy is hard enough.
((((Hugs)))) Do you mind if I ask how old you are? I'm just curious because you seem to have a lot of anxiety about the whole biological clock thing. I always had a rule and made it clear to DH...I will not be pregnant at 40 or over. I seemed like a great cut-off date and a realistic one too. As it turns out I won't be pregnant past 38 because I'm getting my tubes tied as soon as possible after delivery.
I'm trying not to ramble today...Sorry if I have.
I'm 31. I'll be 32 in August. I have always been very adamant that I will NOT be pregnant, or give birth, past my 35th birthday. I have all my logic for it such as the exponential increase in risks in pregnancy and risk of birth defects, then also that I just don't want to be 60 years old when my kid graduates highschool. I don't want to be 50 when my kid is a teen/preteen. Granted I do see the benefit of older parents (imho older parents are WAY better than younger parents because they are more financially stable, emotionally stable, and grown up) BUT I want to have grandkids. I want to be a great-grand-mother, like my Greatgrandmother who is still with us.
I guess I feel like I've already expired because my family has a history of young birthin'. My greatgrandmother was barely 15 when my granny was born, granny was in her early 20s when mother was born, and mother was barely 18 when I was born. So I'm almost as old as my grandmother was when I was born! I AM glad that I waited until it was right- the right man, in a position to have a house already, and stuff. I just don't want to keep putting it off year after year and wake up one day at 45 with no baby of my own. My mother was already kid free by the time she was 45. Well, the little stinkers (much younger half-siblings) are still living with her, but they're 18.
If you've made it this far, I'll go into the Dx'ing part hehe.
I had been diagnosed a number of times previously with anxiety and depression, I was diagnosed with anxiety way back in 1995, but ignored it as 'stupid'. I was diagnosed with depression in the late 90s, then new dr same dx, then newest dr wanted to 'evaluate me' and said BP not depression (depression lasting over 10yrs with bouts of highs w/ irritability). He referred me to the Pdoc where I filled out a book of questions and answered a bunch of questions. He seems like a good Pdoc, and like he knows his stuff, but he sort of talked to me like I was incompetent. Meaning he worded his questions in very basic layman terms. I can't think of an example, but it made me snicker because it was how I would address or question my stepdaughter (age 7) if I had to ask her those sort of questions. I wanted to say uh, I'm not here to be tested for mental retardation... I DO have a college education... but I let him do his thing.
Funny thing though, he got bothered when I cried. hehe. I didn't BAWL or SOB or anything excessive either! you know when something is real important to you and you loose it or can't have it and the tears weasle their way out of your eyeballs no matter how hard you try to NOT cry? Thats how it was, they plopped out. I stayed composed though, used a tissue and excused myself and remained calm. The Pdoc however, well, he sort of looked befuddled and annoyed actually. He also seemed annoyed, or put out, that I did not want to blindly accept his pills too. He told me that an unstable mother has higher rates of miscarriage because of the depression and anxiety!!! I thought of all the nerve! I mean, I miscarried Feb 2006, so 1 year ago exactly! (it was feb 14 2006, the appointment was feb 28, 2007). I thought how rude! But I didn't say anything. He pushed for me to take these meds that are totally bad for pregnancy and heavy hitters. Even if I never get pregnant I don't know if I'd want to take those things. I'd rather start out on the stuff they would put me on if I were pregnant than jumping right into the big-baddie pills.
He asked about drugs and alcohol, so I was honest and told him about my past where I drank alot and smoked marijuana from 1992 through 1999, but that since then I have not touched any drugs and I have not drank more than *maybe* one to two strawberry daiquiris in any given 12 month period. -- you know that Pdoc 'counseled' me against drinking and doing drugs??? Said he wanted me to 'promise' not to do drugs.!? WTF. I had just told him that I stopped everything when I graduated college, and have not had any drugs or alcohol (beyond a little daiquiri maybe once a year) since 1999! Thats 8 years thank you..oh look at me I'm an addict huh. I was a college kid that drank and smoked dope with 10 other college kid friends.
Then he asked if I was a christian. I said, well... I guess so... and he was put out by that too and said ' you GUESS? Do you believe Jesus died on the cross to forgive your sins?" so I was like "uh..yeah".. and that Pdoc said "amen". WTF to that too! I mean, heck I dunno, I was raised christian-ish but not as a church goer, just the general yeah sure okay thing, I'm not into the church-raving amen'ing have you saved your soul today sort of thing.
Mr Pdoc talked funny too. He talked like Mr Rogers. NO KIDDING. He talked JUST LIKE MR ROGERS on Mr Rogers neighborhood. It was wierd. He didn't want me to ask for clarification, just answer. I really started feeling...uncomfortable. So I was fidgetting and holding the clipboard in front of my chest with my arms around it ( body language saying 'I'm uncomfortable', and then I said you know I'm feeling a bit uncomfortable, sort of like I don't know you and you're asking alot of personal questions'. He said in his Mr Rogers voice "you are feeling vulnerable" like I was going to be amazed and come to some great awareness 'oooh vulnerable yeaaah thats it!'.. uh no.. I knew I was feeling vulnerable thats why I TOLD YOU MR ROGERS.
When I first went back to his office he said 'would you kindly follow me please' then 'would you kindly take a seat in the chair' then 'would you kindly tell me xyz'. I got a snicker out of that too.
The only reason I did not argue with him about the Dx is because I already knew them. I had just avoided getting diagnosed up until now. It was funny though, the way he talked and tried so hard to explain in his Mr Rogers voice different examples of 'do you feel this way some times?'. It seemed to annoy him when I would ask for clarification, or say well... I don't today... but I have some times in the past... or this was great, he said he wanted my husband to come to the next appointment so he can explain Bipolar and anxiety to him because he will need to watch me. *snicker* *cough* *cackle* Like I am a mentally retarded child or something. I guess it was just the way he talked AT me that brought that to mind.
Finally he got to the work part of the social history and I told him that I had been a social worker for 7 years, had a bachelors in sociology/criminology and a masters almost finished in psychotherapy. I didn't finish the last year of the graduate degree but that doesn't totally negate all that I learned while I was in the program. I am fully aware of the entire DSM-IV, coding, peer reviewed journal articles concerning bipolar disorder and medications..
Oh this was fun too.. Pdoc (Mr Rogers) one upped me when I said I was concerned about the medications and he mentioned 'there have been studies done that indicate infants born with cleftpalates' and such. yeah.. I actually READ that study thanks. I'm not saying that I'm all that and a bag of chips, nor am I saying that I'm smarter than him. He seems to be very competent and much more educated than I as he is a psychiatrist and all. But I am an educated person, and a grown up to boot. lol
I think the reason it sort of irked me was how his facial expression turned when I said we've been not using contraceptives because we want to TTC. It was sort of a look of disapproval, and the things he said were very discouraging towards my TTC because I am SO unstable that I may not be able to carry to term. YES he SAID THAT. In fact, that was sad right about the time I started to cry, because it made me think of my miscarriage and made me wonder if that was the reason I lost my baby. Even when he said for me to go see my OBGYN and discuss the situation with my husband, he appeared annoyed. He said he 'just couldn't prescribe the medications you need if you don't agree to use contraceptions to prevent pregnancy because the risk is too great'. My response was 'great!'(cause I won't take em if they're not safe so...)
I am not going to feel bad about it either. It is my body, my mental health, my family-planning. I am unable to blindly swallow pills just because someone tells me too, no matter how many doctorates they have or how much experience they have. - The Pdoc is probably right about the meds he wanted to put me on, he is definitely right that I do need to start some meds and get more stable, BUT I have to be comfortable and feel informed before I just start popping pills.
I think I am going to have to print out stuff about the different meds that I know I am going to refuse to take. He's already said "don't trust everything you see on the internet". I guess he thought I was reading random peoples blogs for information on medication and bipolar or something instead of peer-reviewed journal articles from the psychology community on studies. I guess thats a reasonable assumption.
Its a beautiful day in the neighborhood, would you, could you, won't you beee my neighbor!
needed to add:
we made the decisions.
1. I'm going to stay with the school program and finish so I can try out the working from home thing.
2. I'm going to the OBGYN to discuss medication options that are safe for TTC.
3. I'm going to post pone TTC for a few months in order to try out the medication(s) and try to stabilize my mood and anxiety issues.
I would much rather start with the 'safer' meds now and stay on them throughout a future pregnancy than start out now with Big drugs, have to ween off of them and switch to 'safer' medications in order to eventually start TTC.
I'm thinking I want to try Zoloft. Anyone have any experience with it, or with it and being pregnant? I've done some research and it is indicated (and FDA approved) for anxiety, panic disorder, and for bipolar depression. There was some discrepancy as to whether it is category B or category C. I'm thinking if I can switch off the Lexapro on to Zoloft things would greatly improve because Lexapro is indicated for only depression, not BP depression and not anxiety to the same degree.
My thinking is .. why take the 'biggies' meds if I can do well with something safer? Even if I never TTC. I mean, Mr Pdoc is going to have a heck of a time trying to get me to actually take Risperdol, Depakote, Lithium, or Haldol (and actually swallow the pills). I know they are great for some people but I do not feel that I am in a place where I need to go that direction just yet. If I regress to where I was a couple years ago with the unwanted suicidal thoughts and other paranoias, then I will gladly start taking the stronger stuff with no qualms.
Until then, I want to start off at the very minimum and work the dosage up to the therapeutic level rather than start off at the big meds on a big dose and have to work my way down to a therapeutic level that works for me. I mean, it makes complete sense and is logical to me.
I'm glad I read both these posts now.
First, I COMPLETELY understand the pdocs talking down to you and acting like you don't understand ANYTHING and that you just take everything on the internet at face value and don't look at who authored the article/study you are looking at....etc., etc. Had MAJOR disagreements with pdocs about DS's dx....ADD/ADHD, Oppositional Defiant, yada, yada, yada. Even now we have discussions about his meds with GP's and the pdocs.
As far as your meds....are you on any kind of mood stabilizer? I dis-remember if you posted all the meds you are currently on or not, but my experience with Zoloft (WITHOUT a mood stabilizer) was, it triggered rapid cycling as well as exagerating the magnitude of the swings....just a caution and something to think about when switching to Zoloft. Also, research Lamictal for a mood stabilizer. I am currently on it and it works well for me, but not sure of safety with TTC....there are allot of new drugs out now for mood stabilization that are based off seizure medication....again I don't know about safety with TTC as not a worry for our family anymore.
Good luck and don't let the doc's buffaloe ya....just last night DW had a doc prescribe something that would have zonked her out big time and we talked to the pharmacist and he recommende an OTC med that is doing a better job WITHOUT zonking her out....also had a pdoc prescribe a med for her that was EXPLICITELY contra-inicated (I think I used this word right) for a condition she had....GRRRRRRRR!!!!!!!!!!
tk
xyro
"I'm thinking I want to try Zoloft. Anyone have any experience with it, or with it and being pregnant?" I had a stillbirth(DD#1) in '97 (22 wks ges). After wards I desperatly wanted another child but was also depressed so I took Zoloft which btw I was on when DD#1 was concived but stopped as soon as I found out I was preg. I took Zoloft throughout the preg with DD#2. I was induced at 36 wks due to prior problems and she was born with an apgar of 9. I must point out a few things. #1 I have recently been dx'd BP but had been previously dx'd severe depression. #2 I took Zoloft for about 6yrs off and on. I had to go up a dose everytime I went off of it and went back to get the same results. #3 DD#2 is epileptic and developmentally delayed. We don't know what caused these problems and may never have an answer. I don't think it was the Zoloft just a quirk of nature as DD#1 had tested as being Downs at 12 wks ges. The Zoloft was enough to keep me relativly sane during second preg which btw was 3 months after the stillbirth. She was actually due on the anniversary of DD#1's birth, another reason for early induction.
Another thing about Zoloft is I have heard cases of rapid cycling if you aren't also on a mood stabalizer.
Depakote can be a good medication. DS (16) also BP has been taking it since he was 8 when he was diagnosed. He also had been on Zoloft prior to that due to what we thought was depression after loosing DD#1. He did not do well on Zoloft and only stayed on it for a few months.
Both DH and I take Lamictal. Yes, both of us are BP as well. I don't know about Lamictal during preg however.
Hope this was some help. And as always everyone is different and what works for one will not neccisarily work for another.
Brenda a.k.a. MC
I hope you don't mind but I LMAO at your description of your pdoc. Mr. Rogers and I wouldn't get along really well and he'd probably dx me with some kind of anger/aggression thing after the first hour. It's one of the reasons I keep my pdoc even though he often annoys me...I can tell him he's annoying me and he'll say "so...get the hell out of my office then". I like that in a person for some reason.
I've noticed that doctors in the psych field seem to be the least likely to deal with one as a sane, rational, intelligent adult. I find it difficult to believe that with all their years of schooling they never ran across anyone who could tell them that some of their patients would not be cognitively challenged, despite chemical imbalances. I mean my daughter's endocrinologist, who is also the dean of the medical school, accepts that my husband and I can do our own research and tell her new things. My pdoc, on the other hand, will not believe me unless it's in the damn PDR.
I once dated a man (boy...boy-man) whose parents were both high profile child psychiatrists in Manhattan. Talk about a screwed up person. He used to crawl under furniture and drool on himself to win an argument (I'm in pain....). He was also an actor that really wanted to direct, but that's a whole long story. His mom...the eminent doctor...tried to kill herself 2 times while I was with him. Both times with overdoses of meds that won't kill you (halcion, and older sleep medicine that destroys the short term memory was one of them) and both times the doctors in the ER covered it up for her. I think about that every time I'm arguing with my doctor about a choice he is trying to push on me.
I took Zoloft for about a year I think... It may have been only 6 months. It was between two different trials of prozac. I went off because (and I realize this with hindsight) it threw me into a a pretty hypomanic state at a point when I couldn't afford to be anything but completely stable. After I kind of lost it in the GP's office and got sent to my pdoc my meds changed. At that point my dx was still major depression though. I never got dx'd with BP until after a neuro prescribed Topamax for migraines and my moods finally settled down. I had a whole good month before I got pregnant and things went downhill.
I see someone else mentioned anti-convulsants as a class of meds that provide mood stabilization. You want to stay away from those if you ttc. I was taking one (Topamax) when I got pregnant and everyone freaked out, including the makers of Topamax.
Mary
Thanks for the info. I agree completely; I do believe people should take their medications as prescribed and that the doctors ARE the experts BUT I also strongly believe each person has to think for themselves and question anything that they are going to put in their body rather than just blindly taking whatever they're told to without knowing what it is, how it works, what it interacts with, and so forth and so on.
Yeah, as for the Mr Rogers Pdoc, I found him hysterical.
Moodwise: I don't have any problem with 'blowing up' or anything. I do get irritable, where I can't 'hide' my facial expressions or just being distant and sort of cold, but I don't ever yell or anything like that. I do have trouble with not being able to make myself not cry if someone says something that hurts my feelings or mads me really sad.
Someone had asked what meds I'm taking- the only thing that I am taking is Lexapro 20mg. I've been on it for years. I am supposedly, a rapid cycler.
My husband asked if I could get on disability. I don't know. I haven't worked, and have trouble working in the outside world, but if I did the disability thing then wouldn't I be essentially saying 'I'm too crazy to work', and if that is the case am I then also admitting that I would be an unfit mother, not only to a future child, but also as a stepmom? I think I am a very good stepmom/mom, I have raised a very stable child and treat her with dignity and respect (the way I would want to be treated as a child- as a human with equal rights). She does have consequences for her actions, but as a way to teach her NOT to punish her. I don't think I'm the 'worlds greatest mother/stepmom', but I do feel that I am a good and fair parent, and I know I would want to have me as a mom. Thats what I try to do, think of how I would want to be treated or how I would feel if I were to have me as a mom.
The moodstablizers thing is sort of scarey. I think my anxiety disorders are more debilitating than the Bipolar II thing, well the depression does make me unable to function too.
I know you really want that baby NOW, but am glad you're going to postpone and try a conservative meds approach.
"he may just have been asking for a point of reference."
- perhaps, BUT he was really pressuring me to say yes, he even went through the "do you believe in jesus?" "do you believe jesus died for your sins?" Then when I said 'uhh..yeah..' he said "yeah? or YES!" so I said 'uhhh.. Yes?" and then PDOC said "Amen!" Who says AMEN when its just for a point of referrence? lol
"I'm afraid his paternal attitude would drive me right up the wall in short order"
- I would do great with him if it were a paternal attitude sort of thing, he wasnt paternally at all. I tend to cling to paternal figures and try to please them (I had two dads abandon me -the biological dad, then the legally adopted dad- they both abandoned me and I so very much have always wanted, and unintentionally looked for, a dad figure).
Mr Rogers was more.. just condescending and strange. The way he talked about my past 'marijuana use' was like looking down his nose at a junkie. LMAO I mean get real, I was a College kid, ALL the collegekids smoked dope. Heck, even the professors had smoked dope when THEY were college kids!
That can be a very tough decision, and it sounds like you are on your way to making it. Stability, as I learned from personal experience, is not just not having suicidal thoughts, etc., so I have to agree with your pdoc on that one. So maybe it's time to just take care of yourself for a little while, work on getting that job, get the benefits, start seeing a tdoc and pdoc on a regular basis, gain stability then ttc. I know I'm making it sound a lot easier than it probably is, but I'm on the outside looking in. I learned a hard lesson when I finally got stable, and that was that when I was unstable I wasn't an effective parent to my 3 kids. I thought I was, but I wasn't. If they didn't want to go to school I didn't make them. If they wanted to go hang out places that I ordinarily wouldn't let them go, I let them. Things like that. So that's something to think about.
I wish you the best of luck in making this decision. And remember we are here for you. Post as often as you want or need to.
Hugs,
Traci