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Dealing with Severe Anxiety/Depression while in Med. School

Discussion in 'Allopathic' started by MD2b20004, 01.01.04.

  1. MD2b20004

    MD2b20004 Removed

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    I was enrolled as a M1 at a Medical school starting 8/26/03, I took a leave of absence 9/15/03 because i got into severe depression and had uncontrolable anxiety symptoms. I dont think the anxiety and depression is from medical school alone, i had the depression and anxiety before for the past few years mildly but was able to restrain it enough to function. The anxiety and depression took a toll on me before in life; like made me have severe Indecisiveness ( I can never make up my mind on the simplist things, got to the point where i had to tear up receipts after buying clothes so i wont change my mind and return them) sometimes i will get sad out of no where and have muscle aches and lose my appetite, withdrawl from friends, stop answering phones, etc... but with this going on i was able to function without anyone around me knowing i had anxiety or depression because i was a super outgoing guy and was very socialable. I know for a fact that if i didnt have depression and anxiety in undergrad i would of been able to focus better and would of had an extremely higher GPA and MCAT scores, but the anxiety and depression caused me to have symptoms of A-ADD, i cant ever sleep at night b4 3-4am because i am always thinking and worrying about stuff that normal people prob. worry about for a few minutes and forget. (There is alot more symptoms i experienced but too much to list, if your interested and/or want to know more to give me advice you can pm me)

    Anyhow In the summer before medical school, I was feeling a bit less depressed and thought i can handle medical school and put my depression and anxiety in control enough to function, unfortunately with the medical school stress, the great loads of focus needed and my anxiety and depression and lack of concentration from the depression and anxiety, i just got into a huge anxiety attack that took over me for the 2nd two weeks of med school. I mean i will sit in the library open and book and stare at the same page for hours, thats if i wasnt already feeling tired and sluggish always from my depression.

    I for some reason never saw a pychiatrist even though i knew i may need medication because first i was in denial, 2nd i used to think pychiatrists are for the weak and its a mind game, 3rd i didnt want my health insurance and my future malpractice insurance to be screwed over cause see a pychiatrist for depression/anxiety raises your insurance, 4th i was a poor college student and didnt think i can afford the treatment, 5th i didnt want my brain tampered with because i thought all these pychiatrists are going to do is play trial and error with medications and what if they screw my head up more. Here is the delimma, i was on leave to start back in January, so i thought a break can help me get back on track, instead i been way more depressed and had more anxiety and i still didnt see a pyschiatrist due to the reasons above. I so want to be a physician and so love medicine but i am starting to think that my condition is so severe that i shouldnt risk more loans and debt and cosigners when i dont even have control over my own mind, i want to start next semester again but i dont think its feasible because of my progressing symtoms, i may defer until next year if they let me. I am planning on seeing a pyschiatrist hopefully soon cause even if he messed me up with medication i dont think my brain can ruin my life more then it did already, eventhough i have to see how i am going to afford the treatments( i dont have insurance anymore since i only had student insurance and that cut off with my leave of absence and i dont have insurance from my parents --too old)

    Anyhow any feedback, advice, words of wisdom, related stories u like to share and how u handed it, please let me know. you can pm me if you want too.

    I appreciate all the advice and thanks for the help.

    PS
    This is my first post ever on SDN, although i been a fan of reading it and all the great info provided by it.

    Mike
  2. pdiddy

    pdiddy Member

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    happy new year... i think mike you have to first take care of yourself, what you are experienceing is not uncommon, and often responds well to medication (an SSRI) and/or counseling....i would defer coming back to medical school this semester, and wait until you have things under control, as medical school itself is a stress ridden (yet exciting) adventure... as for how to get help, you definitely should get in touch with a psychiatrist and stop putting it off....good luck.
  3. Starflyr

    Starflyr Manic Faerie

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    Dude. Do you know how silly you sound? "Im not going to get treated for my debilitating medical problem b/c it might raise my insurance rates."

    That's like saying "Oh, I wont get my car fixed after a wreck, even though its unsafe to drive b/c my insurance will go up."

    Whatever!

    If your symptoms are so debilitating that you had to take a leave of absence, you need to go see a psychiatrist. Period.

    I have bipolar disorder (no, not the same thing, but...) I also have SEVERAL friends who suffer from severe anxiety and depression like you do. We all go to the psychiatrists, we are all on medication. I swear that probably half my class takes antidepressants of one type or another. Heck, I have one friend who has to take benzos whenever she has to do an oral presentation (ie, every day, now that we're in 3rd year).

    Get the meds. Go to therapy. Take the rest of the year off and get yourself together. Maybe, eventually, you'll be able to deal with this without medication, maybe not. Its most probably a chemical imbalance (unless its PTSD or something). That's what meds are for. To fix it.

    If you're really worried about somebody "screwing up your mind", go see the department head, or the residency director as your physician - or get their recommendation. DO NOT go through student health, cheaper though it may be (If I did that, Id be seeing a 1st year psych resident...ack! No thanks, even though it's free)

    However, if you think the meds are screwing you up, all you have to do is taper off of them - or talk to your doc about switching to another one. Yeah, they have side effects. You might gain some weight and have a decreased libido. BUT....is being able to deal with medical school enough compensation for that?

    Heck, at least you wont have to take meds that screw up your coordination and make you circumlocute constantly b/c you cant remember words at inopportune moments. SSRIs, TCAs, etc, really arent all that bad when it comes to cases.


    good luck...
    Star
  4. stomper627

    stomper627 Go Cougs!!!

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    First thing....you should wait this year out and retry next....but get your depression/anxiety under control. I would recommend seeing a psychiatrist. It has in the past been considered for the "weak"...but that is really our grandparents generations thought process. There are some wonderful medications out there with very minimal side effects that will help you. I think youd be very surprised to see how many of your classmates take them. I know quite a lot in my class were on Benzos for anxiety, or SSRIs for depression.
    Another option if you still cant (or wont) seek professional help...is exercise. I found this to be the best release of stress and anxiety. Ive suffered from mild depression and anxiety my whole life. I saw a psychiatrist in HS for a few years. Great experience...taught me how to control it. Now however, I have found a passion that helps keep me "sane". Its been exercise. Do I still suffer...yes. But its managable and controlled.
    Just a side note...the exercise does wonders for the self esteem issue....
    stomper
  5. MD2b20004

    MD2b20004 Removed

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    If you read the post closely you will realize that the insurance thing was only one of the many reasons not the only reason i restrained from seeing a pychiatrist, if you read the post again you will realize that i dont have health insurance at all now and the costs is what is concerning me on top of the other reasons not the insurance hikes, I DONT have any insurance at all now and worried about how much the process for treatment will cost and if i will be able to afford it.

    Thanks for the posts from all, any other prospectives and advice is appreciated and any pms are welcome too.

    PS
    Plus when your depressed and in anxiety to the point i was/am in trust me you dont think right or make the best decisions, its part of the problem, sometimes its a big deal for me to get motivated to get out and just call a friend or read a book straigh for an hour without being choked up with the anxiety and depression. Financial issues also add to the depression and anxiety, everytime i get a bill from the loan office for payments my anxiety level sky rockets, its like i almost have to avoid opening letters now cause i cant handle stressful situations, it always feels like i am on my last string.
  6. MD2b20004

    MD2b20004 Removed

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    I am also wondering for thse who experienced my symptoms too, is my extreme lack of concentration and foucs and unability to sit down and not shake my leg while sitting down every second and not being able to concentrate in class or sit more then 20 minutes studying before i lose concentration, is that due more to A-ADD or due to an effect or of the anxiety and depression. Also for those who had similiar symptoms to me , please message me and let me know what were diagnosed with , what treatments u went on, whether u thought it was effective, how much the process costed ,and what side effects you have experienced.

    You all been very helpful so far, you dont know how much this helps me esp. in the case i am in and feeling so down and unable to do anythin with this cloud of depression and anxiety constantly looming over my head. I feel more drained then ever...
  7. sflynn

    sflynn Member

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    I have to say I find some of your post somewhat puzzling. First, quit worrying about your loans. SInce w=you withdrew so early on, I would expect that the majority of the money was refunded to you. And second, there is a 6 month grace period on repayment.

    Next, financial reason......most communities have mental health "centers" (the right word escapes me) which offer mental health care at reduced cost.

    I've suffered from depression on againa nd off again my entire life. I take medication when I need to.....usually for a year or more at a time. Thankfully, my depression has never interfered with my work or school. I've learned to look at things in small chunks instead of big chunks. Just because you get up feeling down doesn't mean the rest of the day has to be down. If this hour is bad maybe the next hour won't be. When things are really really bad, I force myself to do things that I don't want to do....and sometimes I'm surprised and enjoy myself.

    Depression is a disease, just like diabetes. You cheat only yourself if you do not seek help. In addition, you don't have to see a psychiatrist, see your family doctor if that makes you more comfortable. Start somewhere....grab ahold of anything that has a chance of making you feel better.

    As far as medical school goes, I agree with others that say you should wait until next year. I think it would be difficult starting in the middle of the year anyway.

    Good luck.

    Stephanie
  8. Starflyr

    Starflyr Manic Faerie

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    Trust me, I do understand the insurance dilemma. But, not having insurance isnt a good excuse for not getting treated. I have only ever had mental health insurance for 1 year. That year did NOT include the time I was hospitalized for 2 months for suicidal ideation. Nor does it include the 3 years of 2x a week therapy I needed to understand how #($*&ed up my thought processes were. NOR does it include the time I committed myself in college b/c I was off of meds, manic, knew it, and no psychiatrist would see me b/c I was moving out of state in 2 weeks.

    Yeah, it sucked financially. Yeah, I had to get help paying for it. But yanno what? If I hadnt, I wouldnt have graduated high school, I wouldnt be in med school, and I likely wouldnt even be alive.

    Go get help. Worry about the $$ later. Heck, when you finish med school, you'll be 150,000 in debt anyways. And you dont sound like you're about to off yourself, so I doubt you'd need inpatient care, which reduces costs DRAMATICALLY.

    Star
  9. Marina9

    Marina9 Senior Member

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    It's common knowledge that doctors have one of the highest suicide rates and that depression is all too prevalent in people in the medical field. What about med students and people who aspire to become docs? Do you think that pre-meds and med students suffer from depression and anxiety at higher rates than the general population? Somebody mentioned in the other thread about depression that about half of their classmates are getting treated for the disorder. Do the rest of you med students agree with this observation?

    If so, do you attribute this to the nature of most people who want to become docs? Or is it more of a situational depression?
  10. Buck Strong

    Buck Strong Removed

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    I don't think 1/2 are getting treated, the figure I heard at school was approx. 40% are clinically depressed at some point during the 4 years. How many actually seek help is probably significantly less...I know being a guy, I'd never go to a shrink for zoloft, when things get tough, and I start feeling like I might be depressed, I usually tell myself to stop being a ***** and suck it up. Unfortunately, those are still the prevaling attitudes in society regarding depression and treatment for depression.
  11. Marina9

    Marina9 Senior Member

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    I agree that there is still this stigma associated with mental illness and that prevents a lot of people from getting help. I feel mildly depressed on and off, but I'm either half in denial or simply unwilling to take drugs or see a therapist. I feel so alone with it. Writing usually helps me think more rationally about what is going on, and the depression always goes away eventually.

    Buck Strong, and anyone else who has gone through this, did you experience depression prior to attending med school or has med school spurred the onset of it?
  12. Buck Strong

    Buck Strong Removed

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    No, just med school, and i'm not sure if i'm actually "clinically depressed", never did one of those evalutions for depression. Most of the low points i've experienced are solely related to the massive amounts of work I have, which i never experienced in college. Plus, social life in med school isn't exactly anything to write home about, the all work and no play thing might contribute a little to us feeling down, but I think it's only normal to feel that way. Plus, personally, talking about it to people in similar positions makes me feel a little better, like I'm not the only one going through some of the tough times associated with med school. I think if you know you're having some of the serious signs of clinical depression, definitely see someone, regardless of what stigmas may or may not exist.
  13. raining4days

    raining4days current status: zzzzzzzz

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    I agree with the others that you need more time, especially if you are going to be on meds. The side effects lasted about a week for me: nausea, sleepiness, frequent urination. But, the frequent urination lasted about a month. But that really depends on people. http://depressionforums.com It took me about six months for the meds to actually work (that is, increased dosages). The bad thing is that SSRIs are addictive. If you forget to take it, your body will remind you. :scared:
  14. njbmd

    njbmd Guest Moderator Emeritus

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    Hi there,

    You have some MAJOR medical problems that need to be totally solved before you attempt medical school again.

    1. You need to get professional treatment for your depression. By the very nature of the disease, you can't be objective about your career, finances or any other important matters. You cannot hope to get yourself back on track without treatment and it is going to be very difficult for you to realize this until you are feeling better.

    2. There are very effective treatments out there for depression both major and minor. Put yourself in the hands of someone that you can trust(like a Family Doc) to evaluate the effectiveness of any treatments that you may undertake for your problem. By the very nature of your disease, you may not appreciate that you are getting better or worse with treatment.

    3. Don't even think about dealing with school matters until you have been in effective treatment and adjusted thoroughly. You are fortunate to be able to identify your problems at this point in your career as opposed to failing out and being saddled with debt in the $200K range with no means to repay it.

    4. You can't change the past but you can affect your future. It does you no good to beat yourself for what GPA or test score that you "might have gotten". You can take responsibility and action to affect your present and future health but you can't do anything about the past. Let it go and move forward to good health.

    Good luck!

    njbmd
  15. KyGrlDr2B

    KyGrlDr2B

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    I have been depressed before, in high school. I only took anti-depressants for about 2 yrs and then I stopped and was fine. My sister is also taking zoloft right now. Lucky for me, I feel like total crap again, but I'm too stubborn to go to the doctor. I don't feel depressed all of the time like I did before so I don't know if it really warrants meds. I keep thinking once 2nd year is over, I'll feel better.:rolleyes:
  16. DocRuth

    DocRuth Member

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    MD2b2004,

    I am really glad you posted what you did. Please please please know that you are not alone. The very fact that you wrote about your experience suggests to me that you are moving beyond the stigma of depression. There are loads of decisions you need to make, but I think njbmd is right in saying you should get treatment first and foremost. You can make decisions when they will be more managable. For now, make the decision to get help. Everything else will come together in time. And please know that people you don't even know are rooting for you.

    DocRuth
  17. gwyn779

    gwyn779 stargazer

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    It's hard to say what exactly is causing your lack of concentration, but there's no way you'll know until you get both the depression and anxiety under control. If you're really thinking ADD, you have to have had inattention problems in childhood. If the inattention only began in college or something, then it's more likely the depression/anxiety.
    As far as having no insurance, the older anti-depressants (tricyclics) are much less expensive and work as well as, if not better than, SSRI's. True, they tend to have more side effects, but not for everyone. Definitely see someone and let them know you have no insurance, because most docs are willing to try to help you as much as possible.
  18. NewGuyBob

    NewGuyBob Member

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    MD2b20004,
    I know EXACTLY what you're going through my friend. After my first semester in medschool I was feeling hopeless, and anxious all the time. I could not leave my apartment without thinking there was going to be a fire and my dogs (which i love )were going to die!! Imagine, my body was sitting in biochem lecture while mi mind was attending my dogs funeral!! I could not concentrate for more than a couple of minutes at a time and everything would distract me. Needless to say my grades took a nosedive, and that only made me more anxious and nervous.
    I went straight to the Psych and he prescribed me Paxil, and that was it. My grades were back to normal, I had no more worries.
    So, my point is: Don't go nuts (no pun intended) dancing around your situation, GO TO YOUR DOC, get the prescription and move on with your life!! You'll be amazed of how well they work. (BTW: in my case I haven't had any side effects at all, and I've been taking Paxil for 2 years non stop) Good luck!
  19. snowbear

    snowbear Senior Member

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    I also think that the best thing for you right now is to find a physician or therapist that you feel comfortable talking with.

    Here are some other ideas that might also help. Assign some time to yourself for exercise. For example, say to yourself "At 12pm I am going to go on a walk for 30 minutes," and do it. For a lot of people, excercise is something that the more you do of it, the more likely you will continue to do it. You can start small and work up. I really think exercise helps with depression/anxiety and it won't hurt you to try.

    Also, writing can be very helpful in figuring out a lot of your feelings and trying to provide yourself with some direction. With your anxieties, try to get down on paper what you are worrying about. For each worry, ask yourself what is the worst possible thing that could come from it. Maybe design some plan of action to combat each worry. Sometimes, the best way to deal with anxiety is to take action against it. And remember, deciding to stop worrying about something is one way of taking action.

    Just some of my personal experience that might help you.
  20. NewGuyBob

    NewGuyBob Member

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    MD2b20004,
    I know EXACTLY what you're going through my friend. After my first semester in medschool I was feeling hopeless, and anxious all the time. I could not leave my apartment without thinking there was going to be a fire and my dogs (which i love )were going to die!! Imagine, my body was sitting in biochem lecture while mi mind was attending my dogs funeral!! I could not concentrate for more than a couple of minutes at a time and everything would distract me. Needless to say my grades took a nosedive, and that only made me more anxious and nervous.
    I went straight to the Psych and he prescribed me Paxil, and that was it. My grades were back to normal, I had no more worries.
    So, my point is: Don't go nuts (no pun intended) dancing around your situation, GO TO YOUR DOC, get the prescription and move on with your life!! You'll be amazed of how well they work. (BTW: in my case I haven't had any side effects at all, and I've been taking Paxil for 2 years non stop) Good luck!
  21. jeff2005

    jeff2005 Senior Member

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    I too have suffered from anxiety/depression on and off for years. It all started in my teens and unfortunately my parents didn't know how to help me. Now I'm a well functioning third year with the help of Effexor 150mg qd, meditation, and an occasional Ambien for sleep. I suffered for 10 years needlessly. The first time I saw someone I too was broke. Fortunately, they gave me 6 months of free samples. See someone TODAY! This is more important than anything else.
  22. tinwindow33

    tinwindow33 Junior Member

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    Check your private messages Md2b20004.
  23. MD2b20004

    MD2b20004 Removed

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    Thank you all. Thank you for all the private messages, the posts, and all the advice on everything, as well as having the kindness of sharing much of your own private experiences with the same problem. I got so many private messages and emails from people who are sincerely trying to help and took the time to extend a helping hand. Something unfortunately my own family isnt doing as of yet (partially because they dont know the seriousness of it and because i didnt stress to them how much it is destroying me- in part do to my lack of energy to do anything) But i want to say that I am proud all of you are going to be my future colleagues and future health care providers, your posts show your concern and dedication in devoting yourself to help others.

    Thank you all.

    Mike

    PS
    any more feedback, experiences, advice etc... is still welcome and appreciated!
  24. Super Rob

    Super Rob Senior Member

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    Mike,

    First, I'm concerned for your safety. Have you thought about hurting someone or wanting to commit suicide? If the answer to either question is yes, then please let someone close to you know what you are thinking and see a doctor or therapist right now... like, back away from the computer and have someone drive you over to emergency services or mental health services.

    I always feel terrible when I learn that a bright, young, and motivated person is struggling with anxiety and depression. You have to understand that anxiety and depression are very normal, human things in moderation. NO ONE has gone through life without becoming anxious or depressed. That would be like saying one can live without ever becoming angry, happy, or embarrassed. I appreciate, however, that your life has been disrupted by the severity of your anxiety and depression and that begs the questions: should you see a psychiatrist and should you take the drugs she hands you?

    Check your PMs
  25. Marina9

    Marina9 Senior Member

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    I keep wondering, how do you tell when your anxiety/depression is normal and when it is a disorder? I talked to my family doctor, who is also a relative, and she wrote that I had mild depression. Because she knew that my mom was reluctant to have me on drugs, she gave me the pamphlet for Zoloft and let me think it over.

    I have an uneasiness about taking antidepressants because I don't want to change the way I think, even if it does make me depressed sometimes. So what if I don't think the way everyone else does sometimes. What is "normal" anyway? So I haven't taken any drugs yet. And right now I am not in a depressed mood, although I think I just got over one. Sometimes I fit the symptoms, and sometimes I don't.

    Should I go ahead and speak with a therapist anyway? I feel slightly uncomfortable discussing this with my physician because she is also a relative and I do have to see her in social settings outside of the medical office. I don't think getting another physician is an option my parents would consider. I also don't really want my parents to know if I am discussing my depression/anxiety with a professional.

    Good luck MD2b20004. You are definitely not alone, if this thread is any indication. And you have made me feel a lot less alone as well. Thanks so much for posting, and all the best to you.
  26. raining4days

    raining4days current status: zzzzzzzz

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    This is what my psychiatrist told me: anxiety/depression is an impediment to your daily actions/routine. Say, you're at home and you're suddenly out of food. You get ready to go out, but then you stop at the door. That's kind-of generalized anxiety. Depression is more like discontinuing doing the things that you used to do.

    Zoloft or any other SSRIs is a long-term thing. You don't take it for 1 month and quit. Or else you can go through very bad withdrawals (see my previous post). SSRIs don't make you happy 24/7. You'll still feel some anxiety/depression (part of being human).
  27. woolie

    woolie Intermountain West

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    I'm glad to see this thread as well. Sometimes I suffer from depression and I have seen different counselors over the years to talk about whatever was going on. I'm not comfortable with taking drugs and so I try and talk out my feelings and that seems to help. For me, alot of my depression has been situational, like many people have described.

    Right now I am doing an AmeriCorps year (can you say: "no money?") and I work with the homeless in a free clinic. Hmmm ... I guess it would be easy to get depressed under these circumstances. I can hardly pay my bills and buy groceries, and I am harrassed and yelled at by (basically) ungrateful and angry patients all day. Also, being poor, I look a the patients and am afraid that I am going to end up where they are and I begin to freak out. :scared: Plus I moved across country to do this and so I am away from alot of familiar people and places and I feel lonely sometimes.

    It's a stressful, difficult situation and yet I like alot of what I am doing. But depressed - yes, I am fighting it off.

    So I go and talk with a therapist each week to help me understand the patients, my own feelings and fears around them, and to try and work through these heavy emotions. I am trying to be active in different community things as well and take every opportunity to make friends and go out with new people - including friends of friends.

    I think depression is very normal and we would abnormal to deny it's existence. Life has challenges and our painful feelings are here to tell us something isn't working right in our lives, and that we need to adress whatever it is as best we can.

    Chin up brother - finish your degree and keep going !
  28. gwyn779

    gwyn779 stargazer

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    When it impairs your life, then you need help. Of course, that level of impairment can vary. I would definitely recommend seeing someone else, because you won't be able to be completely honest with your physician if she's a relative. Someone else can more objectively help you decide if meds are right for you.
  29. MD2b20004

    MD2b20004 Removed

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    From those who experienced seeing a healthcare provider for severe depression/anxiety recently. How much did the process cost? How much do the meds cost per month on average, what prescribtions were given to you for anxiety, depression , etc... if you suffered similiar symtoms as i listed in my original post. What were your symptoms and behavior before treatment what were they after the treatment? How long did it take for the treatment to take effect? Were you diagnosed correctly the first time around or found yourself have to keep going back and forth and changing providers? Is it better to see a physician at a University hospital or at a private clinic?

    How did you explain your problem to the pyschiatrist, and what questions did he ask. I am so drained always i am scared i wont be even able to explain the severity of my depression and anxiety to my pychiatrist since i am always just down, drained, feeling like a wreck and want to avoid anything and everything, even explaining my problem to someone who is going to help me. I am so sick of hurting everyone around me (emotionally)with this disease, screwing up myself with wasting a year, disappointing my family , avoiding friends because they dont know what i am going through, my severe anxiety even pushed me to yell at my gf for something so dumb i cant remember but i never yelled at my gf b4 and she cryed for 2 weeks-- i am just always agitated and mad, drained, angry , bothered worried , at the smallest things. i mean this disease is killing me and destroying my life and my relationships with the people i love. I am in the process of aquiring to get insurance before i get into the slump of mass bills with no money to pay them. Anyone have any idea which insurance is the best for mental health, how much i should expect to pay for insurance ( i have no previous medical problems) and how much is the co pay with the insurance for drugs and physcian fees, is there any other way than my school to get free or reduced healthcare if you have no money. How long should i expect the treatment to last, what side effects should i expect. I am still so scared my doctor is going to play trial and error on me and mess me up more. Those who went thru what i am going thru now and have answers to my questions and others please provide me with any answers and specific concerns , eventhough some of the questions were answered in previous posts and pms from a very helpful bunch of caring people.

    Thank you all.
    Mike

    PS
    eventhough i was too drained to personally respond to all the pms i got and personally thank you all for your support, please realize i appreciate your time, advice, and concern. I apologize that i dont have the focus, energy or well-being to have thanked each one of you individually.
  30. Weil-Felix

    Weil-Felix Super Flying Squirrel

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    You don't need to worry about being able to convey the severity of your symptoms to your doctor. You have done a very good job here on this forum, and if you just tell your doctor what you have told us (heck even if you only tell him/her a tiny bit of what you told us!) they will have no problem diagnosing you correctly. They know all the important questions to ask, your job is to just answer the questions honestly. Depression is a surprisingly straightforward diagnosis. As long as all the criteria are met (see my previous post) and as long as you can rule out other psych disorders (especially bipolar), it's pretty tough to get it wrong. Any primary care doctor in most any setting is trained to diagnose and manage depression. Just go to whoever you are comfortable with, and whoever can get you in the quickest.
  31. bruinrab

    bruinrab Senior Member

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    Hey Mike and others,

    I thought I would just share a little of my own family's story. In October of 2002, my mother was in a near fatal car accident. Just before she was released from the hospital, her surgeon did perhaps the best thing he could for her. He told her that no matter how she felt at that point (basically grateful for being alive), her feelings would change. He told her that she'd probably start to have problems dealing emotionally with what had happened, and that when that happened she should not be afraid to seek help. He also told her that just because she was married to a psychiatrist, she should not expect to be immune to PTSD, nor should she hesitate to seek help out of fear that her condition would reflect badly on my dad.

    Of course, over the next few days, his prediction came true. She started out not being able to handle the sound of the garbage trucks as they came down the street (her car was basically squished by a tractor trailer, so the noise was a trigger). She had trouble riding in a car without bursting into tears, she always felt tired, even after there wasn't much that they could find physically wrong with her. She had a bunch of other symptoms, but she kept thinking "how bad will it look if the psychiatrist's wife is nuts?". She didn't recognize how paralyzed she had become, going from being so active before the accident to being a scared, quivering mess afterwards. Eventually, after we all had yelled at her enough, she relented and went to see one of my dad's colleagues. She started out on a couple of meds, and was soon feeling a lot better. The difference was amazing. Not only was her anxiety much better, she felt better physically. So I guess the lesson from this is that even if you're related to a psychiatrist, you shouldn't be afraid to seek treatment if you need it. There's no way out if you want to return to normalcy within a reasonable amount of time.

    Of course, she wasn't the only one who suffered. All of us were quite badly shaken, and I think I've developed a bit of an anxiety disorder since then. It seems like I almost need something to worry about or be scared of now. When one fear is completely allayed, another soon takes it's place. Of course, I'm not so keen on getting onto meds just yet, so I've been trying to deal by "talk therapy" with my boyfriend. It's kept me sane for now, but I'm not going to refuse real treatment if it gets too bad. I'm quite sure I had mild OCD before too, but I recognized it before anyone else could and basically tried to think my way out of it. I think it worked. :twitch twitch:
  32. KarateGirl

    KarateGirl

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    Wow, looks like we have a general depression support topic going. It's funny--you know medical school almost breeds depression, but you still forget that there are a lot of people out there who understand and have been through what you've been through.

    I've had clinical depression most of my life. It's wreaked havoc on almost every part of my life. It's destroyed relationships, school, work, the whole deal. I take medication now and the difference is like night and day. I struggled for a time with the idea of going on meds, and suffered needlessly because of it, but antidepressants are the best thing that ever happened to me. It's well worth the minor drawbacks. I'm like the poster child for depression treatment. :) I've acquired anxiety problems also in more recent years, and the two conditions are closely intertwined, but both are treatable.

    One pet peeve I've always had is that normal, everyday depression and major clinical depression have the same name. They are not the same thing. Granted, in a sense they are both two different spots on one continuum, but I have experienced both and there is no comparison. I think it's one of the things that contributes to the stigma. People think, "Hell, everyone gets depressed now and then. It's not a big deal." Or "you should just suck it up. That's what I do." Mild depression gets its own term--dysthymia--but major depression gets zip. It's very frustrating.

    Anyway, I've talked to a lot of people about my depression, and helped a bunch who were going through it and needed some support. If Mike, or anyone else here, ever needs advice or someone to talk to, don't ever hesitate to pm me. If I can help even a couple of people avoid at least some of the suffering I went through before I got help, then there was some benefit to my experience.

    Steph

    P.S. Mike, I'm going to pm you links to a couple of really good websites. If anyone else is interested, let me know and I'll pass them along.
  33. BiggMann79

    BiggMann79 Senior Member

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    I'm just going to say the same as everyone else and encourage you to see a psychiatrist. I was in a very similar situation last year, although probably not as bad. I failed gross anatomy very badly and took a leave of absence before Spring break with a VERY low grade in neuroscience and a barely passing grade in physiology (a subject I really like and find easy). I saw a psychiatrist, got diagnosed with depression, was put on Zoloft for a while and didn't like the side effects it gave me (tremors) and changed to Wellbutrin, which seems to really do the trick. I returned to school last semester to retake gross anatomy and I have a 95% in there right now. We just started neuroscience and physiology yesterday, and although I'm a bit nervous about the greatly increased workload I'm confident that I will continue to perform well academically. The key was getting help. I'm lucky in that our student mental health center has a very good psychiatrist (not a resident) who does a great job, and I've never had to pay for meds as I get samples. I hope that you can find something similar with your current financial situation.
  34. raining4days

    raining4days current status: zzzzzzzz

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    I'm Canadian (Ontario resident). We have a government-issued healthcard (OHIP). Technically, I don't pay for the doctor visits. I have a prescription plan (which is about $120 CN). It gives me about an 80-90% "discount". Without the prescription plan, the meds cost about $80-100 (this is a monthly supply of meds depending on dosage strenght).

    At the moment, I am on 50mg Paxil. Like I said, it takes time for the meds to get into your system. So, if you really want meds, think: long-term. I started on Paxil last summer (20 mg). Bad side effects which are nausea, frequent urination and sleepiness. That only lasted less than one month. The thing about SSRIs is that dosages really depend on the person. I was on 20 mg for 3 months--> didn't work. Increased to 30 mg for another month--> didn't work. Increased to 40 mg for another month --> it's working, but a little bit. Increased to 50 mg --> now we are talking. :horns:

    Last year, I got diagnosed with two mental disorders.
    <--- see my profile. That's around the time that I got diagnosed. Couldn't think of a good username. The best one I could think of was "student4life".:rolleyes: So, I came up with one associated with my conditions at that time.

    I've had these conditions for eleven years. So, for me the psychiatrist was no help whatsoever. :sleep: You can't compact eleven years into a 20-minute sessions. So, I took the initiative to better myself. One thing that works for me is keeping an online journal for my family to read. I find that it's hard to convey how these disorders affect me in everyday life to them orally.

    The psychiatrist will basically ask you a list of questions. From that he/she will tell you if you have a mental disorder or not. The first session lasted about 50 minutes (which is just an intro). From then on, it was 20-minute sessions. I used to get meds from my psychiatrist. But, now I get them from my family physician. Hope this helps.
  35. Super Rob

    Super Rob Senior Member

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    raining,

    Please, if you don't mind: How can you tell the Paxil is working and how severe were your symptoms before starting the regimen?
  36. raining4days

    raining4days current status: zzzzzzzz

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    You know Paxil is working because the symptoms of the health disorders will kind-of decreased. You'll feel kind-of numb and "relaxed." Paxil just makes you "comfortable enough" to do everyday activities (ex. going to school). But, you'll still feel some anxiousness. Paxil is not a med for doing oral presentations or public speaking.

    How severe were my symptoms? I have two mental disorders, so I guess I belong in that rare category of loonies. :D Let's just say that my symptoms were so severe that I would piss in empty soda bottles instead of going out of my room. But anyways, Paxil along with constant exposure to whatever was making me anxious/depress/panic is what really helps me. Hope this helps. :)
  37. MD2b20004

    MD2b20004 Removed

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    anyone manage to get the entire treatment of their depression/anxiety by samples, if do how did you manage this. I have a friend in dental school who did this to prevent the meds from going on her records so she wont get screwed when it comes to her dental malpractice insurance. She told me that her professor told her that her malpractice insurance will be drastically higher if the insurance knew she was taking pychiatric meds. Anyway around the records, example samples, etc... Are family physicians also good enough to diagnose and treat depression/anxiety or is it better to just go with a pyschiatrist, whats the pros/cons of each?
  38. mosoriire

    mosoriire Senior Member

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    I think that if simply advising to go to see a physician would work that easily, our friend here would have gone to see one ages ago. Practical advise frome xperience ? *Talk to the person you trust most in the world, especially if you're scared that you will let that person down or look really stupid or out of control or any of the other 2 million reasons you could conjure up. * Set goals with that person in terms of seeking care *Keep up with that person * Stay on whatever type of social or medication therapy you are given.

    I say this because I am exactly where you are. Fortunately, I figured out that something was wrong, and delayed applying to medical school. I finally picked up the courage to apply to medical school - right after scheduling visits with a physician I really trust. The best advise I can give is to find support and stick to it.
  39. Starflyr

    Starflyr Manic Faerie

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    Hmmmm...see, the issue is this: No matter what, it will still be in your record if you go see a physician. That's what all that coding and junk is for. I truly doubt that your insurance will be astronomically higher if you take an anti-depressant (or anti-anxiety) drug like maybe Effexor. It's pretty common. And if you also get some counseling (a good idea), you may be able to get off the med in the future.

    I dont know, I probably have a warped, cynical view of this, b/c if you're going to be screwed over for insurance b/c you take an antidepressant, Im not sure Ill even be able to practice medicine, what with Bipolar I and having been hospitalized twice.

    BUT....dont let "What if's" determine your course of treatment. Please dont. b/c I promise you, that if you dont get help NOW, it'll get worse, and you may become so impaired that you DO require inpatient treatment, and that's a whole different kettle of fish.

    As for cost - well, my psychiatrist charges $90 for a 30 minute session (I just do medication checks now). SO, you might could go to your family doc, but if the treatment doesnt seem to be working well after a month, or if there are really bad side effects, Id go to a psychiatrist. Remember, family docs only have a few months (like, 2) training in psychiatry, psychiatrists have 4 years.

    YOu may also want to look into counseling - there are places that can assess your financial situation and work on a "sliding scale", and counseling may be able to help you as much or more than medication, in the long run.

    good luck.
    Star
  40. MD2b20004

    MD2b20004 Removed

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    I finally started my treatment, the doc (pychiatrist) speaks english with a really thick accent and i have to repeat things twice for him to hear (he is in his late 60s), i dont think he asked me the right questions to get the burning stuff i wanted to say to someone and express all that was in me, years of depression and anxiety(refer to my original post). anyhow, my dad met this pychiatrist at prayer and he agreed to help me for free with samples so it wont go on my record which is what held me back for so many years. The problem is i dont feel like i can open up to the guy, i mean its fustrating that he cant hear good, and it doesnt seem like he asked me the right questions to get the fire out of me. He gave me samples of 50mg of zoloft for 3 weeks, i been taking them for 4 days now and its makes me way worse, i have tremers, light head, bad appetite (couldnt eat for 2 days), naseau, tightness of musles , choking feeling at throat. Anyone else take zoloft for depression and anxiety, and what was your experience with it? should i discontinue taking this med or should i tuff it out and see how far i can go taking it even with the bad side effects. The thing is since i am getting "charity treatment" i really dont have access to my doc , he just arranged for me to come once every 2 weeks at his county office(he works part time for the county) and he will fit me in for a session and give me meds.

    I feel like i am getting worse, what should i do, see a new pychiatrist (i dont have the money for drugs or physician fees for i don work--YES the depression and anxiety got that bad and pretty much handicaps me from everyday stuff) , i also like the fact that none of this is going on my record, or should i look for other ways to get treatment, does it get any better? no one seems to understand what i am going thru, i never told my close friends and my family is old school and dont tend to understand what i am going thru, they just think i am screwing up in life and giving up too easily, my dad even tells me i need to have a stronger personality and that everyone has depression i just have to fight it, only if he knew what i am going thru, i always been independent and lived on my own, now i feel dependent on others, i feel too handicapped to even get or look for a job (too drained and consumed by the depression and anxiety) I need help guys , i need to escape this damn disease and get my independence my life back, this disease made me so pesimistic on everything and i am also always thinking i will fail in life and every decision i make is wrong, not to mention how indecessive it makes me and how difficult it is for me to make decisions for the smallest dumb stuff, i even cryed and couldnt sleep for 3 days because i was stressing if it was the right choice to go with verizon over sprint for cell phone carriers, i know it sounds stupid, and it would to me if i was normal but thats how bad this darn disease got. Please stay with me people and give me advice, any first hand info, etc... as i get through this process.

    Mike
  41. beanbean

    beanbean 1K Member

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    Mike

    My heart goes out to you. I understand what you are going through right now.

    Don't worry about this going on your record. Depression is a disease - if you where diabetic and you weren't happy with your current doctor and medications; you would seek a second opinion. Does your school have any resources for students dealing with mental health issues? At UConn we have a free service for therapy and assistance which is completely confidential.

    Your health and happiness should be your first priority. Find a friend, a clergy member, faculty member at your school - someone....and ask for help. Find a good therapist that you feel comfortable with and who can help you work through these issues.

    Zoloft can have side effects (like any med). You need to talk to your psychiatrist, your primary care doc or another psychiatrist regarding the issue of sticking it out for a bit or changing meds.

    Always remember: This too will pass...

    PM me anytime.

    Deirdre
  42. snowbear

    snowbear Senior Member

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    I believe that speaking with a therapist is VERY beneficial to people suffering from depression and anxiety and is an essential component of treatment. If you are having problems communicating with this therapist, maybe just let him know. Tell him exactly what you told us, that you don't feel like you are prompted to talk about a lot of the things that you want to talk about. Or maybe, just try bringing up some of the things that you want to talk about. See how this goes.

    From my experience working in the mental health profession and from speaking with other mental health professionals, I have found that psychiatrists often do not incorporate psychotherapy into their treatments; they mostly just center treatments around medications. Try reaching out to this psychiatrist as I mentioned in the previous paragraph, but if this doen't work, maybe consider finding a therapist to speak with.

    I have been following your posts and I think that you really just need to stop worrying about this being on your record. Aknowledge that a lot of professionals have been treated for mental illness and that this worrying may be stemming from some of your anxiety. I believe that you can do a lot more harm to yourself and your future by putting off finding treatment, rather than by being treated for your depression and anxiety. As a future health professional, it is very important for you to view depression and anxiety disorders as illnesses that people should not be embarassed to seek treatment for. I guarantee you that in the future, you will be happy with yourself for taking the right steps to regain your health.

    I understand your cost concerns. You said that you were in medical school. Oftentimes universities have health insurance that students can purchase if they were recently enrolled. If not, just apply to kaiser or blue cross. If you don't have the money, ask your parents or friends for help.
  43. KyGrlDr2B

    KyGrlDr2B

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    I took zoloft and i thought it worked wonders. Although I'm pretty sure I didn't take 50 mg...does that sound like a lot to anyone else? My side effects were so minimal that I can't remember what they even were anymore. I also took Effexor and that was the worst medication in the world for me. I used to get what I call "rage fits" where I'd get so worked up and mad over things that I would almost get violent. I'm 100 lbs and I'd be pushing my boyfriend, one time I threw a shoe at him, etc. It was CRAZY. Needless to say, I knew that wasn't the med for me, hahahha.

    Also, I think you should realize something--what is the point in going to a psychiatrist if you don't feel comfortable around him and it is hard for you to be understood??? Go to someone else.
  44. MD2b20004

    MD2b20004 Removed

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    50mg of zoloft made me sick and more depressed and anxious (made me tremor, more dizzy, very tired and sleepy, drained, loss of appetite, etc.. intensify). My doctor seems to be playing trial and error, now he put me on 12.5mg of Paxil and took me off the zoloft. What you all think?
  45. beanbean

    beanbean 1K Member

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    People react differently to different meds. Unfortunately there is a bit of trial and error when it comes to finding the right drug/dosage. Its really no different than finding the right dosage of HTN med for someone with high blood pressure. We are all unique, but I'm sure you will hit upon the right med/dose and find some relief. There are mnay excellent med options available now - much more so than in the past. Hang in there - this too will pass.
  46. MD2b20004

    MD2b20004 Removed

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    so far on lexapro 20mgs, chlonazapin (or however u spell it) one pill at night, and 100mg of seliquel (or whoever u spell it at night), the seliquel is suppose to be an antipychotic but the doc said it works for extreme anxiety, treatment is helping big time so far, just wanted to update u all.
    Mike
  47. Jaded Soul

    Jaded Soul Proloxil > Zoloft

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    Sounds like clonazepam (Klonipin) and Seroquel (quetiapine). I'm glad the treatment is working out for you. Good luck.
  48. BklynWill

    BklynWill EM Attending

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    Can you describe how the treatment is working well? What symptoms of the anx/dep have disappeared? Do you anticipate a fresh start in school?
  49. meanderson

    meanderson Senior Member

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    If the main problem is anxiety, SSRI's like paxil and prozac usually aren't that effective in dealing with this. Paxil loves to market this in their commercials because there is a gazillion dollars out there to be made with an anti-anxiety drug, but popping 25mg paxil MIGHT slightly decrease your GAD over a period of several weeks after starting it. It may deal with the depression a lot more effectively

    What many people are desperately seeking is short acting anti-anxiety meds. It's amazing that in 2004 we still haven't come out with one that is effective and safe long term. Taking strong benzos at high doses like Klonopin and Xanax(4-8mg/day) are unbelievably effective at relieving anxiety throughout the day. The problem of course, is getting off it. If anyone has every taken an average of 7mg xanax a day for 3 months or so and then had to get off it it because their tolerance was becoming higher and higher this can be a very scary experience. The withdrawls are as bad as heroine. Fortunately, psychs can prescribe longer acting benzos for the short term and phenobarb to prevent seizures, but the withdrawl is still something I wouldn't wish on anyone.

    For the person who mentioned taking benzos for presentations and stuff, this can be a great idea. Just make sure it's not something that has to be done every day. If the presentation is once a week and you're popping 2 mg xanax to get ready for it, that will probably be fine because you'll never become dependent on it. The key when taking the stronger benzos(mainly 2mg bars of xanax) is to only use them in rarely needed situations and make sure you don't become dependent on them.
  50. DrMom

    DrMom Official Mom of SDN Moderator Emeritus

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    Please note: this is not a forum for medical advice. Any medical issue needs to be addressed by your personal physician (as the OP has appropriately done).

    I request that posters not give out medical "advice." You all are welcome, of course to discuss medical issues (personal or in general), of course.

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