Yesterday was my first appointment with the psychiatrist since I have had to stop taking Effexor.  She seemed very pleased that my blood sugar and blood pressure are coming down.  I told her in a lot of ways I was feeling better because of that, however, this week has been difficult emotionally.  Not because anything has happened, it is because I have emotionally been all over the place.

I told her about the strange “high” I had on Monday and Tuesday.  It was like my mouth could not get all the things in my brain out fast enough.  My thoughts were racing in every direction and I could not concentrate on anything.  When we examined it closer, she thinks the few days prior to that may have been “highs” as well.  I was so productive, abnormaly so.  We also discussed my extremely down mood of the past couple of days, as well as my extreme irritability and agitation.

She told me that she was going to be watching me carefully, because she is considering changing my diagnosis. She said that she thinks so much attention has been paid to my depression symptoms that there is a possibility other symptoms may have been missed.  Symptoms that might mean I have Bi-Polar Disorder (most likely type II) rather than Major Depression.  Which means the already complicated journey of finding a new medication for me has become rather more complicated.

Finding a right medication mix for me is difficult because of my diabetes and restless leg syndrome.  Most anti-depressants adversely affect both disorders. Now she is also concerned that giving me an anti-depressant alone could cause me to become hypomanic (or even manic).  She is having me stop taking my Welbutrin now, and has given me a prescription for Celexa.  The Welbutrin was only to counteract some of the sexual side effects from the Effexor, so I have no concerns about stopping it. I have to go back to see her next week, and to call if I think I need to come in sooner.

Her desire to have me start a new medication immediately as well as scheduling an appointment for next week created a whole new bit of drama for me.  Because I see this psychiatrist via Tele Med, there has to be a nurse in the office to take care of the prescription part of the appointment.  Once again, the nurse was out sick.  I do not hold it against the nurse for not being there, she is sick and cannot help it.  My problem lies in the fact that there is a whole new staff in the office and it appears they are doing the bare minimum of what they are required to do and that includes not making sure there is someone in the office to take care of prescriptions.  When I let the doctor know that there was no nurse that day – none of the staff had bothered to tell her yet – she was very frustrated.  She absolutely did not want me waiting until sometime next week to start the new medicine (I will explain why in another post).  I suggested that maybe someone from her office could call the prescription in to my pharmacy.  That is the plan we went with.

When I tell the new receptionist that the doctor wanted me back next week, a mini up roar ensues.  First of all it seems out of all the patients in the office at this time, I am in the only one that the doctor wants to see so frequently.  Also since I go to a government funded treatment center, it seems that I am only allowed so many Units (appointments) with the doctor per any six month period.  Apparently, I am eating up my units because the doctor needs to see me so much.  I am sure that this whole unit business has been in place from before the time I started going there, it was just that the old staff had the good grace to not worry me with that information and did what needed to be done so I could have all the access to mental health care that my counselor and doctor at the time felt I needed.  Between me, the doctor, and the counselor, we managed to convince the staff to bend a little.

My counselor saw that I was upset and knew it was from more that what had happened in the office, so she set aside some time to see my right then.  I will let you know how that went in another post.

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