When you don't trust your PDoc what do you do?

[macduffy]

This will be ramble-y so I apologize in advance.

I began treatment for BPdepression almost 3 years ago. I am a difficult patient because I am terrified to gaining weight. My first PDoc added topamax to my Rx cocktail and everything was pretty good (some ups and downs but not too high or too low). I switched doctors (first one moved) and my new PDoc took away the topamax because he wanted me on lithium. I didn't think too much of going off topamax but lithium.... well it didn't work well for me. I became obsessed with the weight gain side effects and my anxiety was high all the time. He took me off and never replaced it with anything else. I gained a total of 30 lbs since being off topamax.

I am in an awful state. I am so very very depressed. I'm used to BP Depression - I have no reason to be depressed I just "am". This depression is 1000% about my weight. Purely situational. I have no clothes, underwear or bras that fit. I can't wear my wedding ring anymore and cringe when my husband "looks" at me or tries to touch me. I don't want to go out of the house because I'm so embarrassed and have nothing to wear. I have had many suicidal thoughts and started googling the best ways to commit suicide. Neither my counsellor or PDoc seemed to think this was anything that needed attention. Apparently researching suicide methods can be calming?

I am told that something will eventually work and then I won't be depressed and will get back to my starting weight because I'll be "happy" again and can focus and have energy.

I just want to be on my original cocktail when I first started to see him. Lamical and Topamax. I have never specifically asked for this as I'm afraid I'll look like I'm drug seeking.

I completely disagree with my PDoc's treatment but he won't budge - Lithium. That's it. That is all there is for me. I am thinking of dropping him and going to a private after hours psychiatry clinic and hope for the best.

What do you do when you don't trust your Dr or when your Dr. doesn't hear what you are saying??

[uni]

Hello macduffy I completely get where you're coming from. I've struggled with eating issues and weight too. Not continuously, but enough to have a healthy respect for body image issues and the power they can have. I believe they are underplayed or even brushed aside by many pdocs. This will sound ***ist, but it seems to me that male pdocs in particular do not "get" the pressure in this world for females to meet ridiculous standards of physical so-called "beauty". (Don't get me started.)

Whether or not your current pdoc would "get" how much of your depression is related to weight gain if it were explained to him in no uncertain terms, I don't know. All you can do is try. Your post explains explains so clearly where you're at. Might those be the very words he needs to hear/read? I really don't know, but it's a thought.

I just want to be on my original cocktail when I first started to see him. Lamical and Topamax. I have never specifically asked for this as I'm afraid I'll look like I'm drug seeking.

So what if he thinks you're drug seeking? People ask that kind of stuff all the time. If you were satisfied with the level of stability you had on them before, asking to go back to that seems reasonable enough.

What do you do when you don't trust your Dr or when your Dr. doesn't hear what you are saying??

In answer to that, I can only tell you my experience and it may not be the right approach for everybody. I've totally disagreed with my pdoc more than once, having been through my share of med changes over the years, and not felt heard sometimes regarding meds or other issues. Sometimes he would be swayed to my way of thinking, sometimes not. Unfortunately there was one point at which we butted heads fully. By mutual agreement he referred me to a different pdoc. Had he not done so, I would have found a new one myself. Ideally, if you decide to change doctors it's a good idea to have an appointment lined up with the new one before dropping the first, just to be on the safe side. I hope you find a solution that works for you.