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Old 11-22-2006, 11:10 AM   #1
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Therapy vs. Psychology

I've been going to my regular physician for depression. I've been taking Lexapro for two months, which has really helped. I had a relapse last week - i went through something stressful and had suicidal thoughts. My doctor asked if I'd thought about seeing a therapist. I said I really hadn't, that at this time I didn't want to get into spending more money. I actually think my insurance is set up so that a mental health visit is only $25, but my regular doctor also wants me to continue seeing him - I'm afraid it will be getting into too much. Therapy is still something I want to look into. But, my question is: how is it different from going to a psychologist, or is it the same thing?

I went to see a psychologist a year ago when I was going through similar problems, and after two sessions, I was $200 poorer and just felt like it was getting nowhere. All we did was discuss past events. I didn't have a bad childhood, so I didn't feel this was of benefit. Is therapy the same - just talk - or is it more intensive? I've heard of hypnotherapy, but that sounds a little scary. I feel like just being on this medicine has made a world of difference. I'm not sure I need more than anti-depressants and routine doctor visits. The problem is that my doctor has a really busy schedule - he told me he wants to see me in 4-6 weeks. They couldn't schedule me in until March, though! I don't know if a therapist would be any easier to get into or not. I should've asked more about it, or if he knew of anyone. I'd like to find out more about therapy in general first, though, and what people who are going through depression/anxiety think about it. Thanks

 
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Old 11-22-2006, 11:47 AM   #2
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Re: Therapy vs. Psychology

imo anyone that is on medication needs to be in some type of therapy with someone who has training...not just a family doctor. You need to find and deal with the causes of the depression....make the necessary changes...and necessary choices to do so. Just taking meds prescribed by a family doctor will not do this for you. A trained therpist will.

 
Old 11-22-2006, 04:45 PM   #3
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Re: Therapy vs. Psychology

Meds alone, at least for me, can make all the difference. It's a good thing, too, as the therapists available through my HMO are generally hohum. I may as well call a friend and chat, kwim?

What I would do in your situation tho is see a psychiatrist instead of a GP. They specialize in mental health and meds. They are more willing to tweak a med dose, whereas from what I've seen online, it's kind of rare that a GP or other non-psychiatrist would up a dose beyond a kind of middle of the road dose. Like Lexapro? I know women who've needed 40 mg. But a GP isn't likely to go there. Therapy (talk therapy, or something more directed like Cognitive Behavioral Therapy) is good if it IS good, but if it isn't it's a waste of time and money. Unfortunately there's no guarantee, and it's hard to find a good one that matches one's needs.

Last edited by msbibe; 11-22-2006 at 04:46 PM.

 
Old 11-23-2006, 07:32 AM   #4
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Re: Therapy vs. Psychology

Quote:
Originally Posted by ms***z
Meds alone, at least for me, can make all the difference. It's a good thing, too, as the therapists available through my HMO are generally hohum. I may as well call a friend and chat, kwim?

What I would do in your situation tho is see a psychiatrist instead of a GP. They specialize in mental health and meds. They are more willing to tweak a med dose, whereas from what I've seen online, it's kind of rare that a GP or other non-psychiatrist would up a dose beyond a kind of middle of the road dose. Like Lexapro? I know women who've needed 40 mg. But a GP isn't likely to go there. Therapy (talk therapy, or something more directed like Cognitive Behavioral Therapy) is good if it IS good, but if it isn't it's a waste of time and money. Unfortunately there's no guarantee, and it's hard to find a good one that matches one's needs.
That's how I feel, too. I don't want to run the risk if there's a good chance it won't help, or even make me feel worse. The psychologist I went to who I really didn't care for is supposed to be one of the best in town, so... About psychiatrists, my doctor had said initially that he could refer me to one, but that he probably wouldn't do much more than a GP would do - talk to me and prescribe medicine. I spoke to a psychiatrist when I had suicidal thoughts this last time and ended up going to the hospital. They made me stay overnight, and I talked to him afterward. He talked to me awhile about what was bothering me and suggested I just double up on my 10mg tablets. He asked me what I wanted to do as a follow-up, and I said I had a follow-up appt. with my GP already, so I'd just feel more comfortable doing that. If it's just going in to talk to someone, I'd say it would be best to speak with someone who I already know and trust. It takes me a long time to open up to strangers. I do feel that if my GP thought I needed a high dose, or if I thought I did, he'd give it to me. He's kind of pro meds. I doubt he'd have a problem with it. I just want to get this resolved.

About getting to the root of my depression - I think it's in the family. My cousin committed suicide and my grandpa also struggled with depression. I've had several bad things happen in the past couple of years and esp. the past several months. The anxiety has always been there, but I think these things happening to me brought out the depression. I see it as a chemical imbalance for the most part. I believe the theory that when certain events happen, especially all at once, it causes your brain chemicals to decrease, causing depression. I firmly believe that if I hadn't had such crappy luck in the past few years, I never would've gotten to this point. So, I believe that the meds in combination with discussion will be enough. I guess I've already made the decision to stick with my regular doctor. At this point, I just want it resolved - I'm on my 3rd appt. with the GP for this, and hopefully, I'll be done after that. It sucks that I can't get in until March, but maybe after that point, I can find a doctor that is easier to get into. I like my doctor, but when this clinic moved to the hospital and several of the doctors left, it seemed to go downhill. When I made this last appointment, they made it with the wrong doctor by mistake! I only caught it when I was putting away my card and saw that another doctor's box was checked. I told them I have no problem seeing another doctor if I actually can get in on Jan. 2! They told me no, not possible, and put me off until March. It's not good when your doctor says to make an appt. for 4-6 weeks and and it turns out to be 12. I don't think switching clinics right now is smart, but maybe after I get the depression stuff sorted out. I at least want to talk to someone at the clinic about what I'll have to do to switch, and let them know I understand that my doctor has a busy schedule, but having to wait this long for a follow-up appt. isn't good. It's something that I feel needs to be addressed sooner than that. Am I being unreasonable?

 
Old 12-26-2006, 03:48 PM   #5
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Re: Therapy vs. Psychology

This sounds SO familiar, and I would love an update on this. My general practitioner has been treating me for depression/anxiety for a few years, and after I had a panic attack last week, brought on by the Ambien that he prescribed to help me sleep, I realized that I might want to see someone who knows a bit more about these meds. I went to therapy when I was in grad school, and it seemed useless to me. I generally come across as well-adjusted, got good grades, no family problems.... I felt like she didn't know what to do with me! But yeah, I made an appointment to see a psychiatrist, and I'm hoping that's helpful and he doesn't suggest therapy again, because it really was a waste of my time!

Also, yes, you should be able to get a follow-up appointment more quickly than that. I couldn't believe, when I called my doctor during a panic attack, how long it took for me to get a return call from the on-call physician. i mean, these meds can really mess with you, and I think a doctor is obligated to follow up if he/she prescribes them.... That's just my opinion!

Anyway, let us know how you're doing!

 
Old 12-27-2006, 09:38 AM   #6
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Re: Therapy vs. Psychology

Anyway, let us know how you're doing!

I'm doing alright. I was able to move up my appointment - went in earlier this month. My doctor asked again about therapy, but I told him again why I thought it was a bad idea. He dropped it, but said he at least wants me to come in to see him every 6-8 weeks. I agreed to this, but hopefully I can get on track with this medicine so I don't have to come in so much. My insurance only pays for half the cost of a doctor's visit.

Anyway, I had been taking 15mg Lexapro for a few weeks prior to this visit. I tried going to 20mg, but felt it was just too much, so I dropped back down to 15. I've been feeling really foggy ever since I tried the 20mg. I only did that one day, but I guess 15mg may be too much, too. It's strange, I had been taking 15mg for one month and had almost too much energy until right around mid-Dec. when I upped the dose (at my doctor's request). My doctor suggested taking it at night. Tried that, but didn't help. I'm at least not slipping backward, getting into negative thinking again. My life is improving though, so I owe part of my recovery to good circumstances. It's a pain now because my next appointment is in March - I always feel like this is a never-ending process. I'm giving Lexapro more time. I guess this foggy, tired feeling could the weather or the holidays (I don't think I'm sick or pregnant). If I continue to feel like I'm on a steady recovery path, then I want to discuss going off Lexapro. At my last appt., my doctor said I'm not ready to think about that yet, but at this point, I just can't see being on AD's long-term, esp. if I continue to feel like a zombie. I also feel that I was right not to try therapy again. I have people in my life that I feel comfortable talking to when I need to, and there's nothing going on currently that I feel the need to talk about in a therapeutic setting.

 
Old 12-27-2006, 10:46 AM   #7
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Re: Therapy vs. Psychology

Your next appointment is in....March?? That seems a long way off especially when you are not finding the Lexapro to be working its best for you right now.

The other thing I was wondering about is It's strange, I had been taking 15mg for one month and had almost too much energy until right around mid-Dec. when I upped the dose (at my doctor's request).
That, to me, is something I'd want a specialist's opinion about. If you mentioned this energy abundance to your doc and nothing was said/asked/done about it, I'd really push for a psychiatrist. And surely one could fit you in before March.

It sounds like you are having mixed feelings about taking an antidepressant right now anyway. Yeah--I was off and on mine the first year quite often. It was ages ago, and they didn't have that "stay on them for 6-12 months" rule of thumb. Six months I could have stuck with. Keep us posted.

 
Old 12-27-2006, 11:46 AM   #8
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Re: Therapy vs. Psychology

Your next appointment is in....March?? That seems a long way off especially when you are not finding the Lexapro to be working its best for you right now.

He wanted to see me in 6-8 weeks, but March is the earliest they could get me in. That's one of the reasons I was thinking about switching clinics down the road - this one has an abundance of patients, and it's tough to get in unless you have an urgent concern. I could probably get in earlier if I wanted to by calling and asking if there are any cancellations (which is how I got in so soon with my last appt.). But, I want to give Lexapro time to work - I guess it can take awhile for your body to become adjused after moving up the dosage. I also want to get into a part-time job, and see how that goes. That will be able to tell me if I've really improved - my anxiety and stress levels haven't been tested much lately because I haven't been doing anything. Overall, I definitely feel less anxious and depressed, but lately I think that's because I'm not feeling anything. I guess this is the numbness that many AD users describe.

About the abundance of energy - I got that when going on Lexapro initially. It tapered off after the second week, and I just felt like the medicine wasn't having much affect at all at that point. That's around the time I moved up to 15mg, and I went through the high energy phase again. I also gained several pounds because of an increase in appetite. I didn't mention this to the doctor because I assumed it was just a normal part of the process. At the time of my last appt., this was tapering off and I was going though the fogginess, which only came in short spells throughout the day. It became an all-day thing shortly after, but like I said before, I think some other things could be factoring into it.

 
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