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Re: Shelli - are you there? » Marie1

Posted by shelliR on November 7, 2001, at 22:21:35

In reply to Re: Shelli - are you there? » shelliR, posted by Marie1 on November 7, 2001, at 7:36:07

> Hi, Shelli.
> To answer your questions, I don't believe the diet pills do anything that I feel physically *at all*, no doubt due to my tolerance to them. I began using them 20 or so years ago because I had gained about 30 lbs in college and during a stressful relationship I was having (this was in my early 20's). They helped me lose the excess weight, but also I noticed a brighter mood. I've probably been dysthymic most of my life (this according to pdoc), but only officially diagnosed when I had my first major depression. Anyway, I kept using the pills, not for weight loss per se, but because they made me feel better. Phentermine acts on either dopamine or uh, that other chemical - can't recall the name. I theorize that I need Prozac to help regulate the seratonin and phentermine for the other. OR, I'm totally full of shit and simply have a psychological dependence on a drug that is meant for short term use only. At this point, who cares. Without it, I'm depressed, so I continue to use it.
> I'm not sure, maybe they do boost my energy somewhat, it's hard to tell. When I was going through my last major depression, I had quit taking them, and, of course, was totally apathetic, lethargic, and energy-less. But that's typical for a depressive state.
> Why, specifically, do you take concerta? Is it to augment, counter side effects, or for ocd? And I wonder why that's ok, when my shrink has such a problem with my use of phentermine. Like you, I don't have a problem with addicitions to other drugs. I can either take or leave cocaine, for example, and it seems to me that would be a drug of choice, given my predilection for stims.
> (As an aside, please don't get the impression I'm some sort of closet middle aged leftover hippie housewife druggie. No one at the PTA meetings would ever suspect I had any kind of substance abuse problem. I'm a kid of the 60's and 70's when we tried all sorts of illicit drugs, so maybe I'm a little more broad minded about the occasion use of non socially sanctioned drugs. OR, I never really grew up ;-) !)
> I've found it interesting to read threads here and on PB about people using opioids and benzos as AD's, because I claim phentermine helps (partially) with my mood. So I understand taking something that others might consider inappropriate for treatment.

My pdoc is big on combining ADs with stimulents. He thinks he most often sees extremely noticeble
changes in depression with that combination. I had tried almost every stimulent (for the same reason) with my past pdoc, except I had never tried concerta. All of the other ones made me feel really awful. Because of the slow release of concerta (really ritalin) my body was able to handle it and even later handle regular ritalin when he wanted to give me a jump start in the morning. I don't think it's
very contraversial for pdocs to give it anymore; at least pdocs who go to psychiatric conventions know that it is a very common adjunct to an AD. If it had the same effect on your lethargy, etc. then that would be great; you might have the same benefit with an pdoc santioned drug. I know you don't have a pdoc now, but maybe after you find one. You might be asking potential pdocs about their feeling of stimulents with ADs. I think your therapist should probably accept that. (If he is not too stubborn, and if you would take him back :-)

I doubt that my pdoc would ever sanction oxycontin as an AD. I'm glad you found a pdoc who took you at your word and understands alternative drug choices.

Most doctors wouldn't. I am totally freaked out about the price and now wish he had started me on something a lot less expensive. My meds cost me almost $1500 this last month. I came home from the pharmacy and cried and cried tonight, I was so scared about how much this is costing me. I have applied to several drug companies to get assistance, but I don't know what's going to happen. I
might be able to work it out, if not, he's got to change both concerta and oxycontin to shorter acting drugs which are not so expensive. It is number one on my list to bring up on Monday when I see him.

Has your therapist since changed her mind about it? Wasn't it difficult to continue working with her after she gave you that ultimatum? Do you discuss your meds with her now?

We've had several major disagreements since I've started working with her in the last three years. I guess that this was my first ultimatum. At first I wasn't sure that I wanted to continue working with her, because figuring out my meds was central to my life, and I wasn't allowed to bring them up in therapy. She said (after learning from my psychiatrist and psychologist that they both supported my trial of codeine) that maybe she would come to change her mind. That was major for her.


It was difficult for a while; I think there was resentment on both sides, but we seem to have ridden through this crisis also. The only way I can defend her point of view was that she really thought that what I was doing was going to destabilize me further and she didn't see any point in doing therapy. With a pdoc in the picture, at least he would have all the responsibility around my drugs. I was just trying to keep alive, and I do resent that neither she nor my pdoc had any options to offer me, yet they outright rejected my option. It's not like I hadn't tried dozens and dozens of other unsuccessful drugs. I can tell that she's never suffered from a horrible depression. Yet of all my therapists, she was the best in working with me when I was in crisis, especially on the phone. Kind of ironic.


> I had been upfront with my pdoc since day one regarding my use of phentermine, since I really believe it helps me to control my depression. I guess he thought that now was a good time to quit since I seem to have the drinking thing under control. (December 24th will be 6 months!!) One week he talked me into giving him my pills (I've since quit carrying them in my purse!), leaving me enough to ease off slowly. I couldn't do it. I'm not sure if it was a contol issue with him or not. I never understood why he felt he was "colluding" with me on my use of phentermine if he just ignored the issue. There were other issues we intended to work on - like my marriage. I really think he was using my transference for him to coerce me into giving up diet pills. Obviously my need (addiction?) is even stronger than that. I have an enormous regard for my pdoc, actually thought I couldn't make it without him, and not seeing him has been painful. But I'll survive - I always do. I've posted elsewhere that I've lost my dad, mother, and two brothers in the last 9 years; it always feels like I'll never recover, but I do. The pain never goes away though.

Well, I think it is a good thing to know that you can live without him.. If you ever go back to him, you will always know this. I don't think that going to a therapist implies that we are putting our lives in their hands unless something comes up which puts our life in jeopardy. Collusion was the same concept that my therapist used, only she felt if I had a pdoc prescribing, that she would then not be responsible. I had always believed that *I*
was responsible.

> Whoa, Shelli, sorry. I never meant to write a dissertation here! If you're still following this, thank you. It is cathartic to write about it.
> Take care of yourself.
> Marie


> I'm the same way; Once I get started, I want to get if all out!

Take care also,

Shelli
>
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