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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Camille Dumont on May 23, 2005, at 22:38:08
Ok, to put this in context, I live in Canada.
Something like 3 years ago I hit a really rough pass that made me suicidal and acted upon it ... of course I failed and was sent for a psych eval ... and re-sent there a few times.
Turns out at that time I was majorly depressed and the p-doc and GP started to prescribe me APs in addition to ADs (Zyprexa, Seroquel, etc.) because I saw things ... I promptly stopped taking those due to side effects like absence seizures.
At that point my GP kind of got the point that maybe this was not the best route. Again, was sent to be evaluated and it turns out that I'm not psychotic or schizophrenic ... I just have SPD (schizoid personality disorder). But GP insisted that I needed the ADs and would need them for the rest of my life.
I disagreed at that time and stopped taking them over the course of a few months. Been completely free of them since March. I don't feel great, I do still feel suicidal sometimes but I also did even on the ADs. All in all, I feel more "real" without them. I would rather feel the ups and downs than just a smooth eveness that the massive doses of ADs brought on.
Now GP doesn't know this but I have to go in for my yearly exam (I've been pushing it back but I need prescription for contraceptive so now I can't push it back anymore). I know he will ask about the ADs (prescriptions are soon going to run out ... had I been taking them). Now my question is this : do I have the right not to take the ADs even if GP says I need to?
What are my rights?
Can I be forced to take them?
Can he check to see if the scripts are being filled?I'm asking this because, well, I would rather not use deception but if it comes to that I'm very much ready to not say a word and even fill the script and dump them if this is what it takes to preserve my freedom not to take drugs I feel I don't need.
Much appreciated.
Posted by Pfinstegg on May 23, 2005, at 23:41:26
In reply to What are my rights?, posted by Camille Dumont on May 23, 2005, at 22:38:08
I think you are definitely within your rights not to take the APs. You have given them a good try, and, if the positives outweighed the negatives, you wouldn't be asking this question here. I think it would be affirmative for you, and probably instructive for your doctor, if you told him exactly what you've told us. The APs can be tremendously helpful- intermittently, or short-term, especially, but, as you know, there are some real threats to one's well-being with them. If you are schizophrenic, then they are really necessary, but for you, it can always be a choice. Gaining weight, developing unhealthy blood lipids and diabetes are the main physical dangers. The one you mentioned- feeling too evened out, and sort of losing your feelings and passions- is not something which a doctor is apt to think is important- but it is. Also, that sounds like a very healthy part of you!
I'm just wondering- do you have a therapist? If you have a good one, whom you can see over a period of years, you really can grow beyond being schizoaffective, if indeed you are now, and have the life you really want. Lots of people have been able to do that-I'm sure you can, too! It is a long-term endeavor, but what could be more worthwhile?
I'm not sure how it works in Canada in terms of long-term therapy aimed at real inner change. It may be easier to obtain that in the US.
.
Posted by Shortelise on May 23, 2005, at 23:59:26
In reply to What are my rights?, posted by Camille Dumont on May 23, 2005, at 22:38:08
There is nothing anyone can do if you don't take your meds unless you are deemed a danger to yourself or others. But this would be a fairly long process. Unless there is something in place already because of your suicide attempt.
I think I might tell my doc that I would prefer not to take the meds and ask him what he would think.
Do you live in a place where it's possible to see a psychiatrist? A referral from your doc would get you in line. I'm in a province where it's fairly easy to see a psychiatrist, and it's been very helpful.
Stay safe.
ShortE
Posted by Jazzed on May 24, 2005, at 7:39:13
In reply to What are my rights?, posted by Camille Dumont on May 23, 2005, at 22:38:08
>
You can't be forced to take them, but maybe the ones you've been prescribed aren't right for you. They all work on different neurotransmitters. The SSRIs work on the serotonin, Wellbutrin works on norepinephrine and dopamine, and the stimulants work on dopamine. Have you tried any natural products to help you feel better? There's 5 HTP (Natrol brand), SAMe, St John's Wort, D-phenylalanine, L-phenylalanine, and DLPA (which is a combo of the last 2), etc... They all also work on different neurotransmitters, and usually don't have the side effects of the prescription ADs. I take 5 HTP religiously, to supplement ther serotonin in my brain. Either I'm deficient, or I get depleted somehow. If I don't take it sometimes I feel VERY depressed. I have tried the others, and the only other one that gave me relief was the SAMe, if you get that you have to get a good (i.e. expensive) brand or it won't work. It's good for fibromyalgia too. Anyway, there are alternatives to the prescriptions, if that's any solace to you.
Good luck!
Jazz
Posted by Camille Dumont on May 24, 2005, at 8:48:55
In reply to Re: What are my rights? » Camille Dumont, posted by Pfinstegg on May 23, 2005, at 23:41:26
> I think you are definitely within your rights not to take the APs. You have given them a good try, and, if the positives outweighed the negatives, you wouldn't be asking this question here. I think it would be affirmative for you, and probably instructive for your doctor, if you told him exactly what you've told us. The APs can be tremendously helpful- intermittently, or short-term, especially, but, as you know, there are some real threats to one's well-being with them. If you are schizophrenic, then they are really necessary, but for you, it can always be a choice. Gaining weight, developing unhealthy blood lipids and diabetes are the main physical dangers. The one you mentioned- feeling too evened out, and sort of losing your feelings and passions- is not something which a doctor is apt to think is important- but it is. Also, that sounds like a very healthy part of you!
>Well the anti-psychotics are not really the problem. I have results from the MMPI and the Inkblot tests that state that I test negative for "thought disturbances". Its more the anti-depressants that I want to be allowed not to take.
> I'm just wondering- do you have a therapist? If you have a good one, whom you can see over a period of years, you really can grow beyond being schizoaffective, if indeed you are now, and have the life you really want. Lots of people have been able to do that-I'm sure you can, too! It is a long-term endeavor, but what could be more worthwhile?
>
I had one, a very much qualified psychologist which I saw for two years. But I stopped. It was not getting anywhere. The fact its, from what I've read, if you're schizoid PD like I am, its very very difficult to get anywhere in therapy. I never felt that "transferance" thing, I never felt any attachment to my therapist, and I felt very little when I quit. And its not her ... its just the way I am. I don't attach to people and I don't feel a need to either. I know that its a very deeply ingrained defense mechanism but when its working well, I feel fine and dandy. Or rather I don't feel ... thus I don't feel depressed. Its when it starts to crumble that things go awry ... but I really doubt much can be done to change the way I am. PDs are apparently notoriously difficult to "treat".> I'm not sure how it works in Canada in terms of long-term therapy aimed at real inner change. It may be easier to obtain that in the US.
> .Unfortunately, here, if you want therapy and you have a job and an insurance, they pay but only to a certain amount. For me its 80% up to $1000 per year ... so around 15 visits. Not a whole lot since most therapist like to see you every two weeks or so.
As I said, I felt it was not going anywhere ... and in a way I wasn't sure that I wanted it to go anywhere ... that is anywhere being me changing the way I am. And if you really don't feel as though there is something "wrong" or "not working" that you want to change, therapy is of very limited use. At least its the way I feel.
Thanks for the reply and insight
Posted by Shortelise on May 24, 2005, at 14:30:31
In reply to Re: What are my rights?, posted by Camille Dumont on May 24, 2005, at 8:48:55
Maybe you don't want me to post to you so you don't read my posts, and that's ok.
In Canada, psychiatrists are covered by medical because they are medical doctors. Psychologists are not. I found A very good psychiatrist.
Hope this helps.
ShortE
Posted by Pfinstegg on May 24, 2005, at 19:22:46
In reply to Re: What are my rights?, posted by Camille Dumont on May 24, 2005, at 8:48:55
If you have a lot of difficulty attaching to a therapist, learning to attach and trust becomes one of the main goals; two years is not a enough time. It can take many years. According to ShortE's post, you can apparently get very good long-term psychotherapy in Canada. I think you are unduly pessimistic about the possibilities for growth and change in personality disorders. They are a big part of what is treated in long-term therapy. Did someone give you a really discouraging prognosis? I think, if you read some of the case histories in the current psychiatric literature, you will be very encouraged about what it's possible to do now.
Posted by Camille Dumont on May 24, 2005, at 23:14:28
In reply to Re: What are my rights? » Camille Dumont, posted by Shortelise on May 24, 2005, at 14:30:31
> Maybe you don't want me to post to you so you don't read my posts, and that's ok.
>I'm not sure I even understand what this is supposed to mean.
> In Canada, psychiatrists are covered by medical because they are medical doctors. Psychologists are not. I found A very good psychiatrist.
>So basically your psychiatrist did therapy ... I mean beyond just pill pushing? In Quebec, or at least in the region I am there is one psychiatrist that I know is not attached to a hospital but she doesn't take any new patients ... other than that you have to go to the psychiatric hospital to see one, at least that I know of. Not something I particularly enjoy.
> Hope this helps.
>
> ShortE
Posted by Camille Dumont on May 24, 2005, at 23:51:27
In reply to Re: What are my rights?, posted by Pfinstegg on May 24, 2005, at 19:22:46
> If you have a lot of difficulty attaching to a therapist, learning to attach and trust becomes one of the main goals; two years is not a enough time. It can take many years. According to ShortE's post, you can apparently get very good long-term psychotherapy in Canada. I think you are unduly pessimistic about the possibilities for growth and change in personality disorders. They are a big part of what is treated in long-term therapy. Did someone give you a really discouraging prognosis? I think, if you read some of the case histories in the current psychiatric literature, you will be very encouraged about what it's possible to do now.
Nobody ever gave me a pessimisstic prognosis. Maybe its my fault for browsing around to learn more about the condition. I end up seeing things like :
"Schizoid personality disorder is a chronic illness with a poor prognosis. The social isolation characteristic of the disorder often prevents others from offering the help or support that could potentially improve the outcome."
"While there are many suggested treatment approaches one could make for this disorder, none of them are likely to be easily effective. As with all personality disorders, the treatment of choice is individual psychotherapy. However, people with this disorder are unlikely to seek treatment unless they are under increased stress or pressure in their life. Treatment will usually be short-term in nature to help the individual solve the immediate crisis or problem. The patient will then likely terminate therapy. Goals of treatment most often are solution-focused using brief therapy approaches."
"People with this disorder rarely seek treatment. The treatment can be difficult due to their initial reduced capacity or desire to form a relationship with a health professional. A non-intrusive support group can alleviate feelings of solitude and fears of social interactions and close relationships. Individual therapy, in most cases, has proven relatively ineffective and often temporarily addresses immediate conditions instead of seeking to terminate the disorder entirely."
"Individuals with this disorder rarely seek treatment, and little is known about successful therapies. Talk therapy may be ineffective because people with schizoid personality disorder have difficulty relating well to others."
" Long term individual therapy is helpful in trying to focus on and instill some optimism in their lives. At times it has been helpful to actually audiotape a therapy session with these individuals on their release, and have the tape played back to them, especially in terms of their interpretation of their affect. They usually have a very minimal range of affect.
Schizoid personality disorder remains a very difficulty disorder to treat, and remains in the shadows of psychiatric diagnoses."
"People with this personality disorder usually don't change much. The goal will be to help them find the most comfortable solitary niche. Cultivate a job and hobbies that are satisfying and allow you to be on your own.
Treatment goals should focus on decreasing resistance to change, goal development, improving social interaction, improving communication, improving self-esteem, and decreasing social isolation. "
Its not exactly all that optimistic and me being a more "half-empty" type of person ... it just seems rather pointless. Because of its inherent nature, there is very little on SPD compared, for example with BPD.
And I'm not even sure that I want to change. Perhaps this is the problem ... my personality is not really a problem, most of the time. I hold a job, pretend to relate to others all day and find my solace on the weekend. The only desire for change I feel is when things go bad. I can relate to the comments on episodic need for therapy.
So I don't know ... for now my main goal is going through that silly yearly exam and remaining meds free. I have a very very faint grasp on who and what I am and the meds just diminish that grasp. I spend days asking me who and what I am ... and taking pills that further disconnect me from what little feelings I have do not help much.
Posted by Pfinstegg on May 25, 2005, at 7:47:15
In reply to Re: What are my rights?, posted by Camille Dumont on May 24, 2005, at 23:51:27
What you quoted is very much on the pessimistic side. There are other, much more encouraging views. I think you did emphasize the most important point= whether or not you personally want to change. The "episodic" nature of treatment which you quoted probably comes from the strong pull to withdraw in the face of attachment feelings which people with SPD may have. I still believe that, if you want treatment, you can benefit a lot from it. I know about several people who have.
This is the end of the thread.
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