Lived Experience Forum

[Emz]

Why do doctors always precribe SSRI's for anxiety?
I do not need my mood elevated. I need it decreased (in the breif periods that I am not anxious them I'm overly excited which can have some pretty shitty outcomes).
I do not need to be happier, I am not depressed.

How does it work that more seretonin is supposed to level me out and stop me living in a state of near-panic?
Are my doctors just following a default action or is there an actual reason they won't prescribe out of the SSRI drug class?

[NikNik]

Hi @Emz

Well.. that's a head scratcher for me - I don't know the in's & out's of medication. 

However, I think the questions you have asked are excellent.

What does you Dr /Drs say when you present these questions to them? As  I said, they are excellent and very valid questions.

[Emz]

I can never ask them questions.
My social anxiety gets in the way of the how I communicate, especially since I only really go to the doctor about meds when I am already in a state.

My brain always runs away and I just agree with everything they say without even thinking about it.

[Appleblossom]

I found your question worthwile. @Emz Good for me to think about.

In many ways I am similar. I have labile mood more than low mood. I have high anxiety but also high experience of performance.  My diagnosis of major depression is probably no longer relevant.  I was exhausted because I was working hard and not getting respect or respite, not because I was sick.  If somehone was good to me I was happy.  If someone was mean I was hurt, angry or afraid.  That is true in present tense.

Write down questions, before you visit.  I note them next to the appointment date in my diary.  however I usually have too much going on for short consultations .. so I persist .. sometimes ... I rollover the questions to next consult, but I try to keep actively engaged in the decision making about my health.

It seems they have fallen on a convention that SSRI and SNRI are both good for depression and anxiety and do trial and error. I have been on both.

It raises some of the issue ..are my meds contributing to sleep problems. 

My current new GP is concerned to monitor my state and be thorough rather than just give out pills so I am trusting that process.

[Emz]

Yes I will have to write some down questions. I just wish I could trust them.

 
I'm glad it sounds like you have a good one.

[Appleblossom]

Your instincts may well be right.  You might have to keep looking.  Dont settle for disrespect, I didnt know how to tell the difference at first.  Also what may work for one person might not work for you.

I have had a lot of bad GP experiences, and that actually came up in my first session with this GP as well as my SI ( about 6 months ago).  I follow all the rules do what is required by their systems.  I am respectful to them. I am careful to acknowledge the good in my life.  I guess my obvious distress is making it obvious that the broader health system has not really worked for me.

I probably really need that psychiatrist but somehow I just hang on til the next session.

[Emz]

Yes I think I need a psychiatrist - if only I had enough mental-health plan sessions!
I don't expect doctors to know everything about everything, but it would be good if they could at least admit it when they are unsure.

I think I will find a new doctor. I find my newest one to be quite slack. She heard I had side effects from the last SSRI, and without even asking what the side effects were she tried to talk me into taking it again.

[mrkotter]

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@Emz wrote:

Yes I think I need a psychiatrist - if only I had enough mental-health plan sessions!

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Actually you don't need a mental health care plan for a psychiatrist. All you need is a referral from a GP.

You only need a mental health care plan if you want to claim sessions for a psychologist under medicare. 

[Emz]

But how much will it cost without a mental health plan? Or is it the same as a doctor? 

[mrkotter]

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@Emz wrote:

But how much will it cost without a mental health plan? Or is it the same as a doctor? 

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Ok. Seeing a psychiatrist or a psychologist are two very different things under Medicare. Completely separate.

To see a psychiatrist you need a referral (mental health care plan is different - I'll get to this). A GP will write you a referral to one. Ask about which one you would like to see - they can help with this. Ask about cost - it does vary, some bulk bill, some cost a lot more (it's exactly like a bulk billing GP or seeing a private GP who leaves you with out of pocket expenses). 

To see a psychiatrist you do not need a mental health care plan at any point. You can see a psychiatrist an unlimited amount of times in a year - as much as they want to see you.

All you need to do is walk into the GP and ask to see a psychiatrist. They write a letter to one. You take that, make an appointment with the psychiatrist, and then take that letter to your first appointment. Simple as that.

A psychologist means you need a mental health care plan as you know this is limited to 10 sessions a year. A mental health care is a requirement, under medicare, to see a psychologist not a psychiatrist.

Does this help?