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Dr. K
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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depression/ psychiatrist please

Resolved Question:

depression / may I speak with a psychiatrist

Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. K replied 3 years ago.

Dr. K :

I am a psychiatrist and ready to chat. Let me know when you're back online.

Customer:

Are you still available?

Customer:

is there another psychiatrist available?

Dr. K :

Hi, sorry, I was with another person. I am here now. What can I help with?

Customer:

I am here

Dr. K :

Tell me what's going on & what you need help with.

Customer:

I am really depressed. I have been taking Wellbutrin x 3 weeks and trying to get the dosage adjusted. I don't know if it is menopause, stressful job or husband being in Afghanistan, maybe a combination of all.

Dr. K :

Depression is almost always multifactorial...so likely related to all those and possibly more reasons.

Customer:

I really do not want to do anything. I work full time at a middle school and am a social worker. I am typically very task oriented, more outgoing, have a list all the time trying to get something accomplished. I need desperately to know if I have a diagnosis and need a different type of treatment.

Dr. K :

As far as the menopause part, your doc can check your hormone levels. Some women do better emotionally with hormone replacement....while others either get worse or have no effect.

Dr. K :

Keep in mind, making one med change at a time is best. If you start hormones and antidepressants at the same time...and then feel better in a month, you may not know which one is helping more.

Customer:

true,

Dr. K :

Tell me more about your wellbutrin dosage...and whether you've tried other meds in the past. Is there any family history of depression, anxiety, bipolar, etc? If so, try to find out what meds have worked or not worked for family members (sometimes patterns run in family....otherwise, despite all the science, taking meds can be a trial & error approach).

Dr. K :

Also, keep in mind seeing a psychologist is a long term therapy that doesn't work after only 2 sessions. But tell your psychologist you don't feel it's helping yet so you can make concrete goals and plans for your treatment.

Customer:

I have tried Celexa, one year ago took it in Feb. for two months to complete the school year...went off of it and didn't have any problems again until this Feb. Celexa worked, no libido, but I tried it again this time with no success. I may need to try something different.

Dr. K :


Depression should be treated holistically. Most research on this condition show the best approach is a combination of medications & psychotherapy.

I almost always recommend 1) psychotherapy with a live therapist, and 2) learning some formal relaxation therapy. Also, by formal relaxation therapy I mean yoga, meditation, or similar methods. Having relaxing hobbies is also important, but not quite the same as formal relaxation therapy.

These last 2 treatments I mentioned are proven by sophisticated studies using brain scans (CT, MRI, EEG, pet scans) to improve brain function. Here's a simple exercise to get you started:


In fact, there is more & more research showing the efficacy of relaxation therapy. Another technique is called mindfulness. These technique has recently been incorporated into a specific type of psychotherapy called CBT (cognitive behavioral therapy) & is being called MCBT. Preliminary studies are promising.

And remember you can't separate emotional health from physical health, so exercise & nutrition are vital.

Also, keep in mind the following:

Customer:

My brother has been diagnosed bipolar. My father is deceased but I believe he had depression most of his life, I just didn't know what it was.

Dr. K :

What dose of celexa worked last time and what dose did you try this time? Has the wellbutrin had any effect?

Dr. K :

Bipolar is highly genetic. Even if you don't have "full fledged" bipolar, it's possible your depression "leans in that direction," so to speak.

Customer:

I am sorry but can't remember, the celexa dosage. The wellbutrin has helped, I don't think I could continue working without it.

Dr. K :

If you havent seen a live psychiatrist or psych-nurse practitioner, try to find one. These meds are too complicated for most family docs.

Dr. K :

Ok, so what's the wellbutrin dosage? The average dose needed is 300mg & the max is 450mg.

Customer:

150 mgs. two times a day, I have tried 1 time a day as well...I have hand tremors as a result.

Dr. K :

Are the tremors worse on the twice/day dose?

Customer:

definately

Dr. K :

Are the tremors getting worse or staying the same recently...?

Customer:

staying about the same

Dr. K :

If they are tolerable, I would stick with the current dose for now. Sometimes side effects go away with time...and other times they don't. This is difficult if not impossible to predict. Also, keep in mind the full effect of a med like wellbutrin can take 1 month (some studies say even longer).

Customer:

okay, I will stay with the Wellbutrin

Dr. K :

Traditional antidepressants can make bipolar worse...or also patients with depression that "lean in the bipolar direction." The good news is wellbutrin is the least likely to do this.

Customer:

okay, my brother has a dual addiction, alcoholism and bipolar.

Dr. K :

A couple other options to discuss with your doc are trying a low dose of lexapro in combination with the wellbutrin; if that works, perhaps you could lower the wellbutrin if the tremors continue and or completely transition to lexapro (it's similar to celexa, but can be better for some).

Dr. K :

Low dose lithium can also help augment meds like wellbutrin.

Dr. K :

The key is seeing a live, trained specialist to see if they think you have any bipolar tendencies. Lamictal is a great medication for people with depression that is of bipolar origin.

Customer:

Lexapro / lithium...okay, I know that it is trial and error. I think my first thing is to find a psychiatrist...how can I find a good, really good psychiatrist in my area?

Dr. K :

There are also several self-help books you can read which can help including: 1) "The Seven Spiritual Laws of Success" by Deepak Chopra, 2) "The Feeling Good Handbook" by David D. Burns, 3) "The Relaxation & Stress Reduction Workbook" by XXXXX XXXXX, & 4) "The Depression Workbook: A Guide for Living with Depression and Manic Depression" by Mary Ellen Copeland and Matthew McKay.

Customer:

okay, thank you for those suggestions

Dr. K :

Where do you live? The best thing is a referral from a trusted doctor, or friends or family. it doesn't hurt to check to see who your insurance will cover unless you can afford to pay cash (which can be very expensive).

Customer:

Clovis, NM closest cities are Lubbock, TX and Amarillo, TX

Dr. K :

Probably the best thing is to check with your psychologist for a psychiatry referral.

Customer:

okay, I will do this

Dr. K :

http://www.ucomparehealthcare.com/drs/new_mexico/psychiatry/Clovis.html I don't know these people, but I just googled that link.

Customer:

okay, thank you...I hope I can save all the suggestions you have made so I can refer back to them

Dr. K :

Anything else I can help with?

Dr. K :


I hope this helps. Let me know if you need more feedback. Good luck & take care.

______________________________________________________________________

Please let me know if you need more information. We can continue the dialog until you are satisfied. Once you are happy with the answers don't forget to hit the ACCEPT button & provide expert feedback. Also remember that this is not an official doctor patient relationship and not a substitute for a full live psychiatric evaluation. Thank you for using justanswers.com

Customer:

I thank you, XXXXX XXXXX given me some good suggestions.

Dr. K :

Use your strengths to overcome your symptoms. There is always hope. Especially as it doesn't sound like you've had ideal treatment yet.

Customer:

thank you again!!!

Dr. K :

Please hit ACCEPT when you're ready to end the chat. Take care.

Dr. K :

You are very welcome.

Customer:

I'm trying to write some of the dialogue down before accepting.

Dr. K :

Take your time. You could try copying at pasting it into a word document to print as well.

Customer:

okay

Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience: 15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
Dr. K and 2 other Mental Health Specialists are ready to help you

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What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
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  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

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Dr. K
Dr. K
Mental Health Professional
357 Satisfied Customers
15 years clinical experience in all areas of psychiatry. Holistic and practical approach.