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Kate McCoy, M.Ed, NBCC, LPC
Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5458
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Kate: Hi. I just returned from my therapy appt. and am not

Resolved Question:

Kate:

Hi. I just returned from my therapy appt. and am not at all happy. Firstly, my doctor changed my meds. I am going down and eventually off of Symbalta and going on Prozac to help me deal with my OCD a bit.

We haven't dealt with my OCD because she has felt my plate has been quite full. She's right there. Except today I was a few minutes late and she was waiting for me. I was late and frazzled because of my rituals (which by the way I detest doing since I realize they are senseless). She said it was obviously bothering me quite a bit so we should look at it.

She is right in her comments. But I wanted to express my feelings with respect about the assault. I was going to write it down and read it to her but I never took the time to do it. I am thinking it was a chore that I was avoiding on purpose.

She thinks the OCD and PTSD are in the front for my troubles and depression secondary but I am not sure of this either. Sometimes I get so sad and can't dig myself out of that state. Other times I think that if the troubles were gone so would the depression be and the PTSD & OCD. My therapist told me that this may be true but the medicines will assist me in dealing with the problems so that they will not be what I think about day and night.

I've tried quite a few meds with her but they just don't seem to work. I think that if I could just get past all my stuff, then it wouldn't matter about the meds. I figure this is why none of them work. They would work if I had a chemical imbalance wouldn't they?

I find this to be a step backward for me. I see her twice a week and I figured if I could have talked about the assault today then when I see her again at the end of the week, I can discuss it a bit more so I don't feel so upset. Anything to do with the assault upsets me quite a bit. So I think I just wrecked making any progress on Friday as well since I didn't bring up the assault today.

I will end here because I think I am beginning to make little sense in my note to you. If you have any insight, I am always happy and appreciative to get it.

Kathy
Submitted: 2 years ago.
Category: Mental Health
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Kathy,

 

It sounds like you feel your treatment is a bit out of your control. But is also sounds like you feel that fear is holding you back from taking control. Does that sound right?

 

You mention wanting to talk about your assault with your therapist but either fearing how you will feel talking about it or putting it off because of the feelings you have about it. So your desire to face your assault is there, it's just being blocked by your fear. This is a very good sign and means that you are recovering. It may not feel good, but that is ok.

 

Your therapist may be taking the lead in therapy because she feels that either this is the path you would most benefit from or she sees you struggle with therapy and wants to help you find what is most important to talk about. But if you have your own ideas about what you want to say, then working towards bringing this issue up should be your next step.

 

Talk to her about your difficulty with speaking up. I know it's been a topic before, but it may need more work. Confronting how you feel when you assert yourself helps you learn how to get your needs met, a very important step in recovery.

 

It is hard to tell with OCD, PTSD and depression which came first. You can go by which you developed first, but if they were all initiated by the assault, then it may be too hard to tell. I agree with you that mediation may not be necessary if you feel you are able to cope with your daily life without them. The best way to know is if you slowly taper off your medication and see how you feel.

 

Chemical imbalances are mostly thought to affect people with illnesses such as Bipolar and Schizophrenia. People with PTSD usually are not thought to have imbalances. Depression can be influenced by a chemical imbalance, but studies are still not clear exactly what causes depression. If your depression started at the time of the assault, than most likely it is environmental in cause and not an imbalance.

 

There is nothing wrong with bringing up your assault with your therapist on Friday. There is no set rule about when to bring up certain issues since it is the therapists job to be sure you are able to cope with your feelings before you end the session. You may still want to try it and see how it goes.

 

Kate

Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5458
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
Kate McCoy, M.Ed, NBCC, LPC and 2 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.

Kate:

 

Thanks for your response. I've dealt with OCD for about a year when I was 17 and graduating high school. I was having trouble with that transition. But it did go away once I got a job and started university. My therapist said those are both good things as many people start OCD much younger.

 

I'm not sure what I want except to feel better. Some of the meds I am on (gabopentin) for example, are for night terrors. That med works to eliminate those which is good because they are terrible to go through. I also take Clonazopam which help me calm down. It's the depression drugs that I wonder about. Have you heard any bad or good things about Prozac? I checked online and couldn't find anything of value.

 

I do worry quite a bit about me left upset especially on a Friday with the weekend looming ahead. While most people look forward to the weekend, I am terrified of being left alone with my feelings and emotions since I do not know how to handle them yet. Sometimes it all becomes too much for me.

 

I wish I had more than desire when it comes to talking about the assault. It doesn't feel like I am making progress when I can't talk about it and keep putting it off. Fear is very powerful. I always seem to feel afraid. More importantly, besides the obvious of being afraid of being attacked again, I am afraid of being alone with my feelings.

 

Kathy

Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Kathy,

 

Some of the medications you take are necessary and I agree you should stay on them. But depression medications are only if you feel you cannot function without them. In my experience, not everyone with depression takes medication. And if you feel therapy and other supports are enough to help you move towards healing, then medications are not needed.

 

My concern is that you were feeling so bad recently that you felt unable to function during the day, preferring to sleep and avoid life. What you went through was very difficult and I doubt therapy alone could have helped. But if you are better now and have been able to stabilize your emotions, then discontinuing the medications should be considered in the near future. You may just need a bit more time to tell if it is a good move for you. The danger is the medication can make you feel better then you feel you don't need them because you no longer have the symptoms, a common experience in recovery. Your therapist should be able to help you make that judgment.

 

Prozac is used to treat depression, panic and OCD. So you may be on the medication to address those three issues. I have heard good and bad about Prozac. But that is mostly due to the fact that every medication reacts differently in each person. No person will have the same experience as the next with a medication because everyone's body chemistry is so different. So one person can have a horrible reaction and another feel it's helped them enormously. It depends very much on your personal experience.

 

Talk with your therapist about coping mechanisms to get you through the tough time you may have over the weekend, or at any time. You may also want to consider that your apprehension about the weekend may be a learned behavior. You may feel because your therapist is not available then that you are trapped with your feelings. Or that the weekend represents a shift in schedules, which may make you feel upset. All of these feelings impact how you approach feeling alone with your feelings.

 

You may also want to consider setting up some type of support for yourself during the weekends. A support group or even on line forum can give you a place to turn when you feel overwhelmed. I am here as well. I can talk with you as often as possible to help you through. Just changing how you approach the weekend can make a big difference.

 

Kate

Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5458
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
Kate McCoy, M.Ed, NBCC, LPC and 2 other Mental Health Specialists are ready to help you

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