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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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Hi Dear,My name isXXXXX live in Canada. I was in a car

Customer Question

Hi Dear,

My name isXXXXX live in Canada. I was in a car accident back in sept 7 2011. I was diagnosed with PTSD and Anxiety. I have refered to psychiatrist for PTSD I am waiting for an appointment. For the past a month I feel sad and unhappy, I lost interest in activities I used to enjoy, My sleep is completely lost, having concentration problems, loss of energy, headeaches, I get upset easily (Mood Swings). Now for the past 2 weeks I can't recall certain information such as personal information and past experinces like I can't recall my childhood my siblings told me some stuff about my past experince and events but I can't recall it. After the accident I was having problems with memory like forget things but last two weeks I am very very stressed and can't recall certain events Is this mean I have Dossociative problems? Your help is appreciate it.

Regards,
S
Submitted: 2 years ago.
Category: Mental Health
Expert:  commissure replied 2 years ago.
Hello, this is Dr. David. I have read your question and am ready to help.

Not necessarily dissociative disorder

More likely depressive disorder

I would talk to your doctor about an antidepressant medication like lexapro or celexa
Customer: replied 2 years ago.
Relist: Inaccurate answer.

I am not happy at all it is inaccurate answer and answer quality I need a broad and more informative answer please and please assign a psychiatrist or neurologist or Dr Abby she is online now thank you and please hurry.
Expert:  DrThomasMD replied 2 years ago.
Hello from JA
Dr. Abby is not on line currently
I am a board certified internist and broad certified in integrative medicine and well as certified in classical homeopathy, trained in functional medicine and have a degree in psychology as well.

I tend to take a very broad view of situations.
Would you like some help?
Customer: replied 2 years ago.
Relist: Other.
Please assign a psychiatrist or refund my money back. Thanks
Expert:  Camille-Mod replied 2 years ago.
Hi, I am a Moderator for Just Answer. I have recategorized your question so that our Mental Health Professionals can help you. Sometimes, finding the right Expert can take a little longer than expected and we thank you greatly for your understanding. We’ll be in touch again shortly:-)
Expert:  Dr. Michael replied 2 years ago.
Hello. I believe I can be of help to you with this issue.

Feel free to review my credentials on this site and let me know if you'd like me to respond to your question. I can tell you that you are not being treated correctly for your problem, which appears to be a combination of PTSD and clinical depression. Medication alone is not likely to help you, as you've found out already.

Let me know.
Customer: replied 2 years ago.

 

Hi Dr Michael,

 

Kindly respond to my question. Thank you very much,

 

Regards,

Siar

Expert:  Dr. Michael replied 2 years ago.
Let's take a moment and have you review what YOU see as your symptoms and problem areas. You have been diagnosed with PTSD, which would suggest some of the follow symptoms. I'd like you to confirm or dis confirm whether you experience them. Then, I can talk to you about some treatment or intervention options if you'd like.

First, your diagnosis would infer that you are having such problems as flashbacks regarding this accident or other past traumatic events. This would involve intrusive and unwanted memories or visual images inside your mind of an accident or traumatic event. You are experiencing fear and avoidance responses to anxiety-provoking situations; so you may be isolating yourself and doing things that are out of character for you---escaping and avoiding stress situations you used to handle quite well. It is common for instance for a person experiencing a car accident to develop a fear of driving or riding in cars and even, a fear of traveling to ordinary places. They dislike being in crowded areas that feel 'chaotic' to them and uncontrolled.

Presumably, you startle easily or have sudden, severe anxiety reactions when certain situations or triggers in the environment are present. You may be having anxiety or panic attacks from time to time. You have already noted that your sleeping is disturbed, as is your eating. One would infer that the sleep problems involve trouble falling asleep and staying asleep, as well as early morning awakening, and then, feeling sleep deprived during the day. This sleep deprivation wears on you over time and you increasingly feel more and more tired, and less full of energy, physical strength, etc.

You mention memory and concentration problems which could be related to either the anxiety and depression you are experiencing or to the medication you have been taking, or both. The medication you are taking for example, is well known to affect concentration, learning memory, and slowness of recall, slowed problem-solving, etc.


You mentioned loss of interest in activities and feeling sad much of the time. This is a depression-related symptom we call anhedonia or loss of interest in everyday activities and associated with it, an inability to derive pleasure from activities one formerly enjoyed. It is often associated with a loss of sexual interest and sometimes, loss of sexual functioning. Also, the person may become spontaneously tearful for no apparent reason. they increasingly isolate themselves from others because they'd rather be alone, even though they feel bored, and little they do actually interests them.

All in all, your life has been severely disrupted by the accident as have your interpersonal relationships. So if one 'steps back' and takes a look at your life right now, one might say you have suffered some significant 'losses'. Most of what you did, who you related to regularly, enjoyed, were motivated to 'do' are 'lost' or seem to have 'gone'.

I don't believe you are suffering from a dissociative reaction or have a dissociative disorder. Everything you describe fits the combination diagnosis of PTSD and depression. I've summarized the key symptoms so I'll pause here and ask you to affirm or dis confirm what I've suggested above about symptoms of PTSD and clinical depression. Then we can talk about what to do if this conceptualization of your problems makes sense. I'll await your reply. Thanks for your patience regarding the significant time zone differences.
Expert:  Dr. Michael replied 2 years ago.
I see you read my last post. Do you have a follow up reply about whether these other symptoms and problems match your current experience? If not, please click on the green Accept button at the bottom of the screen. Thanks.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
Dr. Michael and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.

 

Hi Dr. Michael,

 

Sorry for delay due to time zone. Everything you said make sense now I confirm all symptoms for PTSD, Anxiety, and Depression.

 

My other question is for my first appt with phsyciatrist which is for PTSD Can I also tell him about depression I feel? Since it is my first appointment and I am scared from doctors what he or she will ask? I mean will they keep me for hours to answer their questions?

 

Thanks Dr Michael,

Siar

Expert:  Dr. Michael replied 2 years ago.
Absolutely tell the psychiatrist about the depression symptoms. He or she will tell you that the medication they prescribe for the PTSD will probably help the depression at the same time, and if it is the right medication, it certainly will. Now, please realize that finding the right medication for these problems is a 'crap shoot'. This means that considerable experimentation and trial and error has to occur in many cases before the right medication, at the right dose is found.

Your appointment will probably take no longer than 30 minutes. Nothing to be scare of. The psychiatrist is highly motivated to get you some help as soon as possible, as quickly as possible. He or she will want you in and out of the office fairly quickly. They do not have time for psychotherapy as a rule.

Now, the full treatment of your PTSD should truly also involve specialized counseling or therapy approaches, such as: 1) cognitive behavioral therapy; 2) Acceptance and Commitment therapy; 3) EMDR therapy. These are actually 'best' for PTSD because while this is an anxiety disorder, some degree of conditioning or learning has occurred that ties your physiological reactions i.e., your anxiety and 'sympathetic nervous system' reactivity to situational cues in the environment. That is, you likely find that when you think about or directly experience something related to your accident, the experience triggers anxiety and escape and avoidance urges. So this connection between situational phenomena and your own physiology suggests that learning processes play a role in maintaining your symptoms. The therapies I mentioned will help you unlearn these connections and actually, will help you with your emotion regulation SKILLS going forward. So pills cannot provide skills and one benefits from both when dealing with PTSD and depression.

A Ph.D clinical or counseling psychologist, who uses these methods and works a lot with patients who have anxiety disorders is the type of therapist you want to see. Do not seek out a therapist of any kind who doesn't spontaneously talk about using one of the three methods for dealing with PTSD. Also, you can tell your psychiatrist you'd like to combine medication with either CBT or ACT (literally called 'act' therapy) therapy and does he/she 'know of a good clinical psychologist who uses these approaches to help people like me'. A generalist mental health counselor, social worker or therapist won't do here. A good psychiatrist will have several referrals to offer you.

PTSD and depression are very treatable, using a combination of medication and the RIGHT therapy. What do you think?
Customer: replied 2 years ago.

 

Thank you so much Dr. Michael you gave so so good information it helped me alot I will tell everything to my psychiatrist with regards XXXXX XXXXX and ask him to reffer me to a good psychologist. I am sure I will over come with it but it will take some time. Thank you for your help,

 

Regards,

Siar

Expert:  Dr. Michael replied 2 years ago.
Thanks for your kind words. My best to you!
Customer: replied 2 years ago.

 

You are most welcome :)

Expert:  Dr. Michael replied 2 years ago.
Thanks.
Customer: replied 2 years ago.

 

Hi Dr. Michael,

 

Hope you are fine. I went to Psychiatrist he prescribed me ratio-Venlafaxine xr 75mg and Apo-Quetiapine 25mg I know they are for depression but what kind of depression Clinical or MDD? my second question is I been taking it for the past 4 weeks and no effect yet I am actully more depressed then before? Your help is greatly appreciate it.

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