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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4898
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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6 years ago I use to talk Alot,was happy,and did not care about

Customer Question

6 years ago I use to talk Alot,was happy,and did not care about anything.Today I am quit,not happy most of the time,and care about the smallest things.I want to go back to the way I was like 6 years ago.What do I need to change about myself?do I need medication? Help.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you are feeling this way, I understand your desire to feel happy and like yourself again.

DoctorZ :

I would like to ask a few questions to better help you, did anything occur in the last 6 years to contribute to this change of behavior that you can think of?

Customer: well in middle school I use to be pick on and was bullied Alot, so much that I just stop talking.I hardly talk because everyone in most my middle school classes were jerks.
DoctorZ :

I am sorry that you went through that. Did you get bullied or picked on while in high school as well?

Customer: No Doctorz I did't
DoctorZ :

But you continued your behavior of not talking in high school as you mentioned, were you afraid that if you did talk or become more noticed that you would get picked on again?

Customer: That and if I did that I Would just stand out because I talk realey loud.
DoctorZ :

Okay, well it seems like what happened to you in middle school really effected you and caused you to have low self-esteem and low self-confidence, so this is why you are very sensitive to the smallest things and not happy most of the time. Low self-esteem can cause a mild depression, which is what I believe that you have.

Customer: Ok
DoctorZ :

Now the first line of treatment is usually therapy, more specifically Cognitive Behavioral Therapy (CBT) as it is the best evidence based therapy to help you. You also mentioned medications. I do not believe that you need medications just yet, but you can certainly ask me or your general practitioner about the use of anti-depressant. The medication will help with your symptoms, but will not get at the root cause, only therapy can do that.

DoctorZ :

I can show you some CBT techniques to help you relieve some of these symptoms you have been having

Customer: Alright
DoctorZ :

So your symptoms are caused by negative thoughts that have become a habit for you in the last 6 years. So CBT works by changing that automatic negative thought process to become more positive and plausible, which will then lead to a lessening of your symptoms and you will feel more happy and self-confident.

DoctorZ :

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more positive and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

DoctorZ :

Therapy is a gradual process and takes time for it to be effective, but this thought record is very beneficial and will help you lessen these symptoms.

DoctorZ :

In addition, this technique helps by exposing those negative self-critical beliefs that you may have about your self and replacing them with more positive beliefs about yourself

DoctorZ :

And this last worksheet I want to give you is called a Behavioral Experiment, where you test out your negative beliefs and see that they may not be plausible and you are forced to reevaluate them.

DoctorZ :

So for instance, you stay quiet a lot because you feel someone will say a negative thing about you. Test that belief out using the Behavioral Experiment sheet and see if it holds true.

Customer: Alright
DoctorZ :

Do you have any questions or concerns at all?

DoctorZ :

Or would you like me to help you find a good therapist in your area to help you?

Customer: Um I would like to find a therapist in my area but since I don't have any health insurance for time it can wait
DoctorZ :

Well a lot of therapists in the United States work on a sliding scale, so they may be able to lower their fees for someone who does not have health insurance to better accommodate you.

Customer: Ok then shure find me a therapists
DoctorZ :

Sure what city and state do you live in and I will look in your area

Customer: City: Minot State: North Dakota
DoctorZ :

Okay, give me a minute while I look in your area

Customer: Ok
DoctorZ :

Here are some good therapists that work on a sliding scale and have experience treating individuals with depression and self-confidence issues

DoctorZ :

These therapists also use CBT, so they will use similar techniques that I showed you earlier in this chat

DoctorZ :

Do you have any questions you like to ask about these therapists or where to go next with this?

DoctorZ :

Is there anything else I can assist you with today?

Customer: cAn you send me all those links you sent me on the chat with instruction and email them toXXX@XXXXXX.XXX
DoctorZ :

I am actually not allowed to email anyone, it is one of the rules on this website, but after you rate me this chat should be sent as a link to your email address so you will always have it for future reference.

DoctorZ :

And actually your email address was blacked out from my view by the website administrators, it is just one of their rules to not exchange personal information

Customer: Sorry about that my iPod is act weird ,ok
DoctorZ :

I understand, is there anything else I can help you with?

Customer: No I think that all I need I hope the CBT helps thx for your services have a nice day
DoctorZ :

Anytime, I am always happy to help.

DoctorZ :

If you have any other questions or concerns please feel free to contact me at anytime.

DoctorZ :

I wish you the best of luck with everything and I hope I provided you with excellent service today

Customer: Do I go to justansureit.com and Look for DoctorZ
DoctorZ :

Yes before a question you write "For DoctorZ" and then write your question. That will show that you want to speak to me, so I will be able to answer you right away.

Customer: Alright then I will see yea bye and thx DoctorZ
DoctorZ :

Anytime, I am glad that I was able to help you. Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4898
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.
I wanted to ask you about anti depressions.I asked a question on here about a month or 2 ago And you gived me CBT worksheets they relived my depression some but it has not worked enough to were I am happy and talkitve.so I wanted to ask you about the anti depressions/medication
Expert:  Dr. Z replied 11 months ago.
Hello again, I am glad that the CBT worksheets helped somewhat with your depression, but not enough. Antidepressants can be very effective in conjunction with the CBT techniques, so I would be happy to help you with some antidepressant medication information. What would you like to know specifically?
Customer: replied 11 months ago.
What dose it do and what are some sideeffects?
Expert:  Dr. Z replied 11 months ago.
Well it really depends on which antidepressant you use to know which dose is best. But typically most psychiatrists or medical professionals will start you on a low dose and then gradually increase the dose for you, so that your body can get used to the medication and you can have the lowest effective dose to minimize any possible side effects that occur. The two most effective categories of antidepressants with the lowest chance for side effects are the SSRI's and SNRI's. I will recommend the best SSRI medication called Lexapro because it is usually faster acting and stays in your system longer. At a dose of 10-20mg/day is usually very effective and should help with your depressive feelings, so that would be one medication to start with for an antidepressant. If that is not effective then I believe Zoloft at 150-200mg/day can also be effective for your symptoms as well. Here are a list of the most common side effects for the SSRI medications

http://www.mayoclinic.com/health/ssris/MH00066

And here are list of the specific side effects for the Lexapro and Zoloft.

http://www.webmd.com/drugs/drug-63990-Lexapro+Oral.aspx?drugid=63990&drugname=Lexapro+Oral&pagenumber=6

http://www.webmd.com/drugs/mono-8095-SERTRALINE+-+ORAL.aspx?drugid=35&drugname=zoloft+oral&pagenumber=6

I hope this answers your question to your satisfaction. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.
Customer: replied 11 months ago.
Can you percribe me anti depress (sorry if spelled percribed wrong)
Expert:  Dr. Z replied 11 months ago.
Actually it is illegal to prescribe medication online, so no doctor can do that for you. You should go to your General Practitioner or to a psychiatrist in your area. I am sorry if this is an inconvenience for you.
Customer: replied 11 months ago.
Ok well I understand its not your falt well that is alll I needed to know and thankyou for your services goodbye
Expert:  Dr. Z replied 11 months ago.
Anytime, best of luck to you and I hope that you get better soon. If you need anything else please feel free to contact me at anytime.
Expert:  Dr. Z replied 11 months ago.
I am sorry you just rated me with bad service, may I ask why?
Customer: replied 11 months ago.
no I did not mean to rate bad sorry about that
Expert:  Dr. Z replied 11 months ago.
It's okay, if you could I would prefer if you rate this answer as positive to negate that negative rating earlier because negative ratings look bad on my reputation here. Thank you very much.
Expert:  Dr. Z replied 11 months ago.
And you rated me bad service again?
Expert:  Dr. Z replied 11 months ago.
So why exactly did you rate me with a bad service on multiple occasions?
Expert:  Dr. Z replied 11 months ago.
If there is something I can do to correct the Bad/Poor service you rated me on, please let me know. Thank you.

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