Dysthymia and anxiety

[hey3]

Hello! I am a 33 year old female. I have posted here before but it has been awhile. I am now a full time student applying to a nursing program that starts in the fall. I have been seeing a therapist for a least four years. I have had panic attacks in the past (3 years ago was the last one). I have taken several antidepressants including, Effexor, Prozac, Deseryl, Paxil, and lexapro. I haven't taken meds for nearly 2 years. I have done OK. I do have periods of time when I am down, don't sleep well, irritable ect. The lexapro helped with some of these symtpoms but did not at all help the obssesing. My therapist told me this week told me that I was Dysthymic and I really needed to take medication. He said I need one of the newer meds with a combination of antianxiety and antidepresant. When I am down, it feels like I need to take something. But then I know eventually the feeling will lift and it won't be so bad. If I should take meds shouldn't I start now so I some of the side effects will be gone before the fall semester starts? (After 4 years of therapy). I know why he did not tell me before is because of the obssessing. I have been this way nearly all of my life. "runs in the family". My therpist says my dysthymia cycles. I am not sure what to do though. Won't this look bad on me when I apply to the nursing program because I have to release my medical records or will it look worse that I have an anxiety/mood disorder and am not taking medication for it. Which is worse? Or should I just not worry about it? Should I have my therapist refer me to a psychiatrist or should I go to my family physician? Needless to say this is buging me to death. I live in a small town and see the nurse and physician all over town. Embarrassing to say the least.

Thank you for your reply.
hey3

[Roger Gould, M.D.]

There are a lot of decisions to be made, and this kind of forum is not the place to make them all, but let me give you some advice to ponder.  Sometimes medications are used too often to cover the normal ups and downs of life, and since that is what you are mostly describing, maybe you should talk more with your therapist about the option of not taking any meds now.  Also, new drugs promise more help but all the research so far shows that the newer drugs have not proven to more effective than the older ones... some things to think about.

[slandis75]

Either way, you already have evidence of a disorder on your records and so you will just need to be truthful about your diagnosis.  Take the medicine because it will make you feel better, live more fully, as well as help you do better in school and in your future career.  Also, do it for your patients who will need someone who is capable of truly being positive and supportive when they are ill - that's something you simply cannot fake.  Also, if you continue to not take care of your illness, it will effect your work and will eventually cause your employer to notice your behavior.  It would be much better to prove yourself as a great student and future employee by receiving treatment, as well as be upfront.  Particularly since you're going into a medical field, the person hiring you should understand your illness and that it shouldn't affect who you are as a person or as a nurse since you are receiving treatment.  Also, he/she will also be able to figure out whether you are lying about needing treatment simply by watching your behavior and adding that to your previous history.  Admit it, you won't get away with it for too long, so just be upfront and take care of yourself today instead of digging yourself into a much deeper hole.  I believe it will be a decision you will be glad you made once you start feeling better.  Remember, right now you're depression is making you think all these negative thoughts.  So when that happens, just think about what my doctor says to me, "Your depression is lying to you - it's lying like a rug."  Now, doesn't the corniness of such a truthful statement make you feel a little better?  No?  Well, just imagine it with a hick accent then. :)

[hey3]

Thanks slandis. I haven't taken meds in a long time. I would really rather battle it out than gain weight :). But I do worry that if I can't take care of myself how can I take care of patients. But at the same time the obsessing could be useful in taking care of patients because checking and double checking can lower the amount of errors a person makes. I do wonder though since my current physican threw my old records away how the school would find the diagnoses anyway unless of course I have to disclose every physician I have been to in the last five years. That will really make me look bad. My grades are excellent and my entrance exam was excellent maybe this will help.