Welcome to the Mood Disorders Forum. Questions in this forum are being answered by Peter Forster, MD and topics covered are anxiety, bipolar, depression, panic disorder, post traumatic stress disorder and stress.
I have been having chronic irritability for a while, I am not sure if the kratom is causing it or depression. Because I had chronic irritability in the past before I discovered the kratom but I don't think it was as bad, now I cant stop obsessing over it, the irritability is so unbearable its like I want to crawl out of my skin. My psychiatrist tried to put me on a anti-psychotic but I am afraid to take it. She never diagnosed me with anything specific, she just said "mood disorder" I also have severe anxiety and depersonalization all the time. I don't know what to do? I am back on a SSRI. What is going on in the brain to make someone chronically irritable in simple scientific terms?
That sounds terrible. And inexcusable in a state like California... but not totally surprising. Mental health funding has been cut year after year, and since costs go up while funds go down sometimes there isn't much left. It is terribly sad for everyone.
I used to be involved in running the San Francisco clinic system but as the task became less and less about improving care and more and more about deciding which necessary services to cut I got out. What happens in such a system is that those who stay are sometimes those who are most burned out or cynical. Not always, there are people who manage to stay committed to their ideals, but even they are asked to figure out how to do impossible things (like figure out very complicated problems, and explain them to the patient, all within 20 minutes).
I do think that self monitoring can play an important role. If your mental health professionals don't have the time to ask all the questions, it can be really helpful if you keep track of the things that are most likely to be important.
I also agree with Jaquta that there are advantages to getting treatment in the primary care setting for some folks - there is likely to be less stigmatization - and also there just aren't enough psychiatrists.... one problem there is that no one is willing to pay for the kind of on-call consultation that would be very helpful to general practitioners...
We have a very dedicated psychiatrist in San Francisco who has been trying for years to get insurance companies to pay for one to one consultation with primary care docs so that patients don't have to be referred to psychiatrists if there is a question or problem that the primary care doc doesn't feel comfortable addressing, but no one wants to do this. Even though study after study shows it is cost effective.
So, I guess we all struggle to find the things that we can do. For me this is one of those things.
The term mood disorder seems pretty broad. To me, a layperson, it doesn't provide much information. Is that depression, bipolar, what? It would take a lot of stress out of the situation if the doctor were to be more specific. I was told to take anti-depressants for nearly a year before anyone bothered to tell me that they thought I was depressed.
I think people think that my anxiety has affected others ability to help me (or for me to engage with that help). Perhaps that is correct to some extent.
That's a difficult one about the meds. Do you trust your doctor? I think that giving up some control and allowing others to treat us can sometimes be helpful.
Honestly, as difficult as it is, if someone told me that taking a med would prevent years of needless pain and suffering I would probably take it.
I was forced to take anti-psychotics when in hospital. I was given im injections until I took anti-depressants. It really s*****. Excuse my language.
If I were suffering from depersonalization a lot of the time I think I would be looking at treating that. If your doctor thinks that taking that med is in your best interest and you are able to make an informed decision I think it could be a good idea. I would look at other solutions first, probably exercise and benzo's, etc but if they weren't effective I would follow the doctors instructions.
I'm not sure about this doctors philosophy of medication. I guess your doctor knows you and your history best and you need to trust that this is best for you at this time.
I sometimes gets that irritability. I liken it to those diagrams I use to see in general science of atoms hitting the sides of containers. If the pressure increases they go berserk. If our bodies or skin were the container and stress, etc increased the intensity of those feelings ... I'm not explaining stuff very well. Hopefully you get the gist of it.
The doctor may be able to explain about the brain, brain chemistry, etc (if that is what is causing the irritability).
Has your doctor assessed for personality disorder's? Not sure if it's applicable but just wondering. You can get substance-induced mood disorders too. ??
I can get very irritable premenstrually so hormones could be another factor.
It's easy to see why you need a degree in this stuff to diagnose and treat.
The funny thing is that my psychiatrist doesn't know anything about me or my history. I have seen my psychiatrist about three times, she has never really let me explain myself, she just interrupts me. I feel like she is in a rush to get me out of the office. I barely have even spoken to her. She is no longer at the clinic, they actually don't even have a psychiatrist at all anymore. So now I have to go to just a regular doctor I never met and try and explain all this to them. Yeah my moods might also be substance induced too, not sure just so confused.
That makes since with your analogy, I think I am going to take psychology and neuroscience classes to figure out my own problems.
thanks for your response
I thought about studying psychology too just to figure my own issues out and to try and resolve them. While self-help is a great idea I'm not sure it's that simple in practice. The best T I have spoken too said not to read and to let her do her job. I think this works well.
I have had doctors who have riffled through my notes. Half the time they seem more interested in reading them than actually talking to me. I just find it rude and disrespectful.
Interrupting you seems pretty rude. I'm sure doctors have a different agenda though. While we may want to discuss things, they may just want information that allows them to diagnose and make better treatment decisions. Sometimes I feel sorry for the doctors and the demands that are placed on them. Sometimes I think they create the mess themselves. I've been stuck in the system nearly 10 years and if anything I am less motivated and more dysfunctional now. The system here just chucks people out the door and if they bother or dare to return they are offered medication and ect.
Didn't your psychiatrist do an initial longer assessment? That seems the norm in most places. Seems strange that she wouldn't let you tell your story.
I wonder if you could write a list of your concerns and post them to her. Let her sift through it in her own time. I get frustrated when people fill my appointment times with nothing. Let them use their own time. I haven't done this before but it probably isn't a good idea as I'm not sure a doctor would take too kindly to it. Hard to know. I use to write stuff down and drop it off for my GP. He didn't seem too perturbed by it, but then he has taken more time and provided better continuity of care than any psychiatrist I have seen.
It sounds as though your area may have a hard time retaining doctors, etc too. Here they just wanted to cut the mhs back to doctors prescribing meds. Maybe if doctors got seriously sick there would be some changes. I once wrote that I thought that doctors should trial meds before they are prescribed. I thought that should actually be mandatory. It's not very realistic but maybe it would cut back on the over-prescribing of meds, especially to the sick and vulnerable.
How much time would a regular doctor give you? Mine slots me in as a last appointment of the morning and has given me up to 40 minutes. Most appointments are only 10-15 minutes though. That's hardly enough time to tell someone your history. A regular doctor also doesn't have the training (although I perceive some to be more qualified than psychiatrists). (It can be nice just talking to 'normal' people too -no offense to the doctor here.)
It all can become pretty confusing after a bit. Is so simple but so complex at the same time. Maybe I should sign up for those classes too.
I think that one problem is that there is no clear direction and no containment of anxiety.
Jaquta and Peter yeah if I good afford a good therapist and psychologist I would be there every week. yeah I felt my psychiatrist was rude, maybe I am just over sensitive. she prescribed me a anti -psychotic medication that cost $580.00. I think the drug company is psychotic. lol
I talked to my art teacher, she has been very supportive, and maybe I will like my new doctor. The mood chart monitoring has also helped tremendously. thank you both so much for the supportive responses.
I feel ok today, no irritability but I think I have a extreme form of OCD or GAD. I get up this morning and my first thought is how my car alignment is off, I had a flat tire and my dad fixed it but when he jacked the car up it fell and made it permanently off alignment. My computer never works properly it constantly freezes or just shuts off, it almost puts me in a rage. I don't know how to fix cars or computers. Sometimes I fear these obsessions will make me psychotic.
Obsessions won't make you psychotic, although they certainly can take over one's life. You might check out the OCD Center of Los Angeles website. It has some useful material. I found this there...
"One of the most effective CBT developments for the treatment of Obsessive-Compulsive Disorder (OCD) and related conditions is Mindfulness-Based Cognitive-Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem – our attempt to control and eliminate our discomfort is the problem. For an individual with OCD or a related anxiety-based condition, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without responding with compulsions, avoidance behaviors, reassurance seeking, and/or mental rituals."
That website is so helpful, I realize now I suffer from pure OCD. For a while I thought I had bi-polar or schizoid personality but it is just OCD. I am also remembering childhood OCD when I was 9 or 10 I had weird rituals, like right before bed, after flushing the toilet I had to run to my bed before it finished flushing, if I didn't make it in time, something bad was going to happen. Also I wouldn't fall asleep until my dad went to bed and he flushed the toilet, then I had to wave at him from my bedroom after he came out of the bathroom. I had forgot about all these childhood behaviors until now. I also developed trichotillmania when I was 12. Thanks so much for your help.
I am remembering more childhood OCD, it is so obvious now, I don't know why I didn't see it before. I totally forgot about these childhood behaviors. I also had body dysmorphic disorder, I constantly looked in the mirror, I thought I was ugly and too skinny, at school I would constantly go to the bathroom and look in the mirror. I thought I had a bad complexion. I had to constantly cover up my bald spots on my head from the hair pulling. I have always had social anxiety, I was very quiet in school and I got embarrassed easy and cried. I was also obsessed with bathing, if we went to visit relatives I would always worry that their shower didn't work. Thanks again for your help.
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