Different doctor, different advice
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Thread Starter
Join Date: May 2006
Location: Japan
Posts: 219
Different doctor, different advice
So I decided to visit another doctor to get a second opinion about the situation I'm in as far as my panic/anxiety goes. Here are the differences
1st doctor told me that I should be on 10mg of Paxil.
2nd doctor said that I should be on a minimum of 20mg, and because I'm a bigger westerner he thinks that even that might be too little and 40mg would be better.
1st doctor told me I could only take 3mg of anti-anxiety meds to relieve panic attacks if I feel them coming on. He said that I could do this twice a day at the max.
2nd doctor said that I could do 6mg of the same medicine 3 times a day, so long as it's spaced out at least 6 to 8 hours, but said it's unlikely I would have to do it more than once. He said 1.5mg was very very little.
1st doctor said that I as soon as I've been 'healthy' a month, I could start to taper off.
2nd doctor said I would have to be healthy at least 4 to 8 months before considering a taper.
1st doctor said that he expected all to go the same as my first round on Paxil.
2nd doctor said that it will be different. He said about 80 percent of patients who are 'cured' will have their anxiety/panic attacks come back on them at a later time in life.
1st doctor said that I should definitely be on Paxil and that I think too much and should just believe him.
2nd doctor said that after hearing all I had to say about my situation he felt that if I just kept the benzos on me and took a proper dose when I felt anxiety coming on, that it would save me from having to go on Paxil.
In the end I decided to stick with Paxil for now. I don't know that it's helped or not, but I have felt that my anxiety has subsided a bit. I don't know if that's just ME or if it's the Paxil.
The only thing both doctors seemed to agree on (And this might be JAPAN talking...) is that alcohol isn't such a big issue with Paxil. I mentioned that for some reason I felt some cravings when I'm normally not in the mood for drinking (I mentioned other side-effects I think I was suffering but that weren't bothersome...). He said the only problem comes when you drink too much, and that would mean you wouldn't be able to sleep well...that's it. I don't think I'll find a doctor in Japan that thinks differently when it comes to alcohol.
1st doctor told me that I should be on 10mg of Paxil.
2nd doctor said that I should be on a minimum of 20mg, and because I'm a bigger westerner he thinks that even that might be too little and 40mg would be better.
1st doctor told me I could only take 3mg of anti-anxiety meds to relieve panic attacks if I feel them coming on. He said that I could do this twice a day at the max.
2nd doctor said that I could do 6mg of the same medicine 3 times a day, so long as it's spaced out at least 6 to 8 hours, but said it's unlikely I would have to do it more than once. He said 1.5mg was very very little.
1st doctor said that I as soon as I've been 'healthy' a month, I could start to taper off.
2nd doctor said I would have to be healthy at least 4 to 8 months before considering a taper.
1st doctor said that he expected all to go the same as my first round on Paxil.
2nd doctor said that it will be different. He said about 80 percent of patients who are 'cured' will have their anxiety/panic attacks come back on them at a later time in life.
1st doctor said that I should definitely be on Paxil and that I think too much and should just believe him.
2nd doctor said that after hearing all I had to say about my situation he felt that if I just kept the benzos on me and took a proper dose when I felt anxiety coming on, that it would save me from having to go on Paxil.
In the end I decided to stick with Paxil for now. I don't know that it's helped or not, but I have felt that my anxiety has subsided a bit. I don't know if that's just ME or if it's the Paxil.
The only thing both doctors seemed to agree on (And this might be JAPAN talking...) is that alcohol isn't such a big issue with Paxil. I mentioned that for some reason I felt some cravings when I'm normally not in the mood for drinking (I mentioned other side-effects I think I was suffering but that weren't bothersome...). He said the only problem comes when you drink too much, and that would mean you wouldn't be able to sleep well...that's it. I don't think I'll find a doctor in Japan that thinks differently when it comes to alcohol.
Member
Join Date: Feb 2007
Location: western north america
Posts: 62
It's not unusual to get different opinions from different doctors. It's what makes this whole thing art as well as science. As I said in another thread, this isn't an infection that gets killed by an antibiotic. It's much more complex than that.
As a result, while some doctors could become more knowledgeable, or at least empathetic, I would guess that your story is more the rule than the exception.
Hang in there, man. If you take a "one last rep" attitude toward the whole thing, you will eventually find yourself on the other side.
As a result, while some doctors could become more knowledgeable, or at least empathetic, I would guess that your story is more the rule than the exception.
Hang in there, man. If you take a "one last rep" attitude toward the whole thing, you will eventually find yourself on the other side.
Member
Join Date: Feb 2007
Location: western north america
Posts: 62
PS: You know, the more I think about your situation and the more I think about where my head was just over a year ago, I think the best thing anyone can say to you is that there is a light at the end of the tunnel. Keep the general in mind as you work on the specifics. If you focus on the specifics, you're going to get bummed out. You have to be a bit dispassionate about the specifics (the medications, the conflicting opinons, etc) otherwise you'll go mad. If you accept them as part of the process (which is not, admittedly, an easy thing to do; it takes work to keep telling yourself this same thing over and over) and believe that there is an edge to this forest, so to speak, it will be easier to get up every day and deal with all this crap that doesn't appear to actually be going anywhere. IOW, as big as these things seem, you have to look at them as little things, and not get too frustrated by the little things.
I think it's the frustration that sets us back more than the actual anxiety or whatever. We get impatient. We want things to change more quickly than we perceive them changing. That's where getting all calm and Buddhist about things helps. It feels like everything is raging around you, but you know that you can still maintain in the midst of it.
At some point, that calm and self-confidence will come, and you won't be as worried no matter what is going on around you, no matter what your current circumstances are. Hell, I still don't have a job. I haven't cashed a check in six months. This disturbs me. But instead of the anxiety of it leading to a sort of paralysis that just makes the situation worse, I'm more focused. I have a plan, a plan to change careers by getting a degree over the next few years and moving into a profession with much more job security. Before, I'd need the cash flow situation to be immediately fixed before I felt any better, before I could sleep. Now, I accept that such changes take some time, and that all I can do is take the steps that need to be taken. Forward progress is all I can make and as long as I'm doing that, I'm not worried. And that's all stuff that is within my power.
And, like alcoholism, I believe some degree of this is just habit. A person gets used to drinking when they get stressed out and someone with an anxiety disorder gets used to wigging out when stress hits. Part of the treatment is simply saying, "no." Saying it 100 times an hour if necessary. Habits break and new ones, good ones, can be formed. I've been sober for almost three years now and I have new habits. The old grooves in the brain have been destroyed and new ones have been built and are being built all the time, getting stronger every day, as I consciously decide for myself each day who I'm going to be and what I'm going to do.
Yes, there is something chemical, something physical, that's going on here. But, just as important, if not more so, is the mental aspect, the aspect of the will.
If you keep grinding it out every day, at some point you will notice a change. Instead of reacting negatively to things, you will find that you react with more confidence, you will believe you can handle a thing and if not handle it, at least tackle it, survive it. You won't any longer believe it can actually hurt you.
After all the therapy I've gone through in the last year, I keep coming back to the thing I didn't want to hear: it all comes from within. No one's going to give you a pill, or answer a question, that's going to solve everything or make everything right.
You must find it within. First, you must believe that it actually exists within you. Not until then will you be able to draw on that strength and develop it, use it. But if you keep grinding it out, you will find it.
Christ said, "The Kingdom of Heaven is within you." The Buddhists also believe that it's all within. Either way, as much support or help or therapy you get from others, it ultimately comes down to finding that "inner strength." That is what is the difference between perceiving a situation as being able to destroy you, and perceiving it as something you can face. This isn't that power of positive thinking BS or motivational speaking or whatever. This is about becoming a whole human being again (or for the first time, depending).
At the end of the day, it's kind of like when we were kids and we were scared of the dark, scared of sleeping with the closet door open or whatever. Mom and Dad can say all they like, and sometimes their assuring words help, but it came down to us getting to a place where we truly believed, truly knew, that there was nothing in that closet that could hurt us.
I'm not saying there aren't things in life that can hurt us. That's not the direction to take the analogy. The analogy means that a good night's sleep as a child is equivalent to the peace of mind that we're looking for, that it's all internal, not external.
Sorry, I was in the mood to ramble. Keep whatever's useful and ignore the rest.
I think it's the frustration that sets us back more than the actual anxiety or whatever. We get impatient. We want things to change more quickly than we perceive them changing. That's where getting all calm and Buddhist about things helps. It feels like everything is raging around you, but you know that you can still maintain in the midst of it.
At some point, that calm and self-confidence will come, and you won't be as worried no matter what is going on around you, no matter what your current circumstances are. Hell, I still don't have a job. I haven't cashed a check in six months. This disturbs me. But instead of the anxiety of it leading to a sort of paralysis that just makes the situation worse, I'm more focused. I have a plan, a plan to change careers by getting a degree over the next few years and moving into a profession with much more job security. Before, I'd need the cash flow situation to be immediately fixed before I felt any better, before I could sleep. Now, I accept that such changes take some time, and that all I can do is take the steps that need to be taken. Forward progress is all I can make and as long as I'm doing that, I'm not worried. And that's all stuff that is within my power.
And, like alcoholism, I believe some degree of this is just habit. A person gets used to drinking when they get stressed out and someone with an anxiety disorder gets used to wigging out when stress hits. Part of the treatment is simply saying, "no." Saying it 100 times an hour if necessary. Habits break and new ones, good ones, can be formed. I've been sober for almost three years now and I have new habits. The old grooves in the brain have been destroyed and new ones have been built and are being built all the time, getting stronger every day, as I consciously decide for myself each day who I'm going to be and what I'm going to do.
Yes, there is something chemical, something physical, that's going on here. But, just as important, if not more so, is the mental aspect, the aspect of the will.
If you keep grinding it out every day, at some point you will notice a change. Instead of reacting negatively to things, you will find that you react with more confidence, you will believe you can handle a thing and if not handle it, at least tackle it, survive it. You won't any longer believe it can actually hurt you.
After all the therapy I've gone through in the last year, I keep coming back to the thing I didn't want to hear: it all comes from within. No one's going to give you a pill, or answer a question, that's going to solve everything or make everything right.
You must find it within. First, you must believe that it actually exists within you. Not until then will you be able to draw on that strength and develop it, use it. But if you keep grinding it out, you will find it.
Christ said, "The Kingdom of Heaven is within you." The Buddhists also believe that it's all within. Either way, as much support or help or therapy you get from others, it ultimately comes down to finding that "inner strength." That is what is the difference between perceiving a situation as being able to destroy you, and perceiving it as something you can face. This isn't that power of positive thinking BS or motivational speaking or whatever. This is about becoming a whole human being again (or for the first time, depending).
At the end of the day, it's kind of like when we were kids and we were scared of the dark, scared of sleeping with the closet door open or whatever. Mom and Dad can say all they like, and sometimes their assuring words help, but it came down to us getting to a place where we truly believed, truly knew, that there was nothing in that closet that could hurt us.
I'm not saying there aren't things in life that can hurt us. That's not the direction to take the analogy. The analogy means that a good night's sleep as a child is equivalent to the peace of mind that we're looking for, that it's all internal, not external.
Sorry, I was in the mood to ramble. Keep whatever's useful and ignore the rest.
Member
Join Date: Feb 2007
Location: western north america
Posts: 62
Thanks.
There's one thing, in spite of my verbosity, that I don't think I made clear. So much of what passes for trying to solve this stuff revolves around getting yourself all jacked up, telling yourself all kinds of positive things, as if just repeating them to yourself is going to change you.
I don't believe that works. All I think it does is whip you up into an emotional frenzy that you'll inevitably come down from, like any other high. Also like any other high, the trough you go down into tends to be lower than where you were to start with.
No, what I'm talking about is defensive, for lack of a better way of putting it. Which is why I like zen meditation. You're not repeating any mantras, you're not trying to offset negative thoughts with positive ones. Essentially, you're fighting this battle in a non-violent manner. You're simply not accepting these negative thoughts. You're either saying, "no" when they get intense or just letting them pass.
And, really, thoughts have no power unless you give them power. They're just thoughts. And once they realize they don't have the ability to annoy you anymore, then tend to go away. By degrees, to be sure, but go away they do.
So, I wouldn't recommend Tony Robbins or a revival preacher for someone with anxiety. It is a battle, but, maybe paradoxically, if you think that way about, it's only going to make things worse. You're just going to get more wound up.
The Buddhists like to say that when you try to sit and mediate, your mind is like a pond that just had a stone thrown into it. Lots of ripples. You can't do anything about them but just wait them out. If you wait, eventually they will dissipate.
Will the basic problem you're anxious about still be there? Of course. The point is that you will be able to think clearly about it. You can't come up with solutions to problems when you're anxious. If you're calm, you can.
So all I'm saying is that with some simple work, you can train yourself.
Again, sorry for the length. I appear to be quite chatty today.
There's one thing, in spite of my verbosity, that I don't think I made clear. So much of what passes for trying to solve this stuff revolves around getting yourself all jacked up, telling yourself all kinds of positive things, as if just repeating them to yourself is going to change you.
I don't believe that works. All I think it does is whip you up into an emotional frenzy that you'll inevitably come down from, like any other high. Also like any other high, the trough you go down into tends to be lower than where you were to start with.
No, what I'm talking about is defensive, for lack of a better way of putting it. Which is why I like zen meditation. You're not repeating any mantras, you're not trying to offset negative thoughts with positive ones. Essentially, you're fighting this battle in a non-violent manner. You're simply not accepting these negative thoughts. You're either saying, "no" when they get intense or just letting them pass.
And, really, thoughts have no power unless you give them power. They're just thoughts. And once they realize they don't have the ability to annoy you anymore, then tend to go away. By degrees, to be sure, but go away they do.
So, I wouldn't recommend Tony Robbins or a revival preacher for someone with anxiety. It is a battle, but, maybe paradoxically, if you think that way about, it's only going to make things worse. You're just going to get more wound up.
The Buddhists like to say that when you try to sit and mediate, your mind is like a pond that just had a stone thrown into it. Lots of ripples. You can't do anything about them but just wait them out. If you wait, eventually they will dissipate.
Will the basic problem you're anxious about still be there? Of course. The point is that you will be able to think clearly about it. You can't come up with solutions to problems when you're anxious. If you're calm, you can.
So all I'm saying is that with some simple work, you can train yourself.
Again, sorry for the length. I appear to be quite chatty today.
Member
Join Date: Feb 2007
Location: western north america
Posts: 62
margo, I think it's just confidence. I've been off the Celexa for three weeks now, and the more time passes, the less concerned I am about regressing. I feel "solid," for lack of a better term and I want to let the others here know that you can get to the other side and what some of the ways are to get there. IOW, I become more and more certain that the things I've been doing really are what got me here and that anyone can do them.
Everything was learned by trial and error. If at least one other person has an easier go of it, it will be worth all my blabbing.
I used to tell people how great I was doing in the hope that I'd actually start feeling like it. This, however, is the real deal.
No magic bullets, no instant gratification, no outrageous promises, but no bs, either. I'm totally confident that if a person does these things, they will improve. They will be mentally healthier, spiritually healthier and physically healthier. It will take work, but anything worth having takes work.
Everything was learned by trial and error. If at least one other person has an easier go of it, it will be worth all my blabbing.
I used to tell people how great I was doing in the hope that I'd actually start feeling like it. This, however, is the real deal.
No magic bullets, no instant gratification, no outrageous promises, but no bs, either. I'm totally confident that if a person does these things, they will improve. They will be mentally healthier, spiritually healthier and physically healthier. It will take work, but anything worth having takes work.
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