![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by TonyIreland on October 14, 2003, at 18:22:51
Hi,
Im new to the board so a big Hello to everyone - Im tony and am 27 yr old programmer from Ireland.
To the point...I have been reading alot of the posts here on Effexor and withdrawl symtoms. Im currently off them this past 3 days and its a nightmare. The thing is my doctor told me to wean off them over a week and then start my celexa.
I was on 150mg a day - so day 1 i took 150mg, day 2 i took 75,day 3 nothing, day 4 75, day 5 nothing and then nothing for another two days and started celexa today. But other doctors have said wean over a period of a month some cases 2 or 3 months - i really dont think GP's know what they are talking about at all!!
I cant sleep - im moody - im feelin dizzy - get electric shock type feelings - cant concentrate - cant eat - no interest :: This is bloody hell!!
Ive been on antidepressants for four years now and I havent a clue what type of depression I have, how i got it and know anything about ever gettin away from it or how to. All my doc does is throw me prescriptions on dugs he knows damn all about. But sure as long as he gets paid - my depression doesnt really matter!!
Id love to have my normal life back and i dwell on this thought and know I will never have it back.
I really cant be bothered anymore - in fact as im writing this msg - im in tears feelin sorry myself goin through this crap. Why????????? why???????? why????????/
Could someone tell me that if there is a God up there - then why the hell does he let this happen????????????
im sorry people im just so angry at being depressed. If i had no parents or brothers/sisters, I would have taken my life a long time ago - But is liing for someone else good enough reason to continue living - idont think so.
My advice - anyone who feels depressed and is prescribed Anti depressants for the first time - seek a second professional opinion.
I really hope the people on this board get free of their depression. Its the worst illness that exists to mankind.
Tony.
Posted by stjames on October 14, 2003, at 19:35:47
In reply to What do GP's really know?, posted by TonyIreland on October 14, 2003, at 18:22:51
I was on 150mg a day - so day 1 i took 150mg, day 2 i took 75,day 3 nothing, day 4 75, day 5 nothing and then nothing for another two days and started celexa today. But other doctors have said wean over a period of a month some cases 2 or 3 months - i really dont think GP's know what they are talking about at all!!
Nor should they or be expected to. They are generalists and mental health (if serious)
requires a specialist.
Posted by Larry B. Piercy on October 14, 2003, at 21:43:37
In reply to What do GP's really know?, posted by TonyIreland on October 14, 2003, at 18:22:51
Scientist say that one day "nothing turned to something("pre-animate particles") and then exploded. This is the big bang theory as I recall it from college physics and for some reason people have no trouble believing that nothing blew up and created all we now see. About the same precentage of the population used to believe the earth was flat, not that long ago.
I can't bring myself to judge the believer or the non-believer because when you look closely at all we believe in, at some point we make assumptions we can't prove.
I haven't seen any proof of God, yet many believe in him/her. The true miracle of life may be evidence of God, as all that is in this universe seems to destroy life and order, and not build them- but again, no real proof. I hope there is a God with all my heart. Some greater force who made us and is watching us - even if he/she is more silent than I would prefer.
Some scientist are beginning to believe that we are devolving, not evolving as darwin believed. Our genetic code seems to be deteriorating as each generation has more and more defects than before. If this is true, it could support that our placement here on earth was by God... but it also supports the theory that alien visitors planted us here.
Maybe this life is like an amusement park ride for souls? You get a life but can't remember your previous existance until its over. You get the thrill of the unknown, the thrill of death, which souls may not otherwise experiance. In a few years we will all laugh at how scared we were during the ride and how funny it was when so many of us took paxil/effexor to reduce stress and the withdrawl caught is all by surprise. Or how scared we were on our death beds until we died could remember everything again. Hey that was awesome, lets do it again - this time I want to be a woman in the middle east, sounds like a real challenge....
I don't know what is true if any of the above - and it is not by a lack of trying on my part.
What I do know is, I am here. Even though life has been horrid lately due to paxil and effexor, I still want to exist and to live. Even though it seems more and more people have become self-centered and unconcerned about others - there are still good people around and the only way I will ever know them is to live.
What will be the next wonderful experiance for me? Will it be winning the lottery? The best sex ever? Something that one of my sons will do to make me proud and happy for them? I don't know the answers to these questions anymore than what will be the next bad experiance for me. But to me its worth living to find out, and I'll deal with the bad to have the good, versus suicide and knowing for sure the last event of my life will be bad.
I pray that there is life after death because I want to exist... but if there isnt, I wont be around to feel the lose. So I will search for answers as I can, enjoy life when I can and try not to be stressed over those things that I have no control over - which is much.
The only thing I can know for certain is I am here now, and overall I like it. I want answers as much as you, but after 40 years of life, I still dont have answers to the big questions.
One of my biggest fears was being fired. Last year I was "layed off" and was unemployed for a year. It was bad, but even it had good points, like spending alot of time with my kids. I'm employed now and unemployment is no longer one of my biggest fears - I have grown and learned.
Maybe life is like a book and to know the ending spoils it and by choice or force, we can't know the ending until we experiance it?
Posted by omegon on October 14, 2003, at 23:50:29
In reply to Re: What do GP's really know?, posted by Larry B. Piercy on October 14, 2003, at 21:43:37
(totally off-topic, sorry)
Excuse me if some of this sounds insensitive / unconstructive. I don't mean it as an attack; it's just that the sort of pseudoscience that's bandied around a lot now really bugs me:
> Scientist say that one day "nothing turned to something("pre-animate particles") and then exploded. This is the big bang theory as I recall it from college physics and for some reason people have no trouble believing that nothing blew up and created all we now see. About the same precentage of the population used to believe the earth was flat, not that long ago.
This is a huge oversimplification.
The point is, which is the best explanation at this point? Science with lots of empirical support, or "oh-well-it-was-just-created-you're-not-allowed-to-ask-how"?> I can't bring myself to judge the believer or the non-believer because when you look closely at all we believe in, at some point we make assumptions we can't prove.
Well yes. You can't know anything for certain, not even whether you're not just dreaming your whole life. Not least because all your information comes via your senses; everyone's senses are unreliable, fuzzy, limited to some degree. And then it gets filtered through your opinions... even worse.
I wouldn't say I judge believers, but I have trouble understanding why they believe. Forgoing pre-fabricated religious explanations seems obviously better for you because it lets you take control of your life. Religion always imposes things on you and tries to stop you thinking for yourself. I can't see how that's ever a good thing.
> I haven't seen any proof of God, yet many believe in him/her. The true miracle of life may be evidence of God, as all that is in this universe seems to destroy life and order, and not build them- but again, no real proof. I hope there is a God with all my heart. Some greater force who made us and is watching us - even if he/she is more silent than I would prefer.
Clear evidence for 4 billion years of evolution isn't enough to convince you that this universe creates life, and has been working rather hard at it for some time without any evidence of divine intervention?
I don't dispute anyone's right to believe in god if they want to, for whatever reason. It's just that I can show you much better reasons for not believing in god. Religion gives you faith. Science gives you faith plus!
(plus demonstrably effective explanations for the world; plus free thought; plus improvement in humanity's condition (see below), for example)
> Some scientist are beginning to believe that we are devolving, not evolving as darwin believed. Our genetic code seems to be deteriorating as each generation has more and more defects than before. If this is true, it could support that our placement here on earth was by God... but it also supports the theory that alien visitors planted us here.
Our genetic code is getting worse because our living conditions have increased enough that natural selection has essentially stopped, so weaker genes can survive. This is a triumph of humanity - millions of people are alive who would die in harsher conditions. This does not disprove the theory of evolution in any way - we've just got control of (most of) the conditions which drive evolution. No credible scientist seriously disputes the theory now; the only people who will tell you otherwise (usually very loudly) are creationists.
Nice anecdote: creationists got together a bunch of creationist scientists (god (!) knows where they found them) and had them sign a petition declaring that they didn't believe the theory of evolution.
Some non-creationist scientists then found a bunch of scientists, all of whom where called Steve, and who outnumbered the creationists, to sign a counter-petition.
(the point being that just because you've got lots of names doesn't mean you have a meaningful sample of all scientists)Medical science is improving so fast now that we will soon be able to easily counter the deterioration - genetic problems are very likely to be easily curable in a few decades or less.
> Maybe this life is like an amusement park ride for souls? You get a life but can't remember your previous existance until its over. You get the thrill of the unknown, the thrill of death, which souls may not otherwise experiance. In a few years we will all laugh at how scared we were during the ride and how funny it was when so many of us took paxil/effexor to reduce stress and the withdrawl caught is all by surprise. Or how scared we were on our death beds until we died could remember everything again. Hey that was awesome, lets do it again - this time I want to be a woman in the middle east, sounds like a real challenge....
Reincarnation / afterlife? I'm not even going to try to discuss it, beyond saying... what possible evidence can you have to believe it? I would say none - so why believe it?
> I don't know what is true if any of the above - and it is not by a lack of trying on my part.
No one does. You just have to choose the most reasonable course.
> What I do know is, I am here. Even though life has been horrid lately due to paxil and effexor, I still want to exist and to live. Even though it seems more and more people have become self-centered and unconcerned about others - there are still good people around and the only way I will ever know them is to live.
I agree with you wholeheartedly on this!! Well said!
> What will be the next wonderful experiance for me? Will it be winning the lottery? The best sex ever? Something that one of my sons will do to make me proud and happy for them? I don't know the answers to these questions anymore than what will be the next bad experiance for me. But to me its worth living to find out, and I'll deal with the bad to have the good, versus suicide and knowing for sure the last event of my life will be bad.
The next wonderful experience will be discovering it!
> I pray that there is life after death because I want to exist... but if there isnt, I wont be around to feel the lose. So I will search for answers as I can, enjoy life when I can and try not to be stressed over those things that I have no control over - which is much.
Stick with life before death. The life expectancy of people alive today might be much longer than you think, given (again) current advances in medicine.
> The only thing I can know for certain is I am here now, and overall I like it. I want answers as much as you, but after 40 years of life, I still dont have answers to the big questions.
Why is there anything instead of nothing?
What's the next step in the series {speech, writing, printing, computers, internet, ...}
How can we best ensure that everyone gets what they want (without hurting others) for ever?> One of my biggest fears was being fired. Last year I was "layed off" and was unemployed for a year. It was bad, but even it had good points, like spending alot of time with my kids. I'm employed now and unemployment is no longer one of my biggest fears - I have grown and learned.
It's good that you still found something positive in facing such a fear!
> Maybe life is like a book and to know the ending spoils it and by choice or force, we can't know the ending until we experiance it?
Apparently... the ancient greeks used to have a different perspective on time from the (mostly) current one. They saw the future as approaching from behind them, and the past receding in front. What wonders are at our backs? Can we look round to see them?
Posted by Dr. Bob on October 15, 2003, at 1:05:46
In reply to Re: science and spirit Larry B. Piercy, posted by omegon on October 14, 2003, at 23:50:29
> (totally off-topic, sorry)
I'd like off-topic posts to be redirected to Psycho-Social-Babble, thanks.
Bob
Posted by ace on October 15, 2003, at 2:34:30
In reply to Re: What do GP's really know?, posted by stjames on October 14, 2003, at 19:35:47
> I was on 150mg a day - so day 1 i took 150mg, day 2 i took 75,day 3 nothing, day 4 75, day 5 nothing and then nothing for another two days and started celexa today. But other doctors have said wean over a period of a month some cases 2 or 3 months - i really dont think GP's know what they are talking about at all!!
>
> Nor should they or be expected to. They are generalists and mental health (if serious)
> requires a specialist.
Huh...GP's don't know what they are talking about? That's a huge generalization. GP's can be far better than any psychiatrist. Just like a certain psychiatrist can be far better than a GP.I think GPs definately should play a role in mental health. And I actually think psychiatry, as a medical speciality, should be no more. There is no blood tests, smears, xrays. Nothing.
That's not to say I don't believe these disorders exist- I think they do. But they represent unspecified shifts in brain chemistry. Labels don't do a great deal. Their can be an infinite amount of shifts in chemistry- which give rise to disorders which defy a neat diagnostic criteria.About weaning off Effexor- it's actually hard for the doctors too. Some folks have no probs weening off in short periods whilst others have probs when weened off real slow.
Psychiatrists typically start people on too higher doses and ween off too fast.
Posted by ace on October 15, 2003, at 2:36:18
In reply to Redirect: off-topic, posted by Dr. Bob on October 15, 2003, at 1:05:46
Is this for social babble?
Posted by ProzacPuppet on October 15, 2003, at 4:25:31
In reply to Re: What do GP's really know?, posted by stjames on October 14, 2003, at 19:35:47
God or no God, life isn't worth dying for.
And I agree with stjames, you really need to find a specialist that knows what he or she is doing. There's a zillion GP'S around that will just prescribe whatever is currently passing as anti depressent medication, but I think you need to find someone that deals with mental health.
Posted by cubic_me on October 15, 2003, at 6:48:11
In reply to What do GP's really know?, posted by TonyIreland on October 14, 2003, at 18:22:51
Hi Tony,
I'm from England and saw my GP about depression. After about a month of treatment with Zoloft she decided it didnt work and sent me to see a psychiatrist. I really dont think I'm in need of a psychiatrist at the moment but I dont think she felt comfortable dealing with someone with suicidal ideation - even though she was a lovely person.
The psychiatrists I have seen have prescribed Effexor, but I get withdrawal syptoms like you describe if I am late taking a dose. They dont believe that Effexor causes withdrawal effects so they are about as useless as the GP. I've been on the same dose for 4 months with no improvement so I dont think they can be that interested in getting me better.
I have abit of a confilct with this because I'm in medical school and want to become a psychiatrist. But all those I've met seem to know nothing and treat their patients like they are just the next one on the convayer belt.
Have you asked for a second opinion or seen a different GP? That is perfectly within your rights. You could also be asked to be reffered to a psychiatrist if you would feel more comfortable with that.
_me
Posted by EscherDementian on October 15, 2003, at 10:24:50
In reply to Re: What do GP's really know?, posted by ace on October 15, 2003, at 2:34:30
Hi Ace,
I have some 'bafflements' re: some of your statements in your answer to TonyIreland's question... could you address them please?
> Huh...GP's don't know what they are talking about? That's a huge generalization. GP's can be far better than any psychiatrist. Just like a certain psychiatrist can be far better than a GP.
Your claim 'far better' seems vastly general. The basis is unclear to me... please clarify?
(And - 'ANY' psychiatrist?) It seems to me that you are comparing trunks and and branches. Both hold a postition in the whole: "tree". Could you define 'far better' in terms of the position of GP's and psychiatrists in the whole: "mental health"?
> I actually think psychiatry, as a medical speciality, should be no more. There is no blood tests, smears, xrays. Nothing.There are MANY medical tests existing in psychiatry: blood, hormones, xray (MRI), etc.etc.... many series of tests, both physical and psychological, are employed in the service of psychiatry. Are you unaware of these tests? Have you forgotten to research a point before using it as criteria for a value judgement? It may serve you to scrutinize your own assumptions before making such a statement.
> they represent unspecified shifts in brain chemistry. Labels don't do a great deal. Their can be an infinite amount of shifts in chemistry- which give rise to disorders which defy a neat diagnostic criteria.
"Labels" as in names? What they "do" is describe and identify, somewhat like the names of parts of a machine that a mechanic knows and uses, or the names of instruments in an orchestra. It occurs to me that the "brain chemistry" that is responsible for disorders is specified in these same ways. Your overall generalization of them as "shifts" "giving rise to" is misleading as a blanket statement. Which is WHY we articulately specify not only categorizations, but dynamics.
Can you give me an example of what you mean by "a neat diagnostic criteria"?
> Psychiatrists typically start people on too higher doses and ween off too fast.
Wow. What are your sources of information for this statement? Can you direct me to the specific proofs you found to support such a huge generalized conclusion?
Or, if you can't, can you name at least 3 documented instances of this?I'm very curious. Your statements contradict information that i 'know', so i am looking forward to 'knowing' your sources and proofs!
Escher
Posted by Dr. Bob on October 16, 2003, at 7:57:31
In reply to Re: Redirect: off-topic Dr. Bob, posted by ace on October 15, 2003, at 2:36:18
> Is this for social babble?
Is what for social babble?
Bob
Posted by ace on October 17, 2003, at 1:55:47
In reply to Re: What do GP's really know? ? ace, posted by EscherDementian on October 15, 2003, at 10:24:50
> Hi Ace,
> I have some 'bafflements' re: some of your statements in your answer to TonyIreland's question... could you address them please?
>
>
> > Huh...GP's don't know what they are talking about? That's a huge generalization. GP's can be far better than any psychiatrist. Just like a certain psychiatrist can be far better than a GP.
>
> Your claim 'far better' seems vastly general. The basis is unclear to me... please clarify?For some people a GP can provide greater service than a psychiatrist with regards to their mental health matters. A lot of people, including myself, have been mistreated by psychiatrists. This includes misdiagnosis, mismedication and outright verbal abuse. That being said I believe there is a MINORITY of vey good psychiatrists who provide their patients with support, both medication and emotionally wise.
> (And - 'ANY' psychiatrist?) It seems to me that you are comparing trunks and and branches. Both hold a postition in the whole: "tree". Could you define 'far better' in terms of the position of GP's and psychiatrists in the whole: "mental health"?
Whether it be a GP or psychiatrist I deem them 'far better' if they treat the patient with absolute respect, consider the patients suggestions for treatment.
> > I actually think psychiatry, as a medical speciality, should be no more. There is no blood tests, smears, xrays. Nothing.
>
> There are MANY medical tests existing in psychiatry: blood, hormones, xray (MRI), etc.etc.... many series of tests, both physical and psychological, are employed in the service of psychiatry. Are you unaware of these tests? Have you forgotten to research a point before using it as criteria for a value judgement? It may serve you to scrutinize your own assumptions before making such a statement.Sure, there are plenty of tests in psychiatry. But NONE of these tests can conclusively validate the existence of any mental illness. Actually, most tests that psychiatrists use are to rule out 'physical problems'. ie the psychiatrist has the patient take an MRI scan- this is to rule out the possibility of TLE. Psychometric tests also do not confirm the existence of any illness. They might show that the patient has a low IQ but the whole conception of what is intelligent is a social construct. In brief, most of the tests used in psychiatry look at the STRUCTURE of the brain. But the function of the brain is what psychiatrists are interested in. The brain is an electrochemical organ. All the current views on mental illness centre around biochemical imbalances. Yet we do not have the capability to measure the amount of neurotransmitter in the synapse. It is a hypothesis, NOT A FACT, that these problems have their genesis in biochemical imbalances.
What I was trying to say was this: DIAGNOSIS IN PSYCHIATRY IS, ULTIMATELY, BASED ON THE SUBJECTIVE IMPRESSION OF ANOTHER HUMAN BEING. THEIR IS NO BLOOD TEST OR SMEAR etc THAT CAN PROVIDE EVIDENCE OF ANY PSYCHIATRIC PROBLEM. Next time you go to your doctor, ask him/her to show you 'your biochemical imbalsance'. They can't do it. The best they have managed was to review suicides where their was seen to be a deficience of serotonin in Cerebrospinal fluid (CSP). But this is also no conclusive proof of a biochemical imbalance (in this case, one of a serotonin deficiency)
> > they represent unspecified shifts in brain chemistry. Labels don't do a great deal. Their can be an infinite amount of shifts in chemistry- which give rise to disorders which defy a neat diagnostic criteria.
>
> "Labels" as in names? What they "do" is describe and identify, somewhat like the names of parts of a machine that a mechanic knows and uses, or the names of instruments in an orchestra. It occurs to me that the "brain chemistry" that is responsible for disorders is specified in these same ways. Your overall generalization of them as "shifts" "giving rise to" is misleading as a blanket statement. Which is WHY we articulately specify not only categorizations, but dynamics.'WE'- are you a psychiatrist?
Let me illustrate: Someone who has 'OCD'- Now, I personally believe that for every person who has this label there is a differing biological aetiology. The same two people who have 'bad' thoughts and need to ritualize both, IMO, have two differing biochemical problems underlying this problem. For instance, one patient could have an excess of a neurotransmitter, but the other one could possess an excess of one, a deficiency in one, and a imbalance between another two.> Can you give me an example of what you mean by "a neat diagnostic criteria"?
Where the symptoms of the patient correspond exactly to DSM criteria. But they don't always: hense of the use of 'NOS'. People can not fit into these 'boxes'. People defy such limitations. We are too dynamic. Some disorders specify that a person must have been suffering from certain symptoms for 14 days or more. But what if they only had them for 12 days? They no longer fit the criteria? What do we do when a patient presents with symptoms which do not fit into any of the boxes?And also, what makes psychiatrists so supreme to diagnose "personality" disorders? Why is it inherently bad to be oppositional to everyone around you. Just because you annoy everyone around you, with eccentric behaviour, doesn't mean you have a 'disorder'. It simply means you are anomolous within the context of a society. Well, who says it's good to fit in with THIS society. This society is a real mess, IMO. People going around killing people, people having suicidal and drug-addicted rock musicians as their role models. But, again, that is just my opinion. And one could argue against me, 'why are these inherently bad things?'
>> > Psychiatrists typically start people on too higher doses and ween off too fast.
>
> Wow. What are your sources of information for this statement? Can you direct me to the specific proofs you found to support such a huge generalized conclusion?No I can't I'm afraid. That statement came from my own experience and many people who I have talked too. Also, many anecdotes. Infact, I believe one of the reasons antipsychotics have a bad rep simply because, a lot of the time, they are started at way too large dose, and knock the patients out.
> Or, if you can't, can you name at least 3 documented instances of this?I'll dig out some of those anecdotes I talked about.
> I'm very curious. Your statements contradict information that i 'know', so i am looking forward to 'knowing' your sources and proofs!
What is this information you 'know'?
Everything I have stated is my opinion. People are free to believe what they want. We are all seeing the world from our own 'lenses' and sometimes, we may get a bit lost in our own views, and forget others. I acknowledge your views and respect your right to have them. You have every right to them. Mine are just different. Which is great...what a boring world it would be if everyone agreed with everyone!
> Escher
>
>
Ace.
Posted by ace on October 17, 2003, at 2:02:51
In reply to Re: Redirect: off-topic, posted by Dr. Bob on October 16, 2003, at 7:57:31
> > Is this for social babble?
>
> Is what for social babble?
>
> BobJust this thread. Cause I noticed you said
it was to be redirected but when I posted a response it came up in psychobabble instead of social babble. I just thought it would (my post, that is) come up in the other forum (social babble)...
Posted by ace on October 17, 2003, at 3:11:37
In reply to Re: What do GP's really know? TonyIreland, posted by cubic_me on October 15, 2003, at 6:48:11
> Hi Tony,
>
> I'm from England and saw my GP about depression. After about a month of treatment with Zoloft she decided it didnt work and sent me to see a psychiatrist. I really dont think I'm in need of a psychiatrist at the moment but I dont think she felt comfortable dealing with someone with suicidal ideation - even though she was a lovely person.
>
> The psychiatrists I have seen have prescribed Effexor, but I get withdrawal syptoms like you describe if I am late taking a dose. They dont believe that Effexor causes withdrawal effects so they are about as useless as the GP. I've been on the same dose for 4 months with no improvement so I dont think they can be that interested in getting me better.Typical. It's very easy for a psychiatrist to put a person on a drug which posseses very little drug interactions and requires no lab monotoring. It suits them. Never mind the fact that the patient is not getting better!
> I have abit of a confilct with this because I'm in medical school and want to become a psychiatrist.I'm on the eve of enetering medical school myself (got a few subjects to pass yet!)- I actually wanted to be a psychiatrist but have changed preference to neurology.
But all those I've met seem to know nothing and treat their patients like they are just the next one on the convayer belt.
I agree. And statistics show that psychiatrists have a high suicide rate, suffer from many of these disorders themselves (which isn't always a bad thing) and frequently abuse drugs. The psychiatrists I've met, both in a therapeutic context and personally, have, for the most part, been either grossly unethical or some of the LEAST caring people.
> Have you asked for a second opinion or seen a different GP? That is perfectly within your rights. You could also be asked to be reffered to a psychiatrist if you would feel more comfortable with that.
>
> _me
Posted by Dr. Bob on October 17, 2003, at 19:12:41
In reply to Re: Redirect: off-topic 03 Dr. Bob, posted by ace on October 17, 2003, at 2:02:51
> > > Is this for social babble?
> >
> > Is what for social babble?
>
> Just this thread. Cause I noticed you said it was to be redirected but when I posted a response it came up in psychobabble instead of social babble.No, this thread is here at PB. Here's a link to PSB:
http://www.dr-bob.org/babble/social/20031011/msgs/270365.html
Bob
Posted by cybercafe on October 18, 2003, at 18:02:50
In reply to Re: What do GP's really know? cubic_me, posted by ace on October 17, 2003, at 3:11:37
> > I have abit of a confilct with this because I'm in medical school and want to become a psychiatrist.
>
> I'm on the eve of enetering medical school myself (got a few subjects to pass yet!)- I actually wanted to be a psychiatrist but have changed preference to neurology.what made you change your mind? i know there are psychiatrists out there with backgrounds in neurology..... or if you want to be really suicidal you could try a M.D. psychiatrist + Ph.D. neurology no? (he says, with no comprehension of the Australian medical system :) )
> But all those I've met seem to know nothing and treat their patients like they are just the next one on the convayer belt.after about 10 apathetic conveyer-belt drive-through psychiatrists i went down to the states to try and trick a doctor into giving me abilify (i strongly urge people NOT to self-medicate unless you spend 10+ hours a day reading psychobabble and medical textbooks... and find yourself constantly explaining things to your doctors)...... and i met my first YOUNG pdoc, and she was so enthusiastic and caring ... man i was really impressed.... no .. blown away ... (i imagine this must be what derealization feels like :) )
YOUNG doctors are very very good in my limited sample size (2? 3?)... (even though they don't know what they're doing, muhahaha, that's cool, they will at least LISTEN and be willing to EDUCATE THEMSELVES... and check this out -- if they don't know what they're doing, they won't just say "okay come back next week" they'll say "i don't know what i'm doing, so" -"i'll refer you to someone who does" or "i'll have a talk with my colleagues")...do you know that very few of the docs in our best mental health hospitals talk with their colleagues? that strikes me as weird.... (though in this case they actually know more about psychiatry than i do... like 100 times more... so i am not passing judgement.... i just think it's WEIRD)...
still moronic... i mean.... out of date, CME-is-not-for-me, docs in general hospitals don't seem to consult with their colleagues... weird.... tragic... the doc who i'm seeing now who knows 1000 times more about psychiatry than me (respect) is a "consultant psychiatrist", the kind other doctors go to when they are stuck.... guess what? i have had plenty of doctors stuck and they never go for consults.... why??
anyways.... so like this young doc in the states spent 1 hour asking me every conceivable question before giving me an antipsychotic ... and then was caring enough to go look for samples!
now compare this to me going to see GP_OLDGUY_WALKINCLINIC who is like "oh you're on 5 mg zyprexa? sure here's a perscription no problem (expected, you WANT to encourage people to take their meds right?) .... in fact why don't you try taking 10 mg (what the???)" ..... in his defence... maybe i'm a *little* hyper/enthusiastic about medicine but is that just me? i mean when the only source of relieve in my life is going to see a doctor and getting some decent medication is it weird to be enthusiastic? ............ like dude... if you want to calm me down don't give me an antipsychotic give me a stimulant for my ADHD ..... wouldn't this guy feel guilty if my ADHD got worse and i developed some movement disorder or became a zombie for no reason?
of course not, he's GP_OLDGUY_WALKINCLINC :)(p.s. i do fine on 2.5 mg zyprexa :) )
> I agree. And statistics show that psychiatrists have a high suicide rate, suffer from many of these disorders themselves (which isn't always a bad thing) and frequently abuse drugs. Thei always thought psychiatry would be one of the most rewarding fields because you can take someone who is feeling worse than anyone on the planet, give them a drug, and in a few weeks see a major improvement.....
whereas you go into oncology and you see so many people die and must feel helpless :(>psychiatrists I've met, both in a therapeutic context and personally, have, for the most part, been either grossly unethical or some of the LEAST caring people.
i think in order to be a psychiatrist, or doctor for that matter, you have to be a little apathetic or it will really get to you ...... and i know families of doctors who all display the same traits... really nice, responsible, idealistic guys who don't find movies like 'faces of death' at all strange... hmmmm... like totally unphased by horror movies or grossness... mild sociopaths (no fear) but definately not psychopaths (no guilt)
like if i were a doc i would want to see max 4 patients a day (uneducated guess) otherwise i would just become an apathetic deliverer of drive-through medicine
speaking of becoming a doc....... can anyone suggest a decent anti-emetic? i have a really bad nausea reflex
Posted by cubic_me on October 19, 2003, at 8:25:41
In reply to Re: What do GP's really know?, posted by cybercafe on October 18, 2003, at 18:02:50
Half the stuff you reffered to in your post was mine, and half was someone else's so I'll mainly talk about what was mine cos otherwise I'll get mega confused :-) Doh! I'm confusing myself already!
I'm from the UK and in my 3rd year of med school so I'm meant to know something by now but really I dont have a clue. We just had a lecture on how to make people belive you know something when you dont have a clue (ie bulls***ing).
> > > I have abit of a confilct with this because I'm in medical school and want to become a psychiatrist.
> > But all those I've met seem to know nothing and treat their patients like they are just the next one on the convayer belt.
>
> after about 10 apathetic conveyer-belt drive-through psychiatrists i went down to the states to try and trick a doctor into giving me abilify (i strongly urge people NOT to self-medicate unless you spend 10+ hours a day reading psychobabble and medical textbooks... and find yourself constantly explaining things to your doctors)...... and i met my first YOUNG pdoc, and she was so enthusiastic and caring ... man i was really impressed.... no .. blown away ... (i imagine this must be what derealization feels like :) )
> YOUNG doctors are very very good in my limited sample size (2? 3?)... (even though they don't know what they're doing, muhahaha, that's cool, they will at least LISTEN and be willing to EDUCATE THEMSELVES... and check this out -- if they don't know what they're doing, they won't just say "okay come back next week" they'll say "i don't know what i'm doing, so" -"i'll refer you to someone who does" or "i'll have a talk with my colleagues")...I went into med school wanting to be a forensic psychiatrist cos I find all that crimonology stuf fascinating and you can help people at the same time :-), from a med student perspective, the psychiatrists I've seen in a proffessional context seem lovely people, really normal and know what they are talking about. But those who have treated me have been useless. I've seen 2 young pdocs, neither seemed caring. The first one's first question (before he even introduced himself) was 'so whats this I've been hearing about you wanting to hurt yourself?' I mean how are you meant to answer a question like that? At least he got a second opinion from the consultant but he was just as bad, his english was so poor that I could hardly understand him (he was foreign - rather than just had a bad education!). The second one is abit better but I've been on the same meds for 4 months without improvement and she just says she'll wait and see-its not her having to live with this c***.
In contrast the GPs I've seen have been fairly young with a caring manner and were willing to listen rather than just firing a load of questions to write in their notes.
If I become a psychiatrist I dont want my patients to hate me like I do mine. How am I meant to build trust with people who have had so many bad experiences? And personally I think oncology is much more rewarding because treatment is more clear cut and the best thing you can give someone is a dignified and peaceful death - hardly what you would describe suicide as.
> do you know that very few of the docs in our best mental health hospitals talk with their colleagues? that strikes me as weird.... (though in this case they actually know more about psychiatry than i do... like 100 times more... so i am not passing judgement.... i just think it's WEIRD)...
>
> still moronic... i mean.... out of date, CME-is-not-for-me, docs in general hospitals don't seem to consult with their colleagues... weird.... tragic... the doc who i'm seeing now who knows 1000 times more about psychiatry than me (respect) is a "consultant psychiatrist", the kind other doctors go to when they are stuck.... guess what? i have had plenty of doctors stuck and they never go for consults.... why??
>
> anyways.... so like this young doc in the states spent 1 hour asking me every conceivable question before giving me an antipsychotic ... and then was caring enough to go look for samples!
>
> now compare this to me going to see GP_OLDGUY_WALKINCLINIC who is like "oh you're on 5 mg zyprexa? sure here's a perscription no problem (expected, you WANT to encourage people to take their meds right?) .... in fact why don't you try taking 10 mg (what the???)" ..... in his defence... maybe i'm a *little* hyper/enthusiastic about medicine but is that just me? i mean when the only source of relieve in my life is going to see a doctor and getting some decent medication is it weird to be enthusiastic? ............ like dude... if you want to calm me down don't give me an antipsychotic give me a stimulant for my ADHD ..... wouldn't this guy feel guilty if my ADHD got worse and i developed some movement disorder or became a zombie for no reason?
> of course not, he's GP_OLDGUY_WALKINCLINC :)
>
> (p.s. i do fine on 2.5 mg zyprexa :) )
>
>
> > I agree. And statistics show that psychiatrists have a high suicide rate, suffer from many of these disorders themselves (which isn't always a bad thing) and frequently abuse drugs. The
>
> i always thought psychiatry would be one of the most rewarding fields because you can take someone who is feeling worse than anyone on the planet, give them a drug, and in a few weeks see a major improvement.....
> whereas you go into oncology and you see so many people die and must feel helpless :(
>
> >psychiatrists I've met, both in a therapeutic context and personally, have, for the most part, been either grossly unethical or some of the LEAST caring people.
>
> i think in order to be a psychiatrist, or doctor for that matter, you have to be a little apathetic or it will really get to you ...... and i know families of doctors who all display the same traits... really nice, responsible, idealistic guys who don't find movies like 'faces of death' at all strange... hmmmm... like totally unphased by horror movies or grossness... mild sociopaths (no fear) but definately not psychopaths (no guilt)
>
> like if i were a doc i would want to see max 4 patients a day (uneducated guess) otherwise i would just become an apathetic deliverer of drive-through medicine
>
I'd definately not want to deal with the 40 or more patients some docs have to in a day. In the UK a GP has 7 minutes with each patient - that hardly makes you feel special!> speaking of becoming a doc....... can anyone suggest a decent anti-emetic? i have a really bad nausea reflex
I know I'm meant to be good at bulls***ing but I really dont know anything about anti-emetics! I suppose it depends what sort of reflux you have. Does it occur at a certain time? How much refluxes? Do you know the cause?
_me
Posted by TonyIreland on October 19, 2003, at 8:36:39
In reply to Re: What do GP's really know? cybercafe, posted by cubic_me on October 19, 2003, at 8:25:41
See what I mean? The last post was from someone who is being taught how to deceive patients.
Its a disgrace - but as i said before and i'll always say it - Money lines the pockets and thats there first priority - after that, if they have time, patient care comes into consideration.
Posted by Dr. Bob on October 19, 2003, at 12:00:52
In reply to Re: What do GP's really know?, posted by TonyIreland on October 19, 2003, at 8:36:39
> Money lines the pockets and thats there first priority
I'd also like to redirect to PSB follow-ups regarding medicine or psychiatry in general. Thanks,
Bob
Posted by cybercafe on October 23, 2003, at 4:48:01
In reply to Re: What do GP's really know? cybercafe, posted by cubic_me on October 19, 2003, at 8:25:41
> I'm from the UK and in my 3rd year of med school so I'm meant to know something by now but really I dont have a clue. We just had a lecture on how to make people belive you know something when you dont have a clue (ie bulls***ing).
that's so cool..... can you give me specific technical terms, so i can say to docs "hey! that's not the right way to _____... you're going about it all wrong" haha :) dude that would be so cool
> I went into med school wanting to be a forensic psychiatrist cos I find all that crimonology stuf fascinating and you can help people at the same time :-), from a med student perspective, the
sounds like something to be passionate about. that is cool. why did you change your mind?
>psychiatrists I've seen in a proffessional context seem lovely people, really normal and know what they are talking about. But those who have treated me have been useless. I've seen 2 young pdocs,
in the UK i saw one good doc in hendon (after waiting forever) several crappy docs who wanted to put me on antipsychotics for anxiety (?????) .... then i went private and saw a really good doc.... or at least... he was the only doc i had who ever returned phone calls :)
>neither seemed caring. The first one's first question (before he even introduced himself) was 'so whats this I've been hearing about you wanting to hurt yourself?' I mean how are you meant to
yes it sounds rather condescending and accusatory
>answer a question like that? At least he got a
second opinion from the consultant but he was just as bad, his english was so poor that I could hardly understand him (he was foreign - rather than just had a bad education!). The second one is abit better but I've been on the same meds for 4 months without improvement and she just says she'll wait and see-its not her having to live with this c***.yeah its bs .... if i could do things over again i would have stood up for myself a lot more .... and probably lied to doctors and treat myself with my own med selections and dosages (as i am doing now) ... you would not believe how needlessly i was suffering while my doc refused to give me an AD ... ... though i guess it's partly my fault cuz any sane person who was depressed and refused an AD would go PSYCHO
> In contrast the GPs I've seen have been fairly young with a caring manner and were willing to listen rather than just firing a load of questions to write in their notes.i had varying experiences depending on the area (rich/poor) ...
> If I become a psychiatrist I dont want my patients to hate me like I do mine. How am I meant to build trust with people who have had so many bad experiences? And personally I think oncology isEASY! return phone calls..... that would automatically put you in the top 0.1% of psychiatrists right off the bat :) :)
>much more rewarding because treatment is more clear cut and the best thing you can give someone is a dignified and peaceful death - hardly what you would describe suicide as.
my doc said suicide among his patients was quite rare..... i think atypicals are really good for getting rid of suicidal ideation ?
> I'd definately not want to deal with the 40 or more patients some docs have to in a day. In the UK a GP has 7 minutes with each patient - that hardly makes you feel special!
yeah everyone knows that's ridiculous..... but what can you do? i guess it's not that easy to open up more med schools ? :(
> I know I'm meant to be good at bulls***ing but I really dont know anything about anti-emetics! I suppose it depends what sort of reflux you have. Does it occur at a certain time? How much refluxes? Do you know the cause?
if i see anything gorey i get nauseous quite easy.... (also hyper ventilate i think)....... if i stick anything in my mouth like an x ray or mouthguard i have a strong gag reflex....
(don't you guys have a more professional sounding word for bulls***?)
Posted by cubic_me on October 23, 2003, at 8:26:08
In reply to Re: What do GP's really know?, posted by cybercafe on October 23, 2003, at 4:48:01
hiya,
I'm afraid I dont know a better word for bull**** but if I fid a more technical term I'll let you know :) Even if you think your pdoc is doing the wrong thing I find it really hard to go against what they are saying. After all, they are *meant* to know what they are talking about, and it is nice to assume that they have your best interests at heart.
I'd still like to do psychiatry, i just think it might be a hard path to take. Being a GP has crossed my mind, but I think there'll be too much of that 'old granny wanting to come for a chat' type thing, and any interesting problems get referred on so you never see them to conclusion.
>
> in the UK i saw one good doc in hendon (after waiting forever) several crappy docs who wanted to put me on antipsychotics for anxiety (?????) .... then i went private and saw a really good doc.... or at least... he was the only doc i had who ever returned phone calls :)
>
> EASY! return phone calls..... that would automatically put you in the top 0.1% of psychiatrists right off the bat :) :)
>>I agee with the returning phone calls thing. I've never phoned a psychiatrist of mine, but i can see how difficult it must be when you really need to speak to them. I suppose some patients geti into the habbit of phoning, and the docs dont want people to get into that cycle and become dependent - i dont know, thats just a guess.
>
> yeah everyone knows that's ridiculous..... but what can you do? i guess it's not that easy to open up more med schools ? :(Yeah, they have opened a few recently but there's still not enough doc's and the young one's are worked way too long hours. With a free health service there are bound to be cutbacks everywhere. I've got a friend who's made several suicide attempts recently and has had her initial pdoc appointment cancelled and rescheduled 3 times, she still hasnt seen him.
Also psychiatry isnt a field that many people want to go into, so there isnt much competition for jobs, especially in the poorer areas. This means that the 'worse' doctors with poorer interpersonal skills get jobs in psychiatry. All the high flighers want to go into surgery or paediatrics.
>
> if i see anything gorey i get nauseous quite easy.... (also hyper ventilate i think)....... if i stick anything in my mouth like an x ray or mouthguard i have a strong gag reflex....
>
Getting nauseous easily sounds more psycological than physical, tho I dont claim to be making a diagnosis! I suppose some people are more sensitive to having things in their mouths than others. Perhaps you should see a real (fully qualified!) doc!_me
Posted by cybercafe on October 28, 2003, at 1:11:58
In reply to Re: What do GP's really know? cybercafe, posted by cubic_me on October 23, 2003, at 8:26:08
> I'm afraid I dont know a better word for bull**** but if I fid a more technical term I'll let you know :) Even if you think your pdoc is doing the
thanks bro, stay on the lookout :)
>wrong thing I find it really hard to go against what they are saying. After all, they are *meant* to know what they are talking about, and it is nice to assume that they have your best interests at heart.
yeah... if only they'd admitt that something might not work, you could put your efforts to coming up with backup plans... or perhaps a better option..
> I'd still like to do psychiatry, i just think it might be a hard path to take. Being a GP hasah but you could get through psychiatry dead easy cuz there is no competition, right?
>crossed my mind, but I think there'll be too much of that 'old granny wanting to come for a chat' type thing, and any interesting problems get referred on so you never see them to conclusion.
true... but in other medicines you might get sick of being stuck in one area, whereas the challenge for gps is limitless cuz they get to deal with it all
> > EASY! return phone calls..... that would automatically put you in the top 0.1% of psychiatrists right off the bat :) :)
> >
>
> >I agee with the returning phone calls thing. I've never phoned a psychiatrist of mine, but i can see how difficult it must be when you really need to speak to them. I suppose some patients geti into the habbit of phoning, and the docs dont want people to get into that cycle and become dependent - i dont know, thats just a guess.i think the doc could just let you know when you are getting out of hand rather than not even make an effort at all.......... i think it just comes down to them being really busy
> Yeah, they have opened a few recently but there's still not enough doc's and the young one's are worked way too long hours. With a free health service there are bound to be cutbacks everywhere. I've got a friend who's made several suicide attempts recently and has had her initial pdoc appointment cancelled and rescheduled 3 times, she still hasnt seen him.
don't they have emergency departments to deal with things like that?? it sounds quite horrible
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