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HIV Life >> Living With HIV

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franfrog
Legend

Reged: 01/05/06
Posts: 1342
Loc: NJ
which is a better choice?
      #242308 - 09/23/08 03:25 PM

My doctor recently diagnosed me with depression. It sort of hit me like a ton of bricks. She put me on lexapro 10mg and then switched me to 20 just last week. I think this is part to do with me explaining my fatigue during the day and insomnia at night. I also switched my sustiva from pm to am hoping this will help. Either way, I have been on ambien for so long I am going to try just weaning myself off of it a little at a time.

Well, my question is she wants me to talk to someone. I am not sure if I am better off at a psycologist or psyciatyrist? From my understanding the psyciatrist will just treat without weekly meetings where a psycologist can treat according to the meetings weekly with them.



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Florida69
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Reged: 02/19/07
Posts: 541
Re: which is a better choice? new
      #242312 - 09/23/08 04:19 PM

The difference in a psychologist and a psychiatrist is basically the medical degree. I was a Psychology major for most of my time in college, you know I think that is why I am so insightful.

Psychologists study the human mind and human behavior. Research psychologists investigate the physical, cognitive, emotional, or social aspects of human behavior. Psychologists in health service fields provide mental health care in hospitals, clinics, schools, or private settings. Psychologists employed in applied settings, such as business, industry, government, or nonprofit organizations, provide training, conduct research, design organizational systems, and act as advocates for psychology.

A psychiatrist is a physician who specializes in the prevention, diagnosis, and treatment of mental, addictive, and emotional disorders, such as the following:

Anxiety
Depression
Developmental disabilities
Psychosis
Substance abuse
Sexual dysfunction


In my opinion and you know how I have way to many of those, you are better off with a shrink (Psychiatrist), they will be the most helpful and if you need medications to help you they are better equiped to prescribe them. I hope that helps sweets, love ya, mean it... HUGS... D

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Lovinlife
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Reged: 08/29/08
Posts: 63
Re: which is a better choice? new
      #242313 - 09/23/08 04:24 PM

I may be wrong about this but.....several friends who saw psychiatrists found that they were very quickly into prescribing more medication whereas a psychologist/therapist may have some more tools for talk therapy or helping you manage or beat the depression without resorting to more medication.

It sounds like seeing a therapist regularly might be really helpful for you...maybe even a therapist who has worked with other HIV/AIDS patients so that they are already aware of some of the things you are experiencing.

Good luck finding some of that "happy happy joy joy" out there that's to be had.

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Florida69
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Reged: 02/19/07
Posts: 541
Re: which is a better choice? new
      #242314 - 09/23/08 04:32 PM

Quote:

I may be wrong about this but.....several friends who saw psychiatrists found that they were very quickly into prescribing more medication whereas a psychologist/therapist may have some more tools for talk therapy or helping you manage or beat the depression without resorting to more medication.

It sounds like seeing a therapist regularly might be really helpful for you...maybe even a therapist who has worked with other HIV/AIDS patients so that they are already aware of some of the things you are experiencing.

Good luck finding some of that "happy happy joy joy" out there that's to be had.




That is a better way of looking at it, thanks T, see and I thought I was being helpful...lol.. Therapy is always a great thing, and never something that you should go into having any apprehension, which I know you will not. D

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Lovinlife
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Reged: 08/29/08
Posts: 63
Re: which is a better choice? new
      #242316 - 09/23/08 04:38 PM

D-you crack me up! i just read your post and was thinking, "oh. duh. that was so much more informative and helpful."
we should start a he said/she said q and a forum. People can read my dumb-ass hippie responses and then learn from your technical, intellectual responses!

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Florida69
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Reged: 02/19/07
Posts: 541
Re: which is a better choice? new
      #242319 - 09/23/08 04:42 PM

You are far from dumb my dear, and as far as newbies go I think you rock, I am totally glad that we have both been on here at the same time. I go through spurts.. LOL.. I was a big psychology major, when I started doing the clinicals and started seeing people crazier than me, I knew that field was not for me, so I got into the legal business instead, I know what is wrong with me.. LOL.. D

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ScotCharles
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Reged: 05/06/05
Posts: 924
Loc: Los Angeles
Re: which is a better choice? new
      #242336 - 09/24/08 01:01 PM

When I told my neurologist that I was depressed and I thought I should talk to a psychologist, he said "No you don't. You just need to take a pill." On his advice I saw a psychiatrist who prescribed 50mg of Imipramine three times a day and 50mg of seroquel at bedtime. Those meds did the trick and I am much more comfortable these days and I don't think of suicide every five minutes like I did before the meds.

Depression is either organic or situational. Situational depression (as in my wife has cancer and I am depressed) responds well to talk therapy. Organic responds better to drugs.

If you have HIV, in all likelihood, your depression is caused by the damage caused by the virus to the mood centers in your brain.

However, you are taking an extremely low dose of antidepressants, so perhaps your doctor sees your depression as situational. A psychiatrist or a psychologist could help you sort that out.

Best wishes and congratulations on seeking help for your depression.

Cheers,

ScotCharles

--------------------
Life is a river.
Carpe diem.

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franfrog
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Reged: 01/05/06
Posts: 1342
Loc: NJ
Re: which is a better choice? new
      #242338 - 09/24/08 01:26 PM

Thank you all for your responses. I think SC you have hit it though. I have talked to a therapist at the very beginning of my diagnosis and got no where. I do not think this is something that has anything to do with talking to anyone.
I have done that it it got me no where. I guess I will discuss that aspect with my doctor. Thank you!

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Kevin2k
Newbie

Reged: 09/24/08
Posts: 3
Re: which is a better choice? new
      #242350 - 09/24/08 09:00 PM

Severe depression is treated on two fronts, meds and therapy. As with trying different meds, the first therapist you saw may not have been right for you. They are individuals just like us. Don't miss out on the positive benefits of 1x1 therapy based on one practitioner. The next you try may be just right for your needs.

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nolaheat
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Reged: 09/24/08
Posts: 1
Re: which is a better choice? new
      #242352 - 09/24/08 09:20 PM

I would try a licensed psychologist, not someone the clinic refers you to see. If you need documentation later down the road the real deal will be of help.

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TdavisMSW
Newbie

Reged: 05/21/08
Posts: 8
Loc: Ft. Lauderdale
Re: which is a better choice? new
      #242353 - 09/24/08 09:22 PM

Hi Fran,

While it's great that your HIV specialist has acknowledged your depression, I think it's best that you be talking to a psychiatrist with experience in HIV issues and antiretrovirals. After all, a psychiatrist IS the specialist with regard to psychiatric medications, right? You'd want to talk to a cardiologist about your heart problems, a nephrologist about your kidney problems, a pulmonologist about your lung problems.

That said, and even if you decide to let your HIV-specialist handle issues of a psychiatric nature, I would "talk" to a Psychologist, a Licensed Mental Health Counselor (LMHC) or a Licensed Clinical Social Worker (LCSW). With my bias as a social worker, I'd encourage you to see a LCSW. Why? Because we are trained in counseling AND in addressing all other issues from a "systems" perspective (a bio-psycho-social perspective) as part of their core training. A social worker, in my humble opinion, will be better prepared to help you address ALL other issues that may be underlying your depression. Although some psychiatrists also provide counseling services, their primary focus is on a biological cause of psychiatric diagnoses. Sometimes, there isn't one. My mother's death isn't a biological cause of my depression, right? Treating my depression with an antidepressant in this situation really is only putting a band-aid on the problem.

Lastly, I think you're doctor also meant "talk" to others who are coping with similar issues. No psychiatrist, no psychologist, no LMCH, no LCSW can give you the kind of support to help you need to establish a sense of normalcy with what you're coping with than others who've already established that sense of normalcy for themselves. In therapy, it is very important for the therapist to monitor any personal disclosures they make to the client - for very good reasons too involved to go into here. But, as important as that is, so too is it important for you to find a support group where those personal disclosures are plenty.

Although I never like hearing that a PCP or HIV-specialist has prescribed psychiatric medications for their patients, it does sound like your doctor has enough concern for your well-being, and enough clarity to acknowledge that he/she can't fix ALL of your problems for you, to refer you to other sources of help outside his/her office.

Keep your chin up. I've been on a Sustiva containing regimen since I was diagnosed in 2000 - and I'm still working, still healthy, still happy. You've got many years of happiness ahead of you, and you will learn out to get there with this added challenge to cope with.

Best,
Terry

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TdavisMSW
Newbie

Reged: 05/21/08
Posts: 8
Loc: Ft. Lauderdale
Re: which is a better choice? new
      #242354 - 09/24/08 09:30 PM

I think your Neurologist is wrong. In the case of HIV, it is organic (meaning, caused by HIV itself), a side effect of the medications - all of which exacerbate the situational depression, and/or situational. I think MOST people would feel VERY depressed from the moment they received a diagnosis of HIV. In fact, many are diagnosed with PTSD. Why? It's a scary, traumatic thing to learn about yourself. That's not organic - that's situaltional. Who WOULDN'T need to talk to someone about that????



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josephshill
Newbie

Reged: 09/03/08
Posts: 3
Re: which is a better choice? new
      #242357 - 09/25/08 01:42 AM

Dear franfrog,
I am being treated for Bi-Polar Disorder since 1981. I have ALWAYS have better progress talking with a psycologist. Psyciatyrist are just for getting the medicine to help your body & mind not to react or dwell upon your depressing thoughts or actions. If you feel that the meds aren't helping or the side affects you cann't deal with, ask for another med. I currently on 2 meds which are about 8-9 drug regime. I recieve weekly counceling from an intern at my local HIV+ support group. As for finding a psyciatrist, your local county mental institution office or case manager at HIV+ support group will help. Let both doctors know all of the drugs taking and using, BE HONEST if you really want a better life!!! I am honest enough to tell them if I STUPIDLY used COCAIN! Just to remind myself I guess, just how close my GRAVE-SITE can be! This is the FACTS from a MENTAL-HIV+ EXPERT! HIV+ since 1982.
Midnight Joe

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ScotCharles
Legend

Reged: 05/06/05
Posts: 924
Loc: Los Angeles
Re: which is a better choice? new
      #242366 - 09/25/08 12:59 PM

My dear boy,

I never said Fran shouldn't talk to someone. I merely said that merely talking would never cure a depression with organic origins.

I have a morbid fear of psychiatrists and psychologists indeed all mental health workers, which I have to work hard to overcome to go to my weekly appointments with the psychiatrist.

Decades ago, homosexuality was thought by most psychiatrists to be a mental disease. When I was fourteen, I told my mother I was gay. She took me to a psychiatrist for regular appointments. I told him I was gay. He prescribed Thorazine three times a day.

Not too long after I started to see the psychiatrist, I tried to kill myself by pouring a whole bottle of Thorazine down my throat chased with a large quantity of my mother's elderberry wine.

After I was released from the mental ward of the local hospital, my mother took me to a government building of some kind. While she and the person we were meeting were out of the room, I flipped through the thick file with my name on it. To my horror, I read in one of the papers that I was to be committed to a mental hospital for treatment.

I left the room, the building, my hometown, the state and never went back. I didn't speak to my mother for twenty years. I was fifteen when I left home never to return.

So now before each session with the psychiatrist for treatment of the depression, anxiety and panic caused by the damage HIV has done to my brain, I do relaxation exercises to combat the panic of seeing a psychiatrist.

ScotCharles

--------------------
Life is a river.
Carpe diem.

Edited by ScotCharles (09/25/08 01:40 PM)

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franfrog
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Reged: 01/05/06
Posts: 1342
Loc: NJ
Re: which is a better choice? new
      #242370 - 09/25/08 01:18 PM

Here is my question-I know I will need medication. I do not mind talking to someone even to know that there is no underlying cause. I was diagnosed HIV+ that is my depression. I have 2 kids and feell like they will be left with no mother. I mean they are all typical thoughts. Knowing that I full on will do everything in my power to stay healthy, I have no thoughts of suicide. I mean this was all covered in the therapist I saw after I was realesed form the hospital after a month from PCP and my diagnosis.

I know that there is nothing that has changed my thoughts and feelings. Anyway, even if I go to see a psychologist and need meds, what happens if they can not prescibe them?

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