Went to see the pdoc nurse practitioner to get my Adderall refilled yesterday. When you go in for a meds checkup with the nurse, they have you fill out this checklisty form in the waiting room where they try to concise a DSM diagnosis into one-word categories–”mood,” “sleep,” “appetite,” “interest,” “anxiety,” etc.–with 1 to 10 (bad to good) rankings.
I’m thinking, okay, this is subjective, and surely she’ll ask me questions and we can discuss it if she has concerns. Because, y’know, that’s what a doctor would do. So I fill it out based on how I’ve been sleeping and stressing this last week, giving “sleep” a “3″ since my circadian cycles have been wonky, and mood a “3″ as well because I’ve been juggling too many hamsters. And I also put down a “4″ for appetite because, well, I’m taking an amphetamine, and it’s an appetite-suppressant. (Which, by the way, is an excellent way to lose weight.)
When I go in, she informs me that “I’m not doing good,” which I thought was a wee bit presumptuous since she’s exchanged all of two, maybe three sentences with me. And she pushes hard for me to get back on an antidepressant. I ask her what she’s basing her assessment on, and she says the 3 I gave “mood.”
Okay, so nurse lady doesn’t subscribe to my “it’s subjective” interpretation and doesn’t realize that that 3 is a 3 for me across the board, and that my board has never been profoundly depressed or psychotic. I try to explain this to her and that I didn’t think “mood” was an effective descriptor for everything that encompasses a person’s mental state, and I’m not suicidal or homicidal, and I’m really not all that depressed either; I’m mostly cranky and stressed.
Her response? “You keep going like this and you’ll end up in the hospital.”
WTF? First of all, I was diagnosed with mild depression–not a hospitalization caliber ailment–and I feel tons better now than I did when I was diagnosed years ago. Second, how can she find it in the least bit appropriate to tell anyone, especially someone who may be feeling emotionally frail, that if they “keep going like this you’ll end up in the hospital” based solely upon a 1 to 10 scale of a one-word descriptor? This woman hasn’t spent fifteen minutes talking to me in the three months she’s been aware of my existence!
I tell her, “No, I really won’t.” And explain to her how hard it was to get off the Effexor and that I would rather not go back on an antidepressant.
She continues to push and suggests I try Celexa which is a “more pure” SSRI than Prozac and isn’t an SNRI.
I try to point out that it wouldn’t take effect for six or so weeks in any case (by which time I fully expect to have selected the hamsters I want to keep in the air, and to have volleyed the rest of them over the fence), and she interrupts me and says “two weeks.”
Huh. Okay, my grad. school Psychopharmacology class was a loooong time ago. Maybe they’ve made strides in the antidepressant field. Might be worth trying.
As I make speculative noises, she rattles on how I should “take this at night before bed.” Since I took the Prozac in the AM, and I don’t want to take something that will make me tired because that’s the whole reason I’m on the Adderall–fighting the fatigue and all–I ask her “so this will make me sleepy?” And she says “no, you just take it before bedtime and when you wake up you’ll feel better.”
Do you get that she was talking to and treating me like a refugee from the short school bus?
Yeah. By this time I’m annoyed, upset, indignant, and doubting myself. Maybe I should go back on an antidepressant. After all, I was dwelling upon it before, and I’m going through a lot right now. But mainly, I just want to get my stupid Adderall refill and leave. So I give her the go ahead on the Celexa.
She enters prescriptions for both meds into the computer and off I go to the pharmacy. But Adderall is a controlled med and requires a hard-copy script, which nurse-lady should have known. I’m forced to go back and wait 45 minutes to get a stupid piece of paper, ensuring that I get caught in rush hour traffic, making an already upset-Eugie extremely unhappy.
After languishing for over an hour in Atlanta’s lovely traffic, I got home and looked up Celexa online. Length of time until effective: 6-8 weeks. May cause drowsiness.
In addition to bullying and coercing me, she lied to me.
I’m obviously sympathetic to the mental health profession, having that MA in Psychology and all, but I’m feeling pretty mistreated by it right now. And I have to wonder, how exactly is the sort of conduct she displayed going to be of benefit to anyone’s mental state?
Because I have indeed been stressed to my eyeballs, I took the Celexa last night. When I woke up this morning, I was groggy and light-headed. And I feel a headache coming on. Oh yeah, so helpful.
Now I’m debating whether it’s worth staying on it, because I was, after all, contemplating going back on an antidepressant, or if I should just pitch the stupid pills out the window.
I’m trying to base my decision not on my experience in getting them, but my overall mental state.
Right now, the window’s looking pretty enticing.
Feh. And she wants to see me back in six weeks. I’d say “no way in hell” except my alternative is to follow-up with a doctor to get my Adderall refilled, which has a co-pay. Seeing her, at least, is free.