#I'm pretty sure my psychiatrist is going to ask if I want to transition because of the general misogyny

[bispacecadet]

actually it would be so funny if I do the computer science apprenticeship because the city I live in is known for 1) having a lot of men and 2) having a lot of IT people

[deadmomjokes]

Normal Anon Again 1: Your response was great, don't worry about a thing there. I just really feel stuck because Im still with my emotionally abusive family, and so I had to sneak to even see a doctor. I honestly felt like the doctor barely ever heard me at all, so even though she did prescribe an SSRI (not that she said what brand), I'm kind of scared to continue treatment with her. Because I made the notebook with a lot of care, she said I had OCD and did bring it up again later when I

had refuted it and tried to explain the notebook was just something I wanted to be well done for her. She didn't ever look at it either, so she based it off me buying little tabs and labeling them for ease of access and writing my name on the front I guess? I don't have a lot of money, as I don't have a job, and getting a job is the main reason I want to try medication... I basically have to move out by 2020 from my family, both by their desires and mine, so I'm on acrazy deadline to try to get my life together and I feel like I have no time to find someone new if I'm going to be looking to move away when all the apartments are renting. So it feels like if I want to try medication this is my one chance, but I don't feel like I can trust the doctor handling them. I don't know if I should just try to find a way to make my life work out for a couple months or give the medication a shot even though I don't trust the provider...I've got to worry about getting a job this month or being homeless too, which is why it feels so one or the other for my current situation. Thank you so much for all your feedback, sorry if this was a little messy being explained, I'm a bit frazzled yet, haha.

Oh man, I’m SO very sorry for everything you’re going through! You’re dealing with a ton, and this incident with Dr Garbage certainly didn’t help.

One thing that may be a possibility is going to a normal doctor, like a family medicine doc or general practitioner, and talking to them about your anxiety/depression problems. They can also prescribe psych medication, and it might be easier to pass off around your family and/or to find once you move, since a lot of offices partner or have networks that you can just transfer through. Anyone from a Nurse Practitioner to a PhD in general medicine can prescribe meds like an SSRI or even low-level mood stabilizers. (For my recently upped dosage, I went to a PA-C and they consulted with the folks at my obgyn, so I never even saw a psychiatrist. Tho I’m trying to get in with one anyway, but that’s way beside the point.)

I definitely understand you being unable to trust the current provider; she clearly didn’t hear you or take everything (anything?) into account. Anyone who comes to you from an emotionally abusive situation should warrant a ton of follow-up questions and in-depth probing. Even beyond that, just in general, taking stock of all the symptoms and reviewing any identified triggers is going to go a long way toward real diagnosis. Your notebook should have made her job a breeze, instead of her having to pick through your anecdotes of what happens when, she could just look at your notes! You were doing everything right; a therapist’s dream, honestly. I’ve been in therapy for years and I’m still not that good at keeping tabs on my own symptoms and patterns. I’m enraged on your behalf, because when someone comes to you for help you should reach back out to them, not be prescriptivist even if you’re dealing with prescriptions.

If medication is something you’ve been considering for a while, and feel like it might be a good fit for you, it may be worth trying the current prescription even though the current doctor is garbage, since SSRIs are usually the first try medications anyway. But that always comes with risks, because sometimes the first try doesn’t really work out for you or your specific situation. But SSRIs as a category are pretty safe, and are used for anxiety disorders (including panic disorder and generalized anxiety), ptsd, depression, and ocd as well. So chances are even if you found a psych who did their job well (aka not labeling you ocd for being prepared), they were going to land on an SSRI as a first try, too. That definitely doesn’t make it an easy decision, tho. That nagging fear may always be with you if you try it anyway despite not really trusting her diagnosis, and that could add a layer of complexity to deciding whether the medicine is right for you. Especially if you end up needing to switch medication or dosage, having a doctor you trust from the outset is going to be important.

I obviously cannot tell you what to do, nor do I want to, or even think I should if I could, because personal situations are just that--personal. I would only caution that if you’re already having difficulty getting or doing a job without medical assistance (ie medication), that trying it under serious stress for a few months may do more harm than good as far as worsening your difficulties, or causing new ones. However, sometimes we aren’t in the position to make the “best” decision for our health because living takes precedence; I’ve taken plenty of jobs that wrecked my mind and body and I kept them anyway because I absolutely had to. So I’m not going to get on a high horse because I know exactly how hard it is, and the difficult decisions you have to make in order to survive. I’m just so very sorry you are in that position to make such a decision.

If you do decide to try the medication anyway, some tips on kind of “going it alone” since you won’t be able to/won’t want to go back to the original doctor:

Start at a lower dose than the full final dosage. If she didn’t prescribe a “titration” schedule, starting at half dose for a week is a good place to begin.

Understand that things might get worse before they get better. You might have horrible mood swings, really bad depressive days, or bad anxiety spells before you start seeing the true effects. This isn’t indicative of whether the medicine is going to work eventually, but if it becomes too much for you to deal with, you should stop anyway.

Side effects may come and go. Just worth noting.

If possible, have someone close to you who knows that you’re starting this medicine. Obviously not a family member given your situation, but if you have a friend or anyone you do trust in your immediate vicinity, or even a friend you communicate with long-distance, make sure someone knows. That way you have someone to report in to and who can check up on you as you adjust.

Start by taking them with food, even if it doesn’t have a nausea warning. I’d suggest evening meal or soon thereafter, because SSRIs often cause drowsiness at first (great for helping with insomnia tho!).

You’re probably going to have a full month or two before it reaches its peak effect, since this is your first time trying them. You might see some relief right away, but full efficacy takes time as it builds up in your system. If you can tolerate the side effects (or don’t have any), and you’re able to deal with the mood swings or psychiatric effects, stick with it at least 6 weeks.

Listen to that “don’t drive or operate machinery” warning. First-time-medication drowsiness is a special breed that sneaks up on you and also makes you feel WEIRD.

You can also see about filling the prescription and then researching the name on the label before you decide whether or not to take it. Or, if you have an online account with the pharmacy, as with CVS, you can see the name of the drug there, or even call the pharmacy she sent it to and ask them what the name of it was (”for insurance purposes” or “because I forgot which one it was”) and then research it on sites like Mayo Clinic and rxlist.com (don’t do webmd). These websites include lists of what it’s approved to treat, so if you’re fairly certain you actually have anxiety/depression, look for that on the list. Just know that all websites are essentially required to remind you that an SSRI (really any antidepressant or mood stabilizer) could worsen any suicidal thoughts or behaviors, though this is mostly a risk for the 24 and under crowd with emphasis on teenagers. And it doesn’t happen to everyone.

Should you decide not to do the medicine right now because of the doctor who prescribed it, I applaud you for your bravery and strength in facing both your uncertain future and your mental/emotional difficulties without the assistance you feel you need. That’s a hard, hard thing to do, and I wish it wasn’t a choice you had to make.

I’ll be sending good vibes, thoughts, and prayers your way as you’re dealing with so many transitions and difficulties. I know cyber hugs are kind of a dated internetism, and may not mean much, but I give you all the cyber hugs my cyber arms can muster.