Doctors Lounge - Psychiatry Answers
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Forum Name: Psychiatric Topics
|niceheartnisa - Thu May 22, 2008 3:03 pm||
Hi, I'm a 31 year old stay at home mom and I'm currently taking 100mg of zoloft a day. My doctor is just a general MD because psychiatric care is not covered well by my insurance. I've had a lot of issues in my life, I was abandoned a lot as a child, bounced all over the foster care system and was back and forth with an unstable, drug addicted biological mother. I was adopted when I was nine but moved out of that home when I was 16. I smoked a lot of pot, never enjoyed it that much, but it was available and I basically just did it to numb myself from all kinds of things like depression, sex abuse, etc. I never cared much about trying new drugs or drinking a lot of alcohol, but I definitely enjoyed any altered sense of being. I have gone through a few hospitalizations where I was never clearly diagnosed with anything other than depression, but I was also much younger then and not able to express myself very easily.
I have two young daughters ages 2 and 4. Just about a year ago I was feeling stressed and irritated and a little depressed, too... but the stress and irritability were so bad that I turned to a doctor to get me back on an SSRI. I had stopped taking them when I became pregnant with my first child and just never got back on them due to breastfeeding and a second pregnancy. I'm even still breastfeeding my 2 year old which is why I chose zoloft and now take 100mg a day of it. Things improved when I first started taking it. I definitely don't feel as constantly edgy as I had a year ago. But I'm still so high strung. I just feel like I can't cope with my children's behaviors so much of the day. And I doubt my parenting skills, my self worth, etc because they are constantly fighting and talking back. I also have what I have self diagnosed with the agreement of my husband and family that I am severely ADD. I just recently started taking 18mg of Strattera for one month, but haven't decided if I want to continue or not. I just didn't notice a huge difference so I'm not rushing to get the next script.
Anyways, let me just get to the point here. I've got another issue, I like vicodin. I'm not an addict, (Famous words, I know.) in the sense that I could go months, years or whatever without thinking how I could get high. It's not a recreational thing so much as it's just that when I do happen to get a prescription for hydrocodone, which has happened occasionally for some back problems, I feel great. Sure, it's euphoria inducing stuff, right? So like if vicodin takes away the edge, puts me in a place where I don't lose it, I'm calm, I'm happy, I'm patient, I can deal with my kids wonderfully... but vicodin is "bad", why is it so bad? And what is there that isn't bad for me that could work better than an SSRI at getting me out of this ready to scream and can't hardly breathe state that I feel I'm in all day long?! My MD prescribed adarax which did nothing but made me feel sleepy. I can't just be sleepy when I have two kids to care for.
I imagined motherhood to be a loving, nurturing journey... and somedays it is, but most days I feel terrible at the way I'm snapping at my kids about everything. I'm taking my oldest daughter in next week for a behavioral evaluation because she is also high strung, anxious and basically we have to walk around on eggshells to TRY to please this four year old. So many things that she does are like triggers for me to explode inside. I know I have a ton of unresolved issues from my childhood that are probably linked to this in many ways. But I just don't have any faith in myself that therapy is going to work in time. Like, I just blinked and she's already four.
|Dr. E. Seigle - Thu Jun 05, 2008 3:25 pm||
You gave a candid, feeling account of your difficult childhood and your current struggles. Given what sounds like a very traumatic, lonely, painful childhood, your feelings of depression and difficulty with the stresses of raising two children, especially at home, are normal and expectable. People with backgrounds such as yours usually carry with them emotional injuries that are untreated, and which affect their moods, self-esteem, stress-tolerance, and relationships. In general, the use of anti-depressants alone is inadequate to help heal these injuries, though they can be helpful. Have you been in psychotherapy for an extended period of time in which you felt well connected and understood by the therapist?
Even if you have had this in the past, you are in a new phase in your life, and either way, I would advise you to have a good evaluation with a reputable psychiatrist, psychologist, or clinical social worker. A psychiatrist is to be preferred to prescribe your medication and maximize its benefit. Some psychiatrists can be your therapist as well, some cannot or don't.
You seem to have the openness and insight to be able to benefit from psychotherapy. Interview two or three recommended therapists and see who you "click" with; ask them after a couple of sessions for their understanding of your problem (and yours) and how they work with their patients. There are many types of psychotherapy, and you should compare what you are told to see what makes sense to you. Good luck!
-Eliot Seigle MD
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