So I saw a new psychiatrist today regarding taper off of my benzo.
The first thing I noticed upon being in the doctor's office is just how full his tiny lobby area was. Granted, there are two
doctors there, but it just seemed cramped. Oh, well. Busy appointment-time?? I hope so.
The doctor was alright, that is, he'll serve the purpose for which I need him: tapering from my benzo... but other than that, he did disappoint me in a couple of ways:
1) He seemed to ask me why I need to taper, what the reason is I need to be off of my medicine and what am I going to do when I am done with my medicine and awful lot during the visit. Now, I realize (and he told me this at the end of the appointment) that he just really wants to know what I am thinking and fully understand it, but it really did give me the impression that he doesn't consider anxiolytic benzodiazepines addictive, at least not in my situation.
2) He was rather impersonal, but that's OK. I've only really seen one other psychiatrist in my entire life, and she was just a sweetheart anyway. I forget that doctors are people too!
3) I hate to say this, and I don't mean to be racial, but he and I obviously had some language barrier issues. He's Indian, and surprisingly enough his English was awful - just awful! I know mine isn't the greatest, but I do have a Bachelor's in language (OK... let all the criticism commence, people!)... so, it just irked me when he couldn't conjugate verbs... English
verbs here! English verbs are easy to use. However, what can I expect from Americans who misuse past participles ... I'm getting off-subject. My point is is that our conversation would have been clearer had his English been a little easier to understand. And I know I suck at speaking other languages in foreign lands, so, I'm no better, I suppose.
4) OK, this is the killer... for those of you who know what tapering off of a medicine that has potential for dependency is like, you know what I mean when I say he had the audacity to compare blood pressure medication with anxiolytic medication (specifically benzodiazepines)! It made me mad as hell.
Actually, a couple of times he made me mad as hell and I had to tell him that
a) I am on a medicine which I should have not been on for more than a couple weeks and have become dependent on them. I tried a taper with a general practitioner who isn't well-versed in psychiatric drugs which made me feel very ill, therefore, I seek a doctor well-versed in them, and if he (this new psychiatrist) isn't that well-versed in it, perhaps I should seek others.
- He didn't seem too offended to this, in fact, he kind of took it as food for thought.
b) When I felt I was being talked "down-to" (perhaps this was part of the language barrier thing again), I just got upset and started spewing as much knowledgeable things I knew about benzodiazepines to him, to show him I'm not just a psycho patient there, but am one who's done my homework, to which he later apologized. Again, he was really just probing me for information, and in fact I know that I can be a brute to those I feel challenge my intellect in what appears to me a negative way. I told him about the Dr. Aston in the UK, how the UK (at least from what I've read) appears to have a little bit more in the way of benzo treatment centers, etc. I told him I know about benzo equivalency dosages, etc., and inquired if he should switch me to a new med that would be easier to pill-split.
From all of this, there were some very good things about this doctor:
1) He praised my recent seeking a therapist/counselor. He told me just how important it is to practice Cognitive Behavioral Therapy, something I admit to having dropped the ball in the past. I told my new doctor that it was in fact my comfort with the benzodiazepine that made me disregard this important aspect of recovery. I vowed to him that I will pick this up with my new therapist, which made things easier in the session.
2) He does
fully support me and my efforts - his words exactly. He doesn't want to see me fail. He's just concerned about how I'm going to be when I do no longer have the clonazepam in my system. He just wanted me to be aware of this, and I really appreciate that.
3) If nothing else, he is a doctor who has the ability to prescribe the medicine and devote all our appointment time on my recovery, which is something I shouldn't be expecting from my GP, who is actually a wonderful internal medicine doctor, but whose attention is more focused on HIV medicines and treatment/prevention.
So, there you have it. My psychiatrist and I have an action plan. I need to continue to see him, not on a regular basis, but at least in a month. I am to practice cognitive behavioral therapy with my therapist. I am also to work on my perfectionism and my self-esteem issues (as he quickly picked up on both - another reason I respect him). I am to continue Effexor at 300 mg/day and clonazepam at 0.25 mg/day. He wants the clonazepam to be continued for 3 months, but I'm not sure if I will go that slow. I asked him if I could taper to 0.125 eventually, like after one month, to which he responded "no," but we'll see. In all honesty, I still feel like I'm "adjusting" to 0.25mg, so, that's OK.
Another important point!!! I did this as a test: I asked him if it's OK to just quit either of my meds "cold turkey." He answered "no." He also said, and this is the deal-clincher, that with any psychiatric medicine, when coming off, "it is always better to go slow, the slower, the better." Thank God he said that!
So, I have someone in my corner, even if he may or may not fully understand me, the feeling of dependence on benzodiazepines, or the English language (?? dunno, it just seemed odd to me). Here's to me and the next step in repair!
(x-posted to julleri
, and panic_anxiety
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