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Suggest Treatment For PTSD, GAD And Panic Attacks
Question: Been back and forth within psychiatry for 21 years.
Diagnosed with PTSD, GAD, borderline, panicattacks and bipolar 2.
What treatment would be suitable? HELP!!!
Diagnosed with PTSD, GAD, borderline, panicattacks and bipolar 2.
What treatment would be suitable? HELP!!!
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
PTSD, GAD, borderline personality disorder, and panic attacks are all best treated with cognitive behavioral therapy. No medications reliably help these conditions, with the possible exception of an antidepressant such as Lexapro or Zoloft. The bipolar 2 diagnosis is often confused with borderline personality disorder, which is a more likely diagnosis than bipolar 2 which is exceedingly rare. If bipolar 2 is a serious consideration, a mood stabilizer such as lamotrigine may help. Therefore, my recommendation is intensive psychotherapy, plus an antidepressant and possibly a mood stabilizer.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
PTSD, GAD, borderline personality disorder, and panic attacks are all best treated with cognitive behavioral therapy. No medications reliably help these conditions, with the possible exception of an antidepressant such as Lexapro or Zoloft. The bipolar 2 diagnosis is often confused with borderline personality disorder, which is a more likely diagnosis than bipolar 2 which is exceedingly rare. If bipolar 2 is a serious consideration, a mood stabilizer such as lamotrigine may help. Therefore, my recommendation is intensive psychotherapy, plus an antidepressant and possibly a mood stabilizer.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I have done a thorough evaluation. Through these 21 years had many doctors. Since I moved a lot. Has received the same diagnosis set of people who have done proper evaluation.I have been testing various medications through the years. But there is always something that can not be right.Have this moment 30mg Abilify (lamotrigine did not work, it did not lithium or Topamax either). Then I Lyrica 600 mg and, if necessary 2mg Xanax. Since I was in panic attacks several times tried to take my life. So xanax stop the worst so I can handle it årminstone.Have also tested dialectical behavior therapy.But it did'nt help.I am now at a point where I'm so confused I do not know what to do with myself.I have overhanging portion of the time manageable anxiety when I take Lyrican.But it is in no way inferior anyway.Things I used to be interested in, love and even compete in. I am interested indeed enough to miss it. But I do not have the ability to fight for it as before. Everything runs out of steam. If I even start with something now.Some days I can even if it sounds strange not get my body to obey. I try to tell myself to go up, both aloud and to myself with the body obeys just do not. So can lie in bed for days and ignore the rest of the world total.I have no idea what to do. Got a new doctor recently. Just as trained as clear. Who could not make any decisions without saying that she would consult with others. Really starting to lose hope of ever going to be good.Have asked and asked for therapy in combination with medication. What they promised me late November last year. But nothing has happened ....What do you do? Where should I start? What should I ask for the help of them?
Brief Answer:
Followup
Detailed Answer:
It sounds like medications are not going to be very helpful for you. This is often the case with borderline personality disorder. The key is sticking with long-term psychotherapy. DBT is often useful if you stick with it. If it did not help you at all despite several months to a year of ongoing DBT treatment, I would consider a different type of therapy, namely psychodynamic psychotherapy. This requires twice a week therapy where you explore your personality and how it can change to improve your mood.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
It sounds like medications are not going to be very helpful for you. This is often the case with borderline personality disorder. The key is sticking with long-term psychotherapy. DBT is often useful if you stick with it. If it did not help you at all despite several months to a year of ongoing DBT treatment, I would consider a different type of therapy, namely psychodynamic psychotherapy. This requires twice a week therapy where you explore your personality and how it can change to improve your mood.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Stuck with it 7 months the first time and about a year the second time.
But what is wrong when I before at least could get out of bed for things I cared about. Now when it's at it's worst my body just won't listen. I can't get myself to move. Sometimes when the anxiety kicks in at it's worst I can look at the Xanax 50 cm away. But simply can't move. So instead I lay in pain for hours. This has been going on for months. And I don't know what has happened...
And then it just stops and everything is amazing. I get things done.
And sometimes it's like I'm both up and down my head is spinning like crazy making plans, lists and so on. But there is no physical energy for it...
And this is not me. I've managed even though borderline to maintain the important relationships in my life... But now it's crashing and I have no idea what to do... And here in Sweden I have a psychiatrist who is without doubt the most incompetent psychatrist I've met in 21 years. And I actually had one who more or less pushed me to overdose sleepingpills. And then prescribe another 100 when I was realized after almost dying...
And now I don't know what's going on... And I have to deal with her...
And I don't know what would happen if I started picking in my past. Push it away and pretend that it's never happened and that there is nothing to say about it..
This is probably the most personal things I've said in 21 years. Since I don't really wanna give people close ammunition to crush me later...
I seriously don't know what to do anymore...
Where in life do I start IF I were to get to know me? And how? How do you process things to get over them? I might sound extremely crazy now (which I am so well)... But I seriously don't know how to procces what's happened...
But what is wrong when I before at least could get out of bed for things I cared about. Now when it's at it's worst my body just won't listen. I can't get myself to move. Sometimes when the anxiety kicks in at it's worst I can look at the Xanax 50 cm away. But simply can't move. So instead I lay in pain for hours. This has been going on for months. And I don't know what has happened...
And then it just stops and everything is amazing. I get things done.
And sometimes it's like I'm both up and down my head is spinning like crazy making plans, lists and so on. But there is no physical energy for it...
And this is not me. I've managed even though borderline to maintain the important relationships in my life... But now it's crashing and I have no idea what to do... And here in Sweden I have a psychiatrist who is without doubt the most incompetent psychatrist I've met in 21 years. And I actually had one who more or less pushed me to overdose sleepingpills. And then prescribe another 100 when I was realized after almost dying...
And now I don't know what's going on... And I have to deal with her...
And I don't know what would happen if I started picking in my past. Push it away and pretend that it's never happened and that there is nothing to say about it..
This is probably the most personal things I've said in 21 years. Since I don't really wanna give people close ammunition to crush me later...
I seriously don't know what to do anymore...
Where in life do I start IF I were to get to know me? And how? How do you process things to get over them? I might sound extremely crazy now (which I am so well)... But I seriously don't know how to procces what's happened...
Brief Answer:
Followup
Detailed Answer:
It sounds like you have a lot to talk about in therapy. I think you simply begin with the very information you've just given me. Talk about how you're feeling defeated and like you can't get out of bed. Explore how current relationships are working or not working. Be honest and open. In time, with more therapy, things will start getting better for you again.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
It sounds like you have a lot to talk about in therapy. I think you simply begin with the very information you've just given me. Talk about how you're feeling defeated and like you can't get out of bed. Explore how current relationships are working or not working. Be honest and open. In time, with more therapy, things will start getting better for you again.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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