Psychiatrist wants me to increase to 30mg? [Archive]

LiveAboveIt

18-03-16, 18:10

I just saw my Psychiatrist today and he wants to increase my Citalopram to 30mg, even though I've only been on 20mg for about 32 days now. Worried that we might be jumping the gun here, but I'm not doing well today. Can't get rid of this fear of everything, being alone or being in certain rooms of the house.. Feeling DP/DR everywhere I go, can't seem to find any comfort. Doing my damndest to not be afraid and not let these fears that "I will never get better" get me down.

Was it difficult for you at first to be able to distract your mind away from the worry about the way you feel? It feels damned near impossible for me right now. Even the Klonopin doesn't seem to be helping with this, which worries me.

He also mentioned that I have issues with cognitive distortion and improper beliefs about being stuck and having no control over my own thoughts, which I found interesting.

MyNameIsTerry

19-03-16, 06:01

Side effects are certainly possible with any dosage increase or decrease. They can be lesser though than when we first start. The size of the jump matters too.

The thing is, how bad you have been suffering recently is all about the side effects of the med, isn't it? You weren't this bad before you started were you? So, shouldn't they be waiting until the side effects reduce before adding more?

I can understand it if your anxiety was the reason and the side effects weren't an issue as it would make sense to get you to a therapeutic dosage they believe is correct if they think 20mg would not be enough. But I don't understand how they would want to pile on more when the side effects are making things even harder as it would make more sense to wait and I don't mean just because of the unpleasantness because the med may not be suited and if the side effects are just too bad or just don't go, this would indicate the need to possibly switch.

---------- Post added at 06:01 ---------- Previous post was at 05:54 ----------

He also mentioned that I have issues with cognitive distortion and improper beliefs about being stuck and having no control over my own thoughts, which I found interesting.

You won't a single person on this forum who doesn't suffer from Cognitive Distortions. These are pretty much fundamental to having an anxiety disorder or depression. Wiki is accurate on these:

https://en.wikipedia.org/wiki/Cognitive_distortion

I see those everywhere on here. I learnt them from a charity after my CBT ended (my CBT taught very little actual CBT) and when I joined here I started practicing them on other peoples threads until I was doing it easily and then I could more easily apply it to my own issues which is always the harder part.

Improper beliefs, well that's just Core Belief issues and again that will be loads if not all of us.

I disagree with the bit in bold red. You are in control, your intrusive thoughts and racing thoughts do not control you, your conscious mind is the executive function making the decisions. Otherwise you would not be responsible for your actions and that would be a whole different affair. We also can't control intrusive thoughts, it's impossible, only our reactions to them. All human beings have intrusive thoughts, as proven in studies, so it's an impossible target, the type of target they advice you not to set in therapy, to control them. Perhaps he meant that you were unable to control your panic reactions, be able to calm your mind from the racing, etc. This would be a common problem with anxiety.