Garett Asks…

Five months ago, I was diagnosed as having bipolar disorder. First I was on Depakote and then I told my doctor I was still having major problems with my sleep. I was always up and about knowing it was 3 o’clock in the morning. I told her about the lack of sleep, and she immediately took me off of the Depakote and switched me to Seroquel.

I started off with sample packets of 25mg. I was amazed I could finally go to sleep, but it wasn’t a sleepy sleep… if that makes any sense. It was like someone knocked my lights out. I had no complaints to tell my doctor because I was enjoying my sleep so much, but finally I went into major states of depression – racing thoughts and unusual energy and then crashing.

I am now taking 800mg of Seroquel a night and 150mg of Lamictal right in there with it. I still get really nervous and irritable at the smallest things, which is having a major impact on my everyday life. My doctor tells me what is good for me but the symptoms of my illness are still there, causing more harm than good.

Does anyone know what I can do to just tell my doctor, “Hey!!! This just isn’t working?”

Dr. Fink Answers…

Hi, Garett–

I think you answered your own question – tell your doctor, “Hey!!! This just isn’t working.” Describe your symptoms. The trouble with some of these meds is that they take awhile to kick in, and then it may be awhile before you really feel better. But if you’ve spent six to eight weeks on the meds and still are not feeling right, your doctor should be sensitive to this and make the necessary adjustments.

Writing down concerns as they come up can help. Bring your log with you to your doctor visits. This will allow you focus on your interactions with your doc while keeping track of her recommendations. Sometimes doctors hear things better if they’re written down in a checklist form – that’s just how we’re trained.

If your doctor does not respond to your needs, you’ve discussed this with her, and she’s still unable to problem solve with you, then you may think about finding another doctor. Before you switch, realize that it’ll take some time to develop a relationship with the new doctor and bring him or her up to speed on what’s going on and what you’ve already tried. You may be better off working with your current doctor, so you don’t need to start from scratch. However, if you continue to feel that your concerns are not being heard, then you may want to look for another opinion.

Finding the right “medication cocktail” that works for you can be a long process and require several adjustments. Shifting your expectations is an important tool for managing frustrations about these challenging medication trials.