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Author Topic: appointment with a psychiatrist  (Read 6250 times)

SAS

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appointment with a psychiatrist
« on: June 28, 2015, 10:54:37 am »
Not sure if I'm posting this correctly but I'm new...anyway I'm nervous about my appt with a shrink. What should I tell him or NOT tell him. My life story is pretty bizarre and I'm not sure if he'll believe it nor have enough time to listen. What does he really want to know? Should I volunteer a lot of my sordid past or should I just answer his questions? Thanks in advance. Scott

Just Me

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appointment with a psychiatrist
« Reply #1 on: June 28, 2015, 05:15:10 pm »
SAS, some ce's are very short and they don't ask much, others can be more involved.  There is no way of knowing ahead a time how good your ce exam will be. Just answer any questions the Dr may ask honestly.  They are only interested in how you mental impairments have affected you since you had to stop working.
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

SAS

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appointment with a psychiatrist
« Reply #2 on: June 28, 2015, 06:04:39 pm »
Isn't your history relevant when your child was kidnapped at 4 years old? I mean the trauma of that changed me forever. The only thing I can hang on to with that is that at least he was
kidnapped by his mother. Still...the pain was almost as bad as if he had died. I mean I never knew and still don't. My son is 33 and I'll never know him.

Lit Love

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appointment with a psychiatrist
« Reply #3 on: June 28, 2015, 06:15:25 pm »
Isn't your history relevant when your child was kidnapped at 4 years old? I mean the trauma of that changed me forever. The only thing I can hang on to with that is that at least he was
kidnapped by his mother. Still...the pain was almost as bad as if he had died. I mean I never knew and still don't. My son is 33 and I'll never know him.

SS will question how the trauma from 29 years ago is only now preventing you from working. 

Many people have issues and disabilities that while significant do not effect their ability to work.

If you've been working with bipolar disorder for 20 or 30 years, why are you now unable to work because of it?  Do you have medical documentation proving you've been seeking the appropriate care, and that you've been compliant taking prescribed medication?


sman1109

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Re: appointment with a psychiatrist
« Reply #4 on: September 20, 2015, 07:37:09 pm »
Isn't your history relevant when your child was kidnapped at 4 years old? I mean the trauma of that changed me forever. The only thing I can hang on to with that is that at least he was
kidnapped by his mother. Still...the pain was almost as bad as if he had died. I mean I never knew and still don't. My son is 33 and I'll never know him.

SS will question how the trauma from 29 years ago is only now preventing you from working. 

Many people have issues and disabilities that while significant do not effect their ability to work.

If you've been working with bipolar disorder for 20 or 30 years, why are you now unable to work because of it?  Do you have medical documentation proving you've been seeking the appropriate care, and that you've been compliant taking prescribed medication?



Thanks for the information, I just think its evil to make people take prescribed medications for depression before allowing them a check from social security.

Medications for depression have a black boxed warning, the strictest warning from the FDA for potentially dangerous and even fatal side effects.

No one should be forced to take that risk, but its the law apparently or at least how the judges interpret it. I think therapy should be enough, but what I think doesn't count.



Lit Love

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Re: appointment with a psychiatrist
« Reply #5 on: September 20, 2015, 08:00:24 pm »
Isn't your history relevant when your child was kidnapped at 4 years old? I mean the trauma of that changed me forever. The only thing I can hang on to with that is that at least he was
kidnapped by his mother. Still...the pain was almost as bad as if he had died. I mean I never knew and still don't. My son is 33 and I'll never know him.

SS will question how the trauma from 29 years ago is only now preventing you from working. 

Many people have issues and disabilities that while significant do not effect their ability to work.

If you've been working with bipolar disorder for 20 or 30 years, why are you now unable to work because of it?  Do you have medical documentation proving you've been seeking the appropriate care, and that you've been compliant taking prescribed medication?



Thanks for the information, I just think its evil to make people take prescribed medications for depression before allowing them a check from social security.

Medications for depression have a black boxed warning, the strictest warning from the FDA for potentially dangerous and even fatal side effects.

No one should be forced to take that risk, but its the law apparently or at least how the judges interpret it. I think therapy should be enough, but what I think doesn't count.


You're expected to be compliant with your doctor's recommendations.  Have you discussed your resistance to taking meds with your doctor? 

Finding the right meds, combo of meds and dosages is an ongoing process.  The hope is to improve your condition so that SSDI is not required.

Different Perspective

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Re: appointment with a psychiatrist
« Reply #6 on: September 20, 2015, 08:46:31 pm »
"I just think its evil to make people take prescribed medications for depression before allowing them a check from social security."  Reply #4.

WOW! Whoa! Wait! Time out!  Where is it written in the Program Operations Manual System, or anywhere else that SSA requires " people take prescribed medications for depression before allowing them a check from social security"?  Ibid.

SSA does not require anyone to take medication, to have surgery, or do anything else contrary to his/her belief.  It is, however, necessary for the applicant to prove his/her condition prevents Significant Gainful Activity.  Certain Listings do say "...despite taking prescribed medications...", or "...failure to follow prescribed treatment..." but http://www.ssa.gov/OP_Home/cfr20/404/404-1530.htm and  https://www.socialsecurity.gov/OP_Home/rulings/di/02/SSR82-59-di-02.html list examples of good reason or justifiable cause for not following treatment.

Certainly, it may be more difficult to prove the inability to perform SGA if not following prescribed treatment, but that is the risk the applicant takes of his/her own free will in not following a treatment plan that is normally safe and has helped thousands of patients. 

If one were to read the warning on ANY medication, one would think there is no way I want to take that.  There is a risk/reward component, however.  If one takes medications as directed and reports ANY side effect to the treating source, the risk of taking most medications far outweighs any potential side effects. 

See Lit Love's comments in Reply #5.

Just Me

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Re: appointment with a psychiatrist
« Reply #7 on: September 20, 2015, 09:16:27 pm »
The air we breath, water we drink and food we eat can cause health problems. Being on the roads,  standing in front on a microwave regularly, etc can be dangerous. But the risks are part of daily life.
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

Bonzai

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Re: appointment with a psychiatrist
« Reply #8 on: September 21, 2015, 09:00:46 am »
To break my experiences down simply:

Life without medications = Chaos - Nervously Fair between Very Bad Manic states.

Life with medications = Good most of the time, Lesser Intense Manic states sometimes.

Due to a combination of Mental and physical impairments, I am on 20 different medications that allow me to function in a somewhat normal fashion.  I still have to contingency plan my life, as I may have a bad spell for the day I have something planned and have to cancel.

Due to my medical history, I would have to agree with a CDR that discontinued my benefits, should it occur that I stopped taking my medications and seeing my providers.  In my case, it would not only be a failure to follow prescribed treatment, but it would rate as one of the dumbest things I have ever done.

It only take three people out a 1000 test to report a side effect in a test study for it to be listed.  If too many people report the side effect, it is never supposed to be put on the market.  During the course of my own medication management of over 20+ years. I have been prescribed medications that made things worse, and we had to go back to the drawing board many times.

"I just think its evil to make people take prescribed medications for depression before allowing them a check from social security."  Reply #4.

What about requiring a claimant to seek medical treatment for an impairment is 'evil'?  The claimant is asking for benefits for an invisible mental condition.  I can not imagine the increased number of claimants seeking disability based on depression if no proof such a condition was required.
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newdawn

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Re: appointment with a psychiatrist
« Reply #9 on: September 21, 2015, 12:19:47 pm »
Personally, psychotropic medications have been a lifesaver for me. I'm grateful to live in an age with so many medication options with so few side effects. If I had been born in another era, who knows if I would still be alive today functioning somewhat in regular society.

The black box warning on some antidepressants has been and remains somewhat controversial. To my knowledge, it was put there for children, adolescents and possibly young adults (those under 25). Therefore, those populations should be monitored closely, especially when beginning treatment. The FDA review that led to the black box warning showed a 4% rate of suicidal thinking or behavior vs. 2% rate for placebo in a group of 2200 children treated by SSRIs. And no completed suicide attempts were reported. While suicidal thinking and attempts are traumatic for the patient, so is depression. While I can't claim definitively that no children and no adults have died as a result of suicide while taking certain antidepressants, there's no evidence to support mass fatalities occurring as a direct result of such treatment.

More recently, results of a comprehensive review of pediatric trials conducted between 1988 and 2006 suggested that the benefits of antidepressant medications likely outweigh their risks to children and adolescents with major depression and anxiety disorders. The study, partially funded by NIMH, was published in the April 18, 2007, issue of the Journal of the American Medical Association.

http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml

There are other articles out there, including one from the New England Journal of Medicine.

I also don't want to downplay the importance of non-medication therapies, which can be very effective even by themselves. It's just that if your depression hasn't improved with non-medication therapy alone, I wouldn't totally dismiss medications on the basis that some children and adolescents had increased suicidal thinking or behavior. Your can always discontinue the medication under your doctor's supervision if by some rare chance you experienced that side effect while taking a certain drug.
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Applied: 11/2013
First Denial: 03/2014
Reconsideration Denial: 11/2014
Hearing: 11/13/15 (Friday the 13th!)
ALJ Approval: 01/15/16 Fully Favorable
Back Pay: 02/13/16
Award Letter: 02/17/16
1st monthly benefit: 03/21/16

sman1109

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Re: appointment with a psychiatrist
« Reply #10 on: September 21, 2015, 12:54:16 pm »
"I just think its evil to make people take prescribed medications for depression before allowing them a check from social security."  Reply #4.

WOW! Whoa! Wait! Time out!  Where is it written in the Program Operations Manual System, or anywhere else that SSA requires " people take prescribed medications for depression before allowing them a check from social security"?  Ibid.

SSA does not require anyone to take medication, to have surgery, or do anything else contrary to his/her belief.  It is, however, necessary for the applicant to prove his/her condition prevents Significant Gainful Activity.  Certain Listings do say "...despite taking prescribed medications...", or "...failure to follow prescribed treatment..." but http://www.ssa.gov/OP_Home/cfr20/404/404-1530.htm and  https://www.socialsecurity.gov/OP_Home/rulings/di/02/SSR82-59-di-02.html list examples of good reason or justifiable cause for not following treatment.

Certainly, it may be more difficult to prove the inability to perform SGA if not following prescribed treatment, but that is the risk the applicant takes of his/her own free will in not following a treatment plan that is normally safe and has helped thousands of patients. 

If one were to read the warning on ANY medication, one would think there is no way I want to take that.  There is a risk/reward component, however.  If one takes medications as directed and reports ANY side effect to the treating source, the risk of taking most medications far outweighs any potential side effects. 

See Lit Love's comments in Reply #5.


With all respect even though it is not clearly written in the law, most at social security wouldn't grant a check to someone who doesn't take dangerous medications for depression, and its wrong. Treatment with talk therapy with a psychologist or therapist, should be enough.

They would much rather I risk the many dangerous side effects of anti-depressant medications, some of which can be permanent or even worst fatal, just to see if I could work. If I choose not to take that risk, my consequence is that I must wait 5 plus years and counting without any income, and all the stress that comes with that.

I feel sorry for those who don't have the support of family during this time, they are pretty much coerced into taking these risks, because they will face brutal poverty otherwise.

Just Me

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Re: appointment with a psychiatrist
« Reply #11 on: September 21, 2015, 01:01:00 pm »
Everyone here has to.take meds. It enables us to function and have a life as opposed to not be able to function and have no life. All meds have.serious risks, to a very small percentage of the population. Have you ever taken aspirin, aleve (naproxen) or Motrin (ibuprofen) ?  They can have serious risks for some people.
« Last Edit: September 21, 2015, 01:05:54 pm by Just Me »
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

Lit Love

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Re: appointment with a psychiatrist
« Reply #12 on: September 21, 2015, 01:32:13 pm »
And not taking meds for someone with a severe mental impairment can be very dangerous as well. 

There is a great documentary that covers a schizophrenic man that was unfortunately killed by the police when he went off his meds.  Anyone interested, pm me.

TraceyJuliet

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Re: appointment with a psychiatrist
« Reply #13 on: September 21, 2015, 03:31:21 pm »
UGH.
I survived the 80's, drug rehab, twins, and divorce. None of those things were as stressful as the disability process.

Stillashamed

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Re: appointment with a psychiatrist
« Reply #14 on: May 23, 2017, 10:24:00 am »
SSA would prefer you to take the medication and medication management without talk therapy then talk therapy alone.

I would just answer the psych's questions honestly, you can speak of family history with the therapist who could forward
a report with your permission to the psych.