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Treatment For Chronic Pain, Anxiety, Bipolar And Attention Deficit Disorder?

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Posted on Tue, 14 May 2013
Question: Looking for a pain management Dr in my area and HELP to get me better. As I stated on the first page. I seem to have multiple issues. I know I'm past due for a mammogram, colonoscopy @ age 50, but I don't seem to care. I lost my brother when I was 15, my parents divorced when I was in the second grade. My Dad became an alcoholic and a drug addict. My Mom died in 2001 at the age of 61 from lung cancer(never smoked). Then my closets family(growing up) My Aunt(she watched us when my Mom worked. And she did work she started from a 20 year old Mom to leave this world as HEAD of H.U.D. in Northeast Florida. I don't even know why I am telling al of this? Then my best friend(the sister I never had) but was like a sister since before my brother died, she was there the year and a half with chemo and radiation with my Mom too. She past away the day after my birthday 2 years ago..... That's the short version. I have Chronic pain, Anxiety, Bipolar, ADD, was OCD but now I just don't care.............What I have is not a life worth living.
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Answered by Dr. Payman Hajiazim (8 hours later)
Hi there, thanks for mentioning a full history and also your current situation. Since you have had several losses in the life, you are prone to major depression. Even if your doctor says that you have bipolar mood issue, I think that its depression part is the prominent one. Depression, pain and sleep problem are three parts of a triangle. They should be managed together in order to solve the patient's problem. Otherwise, she will suffer from all the three ones. Your medications are treating these three problems separately. That can be the reason that you are still suffering from some issues. Adderrall and Effexor you are taking affects your sleep, so you need more sleep pills while they may not be effective well. The medications from the class of tetracyclic antidepression (like maprotyline, mirtazapine) can help your mood and sleep and pain together. You can ask your doctor more about them. If you take such a medication, you can discontinue many medications gradually. The good point is that mirtazapine or maprotyline will hep for your appetite as well. Let me know if you have any question. I wish you a good health.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Payman Hajiazim

Psychiatrist

Practicing since :2000

Answered : 634 Questions

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Treatment For Chronic Pain, Anxiety, Bipolar And Attention Deficit Disorder?

Hi there, thanks for mentioning a full history and also your current situation. Since you have had several losses in the life, you are prone to major depression. Even if your doctor says that you have bipolar mood issue, I think that its depression part is the prominent one. Depression, pain and sleep problem are three parts of a triangle. They should be managed together in order to solve the patient's problem. Otherwise, she will suffer from all the three ones. Your medications are treating these three problems separately. That can be the reason that you are still suffering from some issues. Adderrall and Effexor you are taking affects your sleep, so you need more sleep pills while they may not be effective well. The medications from the class of tetracyclic antidepression (like maprotyline, mirtazapine) can help your mood and sleep and pain together. You can ask your doctor more about them. If you take such a medication, you can discontinue many medications gradually. The good point is that mirtazapine or maprotyline will hep for your appetite as well. Let me know if you have any question. I wish you a good health.