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Suggest Treatment For Severe Depression, Nervous Breakdown And Mood Disorder

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Posted on Sat, 27 Jun 2015
Question: What if your therapist of 7 years whom you've been teaching him about your SAD (also have bipolar) sees you at your final visit with him (leaving the practice) lets you go as a client and doesn't warn you that you are in a shocked hypomanic state. I drove safely home and in a few days had a nervous breakdown due to a rapid descent into depression. I suffered needlessly, staying in bed a lot and not eating much. He had said that he would help give the new private practice therapist a case synopsis- just call him with her name. I was so sick and depressed that I delegated the job to mom. Then I found a local male therapist in my local area and I wanted him. I was upset that a synopsis was being sent to a female therapist so I called my old therapist, who never returned my calls. So, I went to the behavioral health building and the door was locked because it was Friday afternoon. I had lost track of the days. I rang the bell since the door was locked and a female worker answered and said X (my former therapist) could not see my face and that he was in with clients. So she went back to him and handed me a release form which I could hardly steady my hands to write on. She said that she would come back outside for the form. She told me that my former therapist would call me on Saturday. I said that he does not make Saturday calls but she insisted he did. Well, I hopefully waited all Saturday for the call which never came. She was so mean to me to lie and make me feel horrible, just when I was starting to feel better. Not knowing if he told her to lie to me, I will always feel taken advantage of by him. Our relationship of 7 years was a fraud, filled with lies!
doctor
Answered by Dr. Pankaj Borade (2 hours later)
Brief Answer:
detailed and specific description of symptoms needed

Detailed Answer:
Welcome to HCM.
I can understand the mental distress you are going through at present.
From the description of above symptoms, i could understand that you have been suffering a mood disorder, and that your treating consultant is not available for consultation. However, in order to understand and gain a sufficient insight into your illness we need a more elaborative description of your complaints.
Therefore, i would request you to kindly provide a detailed information in terms of
Duration and onset of complaints, how it progressed, records and details of previous diagnosis made, if any prior medications tried, Investigations underwent,etc.
It will help us to have a better clinical picture of your illness.

Waiting for your reply.
Regards,
Dr Pankaj Borade
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Pankaj Borade (9 hours later)
If a long-term therapy relationship is terminated because the therapist is leaving the hospital practice does the former therapist have any obligation if his abrupt announcement to the client causes extremely severe emotional distress (loss of ability to function for about a week following closure, undue emotional distress-suicidal thoughts and bad depression, mental confusion, feelings of bad hopelessness)? I was so confused over his kind offer to mail a case synopsis to the new private practice therapist that I let my mother call and leave a message about where to mail the information to.

I did not know because my Seasonal Affective Disorder (SAD) memory loss that that was the only phone call allowed and I let mom make it. I really did not want the female therapist name that mom left the message about. I had been so depressed that I thought that I did not care that the therapist was a female. So I left 3 calls saying I was sorry to bother him and I wanted a male therapist.

He never called back. I was crushed. I was confused! So I was in the middle of a nervous break-down (depression and loss of mental understanding) and did not realize that it was Friday.

I parked in the parking lot to get away from arguing at home with my mother and read a book in my car for hours with my cell phone, waiting for him to call. He never did. I knew that he returns his calls at the end of a day.

It was about 7 PM so I tried to enter the building but I did not realize that it was considered "after hours." So I rang the bell and a female worker answered the door and said the my former male therapist was with clients. She went back to him to talk and said that he is not allowed after closure of my case, to see my face. She hands me an information release form but I could not hardly write or understand our conversation. At this point, I had become confused and all I wanted to know was how to have the hospital send records to the private practice. I was so confused! I was in the middle of a break-down of my logical thought processes. I was still functioning well enough to do basic things. My driving skills were fine but I felt mentally worn/ retarded.

What I am saying is that under such stress of ending a relationship, I became very confused and went from hypomanic at the last session to very mentally retarded and depressed. I feel that my memories of my beloved therapist will always be ruined and that I will never date and love a man all because the female worker at the door lied to me and told me my therapist would call me on a Saturday! Our last session means nothing since he only cared about me because he was being paid! Even when I was paying him it was all fake! He's gone forever and I feel betrayed and want to die!!
doctor
Answered by Dr. Pankaj Borade (31 hours later)
Brief Answer:
need to see other psychiatrist urgently

Detailed Answer:
thanks for the reply.
I could figure out that there is a very strong issues of transference feelings towards your consultant, that you bear for him.
Transference is an aspect of a patient doctor relationship in which the patient tends to get emotionally affected or involved with the treating consultant. It could ve I a form of love or hatered towards the doctor. In your case it is hatred. ideally this should not happen because our purpose of seeing a doctor is and only is to obtain a consulatation and treatment for the concerned problem.
If one doctor is not available due to what so ever cause( it is causes immense inconvenience and frustration), there is always an option for second consulation. It should be kept in mind that expertise the psychiatrist bears about the subject is more or less constant across all practitioners, and one should nt be hesitant to see a different psychiatrist if the need demands to.
In your case I can understand the immense inconvenience and frustration it created possibly because the "breakdown" episode and not able to see the doctor clashed together.

I could make out a presence of underlying mood disturbances, irritability, frustration, suicidal thoughts, etc that could be a part of mood disorder.

considering all this, my suggestion to you would be
1) Consult a local psychiatrist immediately, if you are not able to obtain appointment you can consider visiting a hospital as suicidal ideas is an emergency to attend.
2) There is certain condition of mood disorder. We need a detailed work up mental status examination which warrants a consulation to psychiatrist in personal.
depending on which medications can be prescribed.
3) lastly, I suggest you to give up thoughts on your previous treating doctor and consider this as a bad experience, You need to move on and seek other psychiatrist help.

you can continue to followup any query regarding problem any time in future.
Hope to have satisfied your concern.

Regards
Dr Pankaj B
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Pankaj Borade

Psychiatrist

Practicing since :2011

Answered : 571 Questions

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Suggest Treatment For Severe Depression, Nervous Breakdown And Mood Disorder

Brief Answer: detailed and specific description of symptoms needed Detailed Answer: Welcome to HCM. I can understand the mental distress you are going through at present. From the description of above symptoms, i could understand that you have been suffering a mood disorder, and that your treating consultant is not available for consultation. However, in order to understand and gain a sufficient insight into your illness we need a more elaborative description of your complaints. Therefore, i would request you to kindly provide a detailed information in terms of Duration and onset of complaints, how it progressed, records and details of previous diagnosis made, if any prior medications tried, Investigations underwent,etc. It will help us to have a better clinical picture of your illness. Waiting for your reply. Regards, Dr Pankaj Borade