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What Causes Abnormal Behaviour?
Question: Hi Doctor! Thank you for your time! I feel horribly restless for quite a while (years), get distracted easily. Occasionally I get too excited and engage into unsafe behaviors that frankly make me shocked from what I am doing. I am married and yet I've had 20 sexual partners in the last 3 years(maybe 2 or 3 using protection). Sometimes I feel low and have a really miserable time dragging myself out of bed. When I talk to people I am horribly agitated and I barely let anyone finish a sentence - I feel it happening, but I can't stop it. I have tried all the antidepressants on the market (frankly I do not believe I am depressed, but all the doctors give me SSRI's and Wellbutrin - the only result is stomach ache) but I can't catch a break and I need to function - I have 2 kids. I feel I am at the end of my rope. Please help!!!!!!!!!!!! XXXX
Brief Answer:
Consult psychiatrist,need psychotherapy and mood stabilizer
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us.
I can understand your pain and discomfort. I read your query in detail.
From narration I think you may be suffering from some kind of personality disorder.It may be borderline personality disorder or histrionic personality disorder.There are also some features of hypomania which suggest bipolar disorder type 2.
For confirmation of diagnosis detail history and mental status examination are required by a psychiatrist.
In such disorder episodes of anger outburst, impulsive behavior and depression are common.
Only SSRI cant help in this situation. There is need of mood stabilizer like sodium valproate or lamotrigine. Anti anxiety medicines also to be given during exacerbation.
With medicines, regular session of psychotherapy with psychiatrist/psychologist are also must. Rapport with therapist and confidence in therapist are necessary for successful psychotherapy. A specific therapy called DBT- Dialecticalt behavior therapy is helpful in Borderline personality.
Simultaneous counselling of close family members also needed to make them understand about your situation and to teach them how they can help you.
So XXXXXXX please consult a good psychiatrist to reach to your problem's diagnosis and treatment.
Hope I have answered your query, I will be happy to answer again if other query is there.
Regards,
Dr.Chntan Solanki.
Consult psychiatrist,need psychotherapy and mood stabilizer
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us.
I can understand your pain and discomfort. I read your query in detail.
From narration I think you may be suffering from some kind of personality disorder.It may be borderline personality disorder or histrionic personality disorder.There are also some features of hypomania which suggest bipolar disorder type 2.
For confirmation of diagnosis detail history and mental status examination are required by a psychiatrist.
In such disorder episodes of anger outburst, impulsive behavior and depression are common.
Only SSRI cant help in this situation. There is need of mood stabilizer like sodium valproate or lamotrigine. Anti anxiety medicines also to be given during exacerbation.
With medicines, regular session of psychotherapy with psychiatrist/psychologist are also must. Rapport with therapist and confidence in therapist are necessary for successful psychotherapy. A specific therapy called DBT- Dialecticalt behavior therapy is helpful in Borderline personality.
Simultaneous counselling of close family members also needed to make them understand about your situation and to teach them how they can help you.
So XXXXXXX please consult a good psychiatrist to reach to your problem's diagnosis and treatment.
Hope I have answered your query, I will be happy to answer again if other query is there.
Regards,
Dr.Chntan Solanki.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you, doctor. That sounds like a shitload of disorders-I have no idea what any of them are and it will probably take me 3 hours on line to get some idea. I do genuinely appreciate time and effort you invested in your response, doctor, but I think I am more confused now. And also you probably won't be surprised by the fact that I turned to drugs - oxycodone and meth. I am not crazy about meth, but I miss oxycodone every minute,of every hour - every day. It was the only thing that made me happy at least for a couple of hours and now I am in detox - it is not going very well. They keep telling me they want me happy which I don't believe - they want me drug free. It is extremely puzzling for me that my mind, my emotional pain and my body are under full control of the system. For God's sake, why can't I decide on being high, sober or whatever else?!!?!The other option is dealing with drug dealers that trust me is no fun. In addition I do not believe in talking - therapy (6 years - nothing)! I have no desire to go to AA meetings where the first thing I am supposed to do is to label myself as an addict. For God's sake - this is ridiculous! And rehab is out of question - I can't leave my children for a month for the sake of sitting there "telling the truth" as I was explained. I am a grown woman and I know everything there is to know about myself. I would be HAPPY to get a medication that (to call a spade a spade) will get me high and give me a much needed break. It is beyond me why this path is a no-no. I would have done it under doctor's orders and would follow his/her directions religiously! I really don't want to OD or deal with drug dealers. Can you please give me a concrete advice?!?! I really needed - all I got until now was judgment and brainwashing attempts. Throwing a bunch of disorders at me is just scary and makes me feel crazy which after reading this letter I am sure you are perfectly aware is not the case. Thank you in advance!!XXXX
Brief Answer:
Modafinil,armodafinil or methylpheidate useful under medical supervision
Detailed Answer:
Hello XXXXXXX
I am sorry for delayed answer. I read your query in detail and I thought over your situation deeply. I think you are clear in your mind that you need to be happy with medicines if you can.
You are not ready for any psychotherapy so it is not at all useful as basic thing is person must be willing to involve in therapy.
You were happy with oxycodone which is an opioid and it can cause severe dependence and in long run many adverse effects on body. That is why your doctor wanted to keep you away from that.
Yes meth can be helpful for sure to get high what you need. But abuse potential adverse reactions of that are also high, so it also needs to be taken under strict medical supervision.
I think you can be given modafinil or armodafinil with SSRI to get high and feel happy. If this not works methylphenidate or dexamphatamine is the best option.
I am sorry but my intention to inform you about possible different diagnosis was not to confuse you. But intention was to clarify the treatment aspect as without exact diagnosis it is not possible to give specific treatment. And frankly I mentioned it to discuss with your doctor about my opinion not for you to search on net. As there more than 350 diagnoses in psychiatry and are practically impossible for you to understand with help of internet. So please do not go into detail about each diagnosis. If after detail evaluation by doctor diagnosis can be confirmed, then only you need to know about that specific diagnosis otherwise you are going to confuse more.
So I also believe that you need medicines and your doctor should give. I have mentioned medicines as per my opinion after knowing your brief history. But your doctor will suggest after detail evaluation as he/she is prescribing doctor.
If you want to know more about medicines which may help, please revert back to me with all medicines you have taken until now with dose, duration and improvement with those.
Hope I have answered your query,
Regards,
Dr.Chintan Solanki.
Modafinil,armodafinil or methylpheidate useful under medical supervision
Detailed Answer:
Hello XXXXXXX
I am sorry for delayed answer. I read your query in detail and I thought over your situation deeply. I think you are clear in your mind that you need to be happy with medicines if you can.
You are not ready for any psychotherapy so it is not at all useful as basic thing is person must be willing to involve in therapy.
You were happy with oxycodone which is an opioid and it can cause severe dependence and in long run many adverse effects on body. That is why your doctor wanted to keep you away from that.
Yes meth can be helpful for sure to get high what you need. But abuse potential adverse reactions of that are also high, so it also needs to be taken under strict medical supervision.
I think you can be given modafinil or armodafinil with SSRI to get high and feel happy. If this not works methylphenidate or dexamphatamine is the best option.
I am sorry but my intention to inform you about possible different diagnosis was not to confuse you. But intention was to clarify the treatment aspect as without exact diagnosis it is not possible to give specific treatment. And frankly I mentioned it to discuss with your doctor about my opinion not for you to search on net. As there more than 350 diagnoses in psychiatry and are practically impossible for you to understand with help of internet. So please do not go into detail about each diagnosis. If after detail evaluation by doctor diagnosis can be confirmed, then only you need to know about that specific diagnosis otherwise you are going to confuse more.
So I also believe that you need medicines and your doctor should give. I have mentioned medicines as per my opinion after knowing your brief history. But your doctor will suggest after detail evaluation as he/she is prescribing doctor.
If you want to know more about medicines which may help, please revert back to me with all medicines you have taken until now with dose, duration and improvement with those.
Hope I have answered your query,
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you, Dr. Solanki. You sound like a very compassionate and open-minded doctor which is extremely rare. Frankly I was really surprised that you didn't attack the meth and took the fact that I am using it very calmly.It would not have been my drug of choice, granted I had a choice. I know oxycodone is not the best thing for my health - but again - MY HEALTH. And it would have been a lot safer being fair and square and taking it from the doctor than meeting a drug dealer on a dark empty parking lot (BTW the dude spent 20 years in jail). Honestly, doctor, doesn't this whole situation seem ridiculous to you? It would have been hysterical, had it not been so sad.You suggested therapy - I have a wonderful shrink that I have been seeing every week for past 3 years. It is a relief, a lot of support, but not real help. I have seen about 5 or 6 psychiatrists (each one has diagnosed me with a different disorder!) and it was a parade of very needless and unpleasant experiences - starting with complete indifference, rigid cliche statements and ending with sexual assault. Apparently it is very hard to find a good psychiatrist - I cannot believe how those cruel, indifferent, inhumane people became doctors. Completely beyond me.That about wraps it up - you get the picture, I am sure. Thank you for your time, your attention, compassion and understanding. I will check the meds, but if you will be writing me again please tell me which one has a potential to get me high (I don't like wasting people's time and play games). One last thing - is there a chance in hell you can treat me?!?! I would be happy to have a doctor like you. Thank you and have a great Thanksgiving!
Brief Answer:
a cocktail of SSRI, mood stabilizer and mood elevator drugs required
Detailed Answer:
Dear XXXXXXX
I have come across patients like you that’s why I can understand your situation and frustration.
Thanks for praising words. I believe most of the doctors are good but not all. I would like to treat you for sure but it is not possible practically. As you are in USA and I am in XXXXXXX Hope you will find some good psychiatrist soon.
In USA practice of medicines is strict under guidelines and doctors do not take much clinical decision and that is why you may not be given medicines you feel to be given.
Yes psychotherapy is not curative but it is supportive tool of treatment in such problems .You should continue your sessions if feasible.
I am not at all feeling that your situation is ridiculous. It is common in people with personality problems to have consultation with different psychiatrists. And practically and frankly speaking to deal with people with such problem is really a big art. Only few of psychiatrist/psychologist can do. It requires lot of patience, emotional understanding and art of establishing rapport and confidence with patient. So now I think you can understand that why you did not come across to such doctor yet.
But of course which personality disorder you have that is to be confirmed for the best outcome and that can be done by a team approach of professionals.
It is the best practice to take medicines written by doctor. In my opinion you require a cocktail of SSRI, mood stabilizer and mood elevator. Specific medicine can be chosen after physical examination. If I were your treating doctor, I would like to start with Sertraline, Armodafinil and Lamotrigine likely. Later on if needed meth can be added.
Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki
Regards & have a great Thanksgiving to you also!
Dr.Chintan Solanki.
a cocktail of SSRI, mood stabilizer and mood elevator drugs required
Detailed Answer:
Dear XXXXXXX
I have come across patients like you that’s why I can understand your situation and frustration.
Thanks for praising words. I believe most of the doctors are good but not all. I would like to treat you for sure but it is not possible practically. As you are in USA and I am in XXXXXXX Hope you will find some good psychiatrist soon.
In USA practice of medicines is strict under guidelines and doctors do not take much clinical decision and that is why you may not be given medicines you feel to be given.
Yes psychotherapy is not curative but it is supportive tool of treatment in such problems .You should continue your sessions if feasible.
I am not at all feeling that your situation is ridiculous. It is common in people with personality problems to have consultation with different psychiatrists. And practically and frankly speaking to deal with people with such problem is really a big art. Only few of psychiatrist/psychologist can do. It requires lot of patience, emotional understanding and art of establishing rapport and confidence with patient. So now I think you can understand that why you did not come across to such doctor yet.
But of course which personality disorder you have that is to be confirmed for the best outcome and that can be done by a team approach of professionals.
It is the best practice to take medicines written by doctor. In my opinion you require a cocktail of SSRI, mood stabilizer and mood elevator. Specific medicine can be chosen after physical examination. If I were your treating doctor, I would like to start with Sertraline, Armodafinil and Lamotrigine likely. Later on if needed meth can be added.
Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki
Regards & have a great Thanksgiving to you also!
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you, Dr. Solanki! You have nothing to improve - you are an excellent doctor. The fact that you are not an XXXXXXX explains A LOT (your reaction to meth for sure - I thought it was illegal). I am Russian myself, have lived here for 12 years and I can't and frankly have no desire to embrace XXXXXXX idiotic mentality. No reasonable individual with normal human values would be able to tolerate, let alone respect it. I don't know if you have ever lived here, but for a normal person it is impossible to even imagine the level of fanatic loyalty to the "PROCEDURE" that controls every aspect of life. The system rules here stronger than in Soviet Russia. At least in Russia people obeyed it with disgust due to the lack of free choice, the brainwashed Americans hold it sacred. They even speak in slogans "Say NO to drugs!" "Be a Good Citizen!" etc. It seems that they have break fluids in their brains. It is very very hard to find a good Dr. - if he/she is not a heartless robot, physicians would be still terrified of making exceptions or doing something slightly different because their license is at stake. We have a large XXXXXXX community here and I know a lot of XXXXXXX people - their minds work a lot like ours. They have a sense of humor and can see few possibilities in every situation. I hate to put pressure on you and create a moral conflict, but please help me!! I would have never dared to ask anything like that if I wasn't in such deep trouble. My problem is not the drugs, it's the system that is forcing itself on my body, my mind, my free will and people who are just unable to understand. Is it possible to be treated by a foreign doctor? I promise I will be the most humble and respecting patient, but please try to help me! I will follow your orders religiously.I perfectly realize how arrogant it is of me is to ask you for help and I sincerely apologize. Unless a miracle happens -the system and its army will make me as miserable as humanly possible - guaranteed. I do not see any way out. I think we should close this chat, please give it a thought and I will contact you on your site in a few days. I know I must sound super dramatic (which probably matches about 60 disorders) - that often comes with the Russians. But the facts still remain - If I make choices about my own body - it's against the law and I cannot imagine an XXXXXXX doctor that will be able to help me without a huge risk of losing his/her license. Thank you so much and please try to understand. Please!!! Thank you for all your help. XXXX
Brief Answer:
Try to search Indian/Russian Doctor and all the best
Detailed Answer:
Hi XXXXXXX
I can understand your situation completely. No need to apologize, I do not feel any arrogance from your side. You are absolutely right on your viewpoint. Even I would like to help and treat patient like you, but only limitation is distance. At present no laws are there which can provide online treatment or prescriptions.
In treatment for psychiatric problem listening to the patient is one important aspect of the treatment as I believe. If I were your treating doctor I think it will take 8-10 sessions each of an hour to just know your case from your side.
From this discussion I got some clues regarding situation. But still I need to know lots of things by which I can reach to some conclusion about your diagnosis. For that your detail history in terms of childhood, education, family, marital, work, consultation with doctors, old prescriptions as well as history from your husband/close relative or friend needed.
I don’t think it is practically possible that you can write these pages of details to me but if you can just try. I will give my time when possible to read and revert back to you.
One option is there. Just give me your exact location. I will try to find if any XXXXXXX or Russian doctor who can help you.Or just click on below link try to search on your own
http://doctor.healthcaremagic.com/doctors/doctors-in-USA/L18861S0
So at present you can close the discussion. Just think about what I have suggested. And revert back to with the below link so you can contact me directly.
Wish you good luck,
Dr.Chintan Solanki.
http://bit.ly/drchintansolanki
Try to search Indian/Russian Doctor and all the best
Detailed Answer:
Hi XXXXXXX
I can understand your situation completely. No need to apologize, I do not feel any arrogance from your side. You are absolutely right on your viewpoint. Even I would like to help and treat patient like you, but only limitation is distance. At present no laws are there which can provide online treatment or prescriptions.
In treatment for psychiatric problem listening to the patient is one important aspect of the treatment as I believe. If I were your treating doctor I think it will take 8-10 sessions each of an hour to just know your case from your side.
From this discussion I got some clues regarding situation. But still I need to know lots of things by which I can reach to some conclusion about your diagnosis. For that your detail history in terms of childhood, education, family, marital, work, consultation with doctors, old prescriptions as well as history from your husband/close relative or friend needed.
I don’t think it is practically possible that you can write these pages of details to me but if you can just try. I will give my time when possible to read and revert back to you.
One option is there. Just give me your exact location. I will try to find if any XXXXXXX or Russian doctor who can help you.Or just click on below link try to search on your own
http://doctor.healthcaremagic.com/doctors/doctors-in-USA/L18861S0
So at present you can close the discussion. Just think about what I have suggested. And revert back to with the below link so you can contact me directly.
Wish you good luck,
Dr.Chintan Solanki.
http://bit.ly/drchintansolanki
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Solanki!!
My exact location is 890 Quetta ct XXXXXXX CA 94087. Please do not send me a Russian doctor - either they got their MD in the States (no difference) or back in Russia where patients had to learn: a. suffer b. suffer quietly. Here no doctor has spent more than 15 min with me per session except of course the one who tried to sexually assault me. Here they believe that the shrink asks questions and the MD just prescribes SSRIs or Wellbutrin or any other crap that does not help. No psychiatrist I have seen ever tried to contact my shrink or my family Dr. An XXXXXXX or maybe a doctor from a different country (I even leave a possibility of an exception of an XXXXXXX MD) that you or any trusted colleagues of yours can recommend would be a great chance although I am still very cautiously optimistic - they all operate under the same rules. You don't have to answer that - I took enough of your time - I will try to contact you via site. Thank you again! XXXX
My exact location is 890 Quetta ct XXXXXXX CA 94087. Please do not send me a Russian doctor - either they got their MD in the States (no difference) or back in Russia where patients had to learn: a. suffer b. suffer quietly. Here no doctor has spent more than 15 min with me per session except of course the one who tried to sexually assault me. Here they believe that the shrink asks questions and the MD just prescribes SSRIs or Wellbutrin or any other crap that does not help. No psychiatrist I have seen ever tried to contact my shrink or my family Dr. An XXXXXXX or maybe a doctor from a different country (I even leave a possibility of an exception of an XXXXXXX MD) that you or any trusted colleagues of yours can recommend would be a great chance although I am still very cautiously optimistic - they all operate under the same rules. You don't have to answer that - I took enough of your time - I will try to contact you via site. Thank you again! XXXX
Brief Answer:
try to search address of mentioned psychiatrist below
Detailed Answer:
Hi XXXXXXX
I am sorry that I could not find specific one near you. But I found 3 names (written below) seems to be non XXXXXXX and first one is XXXXXXX who are practicing in different region in CA.You just try to search there address and try to consult one of them.If you can get appointment, prepare and note down your complaints, problems to the point and discuss with doctor and also inform about our discussion in brief.
Dr. Bhupinder S. Nakai(MD) , Psychiatrist Rancho cucamonga, California
Dr. Daryoush Jamal(MD) , Psychiatrist West covina, California
Dr. XXXXXXX Khan(MD) , Psychiatrist San XXXXXXX California
I am not knowing any one of them personally but I think you may get someone good if lucky!
You are always welcome for queries.
All the best and take care.
Wish you early stability.
Dr.Chintan Solanki.
try to search address of mentioned psychiatrist below
Detailed Answer:
Hi XXXXXXX
I am sorry that I could not find specific one near you. But I found 3 names (written below) seems to be non XXXXXXX and first one is XXXXXXX who are practicing in different region in CA.You just try to search there address and try to consult one of them.If you can get appointment, prepare and note down your complaints, problems to the point and discuss with doctor and also inform about our discussion in brief.
Dr. Bhupinder S. Nakai(MD) , Psychiatrist Rancho cucamonga, California
Dr. Daryoush Jamal(MD) , Psychiatrist West covina, California
Dr. XXXXXXX Khan(MD) , Psychiatrist San XXXXXXX California
I am not knowing any one of them personally but I think you may get someone good if lucky!
You are always welcome for queries.
All the best and take care.
Wish you early stability.
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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