Hopeful, distraught

I have a first meeting in two-and-a-half hours with Dr. J, potentially my new shrink. I am so anxious I could hardly eat breakfast this morning. I just want to find someone who will help me find the tools I need to take control of my life for a change. Not some quack who tells me, "Take this pill, get a job and everything will be okay." I'm in tears right now, but not because my life is unbearable. Quite the opposite: I've had a lot of happiness lately. But things have to change, and I'm afraid of losing my balance again. I have been floundering for ten years and still don't completely understand what the obstacles are.

• ADHD? Probably. Danny said he didn't think so, but I have a lifetime of skill at repressing the socially inappropriate aspects. When I look over the symptoms, most of them apply.


• Some kind of anxiety disorder, for sure. I've had more panic attacks recently. Those are instinctive, physical responses involving adrenalin: fight or flight. I can avoid them, but I can't think them away. Social anxiety is different: more cognitive. That's what I'm experiencing today.
  
• I also have problems with memory and concentration that make it difficult to learn new skills or handle complex stimuli and social situations.
  
• Depression and SAD have been serious issues in the past, although mirtaxapine and the light box seem to have given consistent relief since last spring.

I need to find someone patient and intelligent enough to help me work through all these issues and move forward.

I tried to read LiveJournal last night, but it's impossible with this smudgy screen.

I'm going to the gym now to burn off some steam before the interview. Please think hopeful thoughts for me.

Dr. J.

She is an East Indian woman in her 50s with a warm demeanour and just enough of an accent that she could tell me to jump of a cliff and it would sound wise. But really, I liked her very much. Maybe she will fall in the middle between Dr. C., who passively listened and hardly gave a word of advice in five years, and Dr. B., who had no patience and essentially told me to get a life. I'm looking for someone who, besides diagnosing the problem and prescribing drugs, will listen to my concerns and help with behaviour modification.

It's too early to tell. As she said, it will take several appointments for us to get to the bottom of things, then we can work out a plan. But my first impression is good.

She explained the anxiety symptoms and panic attacks are part of the same biological serotonin deficit that causes depression. Remeron has been working well for me in some respects, improving my sleep pattern and preventing depression, so she wants to increase the dosage from 45 to 60 mg to see whether it will alleviate anxiety. However she indicated we will also address social and behavioural aspects later.

At the end she said, "I don't work evenings and weekends." She suggested that having a doctor in Guelph to help with crisis management might be important, but suggested the walk-in clinic as another option. "I want you to understand I have some limitations." She is not on call.

"I'm not worried about that," I replied. "I'm pretty good at surviving, I'm just not good at managing."

However, I should consider her suggestion about having a crisis management plan in place. Things haven't been that bad in a long time, but if I start making changes, life is bound to get harder before it gets easier. And I guess knowing what to do when Something Horrible happens is one of the keys to facing situations that trigger anxiety and panic.

Thanks for all the kind replies to my previous post. It is very reassuring.