Friend in need

[temp256]

My friend is having some life troubles, and I've been trying to help her through it. But I need some more help.

She's been on lamotrigine and clonazepam as antidepressants long term, but her useless psychiatrist suddenly decided to stop seeing her, and cut off all her medication. Sudden withdrawal from clonazepam causes very severe problems, mainly suicidal tendencies. She can barely afford a a shrink in the first place, and this one was negligent enough to give her a deadly treatment course before dropping her.

What can she do? At the very least she needs enough pills to come off them safely, but stopping the meds is likely a bad idea in the first place. How would she go about reporting the dangerously incompetent shrink?

I know this isn't much to go on, but I'm out of ideas.

 

[viper2000]

Reporting a shrink, you could find the association possibly APA the shrink is apart of or and report her tosome government department for health. There are some cheap to free support groups. Some community run programs can supply help. I dont know what country your in. The number one thing is you provide support and so she knows she can trust you and come talk to you about anything.

 

[temp256]

She's in Illinois, USA. I'm doing the best I can providing support, but there's only so much I can do when she's several hundred miles away from me. I'll give her the APA ethics complaint link.

 

[viper2000]

Yeh APA sounds good if its not the right one they will most likly refer you. Distance makes it hard does she have access to a helpline maybe?

 

[SpecialKay62]

I think your friend should go immediately to a hospital. Immediately. To a hospital. As for reporting the doctor, she can include that in her history and follow up later. That's not the most important issue right now--the chemical imbalance in her brain is. If she is truly depressed, she won't be able to get herself to a hospital. Someone will have to take her. Mental illness is very serious. And just to play Devil's Advocate for a minute, are you sure you have the whole story?

 

[cryforme1v]

my moms dr took her off morphine suddenly, she went from 6 morphine a day to 0.
She was going through such bad withdrawls that we ended up having to take her to a rehab center and they helped a lot.
After they got her withdrawls to stop, my mom and we explained to the dr there what happened and the dr that dropped my moms morphine lost his lisence and can no longer practice medicine.
First things first, get her to the hospital. dont wait till tomorrow, go now.
She could very well be dead by tomorrow, especially considering both of those drugs, if just cut off, can throw a person into high anxiety and panic and even paranoia depending on how depressed she is, and the suicide rate is high.
If you dont want to take her to the hospital, take her to a rehab center.

 

[temp256]

She has no job, no money, and can't possibly afford a hospital or rehab. And I'm unable to physically do anything because of the distance. I don't know what I can do.

 

[ThinkWrite]

First, you are a great friend for doing what you can.

The advice to get immediate care is the first thing that should happen.

Hospitals do have social services departments that can arrange for some funding of medications. Many anti-depressants are not very expensive and could be covered this way. If she is near a reasonable sized city, she may also be able to find a free clinic.

Do you know anyone nearby her that can help her track down social services or a clinic?

 

[SweetErika]

She should go to another doctor, or even the ER, if she's feels she's in danger from her psychiatric problems and/or has any withdrawal symptoms.

Do you know why she was dropped by her shrink? Does the story jibe (because the info on the medications doesn't quite, from what your OP says, IMHO)?

If she was treated negligently, she can report it to the state board, which should investigate and take action as necessary.

 

[SweetErika]

She has no job, no money, and can't possibly afford a hospital or rehab. And I'm unable to physically do anything because of the distance. I don't know what I can do.

She doesn't have to have money for a public hospital's ER to treat her, so that shouldn't be an issue.

 

[cfuhrer]

Lots of good advice so far

Step one- hospital treatment to either get her sustainable short term meds or tittrate her down off of them safely.

Step two- find a Federally Quaified Health Center, the government gives them money to provide low cost/no cost services including mental health. She will need to apply for their sliding scale program and each visit to the mental health provider should cost her in the neighborhood of 20 bucks (but that varies depending on the clinic)

Step three- report the asshat shrink to the APA, the state health department, state physch association, and the AMA (if they are prescribing that means they are a psychiatrist who went to med school and not a psychologist so the AMA should have some record of them too.)

Step four- document EVERYTHING, keep a notebook. When you talk to her, her mental condition, her physcial condition, what steps you told her to take, what steps she actually took, who she talked to, etc. She may have grounds for a law suit or, heaven forbid, attempt to harm herself or someone else. All of that dosumentation will help her or her family hold the shrink repsonsible for the fall out from his decision.

I know there is some distance between you but if you know someone near her who can help physically check on her you should contact them; and you need to talk with her, probably daily, so you can keep your finger on the pulse of things. And not just a daily email but either by phone or skype/webcam so you can gauge tone of voice, body language etc.

Prayers to you and her.... things will probably get worse before they get better.

 

[subwannabe]

Money is not an issue, although that is probably why her doctor dropped her. Most doctors don't work for free and if she wasn't paying then that is why he dropped her. There are providers and doctors for those with no money and that is where she needs to go. It sounds to me like she is disabled from this so should qualify for free care. You need to find out where she can go for this and do whatever you can to get her to go, even if you have to get the people in the white suits to take her away against her will. Other than that you've got to remember that there is only so much you can do and don't let her problems consume your life so much that it drags you down too. Do what you can to help her but in the end everyone is responsible for themselves and if something bad happens you can't blame yourself.

 

[Berwyn]

Step one- hospital treatment to either get her sustainable short term meds or tittrate her down off of them safely.

Step two- find a Federally Quaified Health Center, the government gives them money to provide low cost/no cost services including mental health. She will need to apply for their sliding scale program and each visit to the mental health provider should cost her in the neighborhood of 20 bucks (but that varies depending on the clinic)

Step three- report the asshat shrink to the APA, the state health department, state physch association, and the AMA (if they are prescribing that means they are a psychiatrist who went to med school and not a psychologist so the AMA should have some record of them too.)

Step four- document EVERYTHING, keep a notebook. When you talk to her, her mental condition, her physcial condition, what steps you told her to take, what steps she actually took, who she talked to, etc. She may have grounds for a law suit or, heaven forbid, attempt to harm herself or someone else. All of that dosumentation will help her or her family hold the shrink repsonsible for the fall out from his decision.

I know there is some distance between you but if you know someone near her who can help physically check on her you should contact them; and you need to talk with her, probably daily, so you can keep your finger on the pulse of things. And not just a daily email but either by phone or skype/webcam so you can gauge tone of voice, body language etc.

Prayers to you and her.... things will probably get worse before they get better.

Quoted for emphasis. Especially for the first step. Depending on the dose of klonapin she was taking she could be in significant risk for Benzodiazapam withdrawal, which can cause seizures and rarely death. Again, depending on the dose, she will probably need tapered. Also again to emphasize, if she goes to the ER they can not turn her away because of lack of funds. They have to treat her, and she can worry about setting up a payment plan, or whatever, later.
As someone else said above, you might not be getting the whole story. Neither of those meds are used for depression, and Klonapin is addictive.
Do what you can from where you are. If there is someone near her you can contact that could help than that would be best. Dealing with psych patients is extremely tricky for trained practitioners that have the whole story, let alone someone in another state who is only getting one side of things.

 

[temp256]

I can't get her to go to the ER, but at least she's talking to me, and not doing too bad. I know some druggies, and they said the withdrawals are awful, but not dangerous.

Thanks, everyone.

 

[SweetErika]

I can't get her to go to the ER, but at least she's talking to me, and not doing too bad. I know some druggies, and they said the withdrawals are awful, but not dangerous.

Thanks, everyone.

Why won't she go to the ER?

It's pretty foolish to rely on druggies for health info. As Berwyn said, Klonopin/benzo withdrawal can be extremely dangerous. Leaving psychiatric conditions, like depression and bipolar disorder, untreated can be harmful or deadly, too.

 

[temp256]

I don't know why she won't go. I know it's a bad situation, but there's only so much I can do, and ultimately she has to do these things herself. I know druggies aren't the best sources of medical advice, but they do have experience with Klonopin withdrawal.

I don't know what else I can do.

 

[Berwyn]

I understand that there is only so much you can do, and am glad to hear you realize that too.
I have a lot of experiance working with addicted people....they are not the most reliable source of information. Benzo withdrawl CAN be deadly, but it depends on a lot of things. It will absolutly suck, but how bad, and if it's gonna be dangerous, depends on her age, metabolism, alcohol use, the dose she was taking and how long she was on a regular dose. The first week or so is the critical time (esp the first 48 hrs) but she could have a seziure weeks later....
All you can do is talk to her, let her know you are there, and, like you said, the rest is up to her.

 

[mythtrav16]

The only advice I can offer is that your friend should plan out whatever pills she has left so that the decline is pretty steady. e.g., if she is on a four-pill-a-day regiment and she only has ten pills left, she should take four tomorrow, three the next day, two the day after and the last one the day after. This is obviously not as good as a proper, long-term weaning off the medication, but any attempt at weaning has got to be better than just going off it cold turkey one day.


I faced a similar situation myself a few years back. I was seeing a shrink who didn't even know who I was from appointment-to-appointment. He put me on medication which didn't even work and then $300 down the drain later he suddenly tells he doesn't want to see me anymore. Luckilly I had a month's worth of prescription refills at the time and was able to wean myself off ithe meds properly.

I don't know what it's like where your friend is, but around here the shrinks just don't care because they are too few in number and too heavilly booked.

 

[SumLightCat]

I've nothing really to add, but I would make an observation:

"Your country needs health care reform."

Observation made.

 

[temp256]

She is tapering off as best she can, and has an appointment with a new shrink at the end of the month.

Yes, the US is in desperate need of healthcare reformation, right along with schools, banking, justice, and virtually every other government and political system. But nothing is going to change with any reasonable timeframe.

 

[phoenix1105]

Wrong thread, sorry!