Psychiatrist Questions Fibromyalgia

Dealing with pain anxiety depression

How does one find a dr who will address these, especially the anxiety part without treating you as an addict? Ive known for thirty years what helps in my fibro treatment.. moving from Indiana to Florida was a shock. it's specialist after specialist with their treatments ive already been through...family drs in Indiana trusted me to know when i needed pain meds and anxiety meds along with antidepressants but here ive gone through a terrible rigomoro trying to stay healthy enough to enjoy retirement ! My main meds have been effexor xanax and flexeril pain meds prescribed as needed for the time needed...Drs here dont get it ! Ive been considering finding treatment through Cannabis...Can you help me find out drs near me or how to get approved for this treatment? If it can help all three major areas of my fibro it has to be worth a try! Thank you

Female | 62 years old
Complaint duration: Two years
Medications: Effexor Horizant ropinerole simvastatin 1 xanax per day singulair Levothyroxine ziac
Conditions: Fibro osteo spinal stenosis severe restless legs

18 Answers

Based on the treatment history you provide, I would suggest that you consult a psychiatrist who is an expert psycho- pharmacologist. How do you find one? Your call medical schools psychiatry departments, ask for the chairmans secretary and ask her who with this background the chair would refer you to. What if you were looking to give a million dollars for research to someone who helped you. Who would they suggest you see - could they make this clinician available - you don't have to say that you are actually going to give a million dollar grant.
please find a pain management provider who do a multi-disciplinary approach. OR a pain center with a psychologist and pain doctor. some times university pain clinics have that kind of set up.
good luck
Given the current climate politically. It is very difficult for a Dr to be comfortable prescribing anxiolytics with narcotics. So it is time to try getting off one or the other. Narcotics are actually easier to taper off of. Most long term users are able to get off and have no more pain than they did on their stable dose. Anxiolytics require a slower tapering schedule
You are right. Treating anxiety , depression and pain is becoming increasingly tough because of the CMS guidelines according to which the pain MEDS and benzodiazepines like xanax , Valium and klonopin can not be prescribed simultaneously. The reason being that they are CNS depressants and can have adverse reactions when given together. However the treatment also depends on the severity of symptoms and these medicines can be given if all other treatment options have been exhausted. You need to see a psychiatrist who can or will be able to take care of your anxiety , depression as well as fibromyalgia. You might want to try Valium and neurontin with Effexor rather than xanax and flexeril. Valium helps with muscle spasms and stay in your system longer than xanax
Dear Mrs, the symptoms you have experienced are common and treatable. If not treated adequately they can worsen your depression and vice-versa. There are several treatment combinations that can be very effective, but it seems like your previous Dr already did the testing and found a combination that works.. It sounds like the medication doses are adequate and only as needed. Find a Dr who is willing to communicate with your previous physician to get an adequate history and feels comfortable managing depression complicated by pain.
Having multiple diagnosis can be quite difficult for a patient I am sorry you have it so rough.

However there are medications that treat severe spinal stenosis pain and anxiety the tough part is balancing the sedative part of combining these meds

Recommend
Mental health provider who can communicate with pain Mgmt dr and use of combined skills for best outcome

Hope that is helpful
Hello, I am not familiar with the use of cannabis for treatment. In Texas this is not legal. You may want to contact psychiatrists in the states that have legalized this for medicinal purposes.
Unfortunately I cannot help you find doctors in your area. The problem is that the combination of opioids, muscle relaxants and benzodiazepines have contributed to many many patient deaths. So where someone like yourself may have been responsible in taking this combination of medicine with good result, many others have had disastrous consquences. This combination was also a favorite of persons with illicit drug habits. For these reasons, you are now finding it more difficult to get this combination of medicines. I'm sure the doctors in you area "get it", it's just that this combination is no longer considered "safe". Best of luck and I'm sorry responsible patients like yourself now have a hard time getting the medicines they need.
Dear Dealing with pain, anxiety, depression,

Please remember I am a psychologist, so I can't address medical treatment matters. Also, this reply is for information only and does not constitute treatment.

It sounds like moving to a new location has posed serious challenges to connecting with medical professionals and getting effective treatment for your fibromyalgia. Based on the title of your question, it seems that anxiety and depression are also part of the challenges you are trying to manage and treat.

You may want to consider looking for a psychologist or other therapist that specializes in Health Psychology and therapy. These therapists often have specialized training in medical issues and the mental health concerns that tend to go along with them. These therapists may also be able to suggest medical doctors they are familiar with, who can provide integrated care for your medical conditions.

Each state has a psychological professional association. The Florida state association's member search directory is found here: http://flapsych.site-ym.com/search/. Given that Florida is a very large and populous state, there may be local associations (central, south, north, panhandle, etc). Local associations also usually have directories of members and may include information on specialties (like health psychology). Have a look at the state directory for providers near you. Even if you don't want to see a therapist/psychologist, they may be able to recommend a medical doctor to meet your pain management needs.

Welcome and good luck with your search for effective treatment,

Todd Koser, Psy.D.
NJ & PA Licensed Psychologist
Hi I have just seen your email. It sounds as if you have had a very difficult time with the medical community in Florida. If you have been consulting with pain specialist physicians, it is not too surprising that they resist prescribing pain and anxiety meds along with antidepressants. Perhaps a psychiatrist might be more cooperative; also you might find a clinical psychologist who works with pain and related issues (although psychologists generally do not prescribe medications).

Regarding Cannabis (which could be useful for you), it would be necessary find a doctor who will prescribe it for medical usage (if that option is available in your state).

I hope that you can soon find some support and relief.
I see you are in Florida?
My response to you was for California.
Call your health insurance Co and ask them for a referral list from their doctors in psychopharmacology.
I am sorry you have struggled. This is more of a medication question that is outside of my scope of practice. But I do know from the mental health standpoint how important quality of care is and one recommendation would be to sign a release of information to allow your old doctor to consult on your case with the new doctor in hopes he could share the long history you had and the successes. Good luck!
I am a psychologist not a medical doctor, so if you are in need of that, I could not help. I do know that Florida is new to the canabis treatments and you might have to venture upon it yourself. I am in pinellas county and I do know of a canabis store located on central pinellas. Not quite sure where, but you can google it and most likely find it and others. It really seems to help some individuals and there are different types of taking it, from foods to drinks to typical smoking it. I have a good friend of mine who lives up north and started smoking canabis fir his anxieties and he claimed it helps him. If you are ever in need of counseling or a therapist, I am here to try and help.
I'm sorry you are having such a hard time addressing your mental health and pain. I realize it is difficult to maintain these prescriptions because regulations have become strict due to overprescribing and overuse. Long term studies show daily, long term use of benzodiazepines can increase memory deficits, especially in those with chronic pain experiences. Unfortunately, I think the medical community overuses medications to quiet symptoms instead of trying to understand the source of the problem. Understanding the importance of sleep, diet, and exercise to establish a stronger foundation for health and looking at alternate treatments for depression, anxiety and autoimmune disorders to address the issue of brain health rather than using high powered pharmaceuticals is what I suggest; however, that process takes time and doctors knowledgeable with these practices. A lot of patients develop a tolerance to the medications you listed and will require increased dosages for the same effect. This does not mean the patient is an addict, but it does suggest the medications are a band-aid and the original problem is not getting better. I understand your question was to find a doctor to prescribe to you the medications you are currently taking, as you believe they work for you. I'm just trying to let you know why it is hard to find someone to do that and some alternative solutions. Yet, if you are simply wanting to know which type of doctor to see, I would suggest a psychiatrist and bring your previous medical records for reference.

I hope this was helpful.
Good luck and God bless

Brandi Buchanan, PhD
Clinical Neuropsychologist
Dallas Neuropsychology
214.620.5580/214.535.4874
Hello, with addiction impacting the nation at the rates it currently is, physicians are more cautious then ever with addictive medications. I understand that not everyone will get addicted to the medications you have taken in the past, but many will, so the current approach is very cautious when it comes to prescribing such medications. I would be happy to evaluate you to determine what you need and make appropriate recommendations. Feel free to give me a call at 443-207-1809 and we can discuss.
Take care,
Dr. C
I would suggest you contact the Florida branch of theASCH (the American Society of Clinical Hypnosis), which is excellent in Florida. Perhaps the President of that local society can refer you to a specialist who can assess the situation and provide appropriate care.

Peace,
Marian
I understand your frustration with dealing with your meds and Doctors.

First and most importantly get off the Xanax! This is most one of the worst and most addictive drugs. Xanax is only effective for 4hours max. If you need a benzodiazepine there are much more effective ones then Xanax.

With the war on addiction which we are facing doctors are under pressure from the government and other regulations to try everything else before pain medication.

I see they have not tried Neurontin. This would be a question you should discuss with your physician. If your primary does not wish to prescribe you pain meds, you may need to find a pain specialist to handle that.

I understand your frustration and wish there were a quick fix, but I am sorry to say this is the reality we live with today.

I deal mainly with people dealing with anxiety and panic disorders, and rape survivors.

I would be happy to work with you on your anxiety, if you need to get that under control.

I am sorry I can not help you with all of your issues your dealing with, and am sad to say it is the way the world is head at this time.

If you have further questions feel free to contact me.

Dr. Jacqueline Davitt
I am sorry for your pain. It seems that you suffer from great anxiety which contributes to some of the somatic complaints you mention as well as from depressed mood. I would recommend adding psychotherapy, "talk therapy" which has been found very helpful for pain management, anxiety & depression. Allowing the body to "speak its pain" offers great support & symptom relief on top of medications. I hope that you find a Dr that "gets you" and your pain and frustration soon. Sincerely, Dr. Hirshfeld