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Question
Posted by: Annelize | 2012/10/08

Under what circumstances may a shrink admit you to hospital against your wishes?

Good Morning, CyberShrink

Hope you are well :-)

I recently filled in an online survey form to participate in a trial for a new antidepressant drug.

I have been on anti-anxiety medication for 28 years (in fact, ever since I was diagnosed with an acute anxiety disorder, social phobia and a personality disorder, at the age of 19 years).

Currently I am taking SERDEP (for anxiety, as well as INDERAL LA for anxiety induced palpitations and URBANOL for an anxiety disorder (as well as BETAFERON for Multiple Sclerosis and VESICARE for my bladder).

After I submitted the survey form, I was advised that I do NOT qualify to participate in the trial, partly because of my Multiple Sclerosis and partly because I take SERDEP for anxiety and not depression.
The rooms of the Psychiatry Professor who is doing the trial, e-mailed me to say that he is, nevertheless, willing to see me as a private patient for assessment, at psychiatrist rates, on my own terms (i.e. between 5pm and 6pm, as I work during the day).

I am wondering whether it is really safe to be too honest with a shrink. Can he admit me to hospital against my wishes if I admit that I have been " self-medicating"  for 28 years, and that I spend many thousands of rands every month on top-up anti-anxiety medication of the herbal tincture type (in addition to all the prescription medication I am using). If the pharmacies don''t have the exact medication that I need, e.g. St John''s Wort drops or Herbex Nerve Tonic drops, I improvise with other tinctures, such as Nerva 3 drops by Natura or Herbex Slimming Drops (for off label reasons). I can easily consume 4 bottles of these drops in the space of 5 minutes. The effect lasts only an hour but, during that hour, I feel like I am on a trip, so to speak. It helps me to cope with whatever situation I am in that is anxiety provoking during that particular hour, e.g. a medical appointment.

What I would like to know is: What could the psychiatrist do with all this information? Is he allowed to admit me to a Rehab Centre against my wishes? My liver and kidney function is STILL NORMAL (I have it tested annually, as the medical aid requires this of me, as a BETAFERON patient).

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Our expert says:
Expert ImageCyberShrink

Keeping someone on traditional anti-anxiety meds for 28 years is not recoomended practice.
Anyhow. Serdep is a generic form of Sertraline, an antidepressant also useful in Anxiety ; Urbanol is an over-used benzo sedative-tranquillizer. Inderal is a heart medicine, but can be useful to reduce the PHYSICAL symptoms of anxiety, thopugh doing nothing useful for the psychological symptoms.
Don't over-interpret your being turned down for the trial of a new antidepressant. Such trials are very expensive, and in order to get useable results, are very strictly structured. For instance, they almost always HAVE to exclude anyone with any chronic medical / physical consdition, becvause they're trying to examine the effects in people with no such disorder, first of all. They usually prefer people not taking ANY other nmeds, or only some of a handful.
I'm not sure about a psych prof offering to see you privately, when he encountered you in searching for study participants. If your medical aid will cover such a consultation, maybe a fresh review of the whole situation could be useful.
But it is always a TOTAL waste of money and time ( as well as NOt safe ) NOT to be totally honest and frank with any shrink you see. That's like taking your car into the garage without telling the mechanic about the way the steering wheel and brakes are dodgy. It cheats YOU.
Shrinks are not easily chocked, and, for instance, are used to people taking a range of over-the-counter self-medication, and we need to try to always remember to ask about that. They may not need a prescription, but can interact unhelpfully, even dangerously, with some prescription meds or with each other.
You are probably right to recognize that spending thousands of rands a month on such unproved remedies isn't wise - if ANY of them were truly effective, you'd only need that one.
I doubt that he'd want to admit you to hospital against ypour wishes, and he's only allowed to do so, with the participation of others, if there's a strong reason to believe you are a major danger to yourself or others, which is surely not the case.
However, from what you say, it might be a very good idea to consider accepting a short period in hospital, where you could get a more thorough physical and psych check-up, tests done, and you could be helped to come off all or some of the excessive amounts of meds you've become used to, in a safe setting and with proper help and support.
The abnormally large volumes of the remedies you say you take could cause other forms of bodily damage, especially in combinations not previously tested. And s I say - if they were truly effective, you wouldn't need them all. There is nothign whatever "natural" about these remedies, nomatter how they are advertised, and all must be considered as to whether they are contributing to the problems or to the solutions
And as Tanya wisely points out, don't you also need a rest and some time out in a safe place ?

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3
Our users say:
Posted by: Tanya | 2012/10/08

Absolutely agree with Jenna.
Annalize, am I correct in estimating that you are about 47 years old and seem to be having many problems that require hectic meds let alone all the over the counter stuff you consume.
Seeing a psychiatrist and being 100% HONEST with him can only be beneficial for you. Being admitted into hospital may be a good idea as the specialist can monitor you and undertake test, e.g. bloods to check all your body functions. Also if you are on Medical Aid the cover they offer may be better and, importantly, you can have a rest and it sounds as if you are in dire need of one of those!

Reply to Tanya
Posted by: Jenna | 2012/10/08

Hi there, I am no expert but wish you give you advice anyway.

To me, it sounds like you do have an addiction. Remember those " natural"  drops usually do still contain a little bit of alcohol. Whether it is enough to admit you or not, I don''t know, but it sounds like you do need some help.

Your liver and kidney function may be normal... for now. Just alike a smoke is healthy (for now) but who''s to say how your body will react within a year?

Again, I don''t know if it is enough to admit you against your will, but I do think you will benefit from some therapy. And you can never be too honest, especially when it comes to your health.

Good luck.

Reply to Jenna
Posted by: cybershrink | 2012/10/08

Keeping someone on traditional anti-anxiety meds for 28 years is not recoomended practice.
Anyhow. Serdep is a generic form of Sertraline, an antidepressant also useful in Anxiety ; Urbanol is an over-used benzo sedative-tranquillizer. Inderal is a heart medicine, but can be useful to reduce the PHYSICAL symptoms of anxiety, thopugh doing nothing useful for the psychological symptoms.
Don't over-interpret your being turned down for the trial of a new antidepressant. Such trials are very expensive, and in order to get useable results, are very strictly structured. For instance, they almost always HAVE to exclude anyone with any chronic medical / physical consdition, becvause they're trying to examine the effects in people with no such disorder, first of all. They usually prefer people not taking ANY other nmeds, or only some of a handful.
I'm not sure about a psych prof offering to see you privately, when he encountered you in searching for study participants. If your medical aid will cover such a consultation, maybe a fresh review of the whole situation could be useful.
But it is always a TOTAL waste of money and time ( as well as NOt safe ) NOT to be totally honest and frank with any shrink you see. That's like taking your car into the garage without telling the mechanic about the way the steering wheel and brakes are dodgy. It cheats YOU.
Shrinks are not easily chocked, and, for instance, are used to people taking a range of over-the-counter self-medication, and we need to try to always remember to ask about that. They may not need a prescription, but can interact unhelpfully, even dangerously, with some prescription meds or with each other.
You are probably right to recognize that spending thousands of rands a month on such unproved remedies isn't wise - if ANY of them were truly effective, you'd only need that one.
I doubt that he'd want to admit you to hospital against ypour wishes, and he's only allowed to do so, with the participation of others, if there's a strong reason to believe you are a major danger to yourself or others, which is surely not the case.
However, from what you say, it might be a very good idea to consider accepting a short period in hospital, where you could get a more thorough physical and psych check-up, tests done, and you could be helped to come off all or some of the excessive amounts of meds you've become used to, in a safe setting and with proper help and support.
The abnormally large volumes of the remedies you say you take could cause other forms of bodily damage, especially in combinations not previously tested. And s I say - if they were truly effective, you wouldn't need them all. There is nothign whatever "natural" about these remedies, nomatter how they are advertised, and all must be considered as to whether they are contributing to the problems or to the solutions
And as Tanya wisely points out, don't you also need a rest and some time out in a safe place ?

Reply to cybershrink

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