Withdrawal from Antidepressants
madinamerica.com
madinamerica.com
My doctor eventually prescribed me trazodone, so I could just sleep the withdrawals off.
Lots of nausea and disorientation, but worst of all were the "electric shocks" which really were very disturbing.
Not a single mention of these when having the medicine prescribed!
Some people do report problems even with a very gentle long taper down.
How long were you on it? Do you have any advice? Thanks.
For me, getting off venlafaxine was way harder than quitting tilidine, tramadol or the z-drugs.
I was on Venlafaxine (regular release, not extended release) and missing a dose was as unfun as everyone says it is. Tapering down (from 350 mg) was, for me, easy enough and I stopped after 6 weeks.
My current med has different side effects, but also isn't as effective. I'm not sure tapering down and then back up on a different med is worth the risk.
How long were you on it? Do you have any advice? Thanks.
When I quit, I've taken it for about two years. I was able to prevent the brain zaps by making a concious effort to not move my head or eyes too fast. The other symptoms persisted for some weeks-months.
What difference would it make if the doctor had told you of that side effect before you started the drug? Imagine you have no idea of what brain zaps felt like. Would you have avoided the drug based on such a vague description?
Can you describe the sensation? It's not painful, right? The sensation of an electric shock is sensory nerve input driven by external electricity, but there are no sensory nerves in the brain are there? So it's confusing to me (never been on psych drugs, so never gone through psych drug withdrawal) what these brain electric shocks could possibly feel like.
I assume you can't localize the sensations to somewhere that has nerves, like maybe the eyes, or somewhere—anywhere—else that really does have nerves? So it's like re-balancing the synapses after quitting these drugs causes a phenomenon in the somatosensory cortex that simulates non-localized zap sensations in a place there are no sensory nerves? Is it limited to a sensation, or are other senses (vision, hearing, smell, taste) ever involved? Is it perhaps more like a non-physical zap that's more like an interruption or glitch in consciousness than a ghost physical sensation?
[edit] So one person's experience with one day off meds was a feeling of floating or vague floating-like feeling of imbalance. That's probably related, perhaps an earlier stage of the phenomenon, but doesn't sound quite the same as the electric shocks people mention they get after quitting. Are the electric shock feelings anything like a rapid (instantaneous?) change in balance, like a shift to zero-g and back?
Never heard of brain zaps, my issues were more like a constant fuzz in the back of my head (felt like constantly falling in zero G)
I probably would not have avoided the drugs based on the description, because it doesn't sound as bad as it feels, but I would never quit a SSRI without tapering off again.
[0] in hindsight, not tapering gradually is a really bad idea
But, are you familiar with the sensation of being so tired you drop off to sleep & wake up seemingly instantly, but time has passed? The 'yeah, I'm awake, I'm awake' thing.
Based on going off venlafaxine myself, that's how I'd put it. It isn't painful, and you don't actually lose time. The sensation is extremely jarring, and unpleasant, though. You'll take a step or look to the side and that sort of zap just happens.
... I'm slightly better at getting out of the house to get my prescription refilled these days.
Imagine a sudden electric shock to the middle of your brain. It doesn't exactly hurt, but it is incredibly uncomfortable and jarring. It is like a momentary jolt of energy and caused me to feel pretty disoriented for the following few seconds. It is definitely (feels like, at least) a physical sensation as opposed to just sensory.
I had the same reaction after a couple of weeks of excessive use of ecstacy pills (unknown ingredients obviously, but it felt like it contained a very large dose of MDMA or perhaps MDA), albeit in a much milder form and only lasting for about a week. The first two weeks after I started taking Effexor I actually felt like I was constantly coming up on MDMA, the feeling tapered off shorty after and all I was left with was the horrible side effects. Worst drug I’ve ever used.
" So one person's experience with one day off meds was a feeling of floating or vague floating-like feeling of imbalance. That's probably related, perhaps an earlier stage of the phenomenon, but doesn't sound quite the same as the electric shocks people mention they get after quitting. Are the electric shock feelings anything like a rapid (instantaneous?) change in balance, like a shift to zero-g and back?"
These are both pretty good descriptions.
Pretty constant background floaty/disconnected feeling punctuated by sudden, momentary shift of balance feelings that feel like a large number of synapses have fired all at once, usually triggered by relatively minor head or eye movements. Each one leaves you with a very subtle sensation that you've just lost a split second of consciousness and are just suddenly snapping back awake.
They aren't painful at all (so the electric shock analogy breaks down), but after a while can become pretty distracting and annoying (to the point of not being able to concentrate on work, study, or even entertainment).
I'm not looking forward for the withdrawal symptoms – I know them too well. You will only forget to take it once.
Not looking forward to it.
IANAD, YMMV
During one specific Venlafaxine withdrawal, however, I have experienced severe depression, and got close to suicide. What saved me, ironically as it sounds, was a huge dose of Clonazepan I rationally decided to take just so I could sleep the withdrawal over. I'm still on Venlafaxine for a couple years now, I take it for Anxiety/Panic and that was the only time I've experienced severe depression in years.
What I've learned from all that is simple: that stuff is messing directly and profoundly with your brain, so take it very seriously: anti-depressants are not your over-the-counter shit. Apart from that, find a doctor you trust and talk to them,every little detail. Never trust a psychiatrist who does not suggest some kind of therapy: the meds won't cure you.
Also, I don't know of a single drug that won't give me some kind of discontinuation syndrome if interrupted after continuous use. From nose sprays and anti-acids to hypnotics, all have some rebound effects to them. I believe the bottom line is to be rational about taking any drugs, yet specially the ones messing with your head.
Fluoxetine is the only SSRI I experienced no withdrawal from. I was on a low dose (10-20mg) though, and it mostly worked (went from severe depression to mild/none). I have a standing prescription for this as a fallback, but haven't taken it in 3 years. I avoid taking it because of the sexual side effects. I like having orgasms.
Bupropion triggered a seizure after the first dose. Immediately discontinued.
Venlafaxine was mostly effective, but I went from depressed to robotic/apathetic. When I stopped taking it, I tapered off, but I had brain zaps and developed acute tinnitus for over a month, alternating in each ear. To this day, 15 years after treatment, I still experience moderate hearing loss in my ears several times a month for about 60-90 seconds at a time.
Sertraline was the worst. I got up to 150mg before the problems. It triggered a hypomanic episode that lasted for about a month. I didn't sleep at all for the first three days it manifested. The doctor stopped treatment immediately and put me on risperidone, which is a new level of awfulness. I just quit taking it after a month, and told my doctor I would never take any antipsychotic again.
I have a great doctor now. He's not even a psychiatrist, just a generalist, but he's treated many cases of depression over the past 20 years. He figured I didn't have unipolar depression, but bipolar, due to the hypomania. SSRIs are bad, and not recommended, as monotherapy for bipolar. So he put me on lamotrigine and I haven't had a depressive (or manic) episode for over two years. I've also experienced no noticeable side effects.
I've found the only thing that matters in the treatment of mental/behavioral disorders is your doctor's skill and knowledge. Don't be afraid to dump a mediocre doctor; it's your wellbeing on the line.
I had a very similar experience. Tried a couple of SSRIs prior to sertraline and had a manic episode shortly after starting it. I was up for about 3 days and drinking furiously. Felt like I was on coke. Immediately stopped once I realised what was happening but it was so gradual and I was manic so it had to be pointed out to me that I was flying.
The doctor gave me citalopram (brand name is Celexa, I think?) I had to stop taking it. I'll list the side effects I had, but not before I point out: It saved my life. Yes, I had bad side effects. But it also helped me overcome the anxiety and rage I was suffering from and resolve to come out about my status.
Ultimately I had to taper off of it, which was hard. My doctor advised reducing my dose by 1/4 the original value every 9 days until I was done. The end of it was quite rough, I confess.
But while on it, I gained nearly all the weight I lost in a year of physical training back (just 4 months of treatment), my heart palpitations were nauseatingly bad, and I suddenly had to sleep a lot longer to get even a modicum of rest.
When people say, "You should consider medication" it is to help normalize the idea that in trauma situations medication can help people with some types of MI. It is not because they're fun, side-effect free, or not a "real" course of treatment. It's important to remember that when considering these stories and your own mental health.
At a personal level, many people refuse chemical intervention for these issues.
Having prescribed a ton of SSRI/SNRI meds since their introduction, and taken my share as well, it's a phenomenon I'm very familiar with.
Called a "discontinuation syndrome", technically not the same as "withdrawal", which is associated with tolerance, the need to continually increase dose to get the same effect. SSRIs can produce a D/C effect at low or high dose if more likely with greater dose.
Individual response to SSRI D/C varies greatly. I've been very surprised at times when people tell me they've gone off 200mg of Zoloft and never noticed a thing. Others report D/C effects for weeks even after tapering down very gradually.
Most of the time problems with D/C reflect short half-life of compounds. Effexor is notorious in this regard. OTOH more persistent agents like Prozac are typically less troublesome. In fact it's a common strategy to use Prozac as an means to ease D/C when stopping short duration meds.
Going by reports of (probably) a thousand patients, as well as my own experience of D/C effects, generally they're mild to moderate and dissipate within a few days. However there are exceptions and I never hesitated to go as slowly as necessary to minimize excessive discomfort while tapering off the medication.
As I've commented before on HN, this subject again emphasizes some crucially important principles. One is that any medication can cause any side effect at any time. No free lunch, all medicines have numerous effects, some favorable and some not, so it's important to make sure there's a damn good reason for using any medication and understand the risks and benefits.
Finally, every individual has a unique condition and responds uniquely to the treatments we have to offer. It's a partnership between the prescriber and the patient, communication about what's happening during the course of treatment is vital. Believe me I know, whether in the role of doctor or patient, it's a highly evolved art form.
The problems pointed out in this article -- which are in some degree real even if heavily editorialized -- must be understood in light of a wider context which includes:
0) The very poor standards of validity and replicability in most fields of experimental psych-whatever. The Popperian method ain't what it used to be.
1) The Viennese Waltz of bad incentives throughout the psychiatry research pipeline. Most notably, drug companies are incentivized for fraud and deceit by being rewarded for closely-guarded research, hiding negative studies and obtaining patent extensions for new applications of existing drugs.
2) Somewhat related to (1): the unfortunate drug safety model prevalent in all relevant nations in which drugs must be proven to work for some pathology. Besides incentivizing recklessness in industry-led research, this means viable off-label usages go "underground" (topiramate for dissociative disorders is a typical case where FDA-worthy testing might be impossible). It might be better if the FDA and its counterparts instead regulated for drug _safety_ in humans and let the academic and clinical communities evolve their professional consensuses.
3) Much related to (0): the effective failure of "talking cures" in outcompeting drugs (specially "dirty drugs" like anticonvulsants, neuroleptics and non-SSRI antidepressants) for "simple" depression, bereavement and related mental health issues of which one could whip up a "social critique" of drug use and so forth. "Mad in America" is obviously not willing to make a fuss of things like bipolar where people will take their lithium for decades and bear the side-effects because the alternative is to go actually mad-crazy.
Did I miss something?
The problem is that safety is not binary - it's a question of severity and probability of adverse effects vs the benefit of the drug (the risk of adverse side effects is more acceptable for a cancer treatment than a cough medicine for instance). The purported purpose of regulation is to balance risk vs benefit. Therefore the regulator needs to incorporate the indication into their decision, and so they must evaluate if it actually works.
The creation and promotion of "Bipolar" as a DSM disorder is covered in Anatomy of an Epidemic, Robert Whitaker's followup to Mad in America.
> [...] because the alternative is to go actually mad-crazy.
The whole point of Whitaker's Mad in America foundation is to change the paradigm of our approach to mental health. nstead of trying to find the right drug to make a symptom go away, it would be much more effective to figure out non-psychotropic-drug ways to help people function better.
Dr. Whitaker could be going full Foucault, but as well established by Hollywood, you never go full Foucault.
The physiological basis for scihzophrenia wasn't figured out and ignored until the 1970's.
> Dr. Whitaker could be going full Foucault, but as well established by Hollywood, you never go full Foucault.
Robert Whitaker is a journalist, not a doctor. He's sort of like the kid who points out that the emperor got swindled by his tailors.
I like the reference to the quote from Tropic Thunder, but I'm not up to date on Foucault's contributions to philosophy.
I made this in Excel for someone a few years ago, but it would make a good weekend project if someone wants to learn react or whatever.
I quit taking it because my IBS was not really IBS, it was a defective gallbladder. It was removed and my symptoms went away.
The meds with worst discontinuation effects are those with short half life. Those with longer half life tend to have gentler discontinuation effects.
EG https://www.ncbi.nlm.nih.gov/pubmed/10855379/
> Serotonin re-uptake inhibitor withdrawal syndrome generally begins within 24 to 48 hours after discontinuing the drug. Signs reach their maximum on day 5 and usually resolve within 2 to 3 weeks. Withdrawal syndrome is more common with short half-life drugs (paroxetine, fluvoxamine). The intensity of the clinical signs depends on the daily dose and how long the drug has been given.
"
Mad in America was the title of investigative journalist Robert Whitaker's first book. Whitaker's second book, Anatomy of an Epidemic, proposes that there is not and has never been any evidence that commonly used psychiatric prescriptions actually work over the long-term.
This HN submission was from 2 days ago: Psychiatrists Must Face Possibility That Medications Hurt More Than They Help (scientificamerican.com) - https://news.ycombinator.com/item?id=13186201
The Scientific American article says, essentially, that "Maybe Robert Whitaker is right..."
I am not anti-psychiatry, I am opposed to treating symptoms instead of causes. My friend would be doing much better if her psychiatrists would prescribe useful drugs (naltrexone, thyroid, B-vitamins, etc), instead of harmful ones.
You can't launder your biases away by putting them behind the abstraction barrier of what the government or what drug companies are willing to fund. That's how you end up with p-hacking. Better to acknowledge that the reason people do science is to do things with science, not because they find sound research intrinsically fulfilling, and that everyone and every funding agency brings their biases, their hopes and dreams for society, with them.
More like, profit-driven. If we want to get better, we have to stop allowing a class of society to profit from the sickness. Pharmaceutical companies exist not to make anyones lives better - they exist to generate profit.
I'm highly suspicious of the drug-taking culture, as it attempts to justify the enslavement of the individual by way of supplanting their supposed mental-health problems with a very profitable subscription to a proprietary/patented/owned drug formula. I think it is very sad to read this HN article and listen to all the stories of folks who think they are improving their lives with this chemical dependency, and it is really tragic that drug-taking is such a cultural phenomenon that anyone who dares to rise above the field and say "hey, maybe we don't need to do this - maybe there is another way" gets cut down to serve as fodder for the rest of the poppies.
Its quite possible that we've all been swindled by our own hubris. Its happened before. The Romans had their lead pipes, the Victorians their laudanum, and we - "modern" society - have our Prozac and Zoloft. Dare to mention alternative means of lifting oneself out of the mire, and you will incur a great deal of wrath - such is the investment in the propaganda from the multi-billion-dollar pharmaceutical industry in capturing the subject and making sure nobody dares think otherwise to their drug-delivery supply chains...
David Foster Wallace:
Wallace died by suicide on September 12, 2008, at age 46. Wallace's father reported in an interview that his son had suffered from depression for more than 20 years and that antidepressant medication had allowed him to be productive.[42] When Wallace experienced severe side effects from the medication, he attempted to wean himself from his primary antidepressant, phenelzine.[43] On his doctor's advice, Wallace stopped taking the medication in June 2007,[42] then the depression returned. Wallace received other treatments, including electroconvulsive therapy. When he returned to phenelzine, he found that it had lost its effectiveness.[43] His wife kept a watchful eye on him in the following days, but on September 12, Wallace went into the garage, wrote a two-page note, and arranged part of the manuscript for The Pale King before hanging himself from a patio rafter.[49]
It's something to be very careful about...
I think his case is very much an edge case here. He had very serious problems with a hard to treat depression and was on a MAO inhibitor, which is seen as the last resort for pharmacological treatments of depression because its so unstable, short-lived, and has nasty side effects and is difficult to ween off. SSRI's are much more safe.
https://quomodocumque.files.wordpress.com/2008/09/wallace-am...
Prior to Nardil, I had been taking Prozac (fluoxetine) but a combination of sexual side effects, an impatient disposition, and scientific curiosity prompted me to ask my psychiatrist about Nardil. He said, "Why not?" This psychiatrist would prescribe just about anything (not that I see anything wrong with that) so over the course of grad school I tried Prozac, Nardil, Modafinil, and Adderall. Oddly enough, it turned out that an extremely low dosage of Adderall fixed most of my issues. My psychiatrist started with me 30 mg twice a day but I found that 10 mg worked better (less euphoria, more focus), so nowadays I only take 10 mg Adderall about twice a week and don't seem to have any depression or focus issues anymore.
I guess I am asking you about Modafinil because somehow I was under the impression it's a somewhat casual drug and the rest in your list seem like heavy weights to me. I have never taken any kind of antidepressant but sometimes think I need to.
After researching the subject a bit, my guess as to why Modafinil had no effect on me is that I probably have the wrong variant of the rs4680 gene. rs4680 is known as the worrier/warrior gene; those with the AA variant tend to be neurotic, have high anxiety, and handle stress poorly (my personality in a nutshell). Studies have shown that people with this variant of rs4680 do not significantly respond to Modafinil, so I suspect that I am one of them. I plan on sending a DNA sample to 23andme soon to confirm whether or not my hunch is correct.
With regard to getting a prescription, I'll note that my psychiatrist couldn't prescribe Modafinil directly to treat anxiety, so he indirectly prescribed it to address the "sleep issues" that were caused by my anxiety/depression.
For me, 5 mg of Adderall does what I was hoping Modafinil would do. Personally speaking, productivity is far more important to me than "feeling good", which is what I think a lot of people abuse Adderall for (and it certainly does produce that "feel good" sensation at high enough dosages). But at 10 mg and less, it's like a much "smoother" version of caffeine. In fact, lately I've found that I don't really like caffeine anymore because it makes me crankier, sweatier, and more jittery than Adderall does, and it doesn't help my ability to focus as well.
The drugs all have side-effects, different for each person who takes them. And often those side-effects are as bad as the original ailment. But you trust your doctor, and you're in a bad spot... and you figure, "Fuck it, maybe it'll work and I'm willing to try anything at this point..." And ugh, it just all sucks.
It's so hard to fix once you start down the medication path. Testing drugs, trying to find the right dose... deciding if the side-effects are worth the gains... withdrawal from drugs... drugs to help with the side-effects... drugs to help with the withdrawal... (often a few loops)... all of this can fundamentally change your personality and motivations, or have just no impact on you what-so-ever and leave you beyond frustrated.
If you had cancer, everyone would be there to support you. If you have a mental illness, there's not much chance of getting support from peers... or friends -- it's tough, it's not their job to support you -- sure... but a lot of times mental health issues are exacerbated by feeling of isolation... which leads to medical treatment because you don't have other options... and the doctors all seem confident that drugs will help...
Anyway, anything you can do to avoid mental health issues in the first place... do that. And if you don't have mental health issues, be thankful and humbly accept you're one concussion, bad breakup, car accident, death in the family, death of a pet, loss of job, or bad decision away from it if you aren't careful.
I was ripped out of my bed by ambulance officers with police present, despite my protests and my wife's - eventually agreeing to go voluntarily with them in their ambulance. Then after I got into the ED itself I discovered I'd been sectioned and not allowed to leave. After I realised this was what had happened I got placed in an isolation room, with no explanation as to why, and there I sat quietly rotting for the next 5.5 hours. In other words, I got no care, had my rights stripped and was treated like a criminal because after a sustained period of incredible stress I had a breakdown. I was then sent back home as they decided I shouldn't have been there in the first place.
I was then sent a bill for $600.
The system sucks.
That sounds like enough to _cause_ a breakdown!
And I absolutely cannot talk to anyone involved in medicine, because their treatment for suicidal ideation from a mental breakdown has the unique side effect of making me feel like I want to die to escape the disrespect and indignity of being treated like a criminal who must be locked away.
It's good that you had your family around you. The system is too big to understand you on a timely and personal level.
Because most people have no clue what to do about psychological illness, are afraid of doing more harm than good (not wrongly) and have pathology of their own that they're having trouble dealing with. And if mental illness as tied to family dysfunction as I think, then the people who would most want to help you are those you should trust the least to do so.
Generally curious. The only solution I see is some empathy machine that allows you empirically experience someone else's experiences (VR perhaps?) along with understanding their feelings while going through those experiences.
I guess I'm asking for the ability to read minds...
Worst sickness of my life. Felt like death flu. Uncontrollable vomiting, diarrhea, chills, shivering, fever. I spent 4 days between bed and bathroom. Then suddenly on day 5 I was fine.
While I was on it, it completely turned off everything below the belt. No response to stimulation at all. And mentally I was a zombie. Evil stuff.
No such problems on Zoloft, celexa, or Prozac.
I ended up coming back on it though. It helps a lot!
"Bad LOL. It could not find the first drug I want to look at- apixaban or Eliquis. Generic name and brand name, respectively"
Apixaban is apparently a common drug. That said, even she was interested in such a portal as well, saying that it just needs more data.
Of course, that doesn't mean the article is useless or not addressing real phenomena. Antidepressant withdrawal is real, and IME it's something you're more likely to hear about as a horror story from a patient (especially if they tried to stop Effexor cold-turkey) rather than as part of standard descriptions of depression treatment and its risks/shortcomings.
But I also think that taking such a universal anti-psychiatric drug stance is probably too hardline of a position. I think they are the lesser of two (or more) evils for a lot of patients.
But for some people the results are miraculous. They solve real problems with few if any side effects. For others, they either don't work at all or have intolerable side effects.
The situation would be a whole lot better if we could predict likely efficacy and side effects in advance, especially cases where treatment is more likely to do harm that to help.
Interestingly, I've read a lot (not so much recently) on the subject and taken several SSRIs myself (with good short term experience, minor sides), but I learned a lot from the discussion here. So many people take these drugs — the data necessary to understand and perhaps to predict ... is out there. Not easy to get at, but really plentiful. Reading this made me think about the feasibility of mining message boards for first person accounts of SSRI experience.
Still, for many people, it's more trial and error than it needs to be. Many family doctors still don't match up symptoms with neurotransmitters, and then put people on the wrong class of drugs altogether (e.g. something like Wellbutrin which works on norepinephrine and dopamine instead of an SSRI for anxiety which is more associated with serotonin).
Part of the reason is that new drugs keep coming out so it's difficult to keep up, and eventually they all start to blur together.
The best practical predictor of success on a given medication today is if you have a close relative who's had success on that medication.
So include the social graphs of people who are on antidepressant discussion boards and pick up on friends, family, socioeconomic features ...
I so want to use ML tools on medical treatment data, but it's so hard to come by. Have toyed with a couple of startup ideas based on the tendency of people who share a condition to establish ties. Crohn's disease, cutaneous lymphoma. But the groups are too small. Mood disorders on the other hand...
Are they? Calling it "Discontinuation syndrome" rather than withdrawal seems like clever marketing.
I've always wondered if it was a windrawl side effect
Not that you shouldn't trust doctors, but I always do some Googling to get a second opinion about all psychoactive drugs I'm prescribed.
I tried to nitpick on things that mattered for me, but you cannot easily claim "I'm more up to date than you on <xyz> illness" to a legal doctor without feeling a little ridiculous.
That's why I root for more non invasive monitoring and intervention. Many doctors told me the "based on these tests, you have nothing", bailing out when I asked for more because deeper tests would require potential ICU. So you end up floating in the unknown hoping for the best.
One dared me to reproduce heart failure on the spot because there was some tension between me and him.
It odd.
I remember being off one day (10mg per day) and having the same sensation you get when an elevator stops after going up. A chill in your spine, except it was very intense, and located in my brain only. Lasted a day, only thing that would relieve it is swallowing something..
I really hope I don't have to enjoy this kind of black magic again next month. I'll be sure to go off very smoothly.
* Research the potential withdrawal effects. They're much more upsetting and disruptive when you don't know what to expect or how to attribute the effects. But don't panic preemptively and expect all of them, just commit them to memory so that you don't panic if and when they occur.
* As others have suggested - taper off as gradually as you can.
* Do not schedule the discontinuation around any deadlines or professional engagements. Use a bad case of the flu as an excuse - assuming you're in the northern hemisphere it's flu season, and conveniently enough SSRI withdrawal symptoms can resemble those of the flu (http://www.aafp.org/afp/2006/0801/p449.html).
Having been prescribed paroxetene for crippling anxiety and having suffered through severe withdrawal effects myself, hopefully this will help.
After that experience, I decided it was better to just feel depressed.
Ironically, sexual issues can cause depression, and sexual issues are a side effect of a lot of medications used to treat depressions.
Arrogance, showboating, non-science and anti-pragmatism are the biggest killers.
A bunch of drugs were stopped in the past because of post marketing reports.
I suspect this is probably highly regional, and highly doctor-specific. Was this doctor a General Physician, or a psychiatrist?
I hope you're well now.