Looking for advice on anti-depressants please

I know, I was shocked at what my SIL said about the way my FIL's doctors were prescribing for him without any thought to what other doctors were prescribing or his overall health. There was no effort at all to view him as a whole human life with many different issues. Every doctor was just cramming in as many patients as possible, not thinking through what each person needed, not watching for drug interactions, and basically killing their patients through neglect. I think in many cases they were simply so overworked they couldn't keep adequate track of each patient's overall health and were just desperately working in a piecemeal fashion.

Friendorfoe had some advice that is worth reading, I think. I also remember seeing a social worker for talk therapy in Manhattan when I was divorcing an abusive husband, and she charged on a sliding scale according to income. I did the same thing when I was in college in Boulder and Denver, so it's not just NYC.

Is your friend pretty fluent in English? I ask because psychotherapy in English can be very frustrating for people who are not very fluent. In Manhattan one of the go to places was Jewish Family Services. Even if the first place you call doesn't offer the services she needs, they may be able to refer you to a place that can help. I am wondering if there is a go to place of this kind out here? Assuming your friend lives in NJ?

Are there not any organizations that work with refugees from Iraq? A lot of people will be going through similar hardships. Having a place where there are similar people might be of some comfort also.

In a world that espouses the superiority of free market, cutting money for social programs seems to offend too few.

I wonder if she could go to an urgent care facility and then get referrals from there? I really don't know anything re Medicaid acceptance, but when I have gone to the Summit Medical Group Urgent Care, they have gotten me in essentially immediately to other specialists when it was deemed medically necessary.

Hi krugle1,

There are some special mental health programs specifically for refugees that I know of but am not personally familiar with (in particular, the one at Bellvue has an outstanding reputation). Even if she's been here awhile, if you think her immigrant status is an important component of her depressive symptoms, a program specifically targeted for immigrants (especially those who may have experienced significant trauma) may be helpful:

Cross Cultural Counseling Center, Intl Institute of New Jersey Jersey City, NJ. The institute helps immigrants and refugees build full and productive lives in the United States; works to ensure their fair and equitable treatment; and enhances public awareness of their contribution to American social and economic development. Each year, as we have since 1918, we strengthen the multi-cultural fabric of New Jersey.

Bellvue/NYU program for survivors of torture

http://www.survivorsoftorture.org/who-we-are/our-mission-and-history

International Trauma Studies Program- REFUGE New York, NY. The International Trauma Studies Program is committed to enhancing the natural resilience and coping capacities in individuals, families, and communities that have endured and/or are threatened by traumatic events - domestic and political violence, war and natural disaster. ITSP pursues its mission through providing professional training, conducting innovative research, offering technical assistance to international organizations, and helping build a global learning community in mental health and human rights.

I don't have time to distill the info right now, but there is mention of an organization that works with Iraqis. They even mention an Iraqi who moved to Maplewood. Maybe the org mentioned in the article would be a place to look. http://www.nj.com/news/index.ssf/2009/10/iraqi_refugees_in_new_jersey_a.html

Here is another story from NJ.com about Iraqi refugees in NJ that mentions several organizations that could be helpful, including Catholic Charities in Paterson.

http://www.nj.com/south/index.ssf/2008/08/nj_to_host_iraqi_refugees.html

A resource I just found online (they are in NYC). It seems to be mostly about getting people out of trouble overseas, but I wonder whether they have information to help people after they have made it to the US. Don't know why the link won't go "live," but you can copy and paste.

http://refugeerights.org/our-work/contact-us/

Iraqi Refugee Assistance Project
Urban Justice Center

40 Rector Street, 9th Fl
New York, NY 10006

Email Us at info@refugeerights.org.

For more information on the Refugee Roadmap program, please email info@refugeeroadmap.org.

Another thought:

http://www.state.nj.us/humanservices/dfd/programs/refugee/

Refugee Resettlement Program (RRP) is a federally funded program that provides cash and medical assistance to refugees. An individual is considered a refugee for purposes of RRP if he or she fled from and cannot return to his or her place of national origin because of fear of persecution on account of race, religion or political opinion.

Only single individuals or couples without children are eligible for the RRP program, which is administered by the county welfare agencies for up to eight months, based on the refugee's date of entry into this country. All other refugees, if otherwise eligible, can receive assistance under the WFNJ program.

For more information, call:
609-588-2989

Call Dr. Ejiofor in east orange. Takes medicaid. Psychiatrist. May be a 2 week wait. Good luck!

krugle1 said:
Problem is she has Medicaid. Close to impossible to get an appt. I hate to generalize, but I've been to a number of Medicaid doctors with my friends, and they can be less than stellar. Thus, I'm doing a bit of research.
Free or reduced psych care can take a long time to get an appt, and she needs one immediately.

Call Dr. Ejiofor in east orange. Takes medicaid. Psychiatrist. May be a 2 week wait. Good luck!

krugle1 said:
Problem is she has Medicaid. Close to impossible to get an appt. I hate to generalize, but I've been to a number of Medicaid doctors with my friends, and they can be less than stellar. Thus, I'm doing a bit of research.
Free or reduced psych care can take a long time to get an appt, and she needs one immediately.

I will try to PM you.

As someone else mentioned, Jewish Family Service may be able to help:

Focused on minimizing the stress of the crisis event, counseling can provide emotional support and improvement of in-the-moment coping strategies. JFS is a voluntary outpatient service. If desired, crisis counseling can be extended into traditional, longer term psychotherapy.

Clients who require more service than what JFS can offer are referred to the appropriate resources. Telephone based support can help provide callers with a variety of referrals, including:

• psychiatric assessment and evaluation
• hospitalization for stabilization
• government entitlement referrals and entitlement screenings
• community based resources that respond to the individual’s needs

All JFS services are offered on a non-discriminatory basis. JFS of MetroWest NJ is licensed by the State of New Jersey as a provider of outpatient mental health counseling services. We have managed care contracts with most insurance companies. Insurance plan benefits vary, and our intake specialist can help you to determine your level of insurance coverage. JFS accepts Medicare and Medicaid plans. Clients can self-pay for services, and we offer a subsidized sliding scale for those requiring financial assistance.

• 973-765-9050

I just had another thought. What is your friend's religion? Could she find support in a church/temple/mosque here? I have to believe a clergy person could help her get started on finding help.

Any university that grants a PhD in Psychology has a low cost/sliding scale counselling service. The same goes for medical and dental care. When I was a young, starving artist, I got all my dental work done at dental schools (Ohio State was great, NYU not so much).

I did have an idiot allergist give me a prescription for an antidepressant that sent me into hyper-anxiety mode. When a friend saw the starting dosage, she expressed concern. An internist should be better than an allergist but I might still do a little research and/or ask a pharmacist if a prescription is written for her. Especially if she is taking other medication. Never hurts to check with a pharmacist in my opinion.

UBHC - the mental health division of UMDNJ almost certainly takes medicaid

http://ubhc.rutgers.edu/services/adult/index.html

I am almost certain that Jewish Family Services can help with services for a patient with Medicaid.

Also refer to:

https://findtreatment.samhsa.gov/

THERE SEEMS TO BE A VERY INAPPROPRIATE ATTACK ON ME FOR SHARING MY KNOWLEDGE GOING ON HERE. FIRST OF ALL, YOU ASSUMED NO ONE ON HERE HAS MEDICAL KNOWLEDGE. I HAVE IN FACT WORKED IN THE MEDICAL FIELD. SECONDLY, THERE WAS NO SUGGESTION TO GET THE MEDS WITHOUT THE USE OF A PHYSICIAN. THERE IS ABSOLUTELY NOTHING WRONG WITH RESEARCHING AND GETTING KNOWLEDGE FROM OTHERS --INCLUDING OTHER PROFESSIONALS AND NON PROFESSIONALS TO KNOW WHAT YOU SHOULD ASK A DOCTOR ABOUT. IN FACT THAT IS THE APPROPRIATE WAY TO MANAGE YOUR OWN PERSONAL HEALTHCARE. AND OFTEN INFORMATION FROM PEOPLE WHO HAVE BEEN THERE IS BETTER THAN WHAT A PROFESSIONAL WILL GIVE YOU.

THE POINT OF GETTING INFORMATION FROM OTHERS IS TO HAVE BACKGROUND KNOWLEDGE AND KNOW OPTIONS YOU CAN APPROACH YOUR PERSONAL DOCTOR WITH TO MAKE AN INFORMED DECISION IN YOUR CARE.

PeggyC said:
Glad you guys said it first. Although some of that post was of value, most was not helpful at all.
Again, there is no way (safely or legally) to get hold of any kind of mental health medication without seeing a physician of some kind. A primary care physician can give her something on an emergency basis while trying to work out how to get help in the long run, but I don't see any point whatsoever in a lot of lay people trying to advise a person we have never met on what kinds of mental health drugs they should be taking.
SMH.

WHAT GAVE YOU THE IDEA THAT I SUGGESTED GETTING THE DRUGS ILLEGALLY???

COMMON SENSE TELLS YOU THAT THIS IS JUST INFORMATION THE OP CAN BRING WITH HER TO A PERSONAL DOCTOR (WITH HER FRIEND) SO SHE KNOWS WHAT TO DISCUSS WITH THE DOCTOR.

CLEARLY I DID NOT ADVISE ANYONE TO USE A SPECIFIC MED. I GAVE GENERAL INFO ABOUT VARIOUS MEDS TO CONSIDER.

IT WAS NOT ADVICE ON WHAT TO ACTUALLY TAKE..COMMON SENSE TELLS YOU THAT.

anti depressants are not addictive, but the benzo anti anxiety meds are (that is why vistiril and buspar are better)...sleep meds cause dependence/addiction (that is why trazodone or silenor is better).

many PCPs insist on being pricks and will not prescribe any specialty meds even on a temporary basis.

jeffl said:
No antidepressant is better than any other. The only thing that you're choosing is the side effect profile. That being said, some antidepressants will work better than others for any given indiviudual. Any primary care doc worth his/her keep is familiar with prescribing antidepressants and has one or two that they're very comfortable with. Antidepressants are also the best long term (pharmacologic) solution for generalized anxiety. Chronic use of the benzodiazapines are, at the very least, habit forming. Buspar...eh. So I'd advise her to go to her PC doc and try what he/she prescribes.

not totally true...no ONE antidepressant is better for EVERYONE...people respond differently to different meds...prozac may be better for one person while another responds to effexor (on a side note-i am told effexor has horrible withdrawals -worse than others and they come on quickly)..you also want to avoid MAOI because they have a lot of interactions--potentially fatal--even with OTC meds..i would use that as a last resort.

I have never found an urgent care facility willing to do anything other than urgent/sudden physical illness or injury...it would be a waste of time to just go there for a referral for anything.

i have a chronic rheumatology condition...found an urgent care place that said they did that when I was between docs and out of meds (the last one had become seriously cognitively impaired and is in the process of losing his license most likely)...and they said they service was only give you a name and number and telling you to make an appointment with the specialist...

Most people wouldn't just go into a car dealer and say I need a car for a family of 4 to get to school, work and the beach and tell them to just give you what they think is best...so why on earth is it wrong to get informed on medication possibilities-from any source-before going to a doctor?

AND IF I DIDN't GET MEDICATION RECOMMENDATIONS FROM WHAT YOU ALLEGE IS A LAY PERSON (in my case a friend who did not work in the medical field) I WOULD BE IN A NURSING HOME OR DEAD BECAUSE THE DOCTOR NEVER SUGGESTED THOSE TREATMENTS....I HAD TO SPECIFICALLY ASK THE DOCTOR IS THE MEDS MY FRIEND SUGGESTED WERE APPROPRIATE

Er, hold on. How many people are screaming here?? And why are we all so sensitive about the fact that there are people who believe it is much safer to let a doctor or pharmacist advise about medication than people without medical degrees?

Mountainside hospital in Montclair has a psychiatric out patient center. I don't know what kind of insurance they take but it's worth a call. If they can't help, perhaps they can give you referrals. Also, if she hasn't had a period in 3 years the depression may be caused by a medical issue like a thyroid disorder. Has she been checked for any other health problems?

NJBorn, good point. She has poly-cystic.

Thank you, everyone, for the referrals. I'll call them now.

I believe that's what I said.

IamMe said:

jeffl said:
No antidepressant is better than any other. The only thing that you're choosing is the side effect profile. That being said, some antidepressants will work better than others for any given indiviudual. Any primary care doc worth his/her keep is familiar with prescribing antidepressants and has one or two that they're very comfortable with. Antidepressants are also the best long term (pharmacologic) solution for generalized anxiety. Chronic use of the benzodiazapines are, at the very least, habit forming. Buspar...eh. So I'd advise her to go to her PC doc and try what he/she prescribes.

not totally true...no ONE antidepressant is better for EVERYONE...people respond differently to different meds...prozac may be better for one person while another responds to effexor (on a side note-i am told effexor has horrible withdrawals -worse than others and they come on quickly)..you also want to avoid MAOI because they have a lot of interactions--potentially fatal--even with OTC meds..i would use that as a last resort.

Women with very low body fat can miss their periods and develop depression. Is she painfully thin?

Her best bet might be a post-graduate psychotherapy institute. These are professionals who already have their graduate degrees and/or licenses and are getting advanced training. They provide very low-cost care. Could be as low as $10/session. It's usually easy to get in as a patient because each post-graduate trainee has to see a certain number of patients, so they always need to fill spots because a lot of the patients come and go.

And all these institutes have a prescribing professional on staff or as a consultant.

Where does your friend live? Here are some institutes in NYC:

Institute for Contemporary Psychotherapy

Metropolitan Institute for Training in Psychoanalytic Psychotherapy

Training Institute for Mental Health

In NJ:

Academy of Clinical and Applied Psychoanalysis

jeffl that is what you said. IamMe apparently has no idea how he/she comes across. Highly reactive.Had (s)he had not been so reactive, they might have noticed what you did say.