Psych history, decreasing drugs, who to tell?

[Pat_Pat RN]

I've been diagnosed with depression, general anxiety and panic disorder in the past. I take Effexor and Xanax for these problems.

I am wanting to decrease my dosages, and maybe get off the Effexor completely.

I was placed on a high dose, 300mg daily by a psychiatrist several years ago. She has since moved on and I don't see a therapist of any nature. I'm doing good with these problems. My family doc refills my RX's for me. I know the horrible problems with decreasing Effexor and will follow closely with my FD on decreasing slowly, etc.

My real question is who should I tell at work? Anyone? I was thinking my direct supervisor who sees me every time I work, she could have a good "snapshot" of how I'm doing, without falling into the "frog in boiling water" phenomenon and not see a slow subtle change. I'd like for someone to keep an eye on me for behavior and mood changes, but don't know if she would be "required" to tell anyone else, or if this could create problems for me.

Thanks for any input.

Pat

[traumaRUs, MSN, APRN]

Hi and welcome. I wouldn't use your work as a reference to adjusting your meds. I would ask a close friend (not necessarily at work) to give you honest feedback. What medications you take and the reason for it are your own business. It is not something your place of employment needs to know about.

[Pat_Pat RN]

I don't have any friends that I see on a regular basis outside of work.

I know, sad.

[traumaRUs, MSN, APRN]

Sorry Pat. Well then, what about seeing a therapist during this time of weaning your meds? Just to give you a safety net. I still wouldn't tell people at work because its none of their business what meds you take. Its not just the particular meds you take, its that you may not want your employer to know what goes on in your private life.

Also - you may want to consider looking into something that interests you in order to get another outlet...take care.

[FireStarterRN, BSN, RN]

I agree, take up a hobby that involves others, join a club, a church, something... it'll be good for you and your general self.

[Nightcrawler, BSN, RN]

I would seriously consider getting back in touch with a psychiatrist prior to making any changes to an established medication regimen. Your FP doc is sufficient for refills when you are on a stable dose, but you really should be monitored by a specialist during any time of dosage change. I am glad that you are aware that you may be caught aware by a gradual return of symptoms, and this is exactly why you should be monitored by a specialist.

By asking a supervisor to monitor your behavior, you would be forming a nurse/patient relationship with your supervisor, which is inappropriate. They are there to supervise your care of your patients- not your mental health. Asking this would very likely make you a target, as they may see your attempt to change your own medication regimen as a potential threat to your ability to provide care to your patients.

Another reason that I think that you should see a specialist is in your choice of preferred medications to eliminate. The Xanax actually has the higher potential for abuse, as it has a much shorter duration, and you may actually start to over/misuse this medication as you come off of the other and your symptoms start to increase.

Your comment that you do not have any friends that you see on a regular basis outside of work also makes me wonder if you are as stable on your meds as you think that you are. A lack of drive for social activities is a sign of major depression, and it may be possible that you actually need to be transitioned to a different med to better control your symptoms.

Whatever you do please do not try to adjust your medications on your own!!! At the very least have an open and honest conversation with your FP doc about your wish to come off of medication, and see what his/her thoughts are on the situation.

[Pat_Pat RN]

I have hobbies and such. Just not things that I do on a regular basis.

I was just thinking that those I work with see me in a fairly consistent environment, under similar circumstances, etc. All else being equal, if I'm acting "different" they would be ones that would see it.

We are a close knit bunch at my hospital, very small. As long as I don't become a danger to the pts, anyone there would do whatever they could to help me. I went to school with the DON's kids, my wife worked with my department heads mother....small town.

I think that myself and my wife might not "see the forest for the trees" if you will.

Thanks for the input.

[nsgnva]

I agree with the other responders....don't tell the people at work! Sad, but true, some in our society aren't very understanding. Things happen at work and I hear "probably that nut job on the psych meds did it" Without my Wellbutrin XL , I'd have killed a few of those unsympathetic co-workers:smokin:. And who knows, maybe whatever led to all the problems that required you to go on meds, aren't there now, or aren't as bad, and you will handle the med adjustments just fine.So take the advice of the others and see a professional and seek other outlets for friends,fun and stress relief. good luck

[RedhairedNurse, BSN, RN]

I have hobbies and such. Just not things that I do on a regular basis.

I was just thinking that those I work with see me in a fairly consistent environment, under similar circumstances, etc. All else being equal, if I'm acting "different" they would be ones that would see it.

We are a close knit bunch at my hospital, very small. As long as I don't become a danger to the pts, anyone there would do whatever they could to help me. I went to school with the DON's kids, my wife worked with my department heads mother....small town.

I think that myself and my wife might not "see the forest for the trees" if you will.

Thanks for the input.

I would think that you would be the first to know if you felt out of the oridinary. I don't think that anyone could observe and be able to tell anything that you would or should already know for yourself. You know yourself better than anybody with or without meds. Right? Wean very very slowly, and see a doc for help!

[pagandeva2000, LPN]

I would not inform my supervisor of this because you can be targeted in a negative way. No matter what we were taught, nursing is not always a compassionate profession, as I have seen too often that nurses do not look out for each other. In fact, many tend to want to attack the more vulnerable people. In addition, you don't really know for sure how your supervisor REALLY views mental illness. She may automatically assume that you are not a safe practitioner, or even if she doesn't, she may share this information (even with good intent), with someone who has a different view.

I echo the suggestions of obtaining psych care to have them ween you off of your medications for supervision and counseling. In addition, they may counsel you in interacting with others, hopefully giving you the courage to gain friendships or to reach out to social circles such as church, or to start new hobbies.

Does your job have an EAP (employee's assistance program)? This, I believe should not be used to monitor you, per se, but they are supposed to keep things confidential and provide resources for counseling. At least, if your supervisor has to know that you are seeing the EAP coordinator (and she does not have to know why), that should let her know that you are trying to help yourself with your private issues.

[pielęgniarka, RN]

What about looking into support groups in your local hospitals or community services? Try googling it or call up a few places in your region.

Good luck.

[TopazLover, BSN, RN]

Check out the forum called Disabilities and click on Mental illness threads. You will find support there.

Don't tell work. I will it were different but we, as a society, do not handle MI well. You have to remember that nursing is a microcosm and subject to more, not less, judgmental attitudes.

More and more nurses suffer with all forms of MI and it will become more accepted, but now it is not so don't set yourself up for problems.

Best of luck.