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Getting referred to a dietitian (Reacting and Venting)

Yeah, so this is about the only place I can rant about this. And I know some of you have experience dealing with this stuff, so double bonus.

I received a letter in the mail today that stated that my primary care physician is referring me to a dietitian because I have depression. On one hand, I think it's awesome that she isn't trying to give me nutrition advice (as she is a MD and not an expert) and is referring me to someone who specializes in that sort of thing. And it's cool that she's considering nutrition deficiencies as a cause (or at least antagonizing) for mood issues. But I can help but wonder just the teensiest bit that maybe she's referring me to a dietitian because I'm a vegetarian.

Maybe I'm being paranoid. And maybe she's required to rule out absolutely any possible cause of depression. But my iron levels are normal. My thyroid levels are normal. I exercise at least three times a week. I get adequate amounts of calcium. I take multivitamins. I don't drink soda. I drink coffee once a week, if that. I rarely drink alcohol. I eat some junk, yeah, but not every day. My diet consists of fruit, vegetables, rice, and beans.

Mood disorders run in my family. I do not have any memories whatsoever of being generally happy or having a sense of self worth. I can't get through a job interview without having a panic attack. I mean, I was either born with this or I learned it from my parents. My therapist hasn't given me a different diagnosis yet, but she did say that I might be "prone to depression." I just don't think my diet has anything to do with it.

Am I reading too much into this?

I don't know if you are reading too much into it or just keeping yourself open-minded yet informed.

(((issa)))

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If your dietitian is open-minded about your diet choices it could still be very helpful. Even if you get everything you need from your diet there are adjustments that can be made that could really help with your depression.

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I'd say go into it with an open mind, but know what nutrients you're getting.  I don't think all nutritionists know all about being veg*n, so sometimes we have to educate them about how we get adequate sources of nutrients.  I think it's great that you're being referred, if just to officially cross nutrition off the list.

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Thanks for the responses. This is one of those posts that I should have typed up and then hit ctrl-x. I'm just frustrated and being a bit irrational. *sigh*

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as someone with a mood disorder i can say that diet does matter a lot in how i feel. i don't know if you're veg or vegan, but i know dairy really messed me up moodwise and that was a large push for me to go vegan.

however, i don't say that to suggest that you aren't eating "right." you sound like you're doing veggie right from your post. it sounds like she just wants to make sure (you don't have a profile so i can't check your info). if you're young i can see the MD being concerned because (from my own experiences) many younger people jump into veggie and do it wrong. but i think it is good that MD cared enough to follow up. i know most of my doctors either a) push drugs or b) ignore my symptoms and never really "think outside the box" when it comes to "fixing" me. so no worries, as everyone has said. i think it is good for everyone to see a veg*n friendly nutritionist just to make sure things are going well.

(if it helps, i once made a trip to the gyno and got yelled at for saying "none" when she asked how much dairy i ate a day! i told her i was vegan and ate a lot of calcium rich foods but she still gave me dairy propaganda after digging around my junk. she wasn't nice about it either!)

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I don't know that I can express this the way I want this to come out...

I think it is great that your MD is sending you to a dietitian, but like you, I am skeptical about the motivation behind it.  You might pull up a dietitian who is going to say hey, you eat better than I do! And the MD will have nothing to say at all. 

As a psychology student in a Master's program, and as someone who has been told she has chronic, intractable depression, and having been diagnosed with about any and every "mental issue" including bipolar II (which is not accurate)...only to figure out that the depression stems for an organic physical illness, NOT a brain chemistry problem...I sometimes wonder if doctors and therapists are too quick to look to depression as a diagnosis.

In the US, 80% of the antidepressants Rxd are written by GPs and FNPs.  These are not people who are properly trained to diagnose and prescribe psychotropic drugs.  I don't trust psychiatrists either because they are there to push pills and it has been my experience that not a one of them wants to really take the time, but they still charge $75 for 10 minutes of their time!  It isn't like GPs actually take the time either (it took mine 11 yrs to diagnose my lupus when it had been staring her in the face, but she kept insisting it was depression that was causing my physical problems).

Blood tests don't tell the entire picture either, not even when they measure iron levels and they will not take the time to educate a patient!!!!

To use self-help for depression...I know you can't let yourself get too hungry, too tired, too lonely or too frustrated.  Therapy can work wonders, but there are those of us who have to obsess about all manner of small $hit in our lives and we make it worse for ourselves.  When I finally stopped beating myself up about all of my shortcomings, about the mistakes I make, about having occasional poor judgment, about money decisions, about how I keep house and starting to accept that I am HUMAN, not SUPERHUMAN, it got better.  I'd hate to tell you how much therapy that took! 

Hang in there and I am sure I am not alone when I say, I'd love to hear what the dietitian had to say.

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(if it helps, i once made a trip to the gyno and got yelled at for saying "none" when she asked how much dairy i ate a day! i told her i was vegan and ate a lot of calcium rich foods but she still gave me dairy propaganda after digging around my junk. she wasn't nice about it either!)

LMFAO!! ;D ;D ;D

i have gotten letters about this sort of thing too.... it may be that your doc is looking at you more holistically, which would be great...
or, like mine, you insurance company requires that your doc send you to ends of the earth, in order to continue covering your specific probs and tests.  (ugh)

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  I don't trust psychiatrists either because they are there to push pills and it has been my experience that not a one of them wants to really take the time, but they still charge $75 for 10 minutes of their time! 

I concur.  However, there are the few and far between that are amazing.  It took me 13 years to find one!  My current doc has weaned me off all medication because we agreed that I'd been on it for a huge portion of my life, and no one knew if I even needed it anymore, due to the doctors I'd had before just upping and upping my dosages if it wasn't working.  Sick, I know, but all too common.
I've been med-free since April 1st.  That's not to say I'm going to be fine for the rest of my life, but wow- it was so amazing to find a doctor that was willing to see how I am without a chemical barrier around me.  If I have to go back on, I'm absolutely willing, and I am truly grateful for the opportunity to have tried life sans medication.

**This is not to say that people do not need meds, nor that they are "bad" in any way.**

Thanks for the responses. This is one of those posts that I should have typed up and then hit ctrl-x. I'm just frustrated and being a bit irrational. *sigh*

You're allowed to feel however you want about this situation.  It is your body/brain we're talking about here!  :D

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I SOOOOO agree with LDF and Meggs on this one! After being mis-treated and misdiagnosed for about 10 yrs in the States (a dr tells you you need the pills, you're 14, you take them--he knows, right?) I finally at age 30 found out what is actually "wrong" in here...and it's not organic, it's the result of "prolonged inescapable life or integrity-threatening trauma" (and goodness knows, I quote.) I finally got with a therapist who could help me learn to manage it. And drugs are NOT the answer.
At 45 and perimenopausal, I am ALSO finally past the age when a Spanish Dr will automatically ask me how many kids I have and when the answer is "None"--immediately decide that my problem is emotional because I am a) bored b) idle c)depressed because I haven't reproduced. For the first time, someone actually realised that I might have a problem that wasn't my "nerves!"
After years of the wrong sort of medication, I have to be so careful what I take of that sort anyway--Valium doesn't relax me, it makes me climb the walls. Prozac causes hallucinations and the complete inability to sleep, for days on end.
It was also disquieting  even at age 17, when I entered the abyss of the "mental health care system" with my first breakdown, that the background message I was picking up from doctors, nurses, psychiatrists etc was "well, you'll never really be well, but don't worry--we're here for you." I got the distinct impression that getting you well and able to manage on your own was NOT what they were there for.
It disturbs me deeply to see Drs prescribing potent antidepressants etc. for young children, instead of exploring the root causes of behavioural or stress problems. If you treat the symptoms, the problem may go merrily on. I fear for future generations of people who have been drugged to the eyeballs from day 1 just because it's a quick fix, and because the doctors and pharmaceutical companies are getting rich. Medical ethics?? I know what I think. :(

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Wow, Yabbit, that is so true.

For years I was told "you'll be on medication for the rest of your life" so it's quite amazing that I was able to find a doc that was willing to listen to me and work with me. 

Some people just have no clue!!

Medication is great for the symptoms, IF you are also getting to the root of the problem, as you said.  Well said, Yabbit and LDF :)

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Wow, I am lucky enough not to have gone through anything like this, but I just wanted to say I hope you get well soon.

Hopefully your doctor means well and is just trying to cover all the bases. Who knows, maybe you will get an awsome dietitian who will pinpoint some minor nutrient you are missing, or that you might have a reaction to something & not realize it & totally fix your problem!!!!

Just try to go into it hoping the best & if you don't like him/her, go to a different one!!!

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Wow, Yabbit, that is so true.

For years I was told "you'll be on medication for the rest of your life" so it's quite amazing that I was able to find a doc that was willing to listen to me and work with me. 

Some people just have no clue!!

Medication is great for the symptoms, IF you are also getting to the root of the problem, as you said.  Well said, Yabbit and LDF :)

It's like I told my therapist (whom thank heaven I no longer need): Sometimes they diagnose you with "a broken leg." They put you in a broken-bone support group, and teach you to live with the limited mobility imposed by your situation--but no one ever actually sets the bone or applies the splints and plaster. And if they do, they expect you to hobble around on crutches for the rest of your life.

Plaster's off, and now I know that if I get dizzy or fall down, I can get up again. It may be hard work and hurt some, and I may sweat, but I will eventually be vertical again. And a lot quicker than I was led to believe!

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I called the doctor's office today. My doctor's out of town, so I talked to a nurse. She asked me if I knew why I was getting the referral since she could tell from looking at my file, and I told her I wasn't sure because the letter said depression and sleep disturbances as the reason for the referral. I asked her if it maybe had something to the fact that I'm a vegetarian. She said, "Ohhh, yeah, that might have something to do with it."

I knew it!  ::)

As it turns out, my insurance doesn't cover dietitian visits unless one has diabetes. I told the nurse this, and she told me to call the insurance company back and see if the insurance company would give me a referral.  ??? I don't know. I'm leaving town tonight, so I'm just going to deal with this stuff when I get back.

Quote:
In the US, 80% of the antidepressants Rxd are written by GPs and FNPs.  These are not people who are properly trained to diagnose and prescribe psychotropic drugs.

Yeah, these are about the last people who need to be prescribing antidepressants and antipsychotics.  At least not without supervision from a mental health professional. I got diagnosed by a GP after reading off a sheet of twenty questions (Some of which I didn't answer honestly - the hell I'm going to tell her I've had suicide ideation). She then tried to give me Buspar (even though she diagnosed me with depression). I told her that I wouldn't take it, and at least she hasn't pushed the issue. Although had she tried to give me Diazepam, I may have taken her up on it.  ;D Kidding!

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There's alot of attitudes we get from our parents unconsciously though. But that doesn't mean we should go blaming our parents for it.

The only way you can get self-worth is from yourself. Don't sit there and wait for someone to tell you or show that they care about you. Start caring about yourself. Say this right now I'm worth a million bucks (don't get cocky) but compare yourself to a million dollars. That's how much you should care about yourself . And then right down your goals and dreams what you want to do in this life and one by one do them. Don't worry about anybody else's life. You just might've not had a very good support system in your life.

If you don't have any memories of being happy don't concentrate on the past  make your happiness now. If you can correct the past go back and correct it I'd say if not then just worry about the present and future, that's it.

If your worrying alot like on a job interview you might be worrying to much of what they think of you. Think of it this way this is the process of it they are not judging me.

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If you don't have any memories of being happy don't concentrate on the past  make your happiness now. If you can correct the past go back and correct it if not always worry about the present and future.

 

indeed...as my best friend said before he threw himself off a parkiing garage in LA...."do what makes you smile"
its the last words we heard him say. and so true.
better than any therapist ive ever seen.

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I was also thinking what else could it be when your going for a job interview.  It could be your scared of failure or success.

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Well it can't hurt.  You can always ask your PMD to give you an honest answer "did you refer me to a dietician because of my vegetarian diet".  Having a dietcian that is sympathetic to your vegetarianism is important.  I would call this person and say "before I see you, are you supportive of the veg*n diet?"    Otherwise, don't bother.  But she/he can help you decide if you aren't getting something, like omega 3's.

I am prone to depression and spent a year on antidepressants in the 80's.  Diet and exercise is my antidepressant.  I definately feel more down when I'm not eating right or exercising.

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I'd say go into it with an open mind, but know what nutrients you're getting.  I don't think all nutritionists know all about being veg*n, so sometimes we have to educate them about how we get adequate sources of nutrients.  I think it's great that you're being referred, if just to officially cross nutrition off the list.

i think that any DIETITIAN should be familiar with the vegan diet. i am a nutrition major and in every applied nutrition class i have had something has come up about veganism. when someones job is to know about peoples diets they should be sure to know dietary restrictions, where nutrients come from, etc.
that being said, many probably are skeptical about you getting everything. but they should know that you can have a very healthy diet.

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