@A MyEpilepsyTeam Member, were you refered to a nurse practitioner for psychiatric services? As far as just therapy, any therapist you’re comfortable with is fantastic. For psychiatric care, diagnosis, prescribing, continued care, etc. We should be seeing neuropschologists. Never, ever, ever someone who isn’t specifically educated in brain disorders. It can do more harm than good. More often than not there isn’t good communication, or something gets missed, or the nurse practitioner just doesn’t know. Because, they don’t. They deal with mental illness, not brain structure or disorder. It’s very common for those of us living with epilepsy to develop PTSD, the right Dr needs to determine what’s actually going on. Your verbal tick could be PTSD, it could be a med prescribed by someone who is out of their depth with neurological conditions. My point is, that just like we don’t go to a gp for our epilepsy, we don’t go to the psych equivalent either. We require specialists.

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@A MyEpilepsyTeam Member - I have been under the care of both a therapist and a psychiatrist since 2015 (when Keppra did not work and caused the beginning of a mood disorder). Sadly, the doctor and the therapists do not interact with each other. I have gone for a neuropsychiatric assessment twice - and perhaps it is time to go again since I am having new symptoms. My neurologist had a family emergency and my end of November appointment was moved to the end of this month. I did want to discuss these issues. I feel the need to withdraw from others where I am living in a community environment when the side effects are most evident - which leaves Lunch (when side effects are not as bad). Other issue is that I am on Medicare - and while they pay for specialists, they do not pay for the neuropsychiatric assessments (2000 US out of pocket). /sigh/ this sucks.

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@A MyEpilepsyTeam Member , Thank you for the information. I think when my Neurologist filled out my disability paperwork she noted PTSD among other stuff. She wanted me to see a Psychiatrist I think but I’ll have to find that paperwork & get back to you. I also saw a counselor in 2022 for a bit but she left the office she was at. Now that I have Medicaid & United Healthcare with my disability being approved, I have a more variety of therapist I could choose to go to. It’s a Psychiatric Nurse Practioner the office put me with when I said I was looking for a Psychiatrist. I’ll try to find that paperwork & get back with you later on this afternoon or something. I appreciate the info. Thank you very much. Your friend in Texas, Becky

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I think you might be undermedicated or need a dosage or med change. Or a drug interaction. Those are seizures. You need to call you neurologist and tell them you need to talk to them like yesterday. Seizures can present as verbal affectations. Skipping back in conversation and continuing from that point like a record skipped, no recollection of the conversation having moved along. An inability to actualy form words, for the thought in your brain to make it to your mouth. Also, did your neurologist refer you to your psychiatric nurse practitioner and does she know if there may be any drug interactions. I have been advised to see a therapist but as far as psychologists go, we should only be seeing neuropsychologists. Period. The others don’t have the training to deal with neurological disorders. They’ll treat depression or anxiety like you would with a standard brain. That’s not us. We can’t just have drugs thrown at us, we can’t even take cold medicine. My neurologist said that doctors are very hesitant about prescribing psychological drugs to people with brain disorders, there are too many variables and you don’t want to screw with your seizure threshold and he is a neuropsychologist as well.

Hi @A MyEpilepsyTeam Member , I see you’re on Vimpat. Sometime around mid 2019 or a little later in that year, I began having verbal tics where I say or holler words, names, phrases or humming or moaning noises uncontrollably. I don’t know what made them start. They’re more active when I’m around others & when they get really active my head starts to hurt & I have TMJ where I grind my teeth when I sleep & so my jaw starts hurting during those really active verbal tics if it’s not hurting already being that my jaw hurts almost daily. I feel like I don’t have a private brain anymore cause sometimes I can’t think of something or someone without saying or hollering something. I was finally approved for my disability in September 2022 & had to do 2 phone hearings with a Judge, a Vocational Expert & my attorney & I explained to the Judge that with these verbal tics people may misinterpret them in a work environment & think I’m talking to them (like the residents when I worked in a nursing home or the customers at the fast food burger place I worked at) cause my own family doesn’t always know if I’m talking to them or if it’s my verbal tics. I say or holler things like “No”, “Don’t”, “Stop”, “Ouch”, “I love you” & if a person is around me to much then I’ll catch up on their name & their name might become part of my verbal tics. I’ve been seeing a Psychiatric Nurse Practioner who has me taking Abilify but I’m having to take a half of 5mg because a whole pill makes my stomach so bloated as has the other anxiety pills that I’ve tried. I was put on Keppra in June 2019 by a Neurology Nurse Practioner who I saw for just a short time but Keppra made me so tired that I had to take a nap every day & eventually I started having trouble sleeping at night & so I got off it. Good luck to you. Your friend in Austin, Becky

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