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https://www.psychforums.com/blog/margharris/body_dysmorphia_docs_update._b-8644_sid-d9c1abdb8c8ecf9012519e35ad8e0efa.html

Author:  margharris [ Tue Jul 07, 2015 6:58 am ]
Blog Subject:  Body dysmorphia: Docs update.

My son was very present during our visit and spoke with confidence. He didn't need any prodding to explain how things had been going. The doc was pleased he had started at AA and felt he was the best he had ever seen him. He felt the new girlfriend was a good addition to help him reflect on how he behaved himself. My son mentioned how concerned she was about appearance and how that bothered him. He would be talking to her across a table and see her eyes gaze over to someone coming in. He felt she was checking them out for how they looked. The doc mentioned that it was important for him to realise he did the same thing. He needed to live in the moment and work on cultivating mindfulness. It is really about focusing on what is important. Being present for the person talking was important in nurturing your own sense of self and the connection you made to that other person.
The medication of Prozac 60mg and Lyrica 150mg twice a day was to stay unchanged. He could take another 150mg Lyrica at bedtime if he felt really stressed. As he has developed some insomnia with the meds, the doc prescribed the addition of 2mg Melatonin one hour before bedtime. The MRIs havent been read yet but he spoke to the guy who does the TMS while we were there. So I gather TMS is definitely an option he thinks is worth doing.
I didn't really think it was appropriate to mention my own concerns. It is important for him to own this illness himself. I would have liked to see about CBT but it doesn't even get mentioned at this stage. I feel they are waiting to see how the meds go for at least 4 months at the therapeutic dose suggested by Katherine Phillips and maybe do some TMS. They are after him developing insight himself. Mindfulness was mentioned though. The outreach worker will do some techniques on this to help him stay in control and sleep better.
He has been a lot better, despite the last hiccup so I have to be pleased for him. Meds do work a lot. Marg

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