I met with my psychiatrist again this week, who added another medication to my list: bupropion (aka Wellbutrin). I've made some progress with the sertraline and trazodone, but I'm still having depression and PTSD issues. I feel a bit better since I found out I did pretty well last semester, but in general I'm still feeling a bit down and a bit anxious. There's an inventory that the VA has you fill out that asks the same questions every time you go to an appointment-- the score of that inventory is a measure of how you're feeling overall. My scores have remained fairly high (lower is better) and so bupropion was prescribed as an addition to my other meds, rather than starting something completely new.
In my wallet, I keep a card with my psychiatrist's number, my clinic's number, and a list of the meds (and doses) I'm taking-- and a note that says I'm a veteran with PTSD. While I don't expect to end up in a situation where someone has to look in my wallet to figure out what to do with me, you never know what might happen. I've already updated my card with the new information. (I've considered having it all stamped on dog tags.)
My doc also put in a referral for one-on-one therapy with another psychiatrist. I requested the additional therapy, and since the cognitive PTSD therapy worked very well for me, my doc agreed that more psychotherapy would be a good idea. That means I'll be reassigned to a team at the main VA hospital, and a new psychiatrist and primary care provider. As my current doc explained, patients are now being assigned to a team rather than a clinic or just being thrown into an appointment pool. As a patient, I'll have one team of providers. My providers will also be able to share information about me, so I won't have to explain my entire life every time I see a doc or a nurse.
Side note: Everything from the meds and doses, to appointments, to getting back into therapy, has been a cooperative effort between me, my doc, and the clinic (and hospital) staff. No one has ever said "You have to...". If you've never been in therapy or on meds, it probably seems like the whole plan is laid out for you-- I think that's because the providers at the VA are used to dealing with vets, and they have some courses of action in mind that work for most vets. Every decision has always been subject to my approval, though. It's okay to ask questions.