Telling someone in "authority " feel suicidal as one last shot or accept have made my mind up and cannot be helped?

[ladolcemorte]

Then got into a dead end argument, via the medium of an emotional/logical brain diagram (of course! ) about how my suicidal thoughts were emotional. Obviously I think, and believe, that they are the end stage of logical reasoning. Think the chilled, hippy vibe coming my way started to slip then...

Was it the "wise mind" diagram with the overlapping circles???? It seems to be all the rage these days. I hate that diagram. It's like, no, you don't understand...the pain is so great, suicide SEEMS logical. I wish it didn't, which is why I'm here, but I can't just switch it off.....It's like telling someone who is anorexic to just eat.
[QUOTE="AtomicNewt, post: 384893, member: 8372"

It's all been terribly draining, even by my low standards, so have been reading on here rather than posting, here's honestly given me some sanity and comfort, but it will be interesting to see how meeting an actual head Dr goes. She sounded a slightly aloof and perhaps lacking a bit of bedside manner as it were, but perhaps otherwise they seem saccharine and patronising?

Who knows! Any tips on shrinks? All the MH professionals seem incredulous that I've managed nearly decade and a half without contact, haha.
[/QUOTE]


At this point I have spoken to more psychiatrists than I can count, and bottom line: they are human beings and run the gamut. Some were absolute assholes. Just...no other way to put it....assholes who said shitty, dismissive things and made me feel worse. (I really should have made a complaint to the college of physicians and surgeons about two of them...but in the state I was in I didn't have the energy). A handful were extraordinarily personable and empathetic. The rest were somewhere in between.

My advice is this: if the shrink is not helpful to you, ask if you can see a different one. I have heard people say that you have to be your own advocate in the healthcare system, and I think that is true, especially when it comes to mental health. If the diagnosis doesn't seem to fit, or if the drugs aren't working, or something else in treatment isn't working, say so. I wonder, in hindsight, if I could have gotten better years ago if I had spoken up about a few things.

 

[AtomicNewt]

What does anyone make of this? Got this from the shrink I saw on Monday. Gods knows what went to the gp...



Apart from anything else, not sure I agreed to or with anything! But then wtf do I know

 

[ladolcemorte]

Well at least they told you what they thought. "Emotionally unstable personality disorder" is an alternate name for "borderline personality disorder". a common diagnosis for women who are suicidal. (even more common for women who have experienced trauma). The language of "difficulties" that "fit best into" the personality disorder is vague. Either you have the disorder or you don't, and if they haven't done a thorough enough assessment to know for sure, or if you have symptoms that approximate the criteria but don't fit neatly in the box, then they should say so.

They might be saying that you need to get treatment for the trauma/personality disorder because treating the depression alone isn't enough. (You might get out of the depression through drugs alone but it could come back if you haven't dealt with the trauma). I would say ask them. Too often mental health clinicians are let off the hook because people suffering from mental health problems are embarrassed to be there in the first place and don't have the confidence to ask for clarification.

Did they give you any other referrals aside from the drugs?

 

[SinisterKid]

I take 30mg Mirtazapine at night and its the only thing that keeps me remotely close to sane. Before I started with it, I barely slept. Now it knocks me out cold for a good few hours.

I think you already knew about the other part. Not sure about the label, but I seem to remember you writing about past events putting you where you are now? But my memory is shit, so I could be well wide of the mark there.

 

[ladolcemorte]

What does anyone make of this? Got this from the shrink I saw on Monday. Gods knows what went to the gp...

View attachment 14935

Apart from anything else, not sure I agreed to or with anything! But then wtf do I know

Oh wait....I assumed the "we" was referring to two clinicians (maybe a shrink and a resident or something)....now that I read your post again,it looks like you are saying the "we" is you and the dr. I find it odd for a doctor to document a patient's agreement with a diagnosis. But just today I received a document stating "agrees with diagnosis"....so maybe it is a new trend in medical documentation ......maybe they figure it somehow insulates against a lawsuit? Like if you sue for negligence and the response is "well you agreed with everything when it was convenient for you"??? Or maybe it is some attempt at a patient centred approach or something....

 

[AtomicNewt]

Oh wait....I assumed the "we" was referring to two clinicians (maybe a shrink and a resident or something)....now that I read your post again,it looks like you are saying the "we" is you and the dr. I find it odd for a doctor to document a patient's agreement with a diagnosis. But just today I received a document stating "agrees with diagnosis"....so maybe it is a new trend in medical documentation ......maybe they figure it somehow insulates against a lawsuit? Like if you sue for negligence and the response is "well you agreed with everything when it was convenient for you"??? Or maybe it is some attempt at a patient centred approach or something....

It does seem a bit odd doesn't it? Might be a touch on the suspicious side with these things but can't imagine it bodes well for us as patients? Keep thinking patient centered my arse. Are we just diagnosing ourselves now? I'm fairly fucked at the moment, to use a technical term - is this an actual diagnosis? It just seems overly vague. Do you mind me asking how yours was? Will I be able to use this to convey some idea to people why I've spent such an enormous amount of time isolated and had to drop out of uni? Will anyone take this at all seriously? Arrrrgh! So many questions and the answers seem so dubious! Though I'd definitely be more up for my role as co-clinician if I get the script book. And the salary.

Oh and more vagueness in suggesting some sort of possible psychological therapies. Which so far have just made things worse. Somehow doesn't seem serious or bothered. I don't know, angsty and tired of this already...

I take 30mg Mirtazapine at night and its the only thing that keeps me remotely close to sane. Before I started with it, I barely slept. Now it knocks me out cold for a good few hours.

I think you already knew about the other part. Not sure about the label, but I seem to remember you writing about past events putting you where you are now? But my memory is shit, so I could be well wide of the mark there.

Well might give the drugs a go then, if only because I'm exhausted with being conscious, in a completely boring way! You never know kid, perhaps being sane is boring and overrated too x

Just realised this thread is mostly me rambling and rambling, but getting advice here and being able to offload without feeling utterly misunderstood is both priceless and actually useful.

 

[ladolcemorte]

I
Do you mind me asking how yours was? Will I be able to use this to convey some idea to people why I've spent such an enormous amount of time isolated and had to drop out of uni? Will anyone take this at all seriously? Arrrrgh! So many questions and the answers seem so dubious! Though I'd definitely be more up for my role as co-clinician if I get the script book. And the salary.

Oh and more vagueness in suggesting some sort of possible psychological therapies. Which so far have just made things worse. Somehow doesn't seem serious or bothered. I don't know, angsty and tired of this already...

Well might give the drugs a go then, if only because I'm exhausted with being conscious, in a completely boring way! You never know kid, perhaps being sane is boring and overrated too x

Just realised this thread is mostly me rambling and rambling, but getting advice here and being able to offload without feeling utterly misunderstood is both priceless and actually useful.

Okay, so, originally my diagnosis was borderline personality disorder. I had to reduce my course load in university to accommodate an intense treatment program of individual and group therapy. I gave the school a note saying I had a medical condition that required me to reduce my courseload. I also gave notes to defer exams for brief hospitalizations after suicide attempts/episodes. The school always accommodated me. The notes never referred to a diagnosis. Just "unable to write exam for medical reasons".

The treatment I did helped, but only to a certain point. I always thought there was more going on than had been diagnosed but I didn't question it.

Over the years I have had to take significant time off work on multiple occasions. The notes did not mention a diagnosis. Just "unable to work for medical reasons". Of course, the notes were written by psychiatrists, so anyone paying attention would figure out that it was a mental health issue.

As for my diagnosis, over the years it kept shifting: some Docs thought major depressive disorder with anxiety as well....one said major depressive disorder with "borderline traits". One said generalized anxiety....one said adhd and depression....I also got "eating disorder not otherwise specified" several times. (Fuck, I can't even get a specific eating disorder).

Last year I finally saw a good dr in the hospital who concluded it was bipolar 2, not borderline. Bipolar 2 and adhd. My outpatient shrink agreed. Now I am in the hospital again. I requested a transfer to the hospital with the really good dr I had before and I got the transfer. He is standing by the bipolar 2 and adhd, but they are doing all this testing (it is exhausting) to see whether or not there may also be a personality disorder/ eating disorder. So I guess we will see....

As for whether anyone takes it seriously, well, it depends on who is asking.....we pay lip service to mental health this day in age, but it is still taboo. And a lot of people still don't get it. Having said that, I have always gotten the time off work or disability/medical insurance when I have needed it. I have had a handful of friends who have stood by, and really cared through it all. I have had other friends who have distanced themselves or disappeared. I expect some of them were fair weather friends who would not have shown up for any difficult time....but I cant help but wonder if some of them would have parked themselves beside my hospital bed for days if I were in here with a broken leg. Of course, I will never know and it doesn't matter. I'd rather not have people like that in my life anyway.

I'm willing to bet that more people will readily understand depression as opposed to a personality disorder (and btw even clinicians will more readily understand depression...there are a lot of misconceptions about borderline personality disorder, and those misconceptions haven't been cleared up because there just hasn't been enough research on it yet). You could always refer simply to the depression, and that isn't disingenuous. You were diagnosed with it and prescribed an antidepressant. There is no drug for personality disorders. (Which is why there isn't as much research...big pharmaceutical companies aren't interested in paying for studies.). I think if you focus on the depression, you can communicate your suffering with less risk of an invalidating reaction. But still no guarantee that people will empathize. It's still an "invisible illness", so people have trouble understanding how debilitating it is.

I think you are doing the right thing in trying the drugs. I too have gotten the "tired of this" reaction from clinicians in the past. (I feel like saying "I'm sorry, is my intolerable suffering inconveniencing you"? Or "oh my, I'm so sorry to have been so impolite. I shall immediately cease feeling suicidal to avoid burdening you...even though this is your JOB")

 

[paul29]

I have run the gamut of psychiatrists, from the chairman emeritus of a major university's psychiatry department, all the way down to an imbecile whose medical license was eventually revoked for malpractice specifically on the basis of my case*, and some two dozen others in between.

Degala Venkata Krishnaprasad - Physician Information

Across the lot of them, there have been exactly three who didn't make me worse. They didn't directly help me, but they did help stabilize me until I could find my own way out.

Even with a "good" psychiatrist, it's still hit-or-miss. I've twice had the experience of having a psychiatrist look at my case, make a snap judgement on what I "need", adopt a ridiculously unhelpful approach to my case on the basis of that snap judgement, only to later realize and acknowledge the error. And that's with a good one. Lesser ones would simply brand the worsening patent as borderline and wash their hands of him.

You really have to doctor-shop on your own to avoid the bad ones. Unfortunately, for most people, this is impossible. Here in Ontario, I would strongly recommend Markham-Stouffville Hospital - IMO, the finest mental health care hospital in the world - and, failing that, CAMH Toronto - the purest of psychiatric prison buildings, but a place where the staff know what they're doing. I also know the places to avoid at all costs. If you live here or have the ability to travel here, I can offer specific advice. Otherwise, unfortunately, you might have to develop local experience on your own, however painful that may be.

 

[oopswronglife]

Who knows! Any tips on shrinks? All the MH professionals seem incredulous that I've managed nearly decade and a half without contact, haha.

Sorry I missed this. Been some bad days that aren't over but wanted to check up on you.

What I have learned is to take the good from what they offer, whilst making them believe you are buying into all of it. If you push back or upset their egos, like most people, they will react. Since they are in a position of authority is rarely goes well for you. Now that's not saying you might not end up with an actually enlightened person (as far as one can be) and truly believe and feel good about them, but even the shit ones, just play the game and glean what you can. I know you feel like breathing techniques etc are bollocks but honestly those little things are the most useful things you get out of psychology. The tools that allow you to reframe and try not to be so reactive. Psychiatrists are a different animal as pills is their game. If you think you can benefit from those there isn't much wrong with short term medication to get you going. The problem with them comes when you have to have them for years and years to function and the side effects are not nice.

Don't be afraid to "kindly" stand up for yourself if you feel its not working. Ask for someone else that might be a better fit. This will often ruffle egos but if you remain cool about it they will have a hard time doing anything about it. If you don't feel safe with them, and believe they are reasonable, it's all a waste of your time.

Personality disorders seem mostly like bullshit catch alls they like to use. Even most people with BPD diagnoses vaguely meet the already questionable criteria. They seem very unwilling to say "I dont know" or "you are a normal person reacting normally to a shit life" etc. They need to label it to feel smart and in control and that results in a lot of dubious diagnoses. Don't get too worried about the words they use to feel more right. Focus on the therapy and work there. If the meds make you feel WORSE after giving them a little time to get into your system, make that known too. They cannot shove them down your throat if you aren't sectioned. My personal view is meds are only useful for crisis things like an all out panic attack, short term antidepressants to get you out of bed and moving etc. Long term psych meds only make sense for people with serious, primary psych issues like schizophrenia, but since its all Pych MDs have its all they do.

 

[ladolcemorte]

I have run the gamut of psychiatrists, from the chairman emeritus of a major university's psychiatry department, all the way down to an imbecile whose medical license was eventually revoked for malpractice specifically on the basis of my case*, and some two dozen others in between.

Degala Venkata Krishnaprasad - Physician Information

Across the lot of them, there have been exactly three who didn't make me worse. They didn't directly help me, but they did help stabilize me until I could find my own way out.

Even with a "good" psychiatrist, it's still hit-or-miss. I've twice had the experience of having a psychiatrist look at my case, make a snap judgement on what I "need", adopt a ridiculously unhelpful approach to my case on the basis of that snap judgement, only to later realize and acknowledge the error. And that's with a good one. Lesser ones would simply brand the worsening patent as borderline and wash their hands of him.

You really have to doctor-shop on your own to avoid the bad ones. Unfortunately, for most people, this is impossible. Here in Ontario, I would strongly recommend Markham-Stouffville Hospital - IMO, the finest mental health care hospital in the world - and, failing that, CAMH Toronto - the purest of psychiatric prison buildings, but a place where the staff know what they're doing. I also know the places to avoid at all costs. If you live here or have the ability to travel here, I can offer specific advice. Otherwise, unfortunately, ĺĺ you might have to develop local experience on your own, however painful that may be.

Sorry I missed this. Been some bad days that aren't over but wanted to check up on you.

What I have learned is to take the good from what they offer, whilst making them believe you are buying into all of it. If you push back or upset their egos, like most people, they will react. Since they are in a position of authority is rarely goes well for you. Now that's not saying you might not end up with an actually enlightened person (as far as one can be) and truly believe and feel good about them, but even the shit ones, just play the game and glean what you can. I know you feel like breathing techniques etc are bollocks but honestly those little things are the most useful things you get out of psychology. The tools that allow you to reframe and try not to be so reactive. Psychiatrists are a different animal as pills is their game. If you think you can benefit from those there isn't much wrong with short term medication to get you going. The problem with them comes when you have to have them for years and years to function and the side effects are not nice.

Don't be afraid to "kindly" stand up for yourself if you feel its not working. Ask for someone else that might be a better fit. This will often ruffle egos but if you remain cool about it they will have a hard time doing anything about it. If you don't feel safe with them, and believe they are reasonable, it's all a waste of your time.

Personality disorders seem mostly like bullshit catch alls they like to use. Even most people with BPD diagnoses vaguely meet the already questionable criteria. They seem very unwilling to say "I dont know" or "you are a normal person reacting normally to a shit life" etc. They need to label it to feel smart and in control and that results in a lot of dubious diagnoses. Don't get too worried about the words they use to feel more right. Focus on the therapy and work there. If the meds make you feel WORSE after giving them a little time to get into your system, make that known too. They cannot shove them down your throat if you aren't sectioned. My personal view is meds are only useful for crisis things like an all out panic attack, short term antidepressants to get you out of bed and moving etc. Long term psych meds only make sense for people with serious, primary psych issues like schizophrenia, but since its all Pych MDs have its all they do.

Very thorough and articulate response.

 

[Ruffian]

Yup. Been thinking about how much of a "coincidence" it was that becoming actively suicidal occurred at the same time I was having cbt. Oh sure I addressed my thoughts, but the conclusion was that I really needed to end my life, that it was the sensible option and not to shy away from it.

Perhaps not what they intended. So perhaps the therapists should approach with a little more caution at times. Think perhaps I always was at the point of needing to end my life and just needed to have a light shone on what was there already. Which cbt seemed to provide. Cbt to Ctb. Not sure it'll make a good campaign poster.

And one last perhaps, perhaps people shouldn't ask another person to unpack a mental box if they have no idea how to put it back again...

Do feel that I need to add it does work for some people! My closest friend was diagnosed with bpd and she credited it with saving her life. Just feel that there needs to be discussion around how it's not going to work for everyone and that the people administering it need to be aware there are dangers too...

I feel like drink more water, cbt, and mindfulness are the answer to everything. Anything where a professional doesn't actually have to work.

 

[paul29]

If you push back or upset their egos, like most people, they will react. Since they are in a position of authority is rarely goes well for you.

They seem very unwilling to say "I dont know" or "you are a normal person reacting normally to a shit life" etc. They need to label it to feel smart and in control and that results in a lot of dubious diagnoses.

This is correct.

You might be interested in the work of Dr. Gregg Henriques - he is one of the few who gets it. I emailed him a couple years ago; he couldn't treat me from a distance, obviously, but he was as generous with his time as anyone could be.

10 Lessons I Learned From Studying Suicidal Behavior

The key lessons I learned from a treatment study on suicidal behavior.

www.psychologytoday.com

Also, from a sufferer's perspective, Johann Hari's book Lost Connections:
Amazon product ASIN 163286830X
Unlike most of the chit chat that's out there, these people actually speak in our voice.

 

[oopswronglife]

How's it going Newt? Any progress or cool new coloring book activities to report?