Doctors Lounge - Psychiatry Answers
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Forum Name: Psychiatric Topics
|helen20 - Sun Jul 22, 2007 3:18 pm|
Hi im a 20 year old female. i was sexually abused from 9 to 15. ive been diagnosed with depression with anxirty and have started to take effexor 75mg once a day. i still feel lonley and get urges to hurt myself, sumtimes i can get over these other times i jst want to be locked up and someone to make me beter. I see a psycotherpaist but i just don't feel like it helps when i really feel bad, i have no one to talk to when i get thee urges, and when i cant get them out of my head i hurt myself, I want to be like my other 20 year old friends who can go out and have boyfriends. I cant have a boyfriend i feel scared of males that they are going to hurt me again.
I want these urges to go away,i want to be normal. somethimes i wish i could be sectioned and then someone would take care of me. Im a university student studying nursing in the Uk, and shouldnt be feeling like this. I feel like giving up, i need some hope, wish someone would tell me its going to be ok. I shoudlnt of made him hurt me when i was younger and now i would be normal like my friends and have a boyfried. i just cant
someone please give me some hope
|Harsiese - Sun Jul 22, 2007 4:00 pm|
Hello there Helen20, i am 39 years old and i recently started taking the Effexor XR 150mg seven weeks ago and life is starting to look a little better for me. i was severely depressed for quite some time because of health issues, some bad anxiety and phobias.
Give your meds time to work things will get better with time.
Trust is a hard thing to gain but you got to know we are not all like that, i have Never hit a women in my life not even my own sister. Please if you get into a relationship and someone hits you, call the police have him charged and Leave him and never look back.
Harsiese a friend from Canada :)
|Dr. K. Eisele - Mon Jul 23, 2007 12:38 am|
I'm so sorry that you are suffering so much. I don't understand why you say you "shouldn't have made him hurt you." There is no way that you deserved to be treated badly. You were sexually abused from age 9 through age 15. Little girls are not for sex!
I was just telling someone today that reality is not always what we would like it to be. Sometimes we do not get to choose reality, it is imposed upon us. You have very good reasons to feel the way that you do, Helen. On the other hand, I do believe that each of us has the ability to change our reality into what we do choose.
Helen, I want you to stand up and say to yourself, everyday, "These things happened to me in the past, but I can do anything I choose to do today and in the future." I want you to empower yourself to move through and beyond your past.
You mentioned wanting to be normal. I would like to know what is normal, and who gets to define it. Is normal whatever happens to be fashionable? Is it what your parents want you to do? Is it whatever the majority of people are doing? I can cite many instances in which those situations were definitely not normal.
Give your medicines time to work, Helen. Antidepressants take up to six weeks to have full effect. You should experience some improvement within the next few weeks, however. If you don't begin to feel better soon, then you should call your doctor. You may need a higher dose, and you probably will. Don't simply quit taking the medicine.
You are who you are only partly because of where you came from and what you went through. You are who you are also because of your personality and temperament. Use your past experiences sparingly, along with your personality and temperament to overcome. Let the past help you now to become stronger, to help others who might also be in such situations, and to grow from.
Please keep in touch. You can do this!
|Dr. Chan Lowe - Mon Jul 23, 2007 2:02 am|
I was just reading through your posts and wanted to reiterate what Dr. Eisele had said. You did not deserve to have this happen to you and it certainly was not your fault that it did.
Often people who have been victimized will blame themselves. It is important to understand that this was not because of something you did. It was not a "payback" you deserved. Nothing you could have done would have made you deserving of being abused.
Try to find someone that you really trust to talk to and take it slow. Healing from these things is rarely overnight but you can keep making progress and eventually you'll be able to look back and realize how much improvement you've made.
Best wishes. I completely agree with Dr. Eisele that you can get through this.
|helen20 - Mon Jul 23, 2007 6:48 am|
Thank you for your replies. I feel down also because of self harm scars, i havent self harmed since March but the scars are getting me down, my doc sed that they wont fade. I cant go on with such scars, my understanding is that they would fade.
i feel so stupid and i want to be over it all. The effexor is making me restless at night,not able to sleep, and i have now developed pins and needles in my thumb.
i feel like im going through it all on my own as parents are unawareandcant be aware. i cant keep making excuses for the scars, i wish they would just go away.
|helen20 - Mon Jul 23, 2007 10:07 am|
my doc has also said about swapping from a psycotherapist to a psychiatrist. whats the difference between them both?its taken so long for me to start to talk to who im seeing at the moment and seeing a psychiatrist is going to make me feel even more madder :(
|Dr. K. Eisele - Tue Jul 24, 2007 12:14 am|
A psychologist is someone who went to college and earned a degree in either social work or psychology. Depending upon where you are and the licensing rules, a therapist will be either a Master's degree level or a Ph.D. level.
I am a psychiatrist. To be a psychiatrist, you go to medical school and learn medicine just like every other doctor. The difference between a psychiatrist and a family doctor, for example, is that we spend lots of time learning about the psychiatric medications, how to read someone's affect and nonverbal communication, and the biology of psychiatric illness. We do learn about general medicine, but not to a great extent. Psychiatrists must know about the "somatic"* disease states in general, how they react with psychiatric illnesses, and how the medications that treat somatic illnesses can interact with medicines that treat psychiatric illnesses. Also, medicines for the somatic illnesses can sometimes cause what may appear to be a psychiatric illness, as an adverse effect.
Personally, I think that people with very serious psychiatric problems should be treated by a psychiatrist rather than their family doctor. A psychologist should be consulted when medication is not enough and the illness is severe enough to require someone who is an expert at psychotherapy (such as a psychologist).
For the type of illness you have, I think a therapist and a psychiatrist should be working with you.
*somatic = purely physical
|helen20 - Mon Jul 30, 2007 3:18 pm|
Hi, i feel so down, ive been back to the doctors as i am not sleeping at all but so tired. She has prescribed me some Zopiclone 3.5mg 1-2 tablets at night. Again they arent working. Im due to have 2 weeks off from seeing my psycotherapist as she is going on holiday. I don't know how i am going to cope, i don't want to see anyone else.
I have tried Citalipram, Fluoxitine before but with no effect, im worried that the effexor will be the same and im just getting these horrble side effects.
Im diagnosed with depression and anxiety but im worried that there is something else wrong with me. im getting these urges to hurt myself when im alone and having visions of me wanting to crash my car or something like that, not to die but to be cared for and have attention. this sounds so so mad.
Do you think there is something else apart from depression? can you recommed any other tablets that may not have such horrible side effects.
Thanks doc for your replies, they have really helped. Please can you just help me out with this??
|Dr. K. Eisele - Tue Jul 31, 2007 10:10 pm|
Please don't give up!! While your therapist is gone on holiday, there should be someone filling in. I know it's not the same as talking to your own therapist, but if you are in crisis, then you need to call. Think about it like this: when you are in crisis and thinking about self-harm, then you haven't got anything to lose by calling whoever is filling in for your therapist. Another thing to consider is that you are able to talk to "us" here in the forum. Isn't that somewhat similar to talking to an unfamiliar therapist?
The alternative thing to do, would be to go to the emergency room. If you decide to do that, please tell them about your thoughts of harming yourself.
About your sleep problem. Have you ever tried a simple glass of warm milk? This is a natural sleep aid. Try taking your Zoplicone with a warm glass of milk.
You mentioned that you have thoughts about hurting yourself, not to die, but to be taken care of. This does not sound as bad as you think it does. I'm relieved that you're not thinking of dying. At some time, everyone needs to be taken care of. I realize that you feel all alone, with no one to take care of you, and I understand how that feels. I want you to try something new that most people don't think of:
Inside you, pardon the cliche, is a scared child.
Hold her and protect her--it is what she needs.
Finally, Helen, you also must know that people who harm themselves because they need taking care of do die, accidentally. This is a dangerous game.
Please don't give up. Get help before it's too late.
|helen20 - Sat Aug 18, 2007 11:43 am|
HI, its me again. the Effexor seemed to be working in the end and have just got 2 months more supply. the side effects have all gone too. But now i don't feel like it is working anymore, feel as bad as i did before, why isnt it working? im drinking heavily when i go out clubbing, and last night got very drunk and became aggressive towards a male. when im sober i would never talk to a male never mind start pushing and shouting at one. i don't know what is happening to me. why has the effexor stopped working and why was i so aggressive when i drank?
I thought things were looking up and i felt alot better but now its gone bad again. i don't want to take effexor anymore as its not working, but i don't want to keep going to my doctor, i feel like i live there at the moment and don't want to be seen as a hypoconderac.
thanks DR K for your replies
|helen20 - Sun Aug 19, 2007 11:09 am|
sorry i said DR K and i meant DR E.
|Dr. K. Eisele - Sun Aug 19, 2007 6:25 pm|
Don't give up! There could be many reasons why the antidepressant didn't work. It could be that it wasn't dose high enough. It could be that you weren't on a high enough dose for a long enough period of time.
Alcohol has a tendency to disinhibit people. Think about how you feel about men. Usually (when you're not drunk), you tend to be frightened of them. Often, people who have been abused like you were hate the type of people who abused them. In your case, this means men. The alcohol is taking away the layer of fear that you normally have when not intoxicated and possibly, your true feelings are showing.
The emotions, though, that have developed during your childhood and out of an extreme emotion, are not necessarily rational. For example, hating all men instead of just the one who abused you is not entirely rational. Of course, you need to be careful that you don't put yourself in an abusive situation again, which means that you don't automatically trust everyone. Notice that this is different from hate.
You would be justified to hate your attacker. After all, look at what he has put you through. Even now, this man is still having a very negative impact on your life. You can refuse to allow him to have control of you any longer. It is difficult journey that takes patience, a good therapist, and the right medicine.
Being open with your physician about adverse effects and the effectiveness of the medicine is one of your main responsibilities right now. Your other responsibilities include complete disclosure to your therapist and keeping yourself safe.
Even though it feels that you practically live at the doctor's office, it tells me that you are trying to overcome. I can't imagine that anyone would think that you are a hypochondriac simply because you are trying so hard to get better. If anyone says that to you then they aren't really helping and can't because they don't understand the nature of your problem.
I hope you are seeing a psychiatrist and not just a family doctor. A competent psychiatrist would not see you that way at all.
Good luck, and please do come back to let us know how you are.
|helen20 - Sun Aug 26, 2007 12:49 pm|
how many effexor 75mg would it take to overdose? what would happen? side effects? long term damage??
|Dr. K. Eisele - Mon Aug 27, 2007 1:52 am|
Can I ask why it is you want to know? If you are thinking about committing or attempting suicide, I won't be a party to it.
I want to help you, Helen, and the only thing I can really tell you right now is that it isn't the way to handle your situation. I want you to try to remember something:
Suicide is a permanent solution to a temporary problem.
There is absolutely no reason why your problem is permanent. You can do this!! Please do not harm yourself. Call your physician, your therapist, whoever you regard as your main support person. Go to the emergency room, or call 911.
DO NOT HARM YOURSELF!! You may think no one cares aboiut you, or you may be thinking that you'll never be well. Neither of those are true. Depression is a terrible disorder that causes you to lie to yourself and believe the lies. No decisions should be made while you are depressed that you would not make if you were not depressed. If that sounds funny, then you may also be surprised to learn that depression is treatable.
|helen20 - Wed Sep 05, 2007 6:43 am|
Ive been to the doctors yet again, didnt see my usual one as she is fully booked for the next 1and a half weeks. the doctotr who i saw said that she couldnt give me anyother anti-depressents and ive got to have a psychiatrist referal. I feel like i was made to say yes that i was ok with it. the dr wont increase my dose. but my other doctor who i normally see said that i probley will have to have it increased. im so confused. can my doctor increase my effexor with out a psychiatrist refferal as one doc is saying yes and the other no. i got reffered to see a psyciatrist last year but did not attend as the person was male. i don't want to be talking to a male, and don't think i could make that any clearer. i now feel like the doctor has given up on me now. the effexor is not working as much as it was. i don't want to looose contact with my psycotherapist as its taken so long to trust her.
please any advice
im going to beg for an appt with my usual doctor tommorow.
thanks for all your help so far, really helped me
|helen20 - Wed Sep 05, 2007 9:49 am|
spoke to my doctor on the phone, she said to upt my tablets to 150mg and see her in 2 weeks today.
|Dr. K. Eisele - Thu Sep 06, 2007 11:58 pm|
I'm not sure, but I think the "doctor" you saw was a psychotherapist, like your usual therapist. Is that maybe what happened?
This might explain the whole thing. In the field of mental healthcare there are many, many different roles. Some providers, like myself, are psychiatrists, meaning we are physicians, and can write prescriptions, authorize a dosage change, etc. Some providers are psychologists who are not physicians, and in almost all states*, do not write prescriptions or authorize dosages changes--their role is counseling, not medicine. Some psychiatrists do both counseling and medications. In nearly every state in the US,* psychologists don't do medicine, they counsel.
If you are still taking less than 225 mg daily of Effexor, then you most likely do ned an increase in your dose. The known effective dosing range is 75 mg up to 225 mg daily.
Hang in there, Helen. You CAN do this. It might be worthwhile to call whoever prescribed the medicine and ask that doctor to increase the dosage.
*In a few states, psychologists do have the ability to legally write prescriptions for medicines used to treat mental illness.
|helen20 - Sun Sep 09, 2007 3:09 pm|
the person that i spoke to was my own doctor who increased my dose to 150mg. actually feeling calmer now, don't no if its the tablets or fate.
im embarrased to talk to my therapist about one issue - im 20 and i still suck my thumb at home, most time i don't realise other times i crave for it. could my past be related to my sucking my thumb till now or is it a habit i cant break? i have tried foul tasting thumb pastes, putting a plaster on it, wearing a ring, all of which don't work. ive now developed jaw clicking and locking which is related to my thumb sucking. but im embarassed to admit that i do it.
thank you for your reply, wouldnt of got this far without the great advice. thank you
|Dr. K. Eisele - Sun Sep 09, 2007 7:48 pm|
I'm so glad to hear you're feeling calmer!
Don't be afraid to tell your therapist about thumb-sucking. It is probably because of your past and the nurturing that you feel you need. It is also a habit most likely. I think for right now, while you are still in "the thick of everything" it is not so important to break the habit. I think it is probably a relatively small problem. At any rate, this information while likely be very helpful for your therapist to know. Trusting your therapist is all about telling her everything.
|helen20 - Thu Sep 27, 2007 1:17 pm|
ive been 4 days off the effexor 150mg, just stopped and don't feel any different. don't think they were working anyway. seeing my psycotherapst 2moro and goin to tell her ive stopped takin them and don't see a point in seeing her anymore either, its not helping.
try to keep tablets, prescritions and going to therapy away from my parents is hard, and now my diary has 'disapperared'. not sure where it has gone but im sure my parents have taken it.
is it ok to have no withdrawel symptoms?
i don't think anything is going to help me, ive tired andnow i give up
|Dr. K. Eisele - Sun Sep 30, 2007 3:43 pm|
Please don't give up!! Depression is a very serious, but treatable, disease.
There are many, many antidepressants that you haven't tried yet. You may also just need to try a different therapist. Many times people will try one therapist, find that it isn't helping, but more likely, the problem is that you just aren't "clicking" with that person. It's okay to shop around for one you feel comfortable with. You might try asking your doctor for another referral. It's okay to say that you just weren't comfortable with the other one, or that you just didn't feel that you were being helped. You can also stand up for yourself. I think you need to try other options before giving up.
Please don't give up.
|helen20 - Wed Oct 10, 2007 3:44 pm|
Dr E, ive posted on the antidepressant forum, please reply when u get the chance. im aware of how busy you must be. your advice has been brill for me and just want to get your professional opinion on what happend
|4PtSake - Mon Nov 12, 2007 5:57 am|
I can't really give you much advice on your situation...I'm having issues dealing with my own abuse as a child...but I have to agree with the Dr's when they say ending your life is a permanant solution to a temporary problem. You're way too young to end it. I felt suicidal frequently when I was way younger than you and I'm now 45. I wonder sometimes if it's been worth it but mostly I'm glad I've stuck around. It's hard but you have to try to find something that gives you hope whether that's a hobby, reading to get your mind off the negatives, journaling, going to church...anything constructive that helps even a little. Don't bury your feelings in booze or illegal drugs...it only makes it worse. I know that from experience.
As far as the thumb sucking I wouldn't worry about that at all. I sucked my thumb well into my 20's. When I was ready to stop I found ways of doing it that worked for me as you will...though I still do it in my sleep sometimes when I'm feeling really insecure and stressed. I see no reason to stop if it helps you cope with things right now.
I sincerely hope you have found a medication that works for you and you are doing better. Please don't give up. There are a million possibilities for things that will help and, though each step may be difficult, it will be worth it in time.
|helen20 - Sun Nov 18, 2007 3:25 pm|
Hi, thanks for your help 4ptsake.
im continuing with the psycotherapist, once a week and aint exactly brill.but im going. still not taking any meds, gp wants to refer me to a psychiatrist but refuse to go.
my psycotherapist keeps saying i am "detatched from my emotions". i no that i feel my emotions but don't/cant express them. when talking to her about the abuse she sed "i was still and didnt move, didnt maintain eye contact and didnt express any emotion"
ive sed to her i feel emotion and cant express it, then it will all build up and il selfharm badly.
what can detatched emotions mean? i really cant express emotions, i don't no how to. i feel them on a very small scale, then one day something will happend and boom i self harm.
my psycotherapist is on holiday 4 3 weeks and i want to see why i cant express my emotions and cant really feel them until they all build up and cum out in one?
please reply as soon as u can
|Dr. K. Eisele - Sun Nov 18, 2007 4:04 pm|
Not expressing emotions, as you have learned, is a big problem, and it is called suppression, and in severe cases, repression, in which memory for the event is also "lost" to consciousness. This a defense mechanism that your mind has developed to protect you from emotions that you have been taught are unacceptable. A very effective non-pharmacological treatment is EMDR.
Why is it that you refuse to see a psychiatrist? For the severity of your illness, you would be much better served by seeing a psychiatrist.
Good luck to you!
|4PtSake - Mon Nov 19, 2007 3:12 pm|
I wish I had all the answers and could make it all go away but I can't. There are a lot of us out there who share a similar past but deal with it in very different ways.
All I can do is say I agree with Dr E and tell you that meds and counseling have helped me get where I am today. I still have bad days but not nearly as bad or as often as I used to.
I've been on several meds over the years and have been seeing the same counselor now for over 10 years. It's only been in the last year I've started feeling comfortable talking to her about the deeper feelings...the ones I could never express to anyone else. It takes time for those of us whose trust has been shattered to build trust again. In the end you have to decide you are worth it and find whatever help you need to help yourself.
I hated the idea of taking meds, and still do, but it can really help to even things out so you don't have the extreme lows where the world seems to be on your shoulders...where it builds to the point of wanting to harm yourself.
When I first started dealing with my past I ended up in a therapy group of people who had dealt with similar pasts...all women and mostly older than myself...and though I was hesitant at first and never spoke much it helped me realize I wasn't nearly as alone as I felt. Much of what they talked about rang true for me too even though our circumstances were all very different. If you can find a group in your area...your Dr might be able to help with that...it might be helpful to hear what other people are going thru and how they deal with it.
As for the EMDR that Dr E mentioned, I've been working with it with my counselor on and off for close to a year now and it really has lessoned the emotions surrounding the things that have happened to me. It doesn't make it go away but it can make it a great deal easier to manage and deal with.
Good luck to you, Helen, and remember YOU ARE WORTH TAKING CARE OF!!!! You didn't do anything wrong and you deserve to be happy and healthy.
|helen20 - Thu Nov 22, 2007 5:39 pm|
Hi and thank you both for your replies.
i see many 'factors' that are stoppin me from gettin more help
1) im a student nurse and my training would be terminated if i saw a psychiatrist as i wouldnt be mentally stable.
2)all psychiatrists in my area are males
3) my family are still totally unaware of everything
5)anti d's havent worked n ive been with my counsellor now for over a yr and at the point now of just mentioning the abuse
i kinda feel like i wanna get locked up and be able to just 'let go' and be me. wiv people who understand. i no sounds stupid.
ive tried anti-ds, fluoxitine, citalapram, effexor and sleeping tablets. effexor was abit more effective, but made me feel even more numb. i was like a robot.
at the moment i am just about going to work, i really have to force myself, thinking about leaving my training.
i feel like i want to carry on seeing my psycotherapist, just wish we werent sitting across the room from each other, sumtimes i feel like i need a hug or someone to hold me while i tlk about my past. i no she cant as its professional misconduct, but thats how i feel.
sometimes i wish i cud be sectioned and just let it all go, let all anger out my trashing a room etc.
hope to see my doc 2moro, due to see my psycotherapist too. can my dr force me to see a psychiatrist. and i no pyschiatrist can prescribe meds but how is the tlking bit different?
plus when im working on the ward and im dealing with my patients, i feel that i want to be them, i want to be ill and looked after, to be cared for and i suppose to have some attention. ive often thought about what it would be like if i was really poorly and needed emergancy care? even thought about faking an illness to be hospitalised, but havent actually done it as common sence sinks in.
du u think its only depression and anxiety i have? this diagnosis was made by my regular doctor who then reffered me to psycotherpist. is there naything obvious to you that i might have? i havent been this honest with anyone yet and wondered if anything stood out?
sorry for going on, thanks for your help
|Dr. K. Eisele - Sat Nov 24, 2007 8:16 pm|
In the US, your psychiatric history would not be allowed to hold you back, unless your psychiatric problem had interfered with your ability to perform the duties of your job, or was likely to do so. Men and women get treated for depression, anxiety, and other psychiatric problems commonly, and those of us who understand the nature of psychiatric problems, applaud them for doing so. At least they had the insight to go get help, which lowers the risk that they will be disabled by their illness at some time in the future.
Your physician cannot "force" you to see a psychiatrist, again though, this is the way it is in the US. Your physician may be able to put a lot of pressure on you, though, by refusing to prescribe your medications any longer. You seem to feel they don't work anyway, though, so maybe this would not be any loss.
You asked also about "talk therapy" with a psychiatrist. In the US, some psychiatrists do psychotherapy, but some do not. Even those who do offer that type of service would not insist you participate in such an activity when you already have a therapist you are established with. When you go to a psychiatrist, initially, an "admission interview" is done, in which you will need to tell the psychiatrist all your symptoms, and answer some questions designed to help you characterize any symptoms that seem vague to you.
Why is it that you cannot speak to your parents about this? You really need their support at this time. (I tried to go back to your previous posts to see if you said why this was, but my browser is sooooo slow today.)
You know, many people have said that pride is one of the seven deadly sins. It causes people to do irrational and sometimes, hateful things. You don't sound like someone who would do something hateful, so I'm wondering if you are really thinking this through. Please try to remember that not all males, or male relatives, or males of a certain age, body habitus, or profession are not the same one(s)(?) who abused you. Don't allow your pride to make decisions on your behalf. Forget about how you might appear to others--it truly doesn't matter. For example, what good does it do you to allow pride to determine what you can and can't do? What's really important in life is how you feel about yourself, because it affects every area of your life. Essentially, don't let pride cause you to do less than you can do. It would be a great shame in the grand scheme of things to deprive the world of a competent, compassionate nurse. That doesn't even cover whatever else you may do in the future, which may include becoming a wife and mother. Who knows? Your future child may be the medical genius who discovers the cure for AIDS, or cancer, or schizophrenia, etc. What I'm saying is that you don't know what your future holds, and if you don't approach it as healthily as you can, you're bound to not do as well as you could have.
As far as your diagnosis is concerned, I'm as sure as I can be over the internet, that you do have PTSD. The treatment for PTSD varies with severity and the type of symptoms the patient has. Sometimes PTSD looks and feels a lot like depression, and in those cases, would be treated with an antidepressant. Sometimes it looks and feels like anxiety, or even psychosis (not a true psychosis, as it involves illusions, rather than delusions or hallucinations). When the latter is the case, we do use antipsychotic medications, probably at a very low dose.
I wonder if your physician would simply consult with one of the psychiatrists in your area, since they are all male.
Please hang on. It isn't strange to me that you want to be cared for. You are going through a great stress which is difficult, even with the best of support systems.
|helen20 - Fri Dec 21, 2007 1:15 pm|
Hello.just needing abit of advice. spoke to my gp on phone today, said i had thoughts of OD,she said i could go to her surgery and she would admit me. ADMIT ME! i of corse i sed no no no way. im not going to kill myself i just said thoughts. she made me promise i wudnt do nethin silly and to see her on mon.
what is it like when ure admitted?
if i went voluntary could i discharge myself?
would it stop me being a nurse?
ive got an appt wiv gp on monday morning and scared shes going to send me to a looney bin. and my parents havent got a bloomin clue bout anything. im nearly qualified as a nurse and i am thinkin bout gettin admitted to a pysch ward?
help, advice pleaseeeeee
|Dr. K. Eisele - Wed Dec 26, 2007 1:49 am|
I don't know how things work where you are. Here in the States, a psychiatric hospitalization need not be disclosed UNLESS you have a psychiatric condition that could forseeably cause you to have difficulty performing the usual duties of your work. The rules are somewhat loosely interpreted, but the point is that someone with a psychotic illness who has a history of having been hospitalized would probably have to disclse such information, but would not necessarily be excluded because of it.
What is it like to be admitted? Again, that depends upon where you are. Here, psychiatric wards and hospitals are very different from ordinary hospitals. Patients where their own clothing and are busy with various activities, such as group therapy, recreational activities, etc. Whether are not you can request discharge, I think, is also location-dependent. In the US, if someone wants to be discharged from inpatient psychiatric care, they submit a request for discharge and then the treatment team has 3 days to complete their evaluation and decide whether or not hospitalization is necessary. At the end of the 3 days, if it is decided that the patient is a danger to himself or others, or is gravely disabled, and still wants to be discharged, then another process, called making a petition to the court. The patient would then be assigned an attorney, and your doctor would have to justify, to a judge, the reasons for denying the discharge request.
The judge makes a decision about the patient's ability to make competent decisions with regard to treatment of his psychiatric condition.
Hope this answers your questions!
|helen20 - Sun Mar 16, 2008 11:50 am|
im still the same, well maybe bit worse. ive hit a dead end wiv my psycotherapist. ive told her i cant tlk to her, well i cant get the words out or say how i feel - cos i don't no coz im numb. I took a piece of paper that had drawings of how i felt on them, she did look at it but then kind of gave it me back. i thought she would help me get through this in another way, like drawing etc. but hasnt.
is it normal to feel numb? i cant cry - sumtimes i want to but cant. how do i get this back?? ive asked my therapist but she never answers. is it normal?
im not taking any meds no either.
i also self harm, but it seems to be getting bit worse, like wanting to be cared for, like wanting to go to hospital and finding myself makin up stories to how i did this. then i sink bk to reality n im like how stupid was that. im running out of ideas now how to feel better
please help like u have done before
|Dr. K. Eisele - Sun Mar 16, 2008 7:00 pm|
I'm so sorry you're feeling worse now. I want to be perfectly frank with you about what I think you need. I think you need to go to the hospital and I think you need to be on medication. Even if you are not suicidal right this moment, you could be, at some time in the near future, such as in an hour or so--maybe not even that long.
I know you've been resistant to the idea of being admitted to a hospital. Sometimes, Helen, we need help, and it's okay to ask for and receive that help. You've said a few times that you want to be cared for; there's nothing wrong with that, and it's okay to ask for it. Sometimes people don't recognize such a simple request, though, and we have to speak to them in "their language."
For example, when an emergency department doc asks you, "Are you suicidal?", think about what he/she really wants to know. They want to know if you are indeed suicidal as a prevailing condition--not just at that very second. People who are considered suicidal often express a bit of ambivalence--I like to call this being on the fence--about whether they live or die. So, if you are suicidal most everyday and for a good portion of most everyday, then yes, you are suicidal.
Something I sense from you is a feeling of being desparate for some help. You've got a bright future ahead of you if you'll only just let someone help you, such as with inpatient treatment. You need antidepressant medication.
I also sense that you don't feel safe. That's another reason you need to go to the hospital. Put a name on that unsafe feeling--it's called suicidal thoughts. Tell them how the cutting keeps getting worse. People who cut themselves as way to relieve tension or to self-soothe do die, albeit usually by accident. They cut a little deeper than they meant to, they took more pills than they intended, etc.
Did you end up doing any EMDR therapy? I don't know if you're therapist is trained in EMDR, but I can't help thinking this could be good for you. Another thing about your therapist I'd like to point out is that sometimes when therapy seems to have "stalled out," it is because the patient has so much resistance to the current issue being worked out. You mentioned that you can't feel anything. This is a common defense mechanism. Many, many patients with PTSD and depression do feel numb because that is the only way they can stand to be; if they allowed themselves to feel they would "crash," meaning their emotions would be too much for them to live with. Most likely, all this numbing is going on just below the level of your consciousness. Sometimes feeling numb is a good thing, as long as it's only temporary. You might give some consideration to taking advantage of this emotional numbing, by beginning to really talk about your past trauma with your therapist if you haven't already done this. Sometimes this is the way to begin feeling again. Do not, however, attempt to do this without a therapist or psychiatrist present.
Helen, I wish you all the best, and please, do keep in touch.
|helen20 - Thu Jun 05, 2008 2:23 pm|
Well after a few months of not beng on here you'd think i ad got ma act together, well no. I have been on and off venlafaxine 150mg for months. My gp says shes stuck in a rutt with me and wants me to be refered to a psych. but it will effect me gettin a job as i qualify in a few weeks as a nurse.
One thing that is bugging me is when i treat pts. its the best feeling in the world, under pressure and bale to deliever the best possible care i can. But sumtimes i begin to wish that i was that pt and i was being admitted to hospital. Im not sure why i want this. the last thing i want is to be messed about with, especially by male docs. it kinda worries me sumtimes. i don't act upon this but it is in ma head sumtimes. then i start thinga bout sum kind o f psych problem i might have?]it would be ablot easier to undertand if i cudnt funstion in my environment, but i can - very well.
and stuff to do wiv school - im still tlkin 2 a psychotherapist. we do seem to be gettin a tiny tiny bit further than the last time i came here but not a great deal
U sed to go to hosp and get admitted. in Uk thats hard in itself unless u go private. Seeing a CPN is as far as u go really unless u r really reaaly bad and unable to function. cant have a CPN cuz ma parents don't no a thing, and don't need one becuase i function well at home and at work.
Ive stopped venlafaxine myself now for over a month. don't feel much different. have cried a few times over silly things but thats it.
i feel like im annoying my gp cuz i wont get reffered so what else can she do, ay?
the thing is the thought about wanting to be admitted to hospital or be hurt in sumway. maybe just im an attention seeker? prob describe it the best.
so bye drugs and Hello to trying to keep ma head above water wiv a bolder tied to ma feet! don't want to use drugs, venlofaxine messed me up, especailly wiv sex drive. and the symptomes other have sed on here i want to keep away from it.
do u think its really possible to do this without drugs and without being admitted to psych unit?
thanks for keep posting bk!
|Dr. K. Eisele - Sat Jun 07, 2008 4:17 pm|
It's good to hear from you again! Actually you sound about the most "put together" as I've heard you. If you don't feel any different now than you did on venlafaxine, then there's no reason to take it. If you are functioning well in both home and work, then that leaves social functioning. I think it's reasonable to approach that one problem with psychotherapy only.
|helen20 - Mon Aug 18, 2008 8:28 am|
I have eventually seen a psychiatrist. she was nasty and mean. she wouldnt listen to me but drove her ideas and opinions right into me. it was liek ure gona listen to my point of view and believe it. gotta go back end of august to see her again. she sed to start bk on the venlafaxibe at 37.5mg and then increase it slowly, so thats what my GP has been doin, im now takin 150mg in morning and 37.5 at night. how i feel........no different. ive told them i don't feel ne differnt and yet they still say carry on wiv them and see me again in 3-4 weeks and my doc is there if i need her. Tried to have a relationship and it hasnt worked, ive never felt more uncomfortable in my life and i don't wanna go through that again. My psycotherapist has given me loadza info sheets about the wise mind, the emotional mind and reasonable mind. all these worksheets are good on apaper but when its 4 in the morning and i want to hurt myself the last thing im gona do is read them. I told her this yet she still says they will work. One says about facing your fear not matter what it is again and again. my only fear at the moment is going to fa with the hurting myself so how does that work?
still feel like a lost cause. ive been working in the Emergancy dept at work recently and have had many suicidal/depressed people in seeking help. they get seen by the crisis team and sent home with a GP follow up. some i think r in a worse state than me. so i still don't think there is much point in going to the hospital as i will just get sent home again. well thats how it is in the UK anyway.
feel lost again. im on my own for another 2 weeks as everyone is on holiday. thats when the feelings are worse, i try to keep occupied but i cant 24/7 for 2 whole weeks solid.
its weired cos this is the only place that i feel like in understood and ca read other ppls questions etc
thank you and yet again sorry 4 wasting your time and reading this
|cal kid - Sun Aug 31, 2008 12:04 am|
Hi helen, I have been living with depression and anxiety for many years and nothing helped as much as a totaly life changing book that I read. It will help you find your own self worth and get to the bottom of why you feel the way that you do. Not just cover the symptoms with medication. Of course stay with your doctors advice and whatever meds. you have been prescribed. but I suggest you have a read. "The Power of Now" by Eckhart Tolle. You will be able to get back in touch with your true inner self and the pain that you feel from your past experience will lose it's power over you. The pain that you feel is not the real you. You are truly a beautiful person no matter what anyone says or what anyone has done to you. Accept the way that you feel as what is right now at this moment. It is as it is. If you accept the way that you feel then how can it hurt you any more. Fighting against the pain will only create more pain. You must yeild to overcome. Acceptance is the key. You are who you are right now. What happened in the past is exactly that, the past. It happened, it's gone now. Keeping it alive in your mind will only keep the pain alive. What happened then cannot affect who you are now in your true self unless you let it by keeping the past alive. Carpe Diem! (Seize the day) Life is what you make it and you can make it anything that you want it to be.
|helen20 - Fri Sep 26, 2008 4:40 am|
thanks for your response calkid. iwill get the book. been trying hard with my psycotherapist and psychiatrist but don't seem to be moving anywhere at the mo. even gone on to abusing laxatives. its like its getting worse than getting better :(
dr saw my s/h marks and said she was alarmed - well dur, i have been doing that alot worse for the past 2 years and yet when they are very superficial you become concerned.......?!
I am still taking effexor 150mg OD, and they don't work, im scared they are goin to make me even fatter and my doc wont let me stop them. she sez stop drinking alcohol when you go out and they we can see what the drinking is masking. if i COULD stop i WOULD stop drinking it. it just acts as a mask for me. and enables me to go out.
Dr E, are you still here?!
|Dr. K. Eisele - Tue Sep 30, 2008 11:26 pm|
Yes, I am still here. You have been able to function in the outside world at least superficially. The reason you can do this is because you have coping, or survival, skills. The problem is that these skills you have developed are maladaptive--meaning they are harmful to you in the long term--and they are addictive as well. Alcohol, cutting, burning, laxative abuse, whatever--all are just band-aids that get you through the moment. They leave behind scars, physical and emotional. What I am getting at here is that you have managed to get by, so far, although not very happily. You have said that you are afraid of losing everything you have worked so hard for. I can certainly understand that.
We all use various coping skills, some more healthy than others. The most well-adjusted person you meet likely sometimes uses maladaptive coping skills on occasion. These skills are like tools that keep close by to use when we are stressed or in a crisis. The problem is that sometimes those tools get bro-ken. Just like a broken wrench or a hammer that's lost its head, maladaptive coping skills can do more harm than good.
Many patients who engage in self-injury end up dying accidentally. They simply go too far with that broken tool. Instead of going out for a new tool, they keep using the old broken one and it does more damage. Continuing to go to your therapist and take your medication is like going out for a new tool.
I don't know if you've ever used positive imagery before. Try to imagine going to your therapist and REALLY engaging in therapy and taking your medication as a shopping trip. Think of this new tool as a brand new car, or whatever you might really want. Think about how hard you've worked to get where you are today, and think about what more you might need to achieve your goal.
Good luck to you, Helen.
|kazza26 - Sat Oct 04, 2008 8:12 am|
can i say something as a person who has suffered sexual abuse ,when i was 17 i was taken to see a councellor who asked me the question do you feel suicidal and if you are we will have to section you .well i said no and never went back again,true was i had thoughts of suicide and once even went to get some pills out to kill myself it was 11 at night so shops were shut ,at the time it was only a few weeks fresh from the crown court case and people just expected me to forget it and act like everything was ok,but the after effects of abuse doesnt stop because the abuser is locked away,so i angryly took the first aid box out and low and behold only found one aspirin tablets and a switch went off in my head and i laughed and thought my family don't replace nothing,and from that point i knew i would never actually commit suicide even though i still have thoughts tothis day,my family don't know about this and never will.my point here is that i said no to the councellors question because from movies i always saw psychiatric hospitals as places where your put in a straight jacket in a padded cell drugged up to the eye balls,where in fact years later i learnt that they are nice places like hotels,damn it why did i lie lol.as for boys i was like you couldnt stand to be touched ,couldnt do relationships ,scared by sex ect,i learnt to over come this by distancing myself from the abuse,i see it as a movie rather then real life,so far its worked,mind you it might not work for you.if you can get sectioned i would go for it,its too late for me but its not for you,,anyways best of luck
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