Posted by fxckfeelings on August 30, 2012
If you listen to (other) experts, psychiatric treatment should always begin with objective evidence, which then determines a diagnosis, which directs us to proven, effective treatments. This expert, on the other hand, thinks that “evidence-based psychiatry” would be very nice if we happened to know lots more than we do, but it is one of life’s great ironies that the organ we know the least about is the home of knowledge itself, the brain. Until we can fully wrap our heads around our minds and how they work, scientific thinking in psychiatry is often wishful thinking. It can actually get in the way of making good, practical decisions and accepting the necessity of living with the unknown, be it a mystery illness or the grey mush in our skulls.
–Dr. Lastname
I’ve been very confused lately because of what’s going on inside me. My father did some bad things to me while I was growing up—things that I just began remembering a year or so ago (sorry, I can’t label it). Since then, other memories surfaced as well, but not many at all. Most of my memories of my childhood are snapshots that are just little moments in time, separated by years in between that I just don’t remember. Anyway, the thing that distresses me is that sometimes, but not all the time, I’ll feel like I have another part of me who is talking in my head. This came to my awareness mostly after the memories started coming up, although I feel like maybe it happened occasionally before. For instance, recently someone asked me a question, and a child’s voice answered in my head. I have other instances of similar things like that happening. One time it seemed like there were two parts conversing with each other and I was just observing the conversation, per se. That being said, I am educated enough about what happened to me and the consequences of it to know that I think I’m describing DID, but from what I’ve read, I don’t think I have it. I don’t switch to other personalities, and I don’t really lose time or anything like that…but I do know I’m not qualified to make that kind of assessment (and I know you can’t just by reading this letter). But my question does relate to that: is it possible to have the kinds of experiences I’ve described and not have DID? Since I’m pretty sure I don’t have it, I feel like I’m just some crazy, messed up person for no reason. It terrifies me to share this with anyone, but I don’t know what to do anymore, and it’s getting harder and harder to keep going.
Diagnosis in psychiatry is never precise and, when given too much attention, can do more harm than good. Until the day a mental illness diagnosis can be determined by peeing on a stick, all we can currently do is lump symptoms together and try to observe what happens to people who fall within an arbitrary category.
In the short run, knowing you’re not alone might be comforting, but it would tell you very little about what to expect from future symptoms or treatments. Worse, it would get you thinking of yourself as a diagnosis instead of as a person who’s trying to live life in spite of some disturbing, hard-to-understand symptoms.
As such a person, ask yourself what you most want to accomplish in this life, despite whatever’s going on in your head. For most people with traumatic childhoods, it’s always meaningful to be decent to others, whether they’re your kids, relatives, or friends. You know how easily people slip into abusiveness when they’re angry and how much it hurts, so you never take a good, supportive relationship for granted.
Most symptoms that impair the way you function won’t prevent you from being the person you want to be or doing what you really want to do, they’ll just slow you down and force you to work harder to think up alternative methods. A good coach helps you to accept your impairment without getting discouraged or demoralized.
So instead of looking for the ultimate shrink diagnostician, find a therapist who can act as a good coach, who isn’t too upset by symptoms, and is eager to see what you’re capable of, even when you’re distracted by traumatic memories, internal conversations or the sensations of observing yourself.
Consult a psychiatrist at least once or twice to get an overview of possible treatments, including medication. Of course, non-medical treatments almost always pose a lower risk, but many medications are relatively safe and require no more than a few weeks to try out. If your symptoms are sufficiently painful and/or disabling, and non-medical treatment is insufficient, then you owe it to yourself to check out every possibility.
Whatever symptoms you have, you want to do your best to manage them without letting them define your life. Keep up your diagnostic questions until you’re confident you’ve heard what the experts have to say, regardless of how unsatisfying that might be, and then forget about what caused your problems or how they might be categorized.
Your next step is to manage your burden and respect yourself for carrying it, even if the nature of that burden remains a mystery.
STATEMENT:
“My psychological symptoms spook me and leave me feeling distracted and distanced from myself, but they can’t take the meaning out of a good day’s work or a solid friendship. I may never figure out why I feel the way I do, or stop myself from feeling that way, but I can certainly lead my life according to my values regardless of the tricks my head likes to play on me.”
No one was more surprised than I when I suddenly got depressed about a year ago, because it’s not something that ever happened to me before. I lost energy, felt like crying, and got anxiety attacks. There was lots of pressure at work, but my job was safe, and I’ve never been prone to buckling under pressure. Now I could barely get to work and I didn’t give a damn about the projects that I was responsible for. My wife finally forced me to see a psychiatrist, I started to feel better on an antidepressant, and then my internist really surprised me by telling me my testosterone was low and I should try a trial of replacement therapy, which I did. Within 2 weeks I was back to normal and a few weeks later I stopped the antidepressant. So now I wonder whether I was really depressed or not or whether I should have tried antidepressant in the first place. My goal is to figure out my diagnosis so I’ll know what to expect.
Even on that rare occasion when a specific psychiatric diagnosis really matters, it doesn’t matter as much as you think. Yes, it was critical to your recovery that you and your doctors checked out testosterone deficiency as a possible cause of depression; the sudden, unexpected onset of your symptoms raised the odds of your having an unusual and potentially curable cause, which deserved an extensive workup of your hormone levels, vitamin levels, evidence of inflammation, etc., so congrats for making a good decision.
You also discovered that depressive symptoms may have many causes, making depression less of a diagnosis than a cluster of symptoms. So, much like aspirin, antidepressants can improve symptoms, no matter what the cause, if they work at all. (Unfortunately, no matter what the cause, antidepressant trials often fail [35% for each trial] and require lots of time [three to four weeks] before there are noticeable results.)
In addition to lucking out with both the diagnosis and the response to antidepressants, you learned a valuable lesson, which is that anyone can get depression. It wasn’t caused by bad psychological or medical hygiene, just bad luck. Getting depression often doesn’t have a deeper meaning other than that we live in a tough, unfair world where people often get sick for no reason, and sometimes that sickness makes your brain miserable.
Your own observations are the best guide to your prognosis. If you responded rapidly to getting testosterone replacement therapy, then you may be relatively unlikely to get depressive symptoms again (as long as you continue taking the testosterone, which you may need indefinitely). At some point, if you want to experiment with reducing the testosterone treatment, ask your physician about the odds and choose a good time for experimenting, when not too much else is going on in your life.
From what you know, there’s no reason to think that your prognosis—your expected luck—is worse than anyone else’s. You made good choices, which is an essential survival skill when you happen to live in a bad luck world.
STATEMENT:
“I’d love to take my mental health for granted the way I used to, and maybe I will, after enough time of not feeling depressed has passed, but there’s no escaping knowing how easy it is to get sick. I’m proud of having made good decisions and happy to have gotten lucky enough to almost balance the bad luck I had to get sick in the first place.”
Posted by fxckfeelings on July 23, 2012
There’s nothing better at inducing helplessness than being molested as a child, but it’s easy to forget that helplessness is a feeling, not a measure of strength and character. If you’ve been traumatized in the past, don’t let the helplessness of this or any other overwhelming experience make you feel like an ineffective victim. Instead, learn to respect your existing effectiveness, regardless of how helpless you felt then or still feel now. You may always feel helpless, but your very survival is proof that you’re stronger than your emotions.
–Dr. Lastname
My life is pretty stable now, but I’ve had a lot of major problems this last year and, in the middle of my troubles, I started to remember being molested by a family friend when I was 14, just after I hit puberty and got breasts overnight. I’ve been struggling to get my daughter help for a major health problem, and then I got fired and had to find a new job, and then my mother started to slip into dementia. Now, I’ve got a new job, my daughter is getting good help, and my father is taking good care of my mother, but I can’t get over a rising feeling of helplessness. If it’s because I was molested, my goal is to get over it.
Before you can even try to recover from the helplessness of current crises, you have to get around the sneaky way it has of making you feel personally ineffective, in part by playing on your memories of the helplessness of being molested. After a while, you can feel like you’re drowning, which is about as helpless as it gets.
In other words, you want to move forward, but helpless feelings cause helpless beliefs by awakening helpless memories. Your mind gets stuck in the notion that you couldn’t do anything in the past, you’re not able to do anything now, then things will probably get worse, and you’ll be powerless to prevent it. WAIT! There is more to read… read on »
Posted by fxckfeelings on May 14, 2012
Marital nastiness, no matter how harsh and unfair, should never make you a victim. Even when your partner is an overbearing jerk, you have a right to leave or stay and an ability to judge for yourself whether you’ve done less than your share and deserve less-than-loving treatment. As long as you remember your choices and exercise your own judgment, even the most painful marriage won’t control your mind.
–Dr. Lastname
Six months ago, I had my husband arrested for domestic violence. I was pregnant at the time. It was a wake-up call for both of us—there were many unspoken resentments between us as I have a very high stress job and he stayed home with our first child. We are both in therapy now, because, while I know I’m not responsible for his actions, I absolutely had some emotional messiness to clean up on my end. Somehow, we have recommitted to truly working together, but I am still so angry at him for putting me through that ordeal. We do love each other, but personality-wise, we are probably not the best match, and if there were not small children involved, I would have divorced him after this. My family, with whom I’ve always had a strained relationship, hate that I’m giving my husband another chance and are punishing me for it, telling me how I am being controlled, putting my children at risk, etc. I had my child 2 months ago and I’m already back at work, working like crazy (someone has to support the family), but I’m so overwhelmed, unsupported and just failed by everyone when I have 2 small children depending on me and a career to manage. The pace that I am keeping is ridiculous. Help! I need to figure out what I need to do to feel less overwhelmed. And if my husband and I are going to have a chance, I need to let go of my anger.
I wish it were possible for everyone to let go of anger and be happy in this life (but for this breakthrough to occur only after I’m retired).
Unfortunately, the unfairness of life, together with the unfairness of the worst personality traits we’re cursed with, make it impossible for many of us not to feel lots of chronic, steady anger on top of whatever one experiences for especially lousy events. For such people, being calm is just being quietly pissed.
So, for members of this club, as much as they wish they could get rid of it, the question isn’t how to let go of anger and feel peace, peace, peace; it’s how to manage one’s daily anger without turning into an emotional Hulk. WAIT! There is more to read… read on »
Posted by fxckfeelings on March 1, 2012
A serious trauma will change the way you see the world, but if you’re not careful, it will also try to change your very beliefs by distorting your feelings and perceptions. You can’t prevent it from causing depression, anxiety, and lots of fear, but if you know what matters in your life and are determined to continue on your course, you can stop it from affecting your beliefs and drawing you into vicious cycles of isolation, conflict, and more trauma. Trauma is random and meaningless; your job is to give meaning to the part of yourself that endures it and still believes you can make the world a better place.
–Dr. Lastname
After a dark couple of years fighting off my worst bout of depression, anxiety and PTSD from a bad sexual assault (aren’t they all!) last year finally saw the fog lift and for me to really get back into my creative work which is now doing really well. I met a guy a few months ago. He is the first man that makes we want to really tackle some of my man issues, so I can really connect in an emotional and sexual way with him. We haven’t been intimate yet as I have been traveling for work, but I am returning soon. I cannot wait to see him, we talk every day and we really do have a special bond already. He has commented on my ‘aloofness’ at times and my ‘shutting down’. I don’t want him to think I don’t care about him, or that it is his fault. For the first time ever, I am considering telling him about the assault (I have never told a partner before) but I worry that it would be too big for him to handle, or that he would treat me differently, either like I’m a fragile victim or that I’m damaged goods. I don’t want or need a rescuer. My goal is to make a decision that would not only benefit me but us as a couple.
When deciding whether to tell a new friend about your abuse, what’s important isn’t whether you tell, but how. You never, ever want trauma to define you; it’s what you do with it that counts.
Post-trauma depression can leave you with hopeless thoughts about your inability to trust or be happy again. It tempts you to regard moments of anxiety and withdrawal in a new relationship, not as normal new relationship jitters, but as evidence of permanent damage and an incapacity to relate.
What you know, however, is that you’ve survived those fears and reflexes while going on with your life and taking the risk of getting close to someone new. They won’t stop you (unless you happen to pair up with a guy who can’t stand occasional depression and aloofness, in which case, he’d be better off with a robot).
So, if you haven’t let being a trauma victim hold you back so far, don’t treat yourself like one now. WAIT! There is more to read… read on »
Posted by fxckfeelings on November 17, 2011
Just as there are diseases that can compromise the human immune system, there are factors that can compromise our emotional immune systems, as well. If you’ve been abused or take too much pleasure in giving, you’re more susceptible, not just to bad relationships, but to more psychic damage from those relationships. There are ways for the emo-immuno-compromised to protect themselves by strengthening their minds and learning to avoid the kind of people that could hurt them the most. Until they develop a mental prophylactic, adopting strict self-standards is the best way for anyone to stay safe.
–Dr. Lastname
I was sexually abused quite a bit by my dad (and am de-repressing memories right now, fun-fun). I am realizing that I am very fearful of the people I love, and avoid them. Honestly, if I didn’t need to bond to keep from going insane, I would never have a close relationship, because anyone I care about enough can destroy me. But I’m in a lot of pain from loneliness as it is.
Many people believe there are tons of benefits to confronting your past, namely that it will teach you something that will bring catharsis to your present. The common notion being that if you can figure out what went wrong then you can avoid being victimized again.
The problem here is that reviving memories of sexual abuse by your dad will also bring back the old feelings of helplessness and having no choice, which, of course, is the opposite of your situation as an adult, so the lessons are the opposite of useful to your life now.
You’re not examining the past to drown yourself in feelings of helplessness, but to assure yourself that you can protect yourself from abuse. WAIT! There is more to read… read on »
Posted by fxckfeelings on January 13, 2011
When faced with scary health issues, from strange lumps to bad thoughts, people often avoid treatments that hurt, particularly after long-standing symptoms have sapped their hope, fed self-hate, or fostered bad habits. They deny anything’s wrong, or they insist that resistance is futile, but either way, if you criticize them for not helping themselves, they will readily agree, hate themselves more, and burrow deeper into their holes and further away from treatment. Before they can find the way out, they need to reconnect with their real strength. Only by recognizing their actual achievements and their past and potential courage, can they face what ails them. The pain may continue, but not its power to intimidate and paralyze.
–Dr. Lastname
Please Note: In responding to suicidal goals, as in the case below, we do not presume to offer emotional support. If you’re at risk of hurting yourself, you should, of course, go to an emergency room, discuss your state of mind with a professional, and decide how much support you need in order to remain safe. In most of the cases we encounter, however, our correspondents are not simply suicidal; they are familiar with treatment and have come to believe that it won’t help. Often, we must agree that their feelings are unlikely to change in the near future. What we try to demonstrate, however, is that negative feelings create falsely negative and hopeless beliefs and that there are ways to recover your strength and perspective, even when the pain won’t let up.
I’m considering suicide. My life is a joke. I am in my late 30s and female and I have never had a relationship with a man. Several men have used me for sex and at least 2 of them begged me not to tell any of their friends they’d had sex with me. I’ve never been loved, been held, been listened to, been cherished. I’ve just been used like a toilet. On the outside I’m pretty. I can hold a conversation and I have a reasonable number of friends. But I hate myself and I don’t feel good enough. I was abandoned by both parents and I was raped for the first time when I was about 2-years-old. It’s like men I meet can smell the self-hate on me and they treat me accordingly. I do not have even one person in my life who cares about me or who I could trust. My friends are there to go for drinks or dinner with me if they can find nothing better to do but they are not there to be supportive ever, in any way. What is the point of me continuing to live?
It’s horrible to feel that you don’t belong to the human race, except for your ability to satisfy the needs and cravings of jerks.
Remember, however, that those feelings almost always beget more falsely negative beliefs, particularly about relationships. Whether or not you’ve done anything wrong, you feel infinitely rejectable, comfortable in the company of jerks, and anxious around people you respect, since you know they will reject you for your anxiety and fundamental worthlessness.
WAIT! There is more to read… read on »
Posted by fxckfeelings on December 2, 2010
People often feel broken by trauma if they can’t stop attacks of anxiety and achieve the sense of control that they’re sure normal people have. Sadly, normal people are as common as guiltless donuts and pegasi; if being broken means that you can’t be fixed, then everyone is broken, because we all eventually have problems about ourselves that can’t be fixed. If you’re out there, braving the risks of relationships and work and child-rearing in spite of trauma symptoms, then you’re not broken—you’re a hero.
–Dr. Lastname
I made the executive decision today to not participate in our airport’s body scan or pat down procedure, and now my whole family is f*cked. I had my “no more than 3oz bottles” in their “official” airline approved baggies, so obviously I arrived at the airport planning to suck it up and be a team player. When we got to the security checkpoint however, I discovered there was not enough scope (or vodka) in my 3oz bottles to get me through the required security procedure. I started having flashbacks dating back to a sexual assault 20+yrs ago, and called off the idea of being a team player. I’m pissed at myself for ruining our plans, and equally pissed that my husband (who knows about my past experience) thinks it’s “silly” that I couldn’t just suck it up and go through it like everyone else. My kid’s are totally confused now as to why we are at home and not at Grandmas. I know from news stories I’m not the only one having a problem with our new security procedures. I know I don’t “owe” anyone an explanation, but it seems avoiding their questions is only making matters worse. How do I explain, without really explaining, why I’m refusing to put myself back in the position that clearly was not in my best interest at the time?
If you’re reactive to your feelings in public, for any reason, life becomes more dramatic, unpredictable and sometimes humiliating. You want your junk, physical and emotional, untouched.
Unfortunately, most times you do end up saying something emotionally, it doesn’t come out cool, leaving you and everyone else feeling a bit violated.
There are, however, some advantages to being emotionally reactive, particularly in the anxious way you describe, even if those advantages don’t involve airports.
WAIT! There is more to read… read on »
Posted by fxckfeelings on September 13, 2010
Whenever you’ve got a potential conflict between friendship and business, you have to draw a line in the sand (maybe literally if you and your pal work in beach rentals). There is always a “boundary” that represents the best possible compromise between your emotional needs and values, and the necessities of your life. Ignoring boundaries is fun at first, but in the thunderdome of the personal and professional, two sides enter and only one leaves. So, instead of mixing the sides of your life until one falls falls apart, keep your boundaries intact with your friends on one side, your work on the other, and life will remain a (boring) beach.
–Dr. Lastname
My old college roommate is one of my closest friends, and he’s always been one of the most generous people I’ve known. When I got laid off and totally broke, he got me a job at his company, and when I first started working there, everything was great. Now he’s my boss and things are very weird. Outside of work, he’s the same old guy—we carpool to work and crack jokes like always. Once we get into the office though, he’s a different guy, not just serious, because that would make sense (he’s my boss, after all), but really nasty with me. He snaps whenever I ask him questions about work stuff, like I’m an idiot who didn’t follow directions and is wasting his time. I really don’t think I’m asking him to do anything above and beyond, just regular employee/boss stuff, but he’s a total jerk about it. I want to stay here because I need the money and like the company as a whole, but I’m afraid that if I do stay, our friendship will fall apart. Then again, if I leave, he might also take that personally. My goal is to keep my job and my friendship intact.
Fortunately, you don’t have to worry about your friend firing you anytime soon. Instead, you have an opportunity to choose whether to lose your friendship or your job.
As Jack Benny once famously said, when a robber barked “Your money or your life,” “I’m thinking, I’m thinking.” And, of course, you could wind up losing both.
WAIT! There is more to read… read on »
Posted by fxckfeelings on February 18, 2010
If about half of all marriages end in divorce, then, say, a tenth of marriages end in nothing short of open warfare. In a marital battle, some people fight by keeping the verbal (and legal) bombs flying, others hide face down in a fox hole, but both of those tactics only serve to make the war intensify. A better battle plan is to give up on any control of your opponent’s forces (or feelings) and, without too many words or too little action/open fire or fatalities, figure out what you think is right and calmly begin peace talks on those terms.
–Dr. Lastname
My husband always saw himself as the righteous protector of our daughter and, after our divorce, he got into the habit of dragging me into court to force me to pay for some super-costly treatment or schooling that was always no more than a little bit better than what was available for free, but he’d look like a hero to our daughter and the court and the social worker, and I’d look like a miserly shit, and I’d complain bitterly, which just got everyone more on his side, and I was screwed. My daughter bought the bullshit, which meant she and her father shared a tight bond based on hating me, the Scrooge. But I thought the court assaults would stop when she turned 18, until yesterday, when I learned he’s suing me, once again, this time to pay for our daughter’s college tuition, even though she never asked me, she’s over 18, and, with her history of alcohol abuse (and no attempt to get sober), paying for her to go to college without going to rehab first is a waste of money. I think they’re both just scraping the barrel for reasons to drag me into court and I’m getting flashbacks about being raped by the judge. I don’t have any illusion about all of us getting along, but I think it’s fair to want this craziness to stop.
Like it or not, it’s your ex’s legal right to haul you into court at his whim, force you to hire a lawyer, and make you look like a creep. As a reward, you get to give him a good chunk of your savings to pay for something you don’t believe in, to someone who’s out to ruin your life.
Say what you will about justice, but most of the time, it isn’t very fair.
There’s no way you can avoid feeling helpless and outraged, and there’s no shower long or hot enough to make the violated feeling walk away. If, however, your goal is to stop this from happening again by repeatedly venting your outrage, you’ll actually make it worse. WAIT! There is more to read… read on »
Posted by fxckfeelings on February 15, 2010
As Valentine’s weekend comes to a close and the Holiday Death Triangle of Christmas-New Year’s-Valentine’s once again completes its cycle of horror, it’s time to reassess what makes relationships last. Sometimes Mr. Right doesn’t have a connection with you that makes you see fireworks, while a connection with Mrs. Wrong does make you see fireworks, but only after her left hook connects with your face (and your family disconnects from your life). Valentine’s Day might be about love, but there’s a reason why good relationships last for years and Valentine’s haunts our lives but once a year.
–Dr. Lastname
I’m in my mid-30s, about to have my first child with my husband of about a year. My husband is a solid guy—he’s steady, and very caring—but deep down, I know a big reason I married him is because I wasn’t getting any younger and wanted to start a family. I dated a guy in law school that I was really in love with, but he was a lot older, made it clear he never wanted kids, and was your basic passionate, unavailable nightmare. I admit, I’m hormonal, which means my husband’s been getting on my nerves a lot lately, which just makes me obsess more and more about how I’ve settled for a life without love. My goal is to figure out how to get through the next stage of my life and live with my decision.
Don’t get superficial and compare the Valentine’s Day smiles at the next bistro table to your current mood and nostalgic memories of past lovers. In my experience, finding the love of your life isn’t too difficult, but finding a good partner is a real pain in the ass.
By “good partner,” I don’t mean someone you’re crazy about, under any and all circumstances, forever and ever, amen. I mean someone who is strong, easy to live and work with, accepts you during your weaker and less likeable moments, communicates on your wavelength, and picks up the load when you can’t. As well as someone whom you can put up with most of the time.
WAIT! There is more to read… read on »
