Posted by fxckfeelings on November 8, 2012
Although stopping long-term intensive psychotherapy can leave you in a state of mourning and fear, particularly if it occurs during tough times or against your wishes, it’s unrealistic to expect that returning to therapy will make everything right again. Instead, give yourself time to adjust to change and reassess your ability to stay functional and positive. Then, if you think it’s necessary, find a therapist who’s a good, supportive coach and use him or her for a different kind of therapy that keeps your head straight without stirring up your deeper feelings. If you’re certain that you have to be “in therapy” to get helpful support and are helpless without it, then the therapy you’re in is helping you a lot less than you think.
–Dr. Lastname
In my early 20s I spent 4 years in therapy (which I think in and of itself says a whole lot about the not good place I was in my head). Therapy ended, not because I was ready, but because I moved. I am now 46, and in the years since I continued to work through a lot of things on my own, with my therapist’s voice in my head, if no longer in actual therapy sessions. In January my grandmother took a turn for the worse, with both health and cognition, and we had to place her in full nursing care. She has always been one of the most influential and positive forces in my life, so I had a hard time dealing with this. It sent me spiraling down into my 4th lifetime episode of depression. I’ve started back on Prozac, which I now realize I need to stay on for the rest of my life to try to prevent future recurrences, and I’ve spent the last 10 months in therapy with my former therapist via phone sessions as we now live 1,000 miles apart. I have finished working through a lot of stuff in that time, meaning I’ve changed my attitudes and perceptions and behaviors, which has changed my life, inner and outer. I wish I’d figured it out 25 years ago, during that first round of therapy, but better late than never. It’s been a hard year. My grandmother died 7 weeks ago. The grief hit me more than I ever imagined. I thought I’d prepared in those months when she was slowly dying, but I was wrong. What is the saying—Where there is no struggle, there is no strength? Good growth has come of the pain—I have returned to college, and I am training for my first full marathon in January. I am at a truly good place in my head and was ready to end therapy, so two weeks ago, with my therapist’s blessing, I had my last session. I knew, though, that ending therapy because I am truly ready is a celebration, but that it would also be a loss. It is currently hitting me harder than I imagined. How do I get through this and find a place of healthy acceptance of this transition?
While it’s unfortunate that stopping intensive psychotherapy after many years is hitting you hard, it’s not surprising. As you well know, loss is painful, be it the death of a loved one or the end of a source of support.
That said, your pain doesn’t mean your psychotherapy has been less complete than you thought or that you stopped it too soon, just that you can be a solid, resilient person and also be very sensitive to loss, both because of temperament and circumstances. WAIT! There is more to read… read on »
Posted by fxckfeelings on September 24, 2012
Coping with the mental illness of a family member can be agonizing, and when you can’t stop destructive behavior, it feels like defeat. Trying to defeat the symptoms of mental illness, however, is like trying to win a war on weight-gain or terror—difficult, endless, and resulting in gains that are easily lost. If you learn to accept setbacks as part of the process, rather than attack them as tests of your love and will, you’ll do more to sustain morale, including yours and your family’s. Take pride in your willingness to endure a difficult, painful, and sometimes frightening relationship; you won’t win or lose a war, but you’ll gain peace.
–Dr. Lastname
I’ve got an adult daughter whom I know is mentally ill—she thinks people are plotting against her, including her very nice husband—and, for the last few years, without my own husband’s help, I’ve desperately tried to persuade her to get treatment before her marriage fell apart and she got arrested for doing something violent and stupid. The harder I tried, however, the more she suspected I was part of the conspiracy. There was a ray of hope 6 months ago when she had a screaming fit one night and got locked up in a mental hospital, but the medication made no difference, and she came out more certain than ever that her husband was her worst enemy, so she left him. My husband says I’m part of the problem because I never take my daughter’s side, but my goal is to restore her to sanity, and I know my husband is in fantasyland if he thinks she’s sane and has a “side” based in reality. I’m getting nowhere, though, and my own marriage is under pressure. What do I do now?
Unfortunately, while there is no surefire cure for paranoia, pushing a paranoid person to get help is a reliable way to make it worse. After all, if somebody thinks the world is against them, disagreeing with that person only confirms their delusions. Call it the paranoia-dox.
If your daughter’s paranoia can’t be helped—and it seems you’ve tried very hard to help her—then I’m sorry, but your husband has the right idea, even if it’s for the wrong reason. By not challenging her feelings of being victimized, your husband avoids the paranoia-dox, which makes it an approach worth trying. WAIT! There is more to read… read on »
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 August 6, 2012
Like all symptoms of mental illness, anxiety and suicidal feelings seem controllable since they’re related to thoughts and how we look at things, especially since they have the potential to be so destructive. In reality, their primary causes are powerful, mysterious and, whether rooted in past events or biology, are not curable or easily reversible by the best treatments, most loving families, and strongest willpower. What good treatment and a loving family can do, however, is give meaning to the courage it takes to ignore pain and dangerous impulses, giving one comfort, if not control.
–Dr. Lastname
How do you get rid of the pain from your child’s suicide? My son died four years ago, and our entire family is still devastated. We are all now living with depression, anger, and our own thoughts of suicide at times. We are all in therapy but it’s moving so slowly, it doesn’t feel like life is moving forward. After a tragedy like this, how do you get your purpose back?
While I can’t imagine anything much worse than having your child suicide, the key to surviving it is to understand how similar it is to having your child die of any other cause. No parents should have to bury their child, no matter how that child’s life ended.
Intuitively, suicide feels like a preventable cause of death, so it seems justified to review the many would-haves and could-haves leading up to it.
Mental health professionals sometimes make things worse by focusing on such possible “causes” as unacknowledged trauma, unshared feelings, or unrecognized calls for help, all of which mean blame. Blame then feeds the depression and anger you talk about, poisoning normal grief with feelings of guilt, regret, and failure. WAIT! There is more to read… read on »
Posted by fxckfeelings on July 16, 2012
While plenty of crazy people make their mental state known with a tell-tale twitch or tinfoil hat, a severely manic person can look relatively sane and still be completely bonkers when it comes to making decisions about life, love, and money. Our laws allow them to fly under the commitment radar until their behavior gets so erratic that they’re about to fly off a mental cliff, whereupon the police (with your help) can take them off to treatment. So if you wish to help someone who is mildly manic, don’t hesitate to offer good advice. If someone is very manic, however, your helpful words may cause nothing but fear, aggravation, and mental jet fuel, so you will need to be quiet, patient, and knowledgeable about commitment law to be helpful when things get out of hand and the tinfoil hats come on.
–Dr. Lastname
I was diagnosed bipolar as an adult and usually take some lithium to deal with it, but, for a few weeks last month, I started to get manic. I rode it out by spending all my time in church and buying a lot of philosophy books. It wasn’t too bad—I just wasted a little money and a lot of time, but otherwise, I felt kinda great, and I haven’t felt depressed, at least not yet. Now I’m back to my old self, but I’m not sure where the mania came from, or when/if it’s going to come back. My goal is to figure out what it happened.
What happened when you got manic is that you got manic, forgetting who you are and what you wanted to do with your mania. That’s what mania tends to do.
It gives you strong feelings that need immediate expression because you feel more real and “in the moment.” It tells you what to do, whether it’s cleaning the house all night, sleeping with as many strangers as possible, or spending your bankroll on religious literature.
What you want—you, as a person and manager of your own interests, rather than a manic diagnosis—is to figure out, during a sane moment, how much manic behavior is safe, where to draw the line, and what you want done about it by you, and if you’re out of commission, what you want done by others. You say nothing about that in your letter; unfortunately, you don’t seem to be present other than as a passive eyewitness to your symptomatic self. WAIT! There is more to read… read on »
Posted by fxckfeelings on July 9, 2012
Depression and life’s miseries have an amazing way of working together to make you feel like a loser who doesn’t belong, has nothing to contribute, and should not get out of bed. That other people are happy just makes you wonder what you did wrong, when it’s just misfortune and depression doing their job really well. The fact is, however, that we create value in life by pursuing what we believe is most important, regardless of whether we get lucky along the way. That’s why you need to assess whether you’ve done your best to live up to your values, disregarding negative thoughts and the failures over which you had no control. Then pain and negative thinking can’t succeed in damaging you, which means you won’t damage yourself.
–Dr. Lastname
I’m not even sure where to begin so I’ll try and keep this as short and concise as possible. I come from a broken family– my mother was abusive and distant, and I became that way to the point where it was hard for me to feel genuine love for anyone because I never learned what love is. I got away from my family and had a string of bad relationships (where if I think about it, I am to blame really). I then met and almost immediately married my husband. He went along with it because he loved me, I pushed for it because I was insecure. I didn’t “feel” any real love for him but wanted him to validate my feelings because I believed then that that’s how love grows. For me back then, love = infatuation. I admit I’ve been messed up. I’ve beaten myself up enough. Anyway, our marriage has been rocky with a major indiscretion on my part and several minor ones (chatting/talking on the phone with strangers) on his part. He forgave me for my error and begged me to stay (this was 3 years ago). Only just a few months ago have I realized how fucked up I am and how I’ve let my “feelings” guide me to hell. I’m still trying to rewire myself and it’s hard work. Unfortunately I recently found out that my husband was still talking to random women for hours because “he’s lonely.” What scares me is that even though I am working on my issues, he still feels lonely and it’s likely he will hurt me again. I realize now that I do love him but I can’t always project it the right way or appear to be happy when really I’m feeling like shit. I keep thinking it’s all my fault that he feels lonely and that nothing I will ever do will help this. I’m really tired of dealing with my own crap and now realizing that he has his own set of issues that may or may not be related to me. I’m very confused. How do I stop obsessing over our faults and focus on the good? I don’t want to throw away everything I’ve accomplished because of my ‘moods’. Please help. How can I trust him again and more importantly, trust myself?
There are a lot of smart people out there with high standards, like yourself, who have brains that naturally favor negative thinking and family backgrounds that are full of sad events and broken relationships.
As such, it’s not your fault that your mind tends to put fault on you and call you broken. What’s worse, if you try to be more positive, your brain pushes back by calling your efforts to think happy thoughts a dismal failure (which, of course, they’re not). Brain 1, You 0.
So, instead of trying to focus less on your faults, aim higher by taking pride in your many remarkable accomplishments. After all, if you can’t think differently, you can nevertheless force yourself to think about different things. WAIT! There is more to read… read on »
Posted by fxckfeelings on June 21, 2012
Bad luck is like a bad smell; sometimes, it just surrounds you, meaning that you’re doing everything right but, due to an uncontrollable curse, everything’s going wrong. Then there are the special few for whom bad luck is generated internally, meaning that your brain is permanently decision-intolerant, and trying to do the right thing usually goes wrong. Either way, you’re stuck with your stink, and you’re going to get blamed unless you and others are brave enough, and realistic enough, to accept the hard-to-tolerate helplessness of having no control. If you can do that, however, you’re ready to appreciate the beautiful things you’re doing with an ugly aroma, whatever dealt it.
–Dr. Lastname
Turning 50 next year, my beard is turning gray, still alone and most importantly, no fuck-buddy! I’m saying I’m on a self imposed ‘sabbatical,’ upgrading and learning new skills, but in reality, well – this economy! But seriously, no work AND anxiety (a left over from when I was assaulted), all-new discovery of depression (as a result of recent diagnosis of Hypothyroidism or a direct result of job loss, who knows?), loss of retaining and maintaining friendships/relationships led to well, being in the space of loneliness – a lonely extrovert is so oxymoronic, I can’t stand it! Currently trying to financially survive on a sure-footed, tight-roped budget thanks to one of the four insurances that did pan out…still, sore about playing by the rules and getting shafted big time anyways and yet, retaining focus on how to get up from the shutdowns and the rapid changes that occurred in a shorter-than-2-year period. My goal is to capture original harmony and yet live in the now, which includes living an even more healthy and play-safe lifestyle along with meaningful work, having an intimate inner circle of friends and have a honeybun(s) in my life. That’s the life I am cultivating – the only thing is how the fuck do I kick-start the process to get there? Can you help me?
Sadly, Dr. Lastname has never figured out the secret to happiness (or put too much value on it), and besides, the real secret of those secrets is mostly that the short-term happiness they bring will be followed by a long period of not-happiness, much like the one you’re struggling to get out of.
On the other hand, we have figured out the secret to pride, which is really what this is about; women may make you happy, but confidence and pride will get you women. So, in order to get laid, you have to think about why your misfortune has laid you so low. WAIT! There is more to read… read on »
Posted by fxckfeelings on June 18, 2012
Macho sports-types like to say that failure is not an option, and in a totally not-macho way, they’re absolutely right. After all, we all have different definitions of success, and while individual skill is a factor, so are luck, fate, and a mess of other circumstances that we can’t control and/or overcome completely. So if you can’t meet certain expectations or fix pressing problems, the good news is, failure is not an option; if you do your best with whatever it is you actually control, judging for yourself what that is, you can never lose.
–Dr. Lastname
At this point in my life I’m not sure in which direction to turn. I am a 37-year-old female going through a divorce, had to move back home and just failed nursing school by just a few points in my final semester. I was so devastated about failing nursing school that I basically fell off the grid for a while. Many of my peers feel as though the school was unfair and are encouraging me to fight this, and I have hired attorneys who have sent letters to the school and are now talking about litigation. All of this is starting to become so overwhelming that I feel like I am starting to spin into a deep depression again. It is so hard to watch everyone around me succeed and pass me by in life. My question is this, should I go on with fighting the school and sink more time and energy into something I’m uncertain of? Or should I just throw in the towel and try something else. I am so conflicted and would love just a no nonsense straight answer without all the fluff. Any insight would be so appreciated.
People feel like failures when they fall behind the achievements of their over-achieving peers, but, by the age of 37, you’ve earned the right to define your progress, or lack of it, in your own terms, regardless of what your school thinks.
Of course you hate to watch your friends pass you by, but don’t ask yourself why you’re not keeping up with them. Instead, ask why you’re wasting time comparing yourself to them instead of asking yourself where you stand according to your own standards, and what you want to do next. WAIT! There is more to read… read on »
Posted by fxckfeelings on June 14, 2012
Fear is truly frightening when it becomes contagious, usually in panic form. After all, getting scared is a manageable and sometimes life-saving experience, but getting panicked means spreading that fear to ill effect among your friends or even among your enemies. Your job then isn’t to express fearful feelings, hoping for relief but instead creating chaos; it’s to cope with the cause of your fear as constructively as possible and then draw courage from knowing you’ve done your best in a fearful world. That way you will inspire confidence in your supporters, which will hopefully be contagious, as well.
–Dr. Lastname
I got married recently, but the honeymoon period came to an abrupt end when my wife and I started fantasizing what our kids would be like and I realized that several of my wife’s relatives are mentally retarded. She has a wonderful family, but still, I don’t know how I’d deal with having an impaired child, and I can’t stop worrying. Naturally, I told her what I was feeling, hoping she could give me some reassurance, but all she said was, “well, do you want to divorce me and marry someone with healthier relatives?” I love her but I don’t know what to do with my worries. My goal is to calm down and have a healthy family.
No one knows better than a pregnant couple how truly scary life can be. The real story of the birds and the bees also involves the bear of unavoidable risk of mutation. The question then isn’t whether you should be afraid, it’s what you do with that fear.
Asking for re-assurance turns you into a kid asking grown-ups for soothing words you should never really believe. True, if they’re dumb enough to reassure you, they deserve the lawsuit you’re entitled to slap on them if things go wrong. In every other way, however, you’ve weakened yourself and spread fear to those who are relying on you for leadership.
You’re the Daddy, so act like one. WAIT! There is more to read… read on »
Posted by fxckfeelings on June 4, 2012
When people argue about medical self-care, be it with family or just with themselves, their feelings are often masquerading as reason. After all, emotions make decisions fraught and complicated, while reason tells you that you can never control your health, just make choices that have costs and probabilities. If you face those costs and probabilities with courage, you need never defend your decisions, regardless of their outcome. It’s natural to worry, but it’s useless to let worrying dictate what you do and don’t do with your health.
–Dr. Lastname
My husband and I have a great marriage, but there’s one issue we seldom agree on, and it’s irritating as well as worrisome. Whenever I decide to get medical advice about a problem, like back pain or anxiety, he suggests I’d do better by sucking it up and staying away from doctors and medicine, which is the way things were done in his family. I, on the other hand, believe you owe it to yourself to get good medical advice and that getting treatment is the way you take good care of yourself. I don’t like his disrespect for my opinion or his lack of sympathy when I’m clearly suffering. My goal is to get him to at least respect my point of view.
It’s natural to emotionalize health care decisions in terms of fear because that’s how we often make them: when we’re worried enough, we see a doctor.
Trouble is, worry can as easily drive you to avoid as to overuse medical care and can also embroil you in endless debates with family members whose worry style is a little different from your own. And there are many styles to choose from. WAIT! There is more to read… read on »
