Posted by fxckfeelings on August 30, 2010
Someday, people with psychiatric problems will get safe, effective treatment without having to make difficult choices, and Thanksgiving dinner will come in a pill, and jetpacks will be available cheaply for every man, woman and child. For now, the state of the art is much better than it’s ever been, but it’s still primitive, and it certainly isn’t inexpensive. Until the silver bullet for curing mental illness is found, patients have to make innumerable tough decisions for themselves, weighing everything from side effects to costs. Or they can just bide their time until their jetpacks arrive to make everything better.
–Dr. Lastname
I decided recently to listen to my friends and family and see a psychiatrist about my depression, but I don’t know whether I’ve made the wrong decision, or whether I’ve just chosen the wrong doctor. Basically, I decided to get help because I feel helpless, but my doctor wants me to do a lot of the work myself and doesn’t really help that much. It’s not just he wants me to ask myself a lot of questions (and answer them—if I had the answers, would I really be paying him?—but also deal with my insurance company and read up on the medication he suggests (he tells me about them, sure, but he says I owe it to myself to read up on them on my own, and that doesn’t make sense to me since he’s a doctor, knows everything about the pills, and he could just tell me himself). My goal is to figure out whether therapy is worth it, or whether I’m just getting help from the wrong source.
I hate to sound like your psychiatrist, but ask yourself what you have a right to expect from treatment, given what you know about its limits and your resources for paying for it.
If you want, you can spin things positively by saying that you’ve heard about good new treatments that can really help and that you’ve got great insurance that you pay a ton of money for. Of course, you’d probably be full of shit.
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Posted by fxckfeelings on August 9, 2010
Whether it’s wishful thinking, fear, or a powerful sales pitch from the church of Scientology, we have lots of emotional reasons for shutting down our logical minds when we have to make medication decisions about psychiatric illness. The good news is that, while those decisions should be made carefully, they’re not rocket science. The bad news is that it requires more courage than brains (or Thetans) to be a good manager of your own health.
–Dr. Lastname
I recently started going to a doctor for my depression. She thinks I should take pills, I’ve seen lots of articles about how antidepressants don’t work and the main reason they’re prescribed is because of the huge investment that big pharmaceutical companies have made in producing and marketing them. It makes sense to me that there are better natural, holistic solutions that get played down by the medical establishment because they can’t make money for anyone and threaten the profits made by those companies. My goal is to find treatments that work best, not the treatments that server the corporate interests.
The problem with most criticism of current drug treatments is its hopefulness; it implies that there are good, effective, cheap and low-side-effect treatments for depression (that are being suppressed). If only principal clause of that statement were true.
Sure, a magic bullet, holistic or otherwise, would be great (there are lots of other unsolved and incurable problems I can work on, so I’m not worried by the hit my business will take).
The truth is, however, that current treatments are time-consuming, weak, often costly, sometimes risky, and not guaranteed to work
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Posted by fxckfeelings on August 5, 2010
We’ve talked many times on this site about how controlling other people is essentially impossible (at least in the long run, but you’d be surprised how obedient people are short-term when you have cake). That’s why pushing for someone else’s acceptance isn’t just hopeless, but when we put that need ahead of our own convictions and priorities, it’s downright dangerous. People in AA are taught right off the bat to accept what they can’t change, which is a valuable lesson to anyone, with or without booze (or cake).
–Dr. Lastname
My husband worries a lot about my drinking and depression but, to my mind, I don’t think my drinking is a problem and I don’t think I’d be depressed if I wasn’t worried that he’d leave me. For the sake of our marriage, I’ve agreed to stop drinking for a while and go to AA, but I really feel that my drinking wasn’t causing me any problems and that I’m doing this to make him happy, which makes me feel weak and angry. I want to get him to accept me the way I am before I can’t take it anymore.
You’re in a tough spot, because partnership really can’t work without acceptance, and acceptance is not something you can control. The more you force acceptance, the harder it is to achieve. Accept that, buddy.
If you try too hard to get his acceptance, you’ll hide whatever you think he won’t accept, which means putting your drinking in the closet and going to the mall instead of AA meetings.
On his end, if he tries too hard to make the relationship work, he’ll pretend you’re not really drinking or that you’re going to change, which also means no real acceptance.
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Posted by fxckfeelings on July 19, 2010
Today’s post tackles a common, yet heretofore-not-submitted question about therapy, namely, how to find good help without breaking the bank in the process. While it’s a simple question, the answer isn’t, so we’ve dedicated the entire post to helping those who want help with their mental illness, but don’t have a dime to spare.
–Dr. Lastname
I’ve been depressed for some time and could use some treatment, but my insurance has a big deductible, so I’ll be paying everything out of my pocket, which isn’t deep. My goal is to get treated for the least amount of money.
I’ll assume from your tone that depression isn’t making you suicidal or putting you at immediate danger of losing your job and/or family because, if it is, you need to forget about the cost of treatment and value the cost of your survival.
If depression is putting your life/work/family in danger, get a psychiatric evaluation, in an emergency room if necessary. Do not pass go, do not collect $200 (no matter how much you need it).
If that isn’t the case, there’s lots you can do to reduce the amount of money you spend on treatment…if you’re willing to spend some time, do some research, and use your common sense.
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Posted by fxckfeelings on July 15, 2010
We Americans love our stuff, but the lust for said stuff can cause individuals to behave badly (see: the demonic/orgasmic audience reaction to Oprah’s car giveaway). Usually, when someone goes overboard with longing for/accumulation of stuff, it’s a family member who steps up to put the breaks on, but when anyone, family or no, gets between someone and their stuff, things can get uglier than anything Oprah could imagine. If family members put limits on their responsibilities, however, there are still ways for stuff-addicted loved ones to break the stuff cycle.
–Dr. Lastname
My parents have decided to retire, sell the big house I grew up in and move into a smaller condo closer to my sister and me. The move makes sense—my sister and I are adults with our own families—but it’s brought up a sort of taboo issue for my parents, which is my mother’s attachment to stuff. She’s not a hoarder, but if my dad wasn’t around to put his foot down, I sometimes worry it could be, because my mother has trouble throwing anything away. She says that moving all the time as a child has given her a different appreciation of objects, and that it’s better to regret having too much stuff than to miss something you threw away and can’t get back. Problem is, there’s no room for this stuff in the new condo, they won’t have the budget for storage, and my sister and I aren’t able to put all of her old work files, souvenir spoons, and elementary school textbooks (seriously) in our basements. What I’m afraid will happen is that my father, who has always taken responsibility for managing their money, will try to get my mother to agree that they can’t afford to move and store her stuff when they move, she’ll keep complaining, and he’ll get nasty. How can we get my mother to learn to let go?
I know you and your father want to make your mother happy and have harmony, but it looks like she’s not eager to adapt a sparse, Zen lifestyle.
The problem is, trying to make someone happy when it’s just not possible usually causes more unhappiness. False hope is dangerous, no good deed goes unpunished, and stuff happens (sometimes in great quantities).
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Posted by fxckfeelings on June 7, 2010
Most people panic if their mental health goes south, and if/when they find a doctor to help them recover, they assume that treatment is a mystery about which doctors know best. If you’re in that situation and disagree with your doctor’s decisions, don’t act like a helpless child challenging an all-knowing parent. Learn what you need to know to make well-informed decisions and stand by them, whether or not your doctor agrees. It’s the best way to cure yourself of panic, and it makes refuting your doctor’s advice a discussion between equals, not a pleading.
–Dr. Lastname
My psychiatrist thinks I should increase my medication, but it already makes me sleepy and has caused me to gain 10 lbs. If anything, I’d really feel better getting off it entirely, because I hate being dependent on it. For the time being, I know I need it, because I’ve barely recovered from my last depression, but even thinking about increasing the dose makes me feel depressed. I’ve seen this doctor throughout my entire illness and she’s been very good with me up to this point, but now that I don’t agree with her I don’t know what to do. I don’t want to have to take more medication.
It’s much easier to have an agreeable disagreement if you’re not pushing someone with your emotions; after all, lawyers use evidence, not tantrums, to win a case.
Still, it’s hard not to push with your emotions when the issue is personal and scary. Unfortunately, you don’t have a choice.
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Posted by fxckfeelings on May 31, 2010
Most good people find themselves doing the same old bad things over and over. For some of us, said bad habits don’t go beyond excessive chocolate or videogame usage, but for others, “bad things” result in horrible consequences. Understanding why people are like that seldom helps, but recognizing when people are like that (whether it’s you or the other guy) can be very helpful if you accept the fact that the problem won’t go away and take responsibility for managing it as it is. You can’t change urges, but you can sure try to change results.
–Dr. Lastname
I love my work, my kids, and my wife, but I have bipolar mood swings (and I’ve taken medication for years) that lead me to do things that get me into trouble. Recently, in spite of the medication, I felt a surge of energy and started to stay up late, sneak into my studio and paint. I’ve also started to drink again. I don’t want to change meds or let people know what’s happening because I want to keep my options open. I love the highs and the freedom, and I hate being told what to do, but I’ve got a demanding day job that doesn’t involve painting, and a wife who doesn’t like it, to say the least, when I’m not honest. So my goal is to get myself under control before people catch on to what’s really happening.
There are few fathers and husbands who can’t identify with the goal of wanting to feel special, have time to themselves, and avoid humiliating comments about eating, drinking, toileting or sleeping habits from their next of kin.
The fraction of these fathers who are dealing with mental illness and addiction to alcohol don’t want to be asked if they’ve been taking their medication or started drinking.
So, if your goal is to avoid immediate disrespect and hang on to your secret Van Gogh identity a little longer, then keep doing just what you’re doing.
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Posted by fxckfeelings on May 3, 2010
Poor, well-meaning, dedicated therapists and the patients who love/destroy them. After all, it’s enticing to let someone persuade you that you’re their guardian angel and the only therapist that can help. It’s a fun ride for everyone, at least until you realize that you’re responsible for something you don’t control, and they’re even less responsible than before for dealing with reality as it is. While this is a shrink-based site, we are the first to admit that therapists are not perfect people, especially when they get in in their heads that they actually are.
–Dr. Lastname
I have a 30-year-old patient whom I’ve been seeing in weekly psychotherapy for 6 months and he had a terrible history of sexual and physical abuse and years in state care. Amazingly, despite all his trauma and several prior failed treatments, he settled into a trusting relationship with me. He tells me I’m the first person he’s bonded with, and he’s been able to stop using cocaine, and, for the first time, sees some hope for himself. The problem is that he just got a new job, and I’m not covered by his new insurance plan. He wrote me a letter telling me how much he feels his recovery depends on continuing the treatment we’ve started and I feel professionally obliged to put his welfare ahead of my financial needs, but I’d like to get paid. My goal is to do right by my patient, and not trigger the feelings of abandonment that underlie much of his negative behavior, but I’m not sure how long I can afford to see him for nothing.
There are many therapists who believe the best thing you can do for a troubled patient like this is to “be there,” providing the steady acceptance and secure relationship that they need for healing. I’m not one of them.
The sad fact is that the healing power of currently available treatments is vastly over-rated and a good example of false hope and the harm it can cause.
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Posted by fxckfeelings on April 15, 2010
While Shut Up! Week began with us doing the up-shutting, it concludes with the more fun exercise of instructing others when they can utilize their own “shut up!” skills. After all, a friend might want to help you, or you might want to help a friend yourself, but sometimes the best thing you can do to help someone is get them to keep their mouth closed. And with that, Shut Up! week shuts down.
–Dr. Lastname
For years, I’ve talked to a friend of mine about my problems who’s also a counselor, and during that time, he’s urged me to seek professional help. I used to brush off that advice, mostly because this friend lives in another city and only ever really talks to me on the phone when I have problems, but in the last few months, I’ve begun to consider taking his advice. I don’t know what to say when I call to make the appointment, however, because I haven’t the faintest how to explain the unknown in my head (which is the main issue that frustrates me). I want to scream, but don’t know why or what. Do you have any advice as far as how to ask for help when I’m not sure what I’m really asking help for?
Remember, funny feelings in your head cause fear, which causes funny feelings, which cause fear, which create a spiral that will flush you down the toilet of needless worry. The first thing to do then is shut up and think about whether you need help.
If you’ve had funny feelings in your head for years, they’re not about to kill you; they’re not telling you to kill yourself or anyone else, and they’re not annoying you to death. WAIT! There is more to read… read on »
Posted by fxckfeelings on April 8, 2010
Many jobs, especially those involving leadership or sales, depend on making a good impression with the public. The risk is becoming so focused on public reaction that you end up like Ed Koch, asking “How’m I doin?” with such frequency that you lose track of exactly what you’re supposed to do (aside from getting people to curb their dogs). Most public jobs, however, involve lots of duties that only make an impression when done very poorly, so success can’t be defined by accolades, and you’re the only one who knows best. It’s up to you to be your own best judge before you end up so hungry for approval that you get stuck in deep dog shit.
–Dr. Lastname
As rabbi of a medium-sized temple for 10 years, I’ve enjoyed a good relationship with my congregation and I love the work. My problem is that I rely on the temple Board to decide whether I get a raise, and, during the last recession, there wasn’t one because everyone felt too poor to pay more dues. When, recently, I began looking at what rabbis of comparable congregations are making, however, I found that my salary is well below the mean, so I’ve been wondering how to become more active without appearing to be greedy, selfish or unresponsive to the problems of the congregation. One way that occurred to me was to do a “360 degree review” and ask everyone to give me feedback on how I’m doing, including the congregation, the board, and people who work for me. My goal is to get a high approval rating and use that to get a raise.
Unlike the woman earlier this week who was too afraid to rock the boat by asking for a raise (until anger made her want to torpedo the ship), you’re inhibited by guilt, empathy, and that certain Jewish ne sais quoi.
Still, no matter how tempting it is, don’t ask the congregation to clap if they think the rabbi deserves a raise. You’re a scholar and a leader, not Tinkerbell.
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