#and i have to talk to my psychiatrist about important medical decisions in an hour

[ghostzzy]

uuuuufgh.

#fatigue has rendered my brain so slippery #so work is absolutely kicking my ass #and i have to talk to my psychiatrist about important medical decisions in an hour #and i have to shower #and i have to vote #and then i have to go trick or treating with my brothers #which will be fun but unfortunately requires being upright and sweating in a polyester costume for several hours #and i’m unimaginably tired. #this is why i don’t do things. like yeah the party was super fun and i’m so glad we did it #but dear god i am already in dysregulation hell and it’s only 2pm on monday 😫😫😫 #izzy.txt

[bloodredfirework]

“The universe works in mysterious ways.” Shiloh had been hearing that since before she could even remember. Her parents had used it often when they’d tried to talk her out of her many depressive episodes during her numerous stays at the hospital, as though blaming the universe would somehow make her feel better by giving her an excuse as to why she was so fucked up. Why didn’t the other kids hear voices? Why didn’t they see monsters all of the time? Just blame the universe and its mysterious ways. After Shiloh had reached the age of thirteen or so, she’d finally come to realize that the things that she was hearing and seeing weren’t the symptoms of schizophrenia or any of the other mental illnesses that her psychiatrists had tried to diagnose her with and medicate her for, but in fact, they were real ghosts and spirits. She’d thought at first that finding out what was wrong with her would be a step in the right direction and that she would be able to find the cure to her problems, but as it turned out, it only made things worse. Not shocking, since the stars had just been aligned against her from birth. She’d been born under the worst of signs. Still, despite her strange and unique obstacles, she’d tried to overcome them and chase her dreams of becoming a star. That only ended up in failure and tragedy too, however, as her rebellious attitude and endeavours only ended winding her up into getting disowned and becoming a high school dropout, who’s biggest accomplishment was keeping the same job at one of the downtown record shops for the last seven years. She didn’t really consider that to be an accomplishment though, and if anything, it was more harmful to her reputation than it was beneficial. It had been nearly a year since Shiloh had finally made the split from Hunter, her dysfunctional boyfriend of nearly six years. Spending such a lengthy amount of time with him had left her with a deep-rooted attachment to him and a lot of love, but when things continued to always spiral out of control without any signs of ever getting better, she’d finally made the decision to leave. The thought of her no longer being there to take care of him was difficult for her to grapple with, but then again, it wasn't as though her life would ever truly be void of his presence. This week in particular, for example, he’d needed to borrow her car. He hadn’t mentioned what it was for, but because he’d sounded pretty desperate, she’d caved and dropped it off along with her keys. Three days later, however, she was dealing with the problem of having all of her phone-calls and texts going unanswered, and she was growing increasingly frustrated. After some digging, she’d found out that he was going to be down at the local hangout spot at the beach for a late-night bonfire, and although the people there weren’t exactly her crowd, she’d decided to drop by to pay him a visit and inquire about getting her car back. She had an important appointment the next morning, and having her property returned to her was non-negotiable. After an hour-long walk from her home, Shiloh had made it to the beach, the glow of the fire in the distance like a beacon in the dark of the night. She followed it, and as she approached, she was quickly able to point Hunter out of the crowd. He’d only recently begun hanging out with all of them, and she wasn’t surprised. They were exactly the type of rough crowd that he was normally drawn to, and probably the exact crowd to cause him to spiral further into the clutches of his dangerous addictions. Almost instantly, Hunter spotted her. He knew that he was going to be in trouble, but he guessed that running away wouldn't do him any good now. He had to face the music sometime. Might as well be now. "Hey, Shy!" He greeted her, holding his arm out and pulling her in for a hug against his side when she'd gotten close enough to get ahold of. It was clear that he was trying to keep the mood light, but even as Shiloh looped an arm around his shoulders to give him a half-assed embrace, she didn't seem willing to cooperate with the tone that he'd tried to set. "Hunter. Can I talk to you?" Shiloh asked, taking a step back to get out of the British male's hold. "You know what it's about." Her tone was anything but pleased or impressed, but she was avoiding making a scene by keeping her voice hushed. Everyone was already looking at her, but she didn't want to give them an excuse to keep staring. "Yeah, I know, I know," Hunter sighed, shaking his head and running the palm of his hand over his face. Rather than getting up and moving to a more private area like he'd been asked to though, he'd decided to stay exactly where he was. This way, if his ex-girlfriend got really upset with him for the news that he was about to give to her, she wouldn't start yelling. "It's about your car, right? I know you're probably pissed because I didn't answer any of your calls or texts, but I've got a good reason, I swear. I just didn't want to worry you. You see, something kind of happened and..." He trailed off, scratching his head as he worked up the nerve to tell her what he'd done. "What do you mean? What happened? This is a joke, right?” Shiloh asked, a very temporary smile on her face.

She paused when all she got was silence. “Did you wreck my fucking car!? Hunter, I have to move tomorrow morning! I need my god damn car!" Shiloh hissed in a quiet but very angry panic, interrupting him before he'd even had the chance to finish his sentence. Wherever his thoughts had been going on the topic didn't matter anyways, because she'd already heard more than she wanted to. Much to her dismay though, he continued and she soon found out that it wasn't that he'd wrecked it, but rather that he'd gotten it impounded because he'd been driving alone again while drunk. "Oh, for fuck's sake."

@narcotlcs​

#narcotlcs #shilohxfelix #v;main verse

[cruz-regina-d-journal]

07: Goal Digger

When we are talking about goals we usually think of something we want only for ourselves. It’s exciting to think of what you can be in the future and what you will have as well, but sometimes some people tend to forget that we still need to make an action before we get something we want. We keep on saying that we want this and that but we don’t even make a move on how to get it. Honestly, the past “Regina” was like that. My mind focuses only on my desires, and we can relate this to Sigmund Freud’s Psychoanalytic Theory which are the id, ego, and superego. Our id says “I want it now!” as our superego says “You still can’t have it because you don’t have money yet”, they battle around our mind until our ego says “Okay, kids, let’s study well, find work, earn money and buy what we want”. In every goal we have, there is always a process that we need to get into. We can’t have anything in an instant! Even at opening our phone, we still need to wait and do something in order to open it, and that is to press the power button. In life we also have actions like opening the power button, but the thing is we need to open ourselves. We need to step out of our comfort zone and find ways on how to achieve our goals.

Since I was a kid, my parents buy me planners and notebooks because I love writing, drawing and putting my goals in it. I have this one perpetual planner that I still update whenever I want or got something, and it always gives me this wonderful feeling at any time my plans worked or have gotten well than I expected it to be. And today it really took me a long time to know what I want to have; maybe because I feel down due to this pandemic and my family experienced a huge deal of a problem related to this year’s stumbling block which made me worry about my future. Nevertheless, I’m glad that we’re now okay and I finally conquered those mind-boggling thoughts. The pictures here  show my short and long term goals that I’ve been thinking since June 2020. I’m sharing this things to you because I think I will be needing your support and guidance 😁 Let’s bring each other to the top!

SHORT TERM GOALS

OBJECTIVE 1: Grow a Plant

TIME FRAME: August 28, 2020-October 5, 2020

RESOURCES: Shovel, seed, pot, healthy soil and water

TASKS: 

Choose the right container for your plant and put the healthy soil in it.

Plant the see at the proper depth and water it with a room-temperature water.

Maintain a consistent moisture and keep the soil warm.

Apply fertilizer every week, give the plant enough sunlight and circulate air.

SUCCESS CRITERIA: Be patient and don’t forget your tasks! 

REASON: I’ve been trying to grow a plant since I was in elementary, but I don’t know why they always wilt. I love plants but I don’t think they love me 😢

OBJECTIVE 2: Bond with my Friends and Family

TIME FRAME: March 2020-July 2020

RESOURCES: Love, happiness, understanding and self

TASKS:

Focus your time with them.

Don’t use phones, engage with them through personal interactions

Make them feel loved/important and laugh with them

Always listen to their stories and respond appropriately

Treasure the moment

SUCCESS CRITERIA: Make time with them and don’t forget to enjoy it!

REASON: As I entered college I noticed that I rarely bond with my other friends and my family because I’m studying at Manila during weekdays. I don’t have a free time whenever I go home to Cavite because I use my weekends for doing my school works and sleeping to regain the energy I’ve used during school days. I feel sad that I failed to divide my time for academics and for enjoying life. And now that it’s finally over, I think that this is a great opportunity to recoup my scantiness.

OBJECTIVE 3: Eat Eggs 5x a month

TIME FRAME: August 13, 2020-October 13,2020

RESOURCES: Eggs, pan, plate and utensils

TASKS:

Eat egg once every week.

Ask your family to not cook eggs for you when you’ve eaten once that week.

Avoid eating soft-cooked eggs.

Find an alternative food when tempted.

SUCCESS CRITERIA: Self-regulation

REASON: My asthma will kick me when I eat too much eggs! 😢 I have an allergy for excessive food, and I want to practice myself to eat egg once a week so that I can restrain myself without any trouble or some kind of temptation.

OBJECTIVE 4: Be a Reading Volunteer

TIME FRAME: September 2020-November 2020

RESOURCES: Book, camera and other gadgets

TASKS:

Pick books that have good life lessons

Look for the age recommendation and mention this

Record yourself reading 

Let people see the book you’re currently reading

Put emotions as you read, let your audience feel what the characters in the book are feeling

Engage with them even in a recorded video (ex. asking questions)

Think of a line that will make a great impact to your audience regarding the lesson of the story 

SUCCESS CRITERIA: Enjoy and engage with your audience

REASON: I am a member of PNU Reading Society and I want to officially become a reading volunteer to help students with their lifelong literacy skills that will empower their learning and also to support those people who are falling behind about reading. 

OBJECTIVE 5: Buy new Optical Glasses

TIME FRAME: January 10, 2020: 1:00PM-3:00PM

RESOURCES: Money, optical frame and receipt

TASKS:

Go to Starfinder Optical Shop at SM

Go to SoYou section and look if there’s a discount (if there is)

Choose an optical frame. Keep in mind the shape of the lens you wat and need, and also its weight

Give the chosen frame to the sales rep. and get your waiting number

Wait for your ophthalmologist to call you before you go in the room

When called, sit properly and let the ophthalmologist check you eyes

Perform the said activities

Observe the weight of the lenses 

Make sure that you picked the right graded lenses

Wait for your optical glasses for 1 hour (and so) 

Present your receipt to the sales rep. and wait for him/her to give your glasses with free case

Wear your glasses to see if it’s okay and check if there’s any damages before leaving

Note: Don’t forget to say thank you!

SUCCESS CRITERIA: Be patient, honest and critical thinker

REASON: I need new glasses because my current one is kind of dirty and is not accurate anymore as months pass by. Inaccurate graded lenses will make me suffer to headaches and dizziness making me hard to study and move.

LONG TERM GOALS

OBJECTIVE 1: Graduate from College

TIME FRAME: July 2019-November 2023

RESOURCES: Perseverance, Time Management and Patience

TASKS: 

Always listen to your professor/speaker

Engage with people around you

Do your tasks correctly as instructed and submit it as soon as possible

Make a to-do list 

Take important notes and organize them all

When there’s an exam, review 2 weeks ahead the test day

Ask questions for clarifications

Join organizations and seminars 

Grab once in a lifetime opportunities

Cry but stand up again when you fail

Believe in yourself 

Dedicate yourself to your course 

SUCCESS CRITERIA: Grit

REASON: Honestly, I want to graduate with latin honors but something struck me and thought that to graduate from college should be my main goal. Honor rolls are just bonuses of your hard work. It is obvious that I want to graduate from college to help my family and give them things that they need and want as well. I want to give them a thank you gift for providing me everything that I needed for years.

OBJECTIVE 2: Open a Business

TIME FRAME: January 2025-January 2029

RESOURCES: Money(Capital), manpower, product/service, promotion, patience, determination and connections

TASKS: 

Think of a business that is unique where many customers will be attracted

Create a solid business plan with your chosen strategy

Make a website or Facebook/Instagram Page about your business

Be approachable to gain customers

Advertise your product/service

When the business grew bigger, register your business name at the Department of Trade and Industry (DTI)

Register with Barangay and present valid IDs

Register your business to your city mayor’s office (LGU)

Register with the Bureau of Internal Revenue (BIR)

Remember to always check your financial status

SUCCESS CRITERIA: Patience, Analytical skill, Accounting, Problem Solving and Communication & Negotiation

REASON: I was an ABM student before and I want to make use of my skills to help my family and those people who need financial assistance. Opening a business was also part of my dreams. Not only that it will help me to gain more money for my post-graduate, but I want to invest my small money from my teaching profession to something that I can make use to the present and future. Nevertheless, having a business will not stop me from teaching.

OBJECTIVE 3: Become a Doctor

TIME FRAME: August 2024-November 2028

RESOURCES: Money, grit, school supplies, experiences and books

TASKS:

Look for a medical school (preferably: De La Salle Medical and Health Sciences Institute)

Take the MCAT (Medical College Application Test)

Focus on your studies to be a Psychiatrist

Earn a Doctor of Medicine and complete your residency

SUCCESS CRITERIA: Patience, Empathy, Focus, Practical & Decision-Making Skills and Time Management 

REASON: I had this late bloomer moment. Before entering college I was confused on what I really want to be. Not that I am boasting but I had this mindset before that any courses will do because I thought I can do everything. My top choices are Architecture, Accountancy, Teaching, and Medical. I chose teaching since there’s a time that I became super inspired of my Senior High School professor and I noticed that from the past few years of my life, I never experienced a class with an excellent Filipino teacher who really took a course of Filipino, and that’s why I want to became one. As I became a BFE Student, I still want to pursue my medical dream. I want to be more useful to my people even if it will take me thousand years to be a 100%.

OBJECTIVE 4: Buy a New House

TIME FRAME: July 2024-July 2026

RESOURCES: Money and communication

TASKS:

Know your budget for your house and stick to it. DON’T EXCEED TO YOUR ESTIMATION!

Research subdivisions or areas that are accessible to buy your needs and public transportation

Get prequalified and preapproved for credit for your mortgage

Find a nice and approachable real estate agent

Start touring to subdivisions or areas that you already searched (Make sure to check every detail of the house especially the water and electrical system and always consider the people who will live with you)

Make an offer

After building the house, get a home inspection and check if there are structural damages before transferring (if there are, contact your real estate agent)

Make sure to pay your monthly bill and coordinate your paperwork

SUCCESS CRITERIA: Hard working, Critical Thinking, Observance and Patience

REASON: I don’t want to be dependent of my family’s money and belongings. I want to buy my own place for my family, and if blessed, I am glad to share my payments with my partner to build our new life together. If my parents want to stay with me, I will let them stay there as well, but if they prefer to stay at our old house, then I’ll support for the renovation of our old house. 

OBJECTIVE 5: Live a Healthy Life

TIME FRAME: August 2020-August 2025

RESOURCES: Healthy food and balanced diet

TASKS: 

Be physically active

Eat a healthy rich diet

Drink vitamins

Do yoga and exercises

Make time with friends and focus in the present

SUCCESS CRITERIA: Self-regulation and willingness

REASON: I have a weak body and I want to practice a healthy life until I get used to it and became my normal habit. I am not a fan of junk food but I still think that I’m not living a healthy life today because I refuse to exercise. But now that I noticed that it is important to take care of yourself and we need these kind of things to prevent us from being sick, I finally told myself that I have to change this kind of lifestyle and start to be healthy; not only physically but also mentally.

#Ethics #Goals

[therapyroomsuk]

How to Choose the Best Therapist for You

There are thousands of therapists out there, but it’s not easy to assess their qualifications, particularly in the throes of a crisis. Here’s our guide to finding help

You may see the words “counselling” and “psychotherapy” and wonder what the difference is. With so many phone numbers and emails you could use, for the uninitiated it’s a bit like putting a pin in an online map and hoping that the person who answers will be kind to you.

When you have reached that difficult moment of emotional crisis where you’ve decided to reach out to a psychology professional, you will probably look online. Cue confusion. You see bewildering lists of accreditation letters – ICP, IACP, PSI, IAHIP, FTAI to name a few - and you notice that there appear to be several methods - Psychoanalytic Psychotherapy, Constructivist Psychotherapy, Couple and Family Therapy, Cognitive Behavioural Therapy, Humanistic Integrative psychotherapy.

Finding a therapist is not like finding a dentist. Your friends will always have lists of dentists, and GPs and personal trainers to call. People tend not to discuss their therapists with each other, partly due to a lingering stigma in Ireland and partly because of the deeply private nature of the problem you are trying to solve.

Today psychotherapy in Ireland has developed to a high standard, even though there is no formal State accreditation of psychotherapists. Still, says psychotherapist Brendan Madden, many people still suffer for four or five years before seeking out a therapist and they may be at the end of their tethers, with sleep problems, anxiety or anger issues.

This feels like a shot in the dark, and yet you’ve never been more vulnerable because things have got pretty stressful for you to be phoning a complete stranger. As the phone rings, you may visualise yourself reaching Gabriel Byrne’s Dr Paul Weston of In Treatment, or Dr Jennifer Melfi in the Sopranos, Frasier Crane or even Sigmund Freud himself, with his goatee and couch where you will lie for an hour trying to remember your dreams. Who knows?

Whatever the reason for considering therapy, there’s no question that people feel extremely vulnerable when they finally decide to make the leap. Can you ask a friend? It’s a good idea, but you may not want to share your friend’s psychotherapist. Your GP may have a psychotherapist or counselling psychologist working in the practice, which can be a good place to start.

Comfortable

Finding a therapist may not seem as straightforward as finding a GP, but it’s actually a good idea to follow the same route. Do you feel comfortable with the person? Have they listened to you on the phone? Are they friendly, clear and otherwise consumer-aware (as in, telling you what they charge)? Are they nearby?

“In the same way we choose a doctor, we should allow ourselves the option of shopping around until we find someone we have a good fit with,” advises Trish Murphy, psychotherapist and Irish Times agony aunt. “This is not always easy and many people choose to stay with the person they first meet and this often works out well.”

Psychotherapists are trained to relate to and treat people who are distressed. They work to alleviate personal suffering and encourage change.

“The therapeutic relationship is very important and you have to be able to trust your therapist,” says Yvonne Tone, a cognitive behavioural therapist, one of the five “modalities” accredited. “It’s about collaborating with the therapist, working in a shared way to understand the problem, such as depression or anxiety, that you want to address.”

But first you have to figure out what all those accreditation letters mean and what the various forms of therapy are. Don’t you? “You can’t say that one therapy is better than another – for example, while CBT (Cognitive Behavioural Therapy) has been shown to be effective, there’s no evidence that it is better than other types of therapy,” says Brendan Madden.

Psychoanalysis, on the other hand, sees the path of self-discovery, in cooperation with the therapist, as an end in itself. “Psychoanalysis respects the individuality of each person,” says Jose Castilho, psychoanalyst and chair of the Irish Council for Psychotherapy.

“It’s not about helping the client to adapt to the world, but helping the individual to adapt to him or herself.”

While it may have a reputation for being the scenic route to wellbeing, since it’s not goal-oriented, psychoanalysis has changed over the years and can help people who are in crisis from a breakup or the loss of a job over a short space of time. Others may remain in “analysis” or other talk therapy for years because of the insights they gain.

Madden practises solution-focused “brief therapy”, where the client is encouraged to become “a solution detective” and discover their own strengths and solutions to whatever problem they’re facing, empowered by the therapist and available Therapy Room to rent.

The uninitiated may think that any therapist of whatever ilk has a gift of insight into their personality that will eventually be revealed like the third secret of Fatima. You are bound to be disappointed, because like the Wizard in Oz, the therapist hasn’t got the answers, only you do. But an effective therapist will help you figure it out.

“Therapy is not a healing ritual or practice performed by the therapist to cure psychological distress. Recovery and emotional healing comes from the strong therapeutic alliance built over time between therapist and client – and it’s really the client who does all the work,” says Madden. Trusting relationship Murphy agrees that establishing a trusting relationship is the key to the success of the therapy. “It’s the relationship between the client and the therapist, not the particular model of therapy, that is most important.”

In recent years, psychotherapy has moved towards shorter, solution-focused therapies that can help the client get through a rough patch or to make a difficult decision. Some therapies, however, can involve much more time. Where there is a serious issue with depression or anxiety, the therapy could take years to get to the source of the problem, says Dermod Moore, chair of the Irish Association of Humanistic and Integrative Psychotherapy (IAHIP).

What’s the difference between a psychiatrist and a psychologist or psychotherapists?

The key difference is that a psychiatrist has been medically trained and holds a medical degree. The suffix “-iatry” means “medical treatment,” and “-logy” means “science” or “theory.” Psychiatry is the medical treatment of the psyche, and practitioners are therefore qualified to prescribe medication, while psychology is the science of the psyche.

A psychotherapist can be a psychiatrist, psychologist or other mental health professional, who has had further specialist training in psychotherapy which focuses on helping people to overcome stress, emotional and relationship problems or troublesome habits.

What qualifications should a psychotherapist have?

All psychotherapists should be accredited with a professional body that adheres to a code of ethics and has complaints procedures and standards of practice. Currently, the Irish Council for Psychotherapy (ICP) is the umbrella body for all psychotherapy in Ireland, representing more than 1,250 psychotherapists who have undergone in-depth training and are committed to the highest standards of professional conduct. Another professional body is the Irish Association for Counselling and Psychotherapy.

Currently, the qualifications required for ICP is seven years’ training, four of those at post- graduate level dedicated specifically to psychotherapy. Many Irish psychotherapists hold the European Certificate for Psychotherapy which qualifies practitioners to work anywhere in Europe.

What will it cost?

Many therapists offer a sliding scale based on your income, so be forthright about what you can afford from the start. The cost varies depending on the psychotherapist but a regular fee is somewhere between €70-€120 per session . Less expensive therapy is available through training programmes or subsidised systems. Many psychotherapists offer a sliding scale for unemployed or retired people. Student therapists need to practise to become qualified, so you can see someone in a training programme for €50 per hour or less. The upside is that student therapists tend to be very enthusiastic, dedicated and well-supervised.

What should my therapist be like?

The therapist should empower you to feel more confident, not less. Empathy is his or her most important quality. Trust your gut instinct about whether this particular therapist is right for you. “Keep it simple and don’t be blinded by jargon. It’s the therapeutic relationship that counts – you have to have a sense that the therapist will listen, understand and work with you towards your goal,” says Madden. If you don’t feel it’s good for you or not what you agreed, then don’t be afraid to find another therapist that’s a better fit for you.

How often do I need to see the psychotherapist?

Usually the first session is used to see if there is a fit between the therapist and client and to agree what the need is about the number of sessions. The average is probably about 8 weekly sessions. Some psychotherapists work on a twice-weekly basis; these would be in the minority.

Are all therapist’s neurotic?

To train as a therapist, you do need to have therapy and sort out your own issues. However, it’s fair to say that there is a tendency for people to be drawn to psychotherapeutic training to sort out their own problems, which probably leads to a higher proportion of neurosis and issues among therapists than among the general population. But that’s usually a good thing because the therapist has probably developed a good deal of compassion and understanding on their journey to mental wellbeing and personal growth.

I’m still not sure. Why do I need a psychotherapist rather than a friend who is a good listener?

A psychotherapist will help to unravel the tangles of the issue and help to clarify what the problem is and what can be dealt with at what time. “Psychotherapy is a safe place to explore and discuss the most difficult of things, even those that are hidden,” advises Trish Murphy.

When should I seek a therapist?

“When you are troubled, suffering, shocked, grieved, floundering and unable to reach decisions,” advises Trish Murphy. “When a relationship – at home, at work or elsewhere – is in trouble is another appropriate time. A critical event might be an ideal time to source help: loss, death, accident, injury, change of country/job, rape, hurt and so on.”

How do I know it’s working?

Generally, how things are working out early on in therapy is predictive of how things will turn out. “You should feel change and notice progress fairly early in the therapy process, over a matter of weeks rather than months,” says Madden. “By six to 10 sessions there should be some early change.”

There’s sometimes a notion that you have to get worse before you get better. Madden disagrees: “If it’s getting worse, something isn’t effective. You should be feeling more hopeful after six to 10 weeks and start to feel better. If not, discuss this with your therapist and consider doing something different .”

How will I know if it’s not working?

From the start, the psychotherapist should be professional and organised and give clear, reassuring answers about their qualifications and experience. The time, date, fee and location of the appointments should be fixed and agreed. The psychotherapist should be empathetic and always put the client’s needs first (for clients at risk of self-harm or abuse, safety needs come first). All psychotherapists are guided by their association’s code of ethics that guide practice and meeting client expectations. If clients are not making progress, therapists are obliged to listen to their feedback, change the direction or focus of therapy, or make a referral onwards. You should feel listened to and heard – that is the core of empathy, a necessary condition for change. With the exception of classical psychoanalysis, the client shouldn’t be expected to do all the talking. The therapist should take turns to summaries, paraphrase and clarify what the client is saying.

Are there cases where a couples therapist is better?

[spector]

This is kind of in the same vein as the last ask (different person) but what are your thoughts on a psychiatrist diagnosing me with adhd after one visit and immediately prescribing meds? I was there to talk about the possibility of me having adhd, but he only talked to me for like half an hour at most

oof yikes i dont like that... it could be the fault of the system i was educated by, because our professors often talk about how USA has a HUGE problem of overdiagnosing patients and getting them on meds as soon as possible, i literally cannot imagine how just 30 minutes of talking can lead to a prescription, it literally baffles me and im not opposed to the general concept of taking medication, of course not!!! its just that to me its a very important decision that needs to be supported by both the doctor and the patient since its going to influence a lot of subjective aspects of ur functioning and i just??? yeah i genuinely cannot imagine me ever doing the same, european therapists/psychiatrists are way less eager to prescribe medications and im not sure why ??? access to medication is generally easier in USA, thats something i noticed when talking to americans online and i dont wanna get into all of that bc i dont have the necessary tools to examine why exactly an american psych-specialist is more likely to slap a diagnosis and a prescription than someone from a different country... 

i’d say he definitely should have done more, i would have done way more, i dont see meds as last resort but it is a serious decision that needs to be discussed with the patient in order to properly introduce it into their lives. my gf described a similar experience with her going to a doctor and walking out with a depression diagnosis and some meds and i just couldnt believe lmfaoooo... god idk its just so weird to me !!! 

#Anonymous

[holdmedownlaw]

2019 – the year I hope could be the start of my renaissance.

Some people know I have chronic insomnia. I often talk about it with my family, friends and those others whom I think should know about it. But nobody really knows how difficult it is to be battling such illness. The suffering is unspeakable; much worse than I can ever describe it. Allah knows.

It started the night before my birthday in 2008. I couldn’t sleep not because the following day was my birthday but because it was my first day in College. I thought it was just that normal night when you don’t get to sleep “because tomorrow is a special and you are so excited about it.” So I went through my first day in college tired but I still had fun nevertheless.

I did not able to sleep again the following night. This time I was alarmed. What could be wrong why I couldn’t sleep? I went to school again the following day but this time I can hardly managed the exhaustion.

I was not able to sleep again on the third night. I started to feel my heart pounding so hard to the point that it made it more difficult even to just calm myself down. I tried not to lose myself. I’m going to a see a doctor tomorrow, I said to myself. But I didn’t. I am so worn out after that day. Maybe I can finally sleep tonight.  But still I had no luck. I started to feel incapable of sleeping. I was getting crazy. “God, I have not slept a single minute for four consecutive nights. I would trade everything to get my eyes shut for even just a few minutes,” I complained to God.

The morning came and I never felt so awful in my life. Later that day, Dad accompanied me to a doctor. I explained how I feel and how I struggled to get sleep. What the doctor did was just gave me a prescription. It was a sleeping pill. To be honest, I was cynical if it could help me get sleep. I believed deep down I needed more than just a pill. I took the pill and tried to sleep. It didn’t work! That time I knew I was screwed.

The torture continued for many, many days. My life was never the same again. As about my studies, I still continued to attend classes despite my deteriorating condition. I just took every class-break I got for rest. And what I mean by rest is that I just lay down and close my eyes and tried to get as much energy as I could get without sleeping to keep me going.

I was able to endure over a month of sleep deprivation. And then there came one night, I was talking to myself, “This is my fate. This is what Allah has ordained for me. I have to be strong and accept it.” I recalled stories of sacrifices of Prophets to keep my spirit alive. While expecting a long night, just like the other previous nights, I closed my eyes. The next time I opened them, I saw the morning light through the small window of my room! I finally get the much needed sleep! I’ve never been so grateful in my life! All praise is due to Allah!

Sleep came back to me but the fear of not being able to sleep didn’t leave me. Every time night falls, the chance of getting a good night sleep is like tossing a coin. And so it did not really last long before insomnia came back again. I was just like given a few nights to breathe and then get back to wrestling again. It has continued to be the case since night of June 13th of 2008.

And just when I thought insomnia could be my only health problem, there came anxiety. It was like that monster who wanted to hurt my almost lifeless body, mercilessly. I did not know what kind of anxiety disorder it really was. I didn’t consult a specialist. I didn’t want to. I just knew I have it.  I couldn’t maintain an eye contact when talking to people. Imagine how devastatingly awkward was that and its negative impact on my social life. I lost a lot of friends. My ordeal served like a filter machine that made me identify who my real true friends are.

Sometimes I sweat excessively even in cold weather. I could remember one time in class my seatmate touched my arms and she felt I was soaking in sweat in a fully air-conditioned room. Goodness!

Many years of my life since anxiety touched me were nightmares. It took a great toll in every aspect of my life – relationships, jobs, studies, etc.! Anxiety also made me become critical of myself – my actions and decisions – which I was not used to be before. And when a person sounded so harsh in criticizing himself in front of his friends or family, imagine how brutal he is to himself in the privacy of his head. Although there were many days I had thoughts of harming myself, I never attempted to. But my devastating health condition made me begged God many times to either cure me or just take me.

My family started to notice although I never told them about it. Sadly, the core of stigma covers our home. I tried to learn more about anxiety and discovered that one in every four persons has anxiety. I also sought inspiration from people who advocate mental illness. Indeed, it is true that when you see others fighting the same battle and more if they fight to voice out what the society has always neglected to address, you feel a little better.

Fast forward to year 2019. Its been already 11 years of seemingly endless struggle. Then, in the dark came a friend who has her own story of struggle with anxiety. She became my classmate in law school in my third year.  She said she was experiencing panic attacks. Honestly I felt glad there was someone in law school who can somehow relate with the situation I am in. From then, we talked frequently about mental illness until one day I opened up to her about planning to see a specialist. I never thought about seeing a Psychiatrist before. It was not in my options. My parents would not approve either. They’ll kill me for worrying so much about what people would say if they find out I am seeing a Psychiatrist. But I was already in my senior year in law school. I had to seek professional help to survive law school.

Then one day, that friend of mine discovered a Psychiatric clinic located near the school. I expressed my desire to make an appointment with the doctor and she enthusiastically offered to do it for me because she said she personally knew the doctor’s secretary. I accepted. I didn’t ask but I speculated she was also planning to get checked but it turned out later that she engaged the services of another Psychiatrist. Maybe she just wanted to know if the Psychiatrist she referred to me is preferable to her. Kinda weird but I didn’t really mind given the fact that people like us who have anxieties really do things weird.

But before I got to have a meeting with the Psychiatrist, I had to go through my parents first and convince them to let me get professional help. My father was strongly against it. He said people would mock our family because one of its members is mentally ill. Nonetheless, I insistently convinced them to be more open to talking about mental illness and overcome the stigma until they finally permitted me to consult a Psychiatrist. What happened with my meeting with the Psychiatrist was different than what I expected though. I thought that before the doctor issues the prescription, I get to share first the entire story of my struggle - how it started, how it has been affecting my life, how I have been trying to cope up, etc., – sort of a counseling. He did ask me how I felt but the questioning I thought was too fixed and limited. It seemed he did not want a long conversation. I could somehow understand because he still had a long line of clients to treat after me. He diagnosed me with General Anxiety Disorder coupled with panic attacks. Then he gave me four medical prescriptions. I have to take four medicines a day! That was the first time I have to take that many medicines a day and probably the most ever in my life.

The following night after my meeting with the doctor, I took the bedtime pill. I was glad with the result. I had like 3 to 4 hours of sleep. That was much better than not getting sleep at all. I didn’t feel perfectly rested but that was a great improvement!

I continued to follow the doctor’s advices religiously and I have been feeling better and better as time goes by. Although I have not really been satisfied with the consultation processes with my Psychiatrist because I think he has not been therapeutic in terms of our doctor-patient relationship, his professional advices have actually been effective so far. One problem I have with one of the prescriptions though, particularly the bedtime pill, is that it has made me extremely dependent on it. I fear that my drug dependency will become permanent but my doctor said he’ll eventually slowly reduce the prescription if I get in the right health condition.

Moving on with my health condition, I am now very happy, Alhamdulillah! I am slowly getting back my self-esteem and confidence. I can now look straight in the eyes making me enjoy communicating to people. The heavy-head feeling is gone. I still struggle falling asleep but at least I still able to get good enough sleep which provide me just the right amount of energy to accomplish my daily tasks. I think it is safe to say that the best decision I’ve made with regards to my health was getting professional help. It cannot be more true to me that sometimes what we are ashamed of to do (address mental illness) is what will actually make us better. By the way, I have been watching motivational videos which I’ve found greatly beneficial.

In Shaa Allah, I will continue to get better and get back the life I have been yearning for years. I have suffered so much damage and destruction in many parts of my life over the past decade. God-willing, I will have the time and health to fix them.

There are many lessons I’ve learned from my years of battle with insomnia and anxiety. I would have never learned the importance of addressing mental illness as a societal issue if I never went through it. The most important though is to keep up the faith in God and to never give up. When you feel pain; when you are tired; when you feel like giving up; when you feel like quitting; when you look around you and nowhere do you see anything remotely looks like success; when it’s all dark; just keep up the faith and believe that God has put you in that darkness for a reason and that after that darkness, you will come out stronger than ever befor

[oldladydatin]

Second Chances...

I’m going to share this because well this is a pretty anonymous blog for one so I feel comfortable and two every year at this time it’s something I think a lot about, it’s a part of who I am. I realize this is going to be some hokey shit. If someone shared this story with me I would think it was some hokey shit they made up to justify their beliefs. It doesn’t really matter to me, even if I hallucinated it, it made a huge impact in my life. Eight years ago today I was laying in a hospital bed, all alone, with Sepsis, not responding to antibiotics, and I was worried I was about to die..... 

A lot of things led up to this day. I had been struggling with depression and anxiety since middle school. I mostly self medicated, I’d been on antidepressants, I’d been to therapists, none of that helped. When I met my ex husband I was a drunk, honestly. I drank a fifth of gin in front of him and then we went driving on trails in the woods and I was barely buzzed, he kept asking if I was okay to drive and I was because I drank like that a lot. On top of struggling with depression and anxiety, I was raped when I was 17 by a friend I trusted and I just sort went off the deep end. I took drugs at parties and didn’t even ask what they were, I was okay with dying. I was angry at the whole fucking world. I never talked about being raped, I told my husband about it later in our marriage, but that was it until I was in my 30′s. I was embarrassed more than anything, I worried I brought it on, like how messed up is that? I worried it was somehow my fault that when I said no 12+ times he didn’t understand it, I didn’t want people to see me like that. All my bad behaviors escalated after that, I went from sort of caring to not caring at all. I used to cut myself and hide them with the like three dozen bracelets I wore all the time, that got worse and I didn’t even necessarily try to hide it. I went from partying once a week to whenever I could. I drank more, I did more drugs, I drank and drove all the time. I got in more trouble. I tried to drop out of school, I wasn’t necessarily struggling academically, I was smart, but I barely went because I’d have panic attacks and I had migraines all the time. I just quit caring. I wasn’t sexually active, I sort of hated being touched after that. I started seeing someone and I never had sex with him, I was too messed up and it was hard being intimate. My ex husband and I were intimate because I felt safe with him, I trusted him. However I wasn’t ever very affectionate towards him, I really struggled with that. My family wasn’t very affectionate, so I didn’t grow up with a lot of touching to begin with, it’s something I’ve struggled with as an adult and oddly being a nurse has helped me get past this, I hug patients all the time, and hold their hands. I was very affectionate with the Mark’s and I loved that feeling, they always made me feel safe and I trusted them, I think those things are important to me in a relationship. 

One day I got a speech from someone I really didn’t even realized cared about me, but he cornered me and lectured me at a party and he meant it, like it was heart felt and I listened. So at some point I was trying to fix myself, I wasn’t doing a great job but I was trying. I had just quit smoking and doing drugs when I met my husband, I was very slowly working on myself. By the time I met my husband our friends were getting into meth. I didn’t have a lot of sense but I had enough to know I didn’t want to do meth. We made the decision to move about an hour away from our friends to a town with more work, where I was already in school studying art. We got engaged and moved into together, yes in that order, I’m old fashioned. I struggled with depression more after we moved, I was very clingy and dependent. I struggled with being sober all the time. I was a mess. I tried different medications, I tried therapy, I tried being a workaholic, I tried any and everything. I never talked about being raped in therapy, I just tried pretend it didn’t happen and it wasn’t apart of me. I graduated with my art degree and we decided to start a family. It took years to get pregnant but I got pregnant. I was the worst pregnant woman on the face of the planet. I had hyperemesis gravida, it’s a real thing. I threw up so much I was chronically dehydrated, the people in the emergency room knew me by first name. I continually visited them for dehydration, migraines, UTI’s and for episodes of vomitting that didn’t stop for hours. By the third trimester I had quit school and I just laid on the couch and cried all day, I was so depressed it was unreal. We talked to the OB doctors about it and they started me on antidepressants that were safe during pregnancy. They tried to schedule a c-section because of my anatomy they already knew I wouldn’t be able to have her naturally. I insistent on a natural birth, I went 24 hours in labor after my water broke, no drugs, trying every damn thing I could and still ended up with a c-section. I felt like a disappointment as a woman, c-sections are viewed by some women as the “easy” way out. It was a major abdominal surgery, that took weeks to recover from and the experience emotionally damaging and I was already struggling. 

I had severe post-pardum depression, possibly psychosis, also a thing. I had panic attacks, I had a hard time even grocery shopping because I’d walk in the store and it would almost warp and seem so endless that I thought I wasn’t getting out. I was trying to load a trailer at one point to move things to our storage unit and I started hallucinating that bugs were crawling all over me. I never slept, when I did I had nightmares. Everything people said to me was blown out of proportion. If someone nitpicked the way I was holding her I felt like they were criticizing me as mother. I decided to kill myself. I picked a date, wrote a letter, it wasn’t me thinking about it, I had a very well thought out plan. My husband found out and we went to the ER and I spent 3 weeks in a half way house for psych patients, doing group and seeing doctors, the whole thing. After that it was psychiatrists and more pills and more diagnosis. My ex husband got laid off from his job and decided it would be best to try to live in another state. I was excited to go one an adventure, but for my health it was probably the worst thing we did. I needed what little support I had at home. In other states this just got worse until I was in another hospital, 3 more weeks I had gained almost 100 lbs between the side effects of the medications and stress eating, At times I barely got out of bed. I was actually in the process of trying to get disability because the panic attacks were so bad I was barely able to hold down a part time job. I was so desperate to feel better I even went to a therapist about the rape but talking about it was so overwhelming I only went to three sessions and quit. I was addicted to drugs that I was prescribed. They prescribed me ambien and ativan. I would pop ativan all day. I would get in an argument with my husband and just pop some ativan during the argument. I started out taking 5 mg of ambien and eventually I was taking 30 mg, I’d run out of pills and barter for more at the job I had. I would take them and black out and go do stuff. It was all very scary. 

I got what I thought was the stomach flu, I was throwing up all week. My ex husband brought home a pregnancy test and asked me to take it. At this point this man never touched me. I didn’t even remember having sex with him in the year before that. Partially that was my fault, because we had sex and I was on ambien and ativan and I didn’t remember it and that made him feel like he took advantage of me so he wouldn’t touch me. As it turned out I was pregnant, We had, had sex when we went home for Christmas, I was drunk and on drugs and I didn’t remember it. This pregnancy was worse, it started with detox. I called my psychiatrist multiple times to try to find out what to do about the medications because they weren’t safe to take during pregnancy. They never returned my calls, so I just quit taking them. I was so sick, I couldn’t sleep, I was sweating so much I was repeatedly changing my clothes, when I did sleep I was having nightmares. I was throwing up all the time. It lasted a few weeks. When I had my first OB appointment I was honest with them about this and they told me I was very lucky that I hadn’t miscarried because of withdrawals. I had the hyperemesis crap again. Migraines, anxiety, I struggled to breath because of my weight, UTI’s, I’m just not good at being pregnant. 

We made the decision for me to go home because I was too sick to take care of my daughter and my ex husband worked. My ex again decided we were moving to another state and I was already so stressed out and I just wanted to go home. But my Dad is extremely critical of me, especially about the weight. I had lost about 45 lbs during the pregnancy at that point and when I told him that he said good for you, you’re not supposed to lose a bunch of weight during pregnancy. We met my family half way because I was too sick to sit in a car for 12 hours, so we stayed the night and drove the rest the next day. I wore jeans that were too tight for this trip because I didn’t want my Dad to make fun of me for wearing sweat pants. They dug into my stomach and I was uncomfortable, I was sweating a lot during the trip. Within the next few weeks the area around the button where they dug in the most became red and started to hurt, and hurt a lot. It just kept spreading and swelling and I was too uncomfortable to sleep. It felt really hot so I’d put ice packs on it at night trying to get comfortable. At my first OB appointment there she diagnosed me with cellulitis and started me on antibiotics. It continued to spread. My parents kept down playing it they didn’t really think I was sick or that it was anything serious. My Dad made comments about how I was just fat and needed to get up and move more. They even took me to a mall because I needed to walk around and then they were going to take me to Apple Bees for my birthday, even though I didn’t like Apple Bees, because they had a lower fat menu. I could barely move I was so uncomfortable, I told them I didn’t want to go and after the mall we just went home. The next day I went to the ER with my daughter, I borrowed a car and lied about where I was going. Within 3 minutes they admitted me, they had medical students in and out of my room to see this infection. Within two weeks I had my son 5 weeks early, he was immediately put on bipap and shipped off to the nearest NICU. I didn’t see him for 4 days and then they transferred me to the same hospital because I had gained 70 lbs from swelling and the infection continued to spread. What started out as a nickel sized red area now wrapped around my entire abdomen to my back. They tried not to do a c-section because it was close to the infection by then but I ended up with an emergency c-section anyways and they were afraid of it spreading to the incision, so they transferred me. I continued to not improve at the other hospital. It wasn’t until I was transferred that I ever heard the term sepsis. I freaked out, I didn’t know anything about it but I knew it could kill you. I had sepsis and I was not responding to antibiotics and they would discuss this in the hallway outside my room. I still insisted on getting up to shower everyday but I couldn’t do it by myself. My ex husband would help me shower and I would stand there and cry. I couldn’t wipe when I went to the bathroom. The entire thing was embarrassing. Eventually I was on oxygen and they were discussing survival odds outside my room, I had no idea what any of it meant. 

One night I was awake in my room alone in the dark, I was worrying because it had been like 4 weeks and I was just getting worse. This light came on in my room and I was able to relax. I felt better, even the burning, throbbing feeling in my stomach felt better. I felt like I was being comforted. I don’t know how to explain it but I felt like I could just go in that moment. I felt like all the pain and suffering could be gone if I wanted it to be. I considered it. I considered leaving the world behind for a split second, just letting everything go. Then I started to imagine this whole life, where I was happy, where I was a good mom, where I didn’t hurt and not just the hurt from the infection, but the hurt in my heart that I had been struggling with my whole life. I thought about my daughter and my baby who I was so in love with already. He was let out of the NICU after only 7 days and he was doing great. He would smile and laugh everytime he heard my voice, nobody in the NICU had ever heard a baby that little laugh. We had a really strong bond from day one. I missed my daughter, I missed cuddling with her on the couch and listening to her stories. I felt like I had so much to live for and I wasn’t ready to die. I made a promise that if I lived I was going to live. I wasn’t going to run from life anymore. I was going to make better choices and work towards being happy. I made a promise to change. The light faded and I was alone in my room again. But I felt hopeful, I wasn’t worried I was going to die anymore. Within 2 days with no explanation at all the swelling improved, the infection was going away and I was responding to antibiotics and they didn’t change them. My labs were coming back better. They started me on lasiks and the weight was coming off and I wasn’t on oxygen. Within four days I was going home after a month long nightmare, I was taking my baby home. I just continued to improve. 

I wake up everyday and chose to be happy. I make better choices, I started working on myself. My ex husband hated that, I think he actually liked me being codependent. and suddenly I wasn’t, suddenly I was going out and doing things alone, or with the kids. I was painting and drawing, when we got settled I started taking art classes. The instructor wasn’t sure why I was taking her class and convinced me to help teach painting at this community center. We moved again and we ended up homeless. I had such a good attitude about this I was like well we’ll just camp until we figure it out. My kids and I lived in a tent for an entire summer, and it was fun. My ex worked and they provided him with hotel rooms. The kids and I hiked, swam, rode bikes, made art, we did all kinds of cool things. To this day my kids think we were on vacation. I changed my whole attitude and when we got settled I went back to school for nursing. I wanted to help people the way people helped me. I wanted to make a difference and I am. I still struggle sometimes but I think about that one moment and the promises I made and I shake myself out of it and get moving. I don’t take drugs, I’ve been offered Vicodin, or ativan by doctors but I’d rather struggle. I drink socially maybe once a month and never when I’m struggling. I’ve been struggling the past month and went to three metal shows and only had water. Every year around this time I think about where I was at 8 years ago and I count my blessings. I think about my life and the promises I made that day and take a look back and try to decided if I’m living up to them. If I’m not I try to decide how I can do better the next year. Some of the best things can come out of the worse days, and that’s what happened 8 years ago. 8 years ago today, I got a second chance. 

[schizophreniachronicles-blog]

The road i have taken

PRACTICAL STEPS TO TAKE ( THE ROAD TO RECOVERY FROM SCHIZOPHRENIA) BY HOMINE SIMPLICE

10.7.18 (6:40AM-8:15 AM) 1) FIND THE ROOTCAUSE:     A) - IS IT DRUG RELATED?           - USE OF MARIJUANA/SHABU/COCAINE/HASH HISH/WEED/MIND ALTERING             DRUGS          - STOP TAKING IT/DETOXIFY          - SEEK DRUG REHABILITATION AND MEDICATION FROM A PSYCHIATRIC            INSTITUTION.          - WILL TRIGGER VOICES/VISIONS/HALLUCINATIONS     B) IS IT BECAUSE OF UNREPENTED AND TOO MUCH SIN? (ONLY IF YOU BELIEVE        IN GOD)        DEUTERONOMY 28: 28-29/DEUTERONOMY 28:45        1 CORINTHIANS 3:15-20/ 1 CORINTHIANS 6:12-20        JAMES 5:13-15       - CONFESS TO GOD DIRECTLY(CHRISTIANS)/ OR A PRIEST(ROMAN CATHOLIC)         ALL YOUR KNOWN SINS FROM THE TIME IN CHILDHOOD WHEN YOU         LEARNED WHAT IS GOOD AND EVIL, UNTIL THE PRESENT TIMES.       -SEEK RELIGIUOS INTERVENTION       - PRAY OVER AND ANOINTING OF THE SICK BY ELDERS OF THE CHURCH  C) IF YOU THINK IT IS AN ATTACK OF THE EVIL SPIRITS OR THE DEVIL( NOT       FALLING UNDER CATEGORY A/B/D/E/F).      - SEEK AN EXORCIST      - READ THE BOOK OF TOBIT IN THE BIBLE(VIA INTERNET/GOOGLE IT!)        ( SALTED FISH HEART AND LIVER AND INCENSE PUT OVER COALS, THE SMOKE        WILL DRIVE AWAY THE EVIL SPIRITS AND WILL NOT COME BACK/TOBIT 6:8) D) IF IT IS CAUSED BY THE ENVIRONMENT?     - ABUSIVE AND AGGRESSIVE PARENTS     - MOLESTATION( SEXUAL AND VERBAL ABUSE)     - PLACES THAT ARE NOT PEACEFUL AND CONDUCIVE TO LIVING(NO PEACE OF       MIND).    - SQUATTER AREA    - TOO MUCH POVERTY    - SO MANY FAILURES AND DISAPPOINTMENTS IN LIFE(EMOTIONAL TURMOILS)    -HAUNTED PLACES    SOLUTION: AVOID TOXIC PEOPLE AND GET OUT OF THE ENVIRONMENT FAST!

E) CAUSED BY INFECTION OF THE WOMB  OF THE MOTHER DURING PREGNANCY?     - TREAT IT MEDICALLY F) SAD EVENTS IN LIFE THAT TRIGGERED SCHIZOPHRENIA:   - DEATH OF A FAMILY MEMBER OR LOVED ONE   - LOSS OF A JOB   - BEING BANKRUPT   -BEING HEARTBROKEN   - NO PEOPLE TO TALK TO OR VENT OUT   - FEELING ISOLATED   - NO SUPPORT SYSTEM   - FEELING OF LIFE HAS NO MEANING   - IT IS A DEADEND/I WANTED TO GIVE UP   - EVERYTHING IS WORTHLESS   -BOTTLED EMOTIONS   - FEELING LOW   - TOO MUCH FRUSTRATIONS AND TRIALS IN LIFE   - FEELING SUICIDAL/TO HURT SOMEBODY OR SELF SOLUTION: IF YOU CANNOT SLEEP WELL FOR MORE THAN 5 DAYS, SEEK MEDICAL                     HELP FROM  A PSYCHIATRIST. PRESCRIPTION FO RIVOTRIL MIGHT BE                     NEEDED. ASK YOUR DOCTOR FOR SLEEPING PILLS.                     EACH PERSON HAS A UNIQUE  PAIN AND FRUSTRATION LEVEL HE OR                     SHE CAN ENDURE. CASE TO CASE BASIS. SOME ARE ONION SKINNED.                     - IT IS SAID IN THE ENCYCLOPEDIA THAT HAVING NO SLEEP FOR 5                       DAYS WILL MAKE YOU MAD AND IRRITABLE.( SEARCH THE INTERNET                       FOR TRUTH ABOUT THIS). G) GENETICS- YOU GET IT FROM YOUR GENES, PARENTS, GRANDPARENTS ,                         RELATIVES. 2) SEEK MEDICAL HELP FROM A PSYCHIATRIST WHO HAD 20-40 YEARS OF    EXPERIENCE. THE OLDER THE BETTER. SINCE MEDICATION IS BY TRIAL AND    ERROR, AN EXPERIENCED PSYCHIATRIST CAN MAKE A SIGNIFICANT DIAGNOSIS    AND A WIDER KNOWLEDGE OF THE RANGE OF MEDICATIONS TO TRY ON THE    PATIENTS. 3) RELY ON GOD FOR HIS MERCY   - READ AND BE KNOWLEDGEABLE UP TO WHAT YOU CAN COMPREHEND ONLY.      YOU COULD NOT MASTER EVERYTHING IN A LIFETIME. DO NOT DWELL ON      MYSTICISM AND NEW AGE STUDIES( ACCORDING FR GABRIEL AMORTH, CHIEF      EXORCIST OF THE VATICAN) OR HIGH FALLUTING WISDOM.   - “A LITTLE KNOWLEDGE IS A DANGEROUS THING. SO IS A LOT”- ALBERT       EINSTEIN   - MEDICATION TAKES TIME TO TAKE EFFECT( 12-18 YEARS IN MY CASE)   - TRY TO SLEEP 8 HOURS A DAY.   - NOT TOO MUCH TV. WATCH NEWS ONLY, AND INTERESTING NEWS ABOUT        MEDICAL BREAKTRHOUGHS/ENCOURAGING TOPICS IN BOOKS/SELF      DEVELOPMENT/LISTEN TO GOOD MUSIC( CLASSICAL AND RELAXATION MUSIC)  - YOU HAVE TO CHANGE YOUR LIFESTYLE TO SIMPLE AND CLEAN LIVING - NO DRUGS/NO WINE /NO WOMEN FROM THE SONG IN THE 80”S TURNING    JAPANESA( LOL)

- BE PASSIONATE FOR HOBBIES - READ “DESIDERATA” POEM, YOU WILL GET AN INSIGHT WHY IT WAS TOP OF THE  CHARTS IN 1970. - SHARE YOUR KNOWLEDGE AND EXPERIENCES TO OTHERS SUCH THAT OTHERS MAY LEARN FROM YOU AND LEAVE A LEGACY. SUCH THAT OTHERS WILL NOT COMMIT THE SAME MISTAKES IN LIFE. - PRAY DAILY(THANK HIM FOR THE DAILY BLESSINGS/ASK FOR DAILY FORGIVENESS OF SINS/ ASK FOR DAILY REQUESTS FOR YOU AND YOUR LOVED ONES). - GET WISDOM FROM READING THE BIBLE( EX PROVERBS/PSALM/ECCLESIASTES/SIRACH/PSALM 23/PSALM 3(UPON WAKING UP)/PSALM 4( BEFORE SLEEPING)/PSALM 15/PSALM 91. - LEARN TO MINGLE WITH THE LOWLY AND SIMPLE PERSONS, SOME OF THEM HAVE GREAT LIFE EXPERIENCES AND KNOWLEDGE, THOUGH UNEDUCATED. BUT YOU HAVE TO FILTER OUT THE TRUTH BY COMPARING WITH FACTS AND FIGURES(IN THE INTERNET). YOU SHOULD ALWAYS MAKE DECISIONS BASED ON DATA THAT YOU GATHERED. DO NOT JUMP THE GUN OR DO BY INSTINCT ONLY. - IT IS A TRIAL BY FIRE, SO BE STRONG AND COURAGIOUS!

4) WHAT THE PATIENT  CAN DO: - LEARN TO LISTEN WELL - DO WHAT IS RIGHT EVEN IF THERE IS NO ONE WATCHING! - ONLY GOD KNOWS OUR FUTURE!

-GOD IS GOOD BOTH TO THE EVIL AND THE GOOD. -SEEK AND YOU SHALL FIND THE CURE

-PUT ORDER INTO YOUR LIFE AND HELP OTHERS

- HAVE AN OPEN EAR TO THOSE PEOPLE YOU LOVE - SURROUND YOURSELF WITH PEOPLE WITH WISDOM AND GODLY PEOPLE   AVOID FALSE PROPHETS AND WOLVES IN SHEEP CLOTHING. AVOID TOXIC   PEOPLE! - ADMIT THAT YOU ARE SICK. ALL OF US, EVEN NORMAL PEOPLE HAVE SOME  KIND OF MADNESS AND INDIOSYNCRACIES. - IT TAKES A LOT OF MONEY AND TIME TO BE TREATED, LOOK FOR CHEAPER AND EFFECTIVE ALTERNATIVES. SEARCH THE INTERNET LIKE AN EAGLE! - GOD SAYS LEARN FORM THE ANT, THEY ARE UNEDUCATED BUT FALLS IN LINE, THEY HARVEST AND LOOK FOR FOOD DURING THE DRY SEASON AND WHEN IT RAINS, IT STAYS ON THE MOUND TO EAT THEIR FOOD. LEARN FORM THEM. 5) BONUS:   - WHAT CAN A SCHIZOPHRENIC COULD POSSIBLY EXPERIENCE: ( THAT OTHERS      WHO ARE NORMAL PEOPLE COULD NOT FEEL OR SEE/ IT IS THE BRAIN THAT      RUN AMUCK/RUNAWAY/ THE BRAIN OVERPOWERS YOUR 5 COMMON      SENSES).      THE BRAIN SENDING MESSAGES TO THE EAR, HEARING VOICES OF MALE OR      FEMALE CURSING YOU. THERE ARE THREATS AND LETTING YOU DO EVIL AND      BAD THINGS.   - THOUGHT BROADCASTING. YOU WILL THINK THAT ALL YOUR THOUGHTS ARE     TRANSMITTED IN THE AIR, SO EVERYONE KNOWS WHAT YOU ARE THINKING.     YOU HAVE NO CONTROL OVER IT. AND NOBODY UNDERSTANDS YOU.     SOMEBODY HAS PLANTED SOME KIND OF A TRANSMITTER IN YOUR HEAD.  - YOU THINK THAT ALIENS HAVE OVERPOWERED YOU AND OR SOME NEW     WORLD ORDER OR HIGHER BEINGS/SPIRITS CONTROL OVER YOU.  - YOU SMELL DIFFERENT ODORS LIKE DUNG OR POOP/EXCRETIONS/PERFUMES    FLOWERS ETC. THAT OTHERS COULD NOT SENSE. - YOU EXPERIENCE A HAIR RAISING AND BLOOD CURDLING VISIONS EXAMPLE SEEING THE DEVIL AND HIS COHORTS. POINTING AT YOU. - YOU THINK THAT OTHERS ARE TALKING ABOUT YOU, AND WOULD LIKE TO HARM YOU. PERSECUTORY THOUGHTS. - YOU THINK YOU ARE COMMUNICATING TO CHARACTERS IN THE TV OR CPHONE - YOU BELIEVE THAT YOU HAVE SOME SPECIAL POWERS DELEGATED ONLY TO YOU, LIKE SAVING THE WHOLE WORLD OR YOU ARE OF GREAT IMPORTANCE( ROYAL BLOOD)/ YOU ARE A KING OR SOMEBODY LIKE SUPERMAN WITH SPECIAL FUNCTIONS ONLY DELEGATED TO YOU BY A SUPERNATURAL FORCE. - YOU BELIEVE IN THE DEVIL /EVIL SPIRITS TOO MUCH ,THAT IT CAN OVERPOWER YOU AND LORD OVER YOU( READ THE BOOK OF JOB IN THE BIBLE. THE DEVIL HAS POWERS ON YOU .ONLY IF HE HAS BEEN GRANTED PERMISSION BY GOD. TO TRY YOUR FAITH) -TALKING EYES, JUST BY LOOKING AT THE EYES OF PERSONS, YOU CAN READ THEIR MINDS JUST LIKE READING LIPS. - YOU FEEL THOUSAND OF NEEDLES PRICKING THE WHOLE OF YOUR BODY. - RAZOR SHARP BLADES SLASHING YOUR FACE AND BLOOD OOZING BUT YOU CANNOT AND OTHERS SEE THE BLOOD BUT YOU CAN FEEL IT. - YOU THINK YOU HAVE TELEKINESIS. - ACID BEING POURED ON YOUR PATE, YOU FEEL YOUR BRAINS BURNING AND  DISSOLVING, YOU SMELL THE FLESH  AND HAIR BURNING. IT HURTS BUT YOU CANNOT DO ANYTHING. - YOU FEEL METAL NAILS BEING PLANTED IN YOUR BRAIN. - YOU THINK YOU HAVE KNOWLEDGE OF HIDDEN TREASURES/WEALTH ETC THAT  IS WHY YOU KEEP ON COMPUTING AND SKETCHING. - YOU HAVE SEEN A LOT OF HORROR MOVIES, IT IS NOW BECOMING A REALITY  TO YOU. SEXUAL EXPERIENCES WITH THE SUCCUBUS OR INCUBUS -ETC. PLEASE ASK ANYONE WHO HAS SURVIVED THE ORDEAL, AND HE/SHE WILL TELL YOU HOW HORRIBLE IT WOULD BE.

MATTHEW:7:7-8: Ask, and it shall be given you; seek, and ye shall find; knock, and it shall be opened unto you: GOOD LUCK AND GOD BLESS!

[your-dietician]

Women Say There Are Too Many Barriers To Accessing Postpartum Depression Drug : Shots

New Post has been published on https://depression-md.com/women-say-there-are-too-many-barriers-to-accessing-postpartum-depression-drug-shots/

Women Say There Are Too Many Barriers To Accessing Postpartum Depression Drug : Shots

Miriam McDonald developed postpartum depression after giving birth to her third son, Nicholas. She says she felt sad, disconnected, and indifferent.

Keith McDonald

hide caption

toggle caption

Keith McDonald

Miriam McDonald developed postpartum depression after giving birth to her third son, Nicholas. She says she felt sad, disconnected, and indifferent.

Keith McDonald

When Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant right away, she and her husband were thrilled. But within three days of giving birth to their son, in September 2019, everything turned.

“I was thinking, ‘Oh my God, what did I do?’ I just brought this baby into this world and I can barely take care of myself right now,” she says. “I feel exhausted. I haven’t slept in three days. I haven’t really eaten in three days.”

As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn’t want to hold her baby, she didn’t want to change him. She says she felt no connection with him at all.

This confused her – she never felt anything like this after her first two kids – and she worried her mood might hurt her son. Untreated postpartum depression can affect babies’ cognitive and social development. For the mother, it can be life or death. Suicide accounts for 20% of maternal deaths.

“Every day, I was crying. Every day, I felt like I just wanted to die. Every day, I thought about ending my life,” says McDonald, who lives in Vacaville, Calif. and works as an IT professional at the University of California, Davis.

She went to Kaiser Permanente, her healthcare provider, for help. She says doctors there put her on a merry-go-round of medication trial and error. The first drug her doctor prescribed made her anxious. Upping the dose of a second drug gave her horrific nightmares. A third drug gave her auditory and visual hallucinations that took seven weeks to go away after she stopped taking it.

Then, her psychiatrist retired. And when McDonald complained to her new psychiatrist that she was still depressed, four months after giving birth, the physician suggested more medications.

“I was desperate,” McDonald said. “I was like, ‘I’m trying to help myself, but things are just getting worse.’ So what am I left with?”

She started doing her own research and learned about a new treatment, called brexanolone. It’s the first and only drug approved by the FDA specifically to treat postpartum depression, which affects 1 out of 8 new mothers in the U.S. Instead of targeting the serotonin system in the brain, like many antidepressants, brexanolone replenishes a hormone metabolite that gets depleted after childbirth — allopregnanolone. Some doctors call allopregnanolone, which is produced by progesterone, “nature’s Valium” because it helps regulate neurotransmitters that affect mood. After giving birth, natural levels of estrogen, progesterone and allopregnanolone all plummet rapidly, making some women vulnerable to postpartum depression. Brexanolone is a synthetic version of allopregnanolone, delivered through an IV infusion over the course of 60 hours. It costs $34,000.

In clinical trials, 75% of women who got brexanolone started to feel better immediately after the 3-day treatment. Half the women went into remission. In the placebo group, 56% of women responded and a quarter went into remission. In practice, doctors are seeing the effectiveness of the drug in the field that mirror the results of the trials.

“People walk out of the hospital, wanting to be with their child, wanting to return home,” said Dr. Riah Patterson, who has been treating women with brexanolone at the University of North Carolina at Chapel Hill since it became available in the summer of 2019. “There is a hopefulness, a brightness. You can really see that transformation in the hospital room over those 60 hours. It’s pretty miraculous.”

For the first year of her son’s life, Miriam McDonald says all her smiles were fake or strained. She struggled to find effective treatment for severe postpartum depression.

Keith McDonald

hide caption

toggle caption

Keith McDonald

McDonald wanted to try it.

But when she asked her doctor for brexanolone, she was told no. In an email, the doctor wrote that the existing studies were “not very impressive.” She added that McDonald did not meet Kaiser Permanente’s criteria for the drug: she would first have to try — and fail to improve with — four medications and electroconvulsive therapy (ECT) before she could try brexanolone. And she had to be six months or less postpartum to try it at all. For Miriam, the clock had run out. She wondered, How could anyone qualify?

“This is crazy. By the time you even try one drug, that’s like four weeks out,” she says. “Another drug is four weeks out, another drug is four weeks out. There’s just no way.”

Kaiser Permanente’s guidance is an outlier. An analysis of guidelines from a dozen health plans revealed that three of them require women to fail treatment with at least one other medication before trying brexanolone. One plan, California’s Medicaid program for low-income women, requires two fails. But Kaiser is the only system NPR found that recommends women first fail four drugs, as well as ECT.

“That’s absurd. So I’m assuming no woman will ever have the opportunity to try brexanolone?” says UNC’s Patterson, one of several experts in postpartum depression who questioned Kaiser’s guidance.

“That is abusive,” says Bethany Sasaki, who runs the Midtown Birth Center in Sacramento and is licensed to administer brexanolone. “Asking someone to fail four oral antidepressants is an unacceptable burden that will undoubtedly create more harm than good.“

Psychiatrist Shannon Clark, who’s been administering brexanolone at UC Davis Medical Center for the last two years, seeing positive results, says there are a lot of reasons new moms may not be candidates for one medication, let alone four: taking pills while breastfeeding could be too anxiety-provoking; some women may not be able to adhere to a daily pill regimen; or they may have a liver condition that contraindicates those medications. Clark called Kaiser’s guidance “terrible” and “insane.”

It could also be illegal, according to some California lawmakers and mental health advocates. Under a California state law that took effect this January, health plans must conform to generally accepted standards of care, including scientific literature and expert consensus, when making decisions about mental health treatment.

“If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law,” says State Senator Scott Wiener, the bill’s author.

Kaiser officials responded by saying they always follow the law. They also say its integrated structure — as both the health insurer and the health provider — makes it different from traditional insurers. At Kaiser, a patient’s doctor determines whether a medication is appropriate, not the health plan, and the criteria doctors use are recommendations, not requirements or pre-requisites that patients need to “exhaust,” says Dr. Maria Koshy, Kaiser’s chair of psychiatry for Northern California.

“At the end of the day, this is an individual clinical decision by both the provider – the physician – and the patient,” she says.

But inside Kaiser, the workplace culture is such that doctors are expected to follow these recommendations, according to former Kaiser clinicians who spoke on background — as well as legislative experts familiar with Kaiser’s model. They say that when Kaiser doctors deviate from the recommendations, they can get questioned or even face consequences.

“These physicians know that if they start routinely ignoring these bad recommendations, that that could have impacts on them professionally,” says Wiener, who has worked on several bills aimed at regulating Kaiser and other insurers in California. “Whether it’s couched as a recommendation or a requirement is almost irrelevant. It has the same effect.”

To McDonald, her physician seemed to follow the recommended criteria as if they were requirements when she declined to prescribe brexanolone. Another patient, Yesenia Munoz, got a similar response when she sought brexanolone treatment. Kaiser’s grievance department sent her a letter denying the request because she had not failed enough medications.

“When I talked to the caseworker at Kaiser that had denied the medication, he said that Zulresso was very expensive,” said Muñoz, referring to brexanolone’s brand name.

In addition to the $34,000 cost for brexanolone, the three-day hospital stay can tack on another $30,000, at least. Another complicating factor is the FDA requirement that health centers obtain a special certification to infuse brexanolone, because of the risks of excessive sedation or fainting from the drug. Kaiser Permanente doesn’t have the certifications yet to administer the treatment at its own hospitals, so it must pay outside hospitals to provide it for Kaiser patients. Kaiser officials say they have plans to eventually open three of their own certified centers in Northern California.

Muñoz, 35, was devastated by the denial. She was overwhelmed by postpartum depression and anxiety shortly after her daughter was born in August 2020. But none of the medications or therapies Kaiser offered her worked. Four months after giving birth, she still felt suicidal.

“I could get out the door sometimes and take the stroller and go walk, and my mind kept on saying, ‘If you just step in front of the car, it’s all going to go away,” she remembers.

After Yesenia Muñoz appealed to state regulators and received brexanolone, she says she felt calm and “happy enough to want to live.”

Rafael Munoz

hide caption

toggle caption

Rafael Munoz

After Yesenia Muñoz appealed to state regulators and received brexanolone, she says she felt calm and “happy enough to want to live.”

Rafael Munoz

Muñoz got help from family members and co-workers to appeal Kaiser’s decision to the state, and after reviewing her medical records, regulators ordered Kaiser to pay for the brexanolone treatment.

Muñoz received the treatment at UC Davis Medical Center, and she started feeling better within the first day.

“The nurse came in and she said something funny and I laughed,” Muñoz says. “It was the first time I had laughed in so long.”

She started looking through photos and videos of her daughter on her phone and she says it was like she was experiencing those moments for the first time. She started making plans for the future.

“It was like a switch flicked and it made me happy enough to want to live,” she says. “It saved my life.”

Sage Therapeutics, the makers of brexanolone, says Kaiser’s approach to the new drug reflects a “a lack of a sense of urgency for treating mental health.” Dr. Steve Kanes, Sage’s chief medical officer, says the company is working on making the treatment more accessible. Its biggest challenge has been getting enough health centers certified, across a wide enough geography, to reach women who need it. The company is studying a pill form of allopregnanolone that could eliminate the need for a hospital stay, but Kanes says that is still not close to being commercially available.

In 2008, Congress passed a landmark federal law aimed at correcting disparities between how insurers pay for mental health treatments compared to physical health. The Mental Health Parity and Addiction Equity Act was later reinforced by provisions in the Affordable Care Act in 2010. But insurers found loopholes, creating overly restrictive or self-serving criteria that made it easy to deny services for mental health care, and as a result, save money.

California’s new law, SB 855, aimed to tighten those loopholes, and has been hailed by advocates as a national model for mental health reform. It requires health plans to use clinically-based, expert-recognized criteria and guidelines in making medical decisions, with the goal of limiting arbitrary or cost-driven denials for treatments of mental health or substance use disorders.

Kaiser operates in 8 states and Washington, DC. In California, it is the largest insurer, holding a 40% share of the market, covering 9.2 million patients. Kaiser officials have questioned how the new state law applies to the Kaiser system, given its unique integrated structure as both health insurer and medical provider. For example, Dr. Maria Koshy, the Kaiser psychiatrist, told NPR that SB 855’s requirement to comply with generally accepted standards of care “does not apply” to its brexanolone recommendations because they were developed and are used by the doctors, not the health plan administrators. When NPR asked Kaiser to provide the brexanolone policy its health plan uses for grievances or appeals, it said it didn’t have one.

“We 100% intended this law to apply to the care people get at Kaiser,” says Julie Snyder, government affairs director at the Steinberg Institute, which co-sponsored the law. “There is no place where we say Kaiser is exempt” because of its integrated structure.

Doctors at Kaiser have historically been “gatekeepers” for services in the system, more so than doctors who work with traditional insurers, says Meiram Bendat, an attorney and licensed psychotherapist who also advised legislators as the law was being drafted. It doesn’t matter if practice recommendations for brexanolone were written by doctors or administrators, or whether the recommendations are mandatory or optional, Bendat says, they must be in compliance with the law.

“If it’s inconsistent with generally accepted standards of care, then it has no place in California,” he says.

Some of Kaiser’s recommended criteria for brexanolone are aligned with generally accepted standards of care; for example, reserving the drug for women who are six months or less postpartum, which was a criterion used in the clinical trials the FDA relied on when it approved the drug.

But the recommendation that patients first try four or five alternative depression treatments before considering brexanolone conflicts with the judgment of half a dozen women’s health experts interviewed for this story. They say there just isn’t enough time to do that in the postpartum period — and too much is at stake.

Not only are babies at risk of developmental and emotional problems if their mother is depressed, husbands and partners are also at higher risk for depression and anxiety. And because new moms are learning to breastfeed, and figuring out what’s part of the new normal and what’s not, it can take months just to realize there’s a problem, explains UNC’s Dr. Riah Patterson.

“It takes so long for this illness to come to recognition and for someone to actually get into an appointment and actually be seen by a provider,” she says.

Dr. Riah Patterson, a specialist in perinatal psychiatry, discusses patients and treatment plans with her trainee, a 3rd year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill.

Madison Piotrowski/UNC Health

hide caption

toggle caption

Madison Piotrowski/UNC Health

Dr. Riah Patterson, a specialist in perinatal psychiatry, discusses patients and treatment plans with her trainee, a 3rd year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill.

Madison Piotrowski/UNC Health

Indeed, the FDA fast tracked the approval of brexanolone in part because of how well and how quickly it worked, allowing women to feel better and get back to their families in three days.

“It’s new, it’s promising,” says Kaiser’s Dr. Koshy, but adds that “it’s not a benign medication.” Six women in the clinical trials felt faint or fainted, which is why the FDA requires women to be continuously monitored in certified health centers when getting the medication.

Also, the safety and efficacy data is limited, Koshy says. The clinical trials only compared brexanolone to placebo, not to alternative treatments. So while the data show brexanolone works better than nothing, there’s no data on whether it works better than drugs like Zoloft, or better than electroconvulsive therapy.

Women who received the placebo in the trials also showed improvement in depressive symptoms — which is common in studies of depression treatments — but more women who received brexanolone showed improvement, and their improvement was more substantial and lasted longer, especially if their depression was more severe before treatment. Women with moderate depression who received the placebo did just as well, 30 days after treatment, as those who received brexanolone, which could be because they felt better on their own, or because other antidepressants they were allowed to take during the trial finally kicked in.

Koshy says Kaiser is always reviewing practice recommendations as new evidence becomes available, but also acknowledged that Kaiser’s recommendations for brexanolone have not been updated since they were first developed two years ago, in July 2019.

Two weeks after this story first aired in Northern California, Koshy informed NPR that Kaiser Permanente is now reviewing the recommendations. She also added that Kaiser had recently communicated with its physicians that the recommendation to try four medications and ECT before considering brexanolone actually applied to a woman’s entire lifetime, not just treatments attempted in the postpartum period. Kaiser confirmed that it did not write this into the recommendations themselves, and declined to offer details about how this information was shared with physicians.

It is unclear what role California’s Department of Managed Health Care, the state agency that regulates Kaiser, might play in resolving issues of access to the infusion. In a statement, department officials said they will review any criteria or guidelines the Kaiser health plan uses for brexanolone, but the department does not have jurisdiction over physician decisions.

The department also monitors patient complaints when new medications or treatments begin to be used, in order to identify problems with access to care. So far, the Department has received two complaints about brexanolone – both were filed by Kaiser patients.

One was Yesenia Munoz. The other was Miriam McDonald.

Before going to the state, McDonald called Kaiser’s grievance department to complain about her treatment and the denial of brexanolone. Kaiser responded by sending the cops to her house for a welfare check.

The officers were calm and nice, McDonald said, but when she closed the door, she cried her eyes out.

“It just brought me to a whole new low,” she said. “Why didn’t my doctor call me and talk to me first? I mean, this is how you treat postpartum mental health? How dare you.”

Kaiser told NPR it cannot comment on any individual cases because of privacy laws, but that generally, “We feel deep compassion for any patient experiencing the difficult and serious effects of postpartum depression, and our goal is always to support every patient’s safe return to a healthy mental state.”

McDonald then appealed Kaiser’s denial of brexanolone to state regulators, but by that time, she was past the six-month postpartum cutoff.

She never got brexanolone.

Still, she continued to fight for relief and eventually got Kaiser to cover a different treatment for severe depression, transcranial magnetic stimulation, which uses an electromagnetic coil to stimulate nerve cells in the brain that control mood. That typically costs about $300 per session, and McDonald went in for the treatment five days a week, for three months. Now she is finally feeling like herself again.

After her efforts to get brexanolone failed, Miriam McDonald received transcranial magnetic stimulation at Kaiser Permanente to treat her postpartum depression. She says her mood started to really improve when her son was about 18 months old.

Miriam McDonald

hide caption

toggle caption

Miriam McDonald

After her efforts to get brexanolone failed, Miriam McDonald received transcranial magnetic stimulation at Kaiser Permanente to treat her postpartum depression. She says her mood started to really improve when her son was about 18 months old.

Miriam McDonald

“I can remember I woke up one day and I was excited. I had actual joy,” she says. “I got up and I walked into his room and I was like, ‘Hey, Nico! Hi! Hey, baby!’ And he jumped up from his crib and giggled and put his arms out. And I just swooped him up in my arms and cried. Because I was like, ‘I am so proud to be your mom.'”

Now when her son smiles at her, she genuinely smiles back. But it took more than 18 months to get here. She can’t help but grieve all the smiles she didn’t return in that time, and how she felt like she was barely present at crucial times, like when her son took his first steps.

“I felt like I’ve been robbed of all those moments,” she says, “of those little milestones, that I’m never going to get back.”

This story comes from NPR’s health reporting partnership with KQED and Kaiser Health News (KHN).

Source link

[therapyroomsuk]

A Guide to Finding The Right Therapist for You

Therapy unlocked: a guide to finding the right therapist for you

There are thousands of therapists out there, but it’s not easy to assess their qualifications, particularly in the throes of a crisis. Here’s our guide to finding help.

When you have reached that difficult moment of emotional crisis where you’ve decided to reach out to a psychology professional, you will probably look online. Cue confusion. You see bewildering lists of accreditation letters – ICP, IACP, PSI, IAHIP, FTAI to name a few - and you notice that there appear to be several methods - Psychoanalytic Psychotherapy, Constructivist Psychotherapy, Couple and Family Therapy, Cognitive Behavioural Therapy, Humanistic Integrative psychotherapy.

You may see the words “counselling” and “psychotherapy” and wonder what the difference is. With so many phone numbers and emails you could use, for the uninitiated it’s a bit like putting a pin in an online map and hoping that the person who answers will be kind to you.

This feels like a shot in the dark, and yet you’ve never been more vulnerable because things have got pretty stressful for you to be phoning a complete stranger. As the phone rings, you may visualise yourself reaching Gabriel Byrne’s Dr Paul Weston of In Treatment, or Dr Jennifer Melfi in the Sopranos, Frasier Crane or even Sigmund Freud himself, with his goatee and couch where you will lie for an hour trying to remember your dreams. Who knows?

Finding a therapist is not like finding a dentist. Your friends will always have lists of dentists, and GPs and personal trainers to call. People tend not to discuss their therapists with each other, partly due to a lingering stigma in Ireland and partly because of the deeply private nature of the problem you are trying to solve.

Today psychotherapy in Ireland has developed to a high standard, even though there is no formal State accreditation of psychotherapists. Still, says psychotherapist Brendan Madden, many people still suffer for four or five years before seeking out a therapist and they may be at the end of their tethers, with sleep problems, anxiety or anger issues.  

Whatever the reason for considering therapy room for rent , there’s no question that people feel extremely vulnerable when they finally decide to make the leap. Can you ask a friend? It’s a good idea, but you may not want to share your friend’s psychotherapist. Your GP may have a psychotherapist or counselling psychologist working in the practice, which can be a good place to start.

Comfortable

Finding a therapist may not seem as straightforward as finding a GP, but it’s actually a good idea to follow the same route. Do you feel comfortable with the person? Have they listened to you on the phone? Are they friendly, clear and otherwise consumer-aware (as in, telling you what they charge)? Are they nearby?

“In the same way we choose a doctor, we should allow ourselves the option of shopping around until we find someone we have a good fit with,” advises Trish Murphy, psychotherapist and Irish Times agony aunt. “This is not always easy and many people choose to stay with the person they first meet and this often works out well.”

Psychotherapists are trained to relate to and treat people who are distressed. They work to alleviate personal suffering and encourage change.

“The therapeutic relationship is very important and you have to be able to trust your therapist,” says Yvonne Tone, a cognitive behavioural therapist, one of the five “modalities” accredited. “It’s about collaborating with the therapist, working in a shared way to understand the problem, such as depression or anxiety, that you want to address.”

But first you have to figure out what all those accreditation letters mean and what the various forms of therapy are. Don’t you? “You can’t say that one therapy is better than another – for example, while CBT (Cognitive Behavioural Therapy) has been shown to be effective, there’s no evidence that it is better than other types of therapy,” says Brendan Madden.

Madden practises solution-focused “brief therapy”, where the client is encouraged to become “a solution detective” and discover their own strengths and solutions to whatever problem they’re facing, empowered by the therapist.

Psychoanalysis, on the other hand, sees the path of self-discovery, in cooperation with the therapist, as an end in itself. “Psychoanalysis respects the individuality of each person,” says Jose Castilho, psychoanalyst and chair of the Irish Council for Psychotherapy.

“It’s not about helping the client to adapt to the world, but helping the individual to adapt to him or herself.”

While it may have a reputation for being the scenic route to wellbeing, since it’s not goal-oriented, psychoanalysis has changed over the years and can help people who are in crisis from a breakup or the loss of a job over a short space of time. Others may remain in “analysis” or other talk therapy for years because of the insights they gain.

The uninitiated may think that any therapist of whatever ilk has a gift of insight into their personality that will eventually be revealed like the third secret of Fatima. You are bound to be disappointed, because like the Wizard in Oz, the therapist hasn’t got the answers, only you do. But an effective therapist will help you figure it out.

“Therapy is not a healing ritual or practice performed by the therapist to cure psychological distress. Recovery and emotional healing comes from the strong therapeutic alliance built over time between therapist and client – and it’s really the client who does all the work,” says Madden. Trusting relationship Murphy agrees that establishing a trusting relationship is the key to the success of the therapy. “It’s the relationship between the client and the therapist, not the particular model of therapy, that is most important.”

In recent years, psychotherapy has moved towards shorter, solution-focused therapies that can help the client get through a rough patch or to make a difficult decision. Some therapies, however, can involve much more time. Where there is a serious issue with depression or anxiety, the therapy could take years to get to the source of the problem, says Dermod Moore, chair of the Irish Association of Humanistic and Integrative Psychotherapy (IAHIP).

What qualifications should a psychotherapist have? All psychotherapists should be accredited with a professional body that adheres to a code of ethics and has complaints procedures and standards of practice. Currently, the Irish Council for Psychotherapy (ICP) is the umbrella body for all psychotherapy in Ireland, representing more than 1,250 psychotherapists who have undergone in-depth training and are committed to the highest standards of professional conduct. Another professional body is the Irish Association for Counselling and Psychotherapy.

Currently, the qualifications required for ICP is seven years’ training, four of those at post- graduate level dedicated specifically to psychotherapy. Many Irish psychotherapists hold the European Certificate for Psychotherapy which qualifies practitioners to work anywhere in Europe.

What’s the difference between a psychiatrist and a psychologist or psychotherapists? The key difference is that a psychiatrist has been medically trained and holds a medical degree. The suffix “-iatry” means “medical treatment,” and “-logy” means “science” or “theory.” Psychiatry is the medical treatment of the psyche, and practitioners are therefore qualified to prescribe medication, while psychology is the science of the psyche.

A psychotherapist can be a psychiatrist, psychologist or other mental health professional, who has had further specialist training in psychotherapy which focuses on helping people to overcome stress, emotional and relationship problems or troublesome habits.

What will it cost? Many therapists offer a sliding scale based on your income, so be forthright about what you can afford from the start. The cost varies depending on the psychotherapist but a regular fee is somewhere between €70-€120 per session . Less expensive therapy is available through training programmes or subsidised systems. Many psychotherapists offer a sliding scale for unemployed or retired people. Student therapists need to practise to become qualified, so you can see someone in a training programme for €50 per hour or less. The upside is that student therapists tend to be very enthusiastic, dedicated and well-supervised.

What should my therapist be like? The therapist should empower you to feel more confident, not less. Empathy is his or her most important quality. Trust your gut instinct about whether this particular therapist is right for you. “Keep it simple and don’t be blinded by jargon. It’s the therapeutic relationship that counts – you have to have a sense that the therapist will listen, understand and work with you towards your goal,” says Madden. If you don’t feel it’s good for you or not what you agreed, then don’t be afraid to find another therapist that’s a better fit for you.

How often do I need to see the psychotherapist? Usually the first session is used to see if there is a fit between the therapist and client and to agree what the need is about the number of sessions. The average is probably about 8 weekly sessions. Some psychotherapists work on a twice-weekly basis; these would be in the minority.

Are all therapist’s neurotic? To train as a therapist, you do need to have therapy and sort out your own issues. However, it’s fair to say that there is a tendency for people to be drawn to psychotherapeutic training to sort out their own problems, which probably leads to a higher proportion of neurosis and issues among therapists than among the general population. But that’s usually a good thing because the therapist has probably developed a good deal of compassion and understanding on their journey to mental wellbeing and personal growth.

I’m still not sure. Why do I need a psychotherapist rather than a friend who is a good listener? A psychotherapist will help to unravel the tangles of the issue and help to clarify what the problem is and what can be dealt with at what time. “Psychotherapy is a safe place to explore and discuss the most difficult of things, even those that are hidden,” advises Trish Murphy.

When should I seek a therapist? “When you are troubled, suffering, shocked, grieved, floundering and unable to reach decisions,” advises Trish Murphy. “When a relationship – at home, at work or elsewhere – is in trouble is another appropriate time. A critical event might be an ideal time to source help: loss, death, accident, injury, change of country/job, rape, hurt and so on.”

How do I know it’s working? Generally, how things are working out early on in therapy is predictive of how things will turn out. “You should feel change and notice progress fairly early in the therapy process, over a matter of weeks rather than months,” says Madden. “By six to 10 sessions there should be some early change.”

There’s sometimes a notion that you have to get worse before you get better. Madden disagrees: “If it’s getting worse, something isn’t effective. You should be feeling more hopeful after six to 10 weeks and start to feel better. If not, discuss this with your therapist and consider doing something different .”

How will I know if it’s not working? From the start, the psychotherapist should be professional and organised and give clear, reassuring answers about their qualifications and experience. The time, date, fee and location of the appointments should be fixed and agreed. The psychotherapist should be empathetic and always put the client’s needs first (for clients at risk of self-harm or abuse, safety needs come first). All psychotherapists are guided by their association’s code of ethics that guide practice and meeting client expectations. If clients are not making progress, therapists are obliged to listen to their feedback, change the direction or focus of therapy, or make a referral onwards. You should feel listened to and heard – that is the core of empathy, a necessary condition for change. With the exception of classical psychoanalysis, the client shouldn’t be expected to do all the talking. The therapist should take turns to summarise, paraphrase and clarify what the client is saying.

Are there cases where a couples therapist is better? Where there are difficulties in an intimate relationship, there is often a case for seeing a couples therapist. Where someone is undergoing personal therapy for depression, for example, and relationship issues arise, this does not necessarily mean leaving the individual therapist. Where both parties are willing, the therapist might seek to work specifically with them on couple issues for a period of time, which can be enormously helpful for both the individual’s depression and the couple relationship. Familytherapyireland. com is the professional body for couple and family therapists.

Many family therapists work with people on an individual, couple and family level. Other therapists offering couple therapy would be expected to have additional training or experience in this area.

#therapy room for rent

[pulmonarymedicine]

Why I Decided to Pursue Respiratory Therapy

If there is one thing people forget to tell you about college, its that you can always start over.

In high school I was big on Crime and Punishment. It was a course I knew about my freshman year of high school that I anticipated three years for. The class was everything I wanted: mock trials, field trips to a prison, and engaging discussions about crime and the American legal system. Yet, what really enticed me was the mind of a criminal. What made them do what they’ve done? Why did they do what they’ve done? I was hooked on the idea, and when I was applying to undergraduate school I knew psychology was the degree program I wanted to be in. I had thoughts about working with criminals in the prison system or working as a psychiatrist. In a sense, I felt like I knew where I was going in life.

Except life has an interesting, almost funny way of messing with you.

In my second year of undergrad I found myself less and less engaged with the material. The information never retained because I never felt myself interested enough in order to do so. College was fun, I had great friends and went to amazing parties, but I couldn’t love the degree plan I was going for. The mystery crime documentaries I used to be so intrigued by were all short-lived interests, and learning about the criminal mind felt like something that was more fun and entertaining when it wasn’t a career. I heard stories about my friends volunteering with crisis centers and telling me how it was difficult not to shoulder the pain they heard while volunteering. I kept asking myself: could I do it? Was there a way that I could become a psychiatrist? Would I be able to stomach the emotions and experiences of criminals? The more I thought about it, the more it dawned on me.

It came to a point that I realized psychology was not the correct degree path for me. If I couldn’t find myself loving the material, finding joy in what I was learning, then it was not worth it. I did not want to be stuck with a degree I couldn’t enjoy and then stuck with a job I knew I wasn’t going to love doing. Although I was already half-way done with the degree program, I knew that I had to switch as soon as possible. Before signing up for my junior year of undergrad, I decided to take a break from college.

It was a difficult decision, especially since my parents were not supportive of it at first. Their mentality was that my degree could land me a job anywhere, but my issue was that I did not want a job but that I wanted a career. I would rather take two years off then to finish two years of a diploma I did not want. Despite it being a tough decision at first, it was the best thing that I could have done for myself. Taking the time to look at my options, explore different careers paths, and just work a normal job made me feel like I had more time than I originally thought. Undergrad is a long four-year journey that makes it feel like if you were to ‘waste’ your time, then you’ll lose that time forever. The decision to stop going to school made me think that I was wasting my time, but I had to remind myself that I was still young and had all the time in the world. People change trajectory all the time, some sooner then others, but its important to know that it is never to late to switch goals in life.

After a year of being on my break, my mother approached me with the idea of becoming a respiratory therapist. I was hesitant at first only because I could not envision myself as someone working with physically ill patients, yet I decided to research the career path just to see what it would entail. The more I researched about the career, the more intrigued I was about it. I was proficient in chemistry and math, but never thought about pursing a STEM career. After hours of research about how to become a respiratory therapist, what they did, and talking to my mother’s coworker who worked as a respiratory therapist I knew that I found a career that I could be excited about.

So, you must be wondering what a respiratory therapist is (I mean, you clicked on this blog for a reason!) and are probably someone who needs to see some variable career choices. Here is my take on what a respiratory therapist is, and why you should become one yourself.

A respiratory therapist (RT) is a trained healthcare worker that aid with cardiopulmonary diseases.  They handle an array of patients from the ones that are critically ill to the more stable patients. They are specialized in treating lung cancer, asthma, emphysema, bronchitis, and pneumonia. When it comes to a career in healthcare/medicine, its important to know that providers are always a part of a major team. Most would assume that careers in healthcare may just be nurses and physicians, but there are other specialized professions out there and they all work together to aid in caring for patients. RTs work alongside physicians, nurses, technicians, assistants, and even medical students in order to provide the best healthcare to a patient.  

There are three types of respiratory care works: a technician, an assistant, and a therapist. Technicians are usually in charge of handling the equipment needed to treat cardiopulmonary diseases such as ventilators and oxygen concentrators, while assistants are students in training that have little to no interaction with patients that are in charge of cleaning and sterilizing the environment or equipment. The therapist is the individual who directly works with a patient and their main duties include (yet are not limited to) administering oxygen to patients, managing ventilators, monitoring the cardiopulmonary system of the patient, and measuring lung function.

Now, you might be asking yourself: how do I become an RT? Most RTs have an associate degree from an accredited college/university with a RT program. Once going through the program, graduates are prepared for certification and registry credentials by the National Board for Respiratory Care. Once they gained their license, they are able to purse jobs in different healthcare environments.

All in all, changing your career goals are not unusual. Many think that they have to stay in their degree plan, or continue to work the job they are in, but it is never too late to shift your circumstances. Working in healthcare will always be a stressful thing, but if you want a fulfilling career that is challenging, satisfying and balanced then I would suggest  looking into the kind of career a RT is. Who knows, it might even be the right plan for you.

[loudgothbf]

He tried to sneak advice not bc he thinks you are stupid but bc he wanted to help. A therapist not trying to help someone with mental health issues is like a doctor not helping someone who passed out on the street. A shitty move. Also you mix up therapist and psychologist/psychiatrist. Therapists work off of the shit psychs find out. They don't find anything. He kept in mind your disliking for therapists and tolled you not to go to one unless you really want to. Also, do you know how hard it is to find a therapist? It can take up to 3 years if not more. Also also, if for once you had been the one to make the move you would have known he had to work non stop for multiple months and didn't contact you bc of that. But no, you need everyone to come to you. Not like you have his number and could have texted him or something.

“Well he, a therapist who supposedly remembered that I don’t trust therapists, should’ve maybe thought about how that would make me feel in a situation where I was already panicking and on edge, and maybe wouldn’t want it used as evidence that I’m irredeemable and stupid. Especially since, yeah, if someone tells you not to do something and you do it anyway, it’s still a dick move even if you had good intentions. If I told you not to throw something out and you did anyway because you thought it was cluttering my room and making me unhappy, and I was mad at you because it was something important to me, that makes you the dick, not me.”

“Also, a therapist not trying to help someone with a mental health problem isn’t at all like a doctor not helping someone who is passed out on the street, actually. For one, a conscious person can consent to care or, as I did, refuse to consent to care, whereas an unconscious person can’t make that decision. For another, anyone could call 911 if they found an unconscious person in the street, and they’d be considered helping, but not anyone can just jump in and give mental health advice because it can actively be harmful. And, if a doctor who was not that person’s doctor decided to take over medical care when that person actively denied them permission to do so, they’d have a million malpractice lawsuits against them, because it’s wrong. So why would it be okay for a therapist to do it?”

“Also, in defense of literally all therapists, they have to think for themselves and can give diagnoses. I’m pretty sure that’s what the exhaustive schooling is for, actually. And their job is, in fact, to find out what the problems are in someone’s life, highlight them, figure out their causes, and help the individual come to a solution. They don’t just sit there and doodle on their notepads while someone talks at them for an hour. Also, strangely, in defense of therapists, finding them is pretty easy because search engines exist. Maybe you have a waiting list that takes a while, but finding one and doing an intake form? No, that takes maybe a week. And waiting lists for general therapy don’t usually last longer than a year. Maybe more specialized shit has longer lists, but general therapy? No. Absolutely not. Not unless you’re trying to get into the office of the only therapist in a 200 kilometer radius. Getting on a waiting list is actually pretty fast, it’s just the waiting, y’know, once you’re on a list that takes a while. And last time I checked, I’m not on any waiting lists. Wonder why that is.”

“Oh, and I’m so very, very sorry that Anno was so so busy, so busy he couldn’t have called me, but he definitely could’ve taken a call and made a lot of time for my problems, and I was just too clueless to know about it. You know, I’ve also been pretty busy in the past few months. Just little things, y’know, like being kidnapped and having to testify in court against someone who put me through years of hell while my testimony was actively being suppressed by the police. Really, it’s nothing to complain about, I should’ve made time to talk to call him. Especially since I asked him for help and he said he’d get back to me if he had anything, so I should’ve known that when he hadn’t gotten back to me yet that I needed to just jump right in and assume he was just sitting on a solution. Yep, thanks. Should’ve just texted him.”

#Anonymous #answered