#but i don't have access to a therapist so i have to do it the hard way

[uncanny-tranny]

I recently had to do a project in one of my psych classes, and man, I knew that CBT was used for every little thing, but seeing over and over, "do CBT! CBT is the best for every mental illness!" was so jarring. I'm absolutely biased because of my own experiences, but I just don't think it's as universal a treatment model as it's touted.

If you didn't benefit from CBT, it's not because you're lazy or didn't try hard enough or lacked intelligence or foresight into your own needs. Frankly, it's a therapy model that (I think) shouldn't be the only readily-accessible model and among the only therapy models covered by insurance. Some of us should not be treated in a CBT model and that's okay. It's not a sign of poor character or unreasonable demands, and if you don't think it's a model that works for you, then it's your right to express that!

[theladygazingatemptiness]

q.... how does one go about informing/reaching out to people about having suicidal thoughts

[selvepnea]

Thinking about. That one post about art. And how it's never good enough. Since you're the one that made it. And how. It might relate to how I view myself?

[politemagic]

i'm in that stage of anxiety right now where i can't focus on anything except for my anxiety.

i want to just take a nap, but i'm too anxious to sleep. i can't write because my brain will destroy every sentence it sees, i can't watch tv because my brain won't stop running long enough to listen, i can't call anyone because my support system are all busy or frustrated with me and even if i could, i have no idea what to say. everyone's just gonna do the "it's okay, don't worry" maneuver on me and i'm just not fucking here for it. i know that. i know that. it does not help. it just makes me feel like a bigger burden for bothering you about it.

[chaotictomtom]

got my 1 year and ½ t checkup appointment this afternoon and everything's good so i don't to see my doc until next year!!! healthy man right here (hormone wise/blood results)

[medicinemane]

Also I gotta ask... at what point is it ok for me to just be kind of messed up?

How much work do I have to put in to moving my life in a positive direction before people will stop just being like "you should get professional help" any time I talk about how I'm doing?

Practically speaking, what is a therapist going to do for me? I'm not saying it's nothing, I'm saying lets talk about what they can actually do

They might be able to help me figure out how to get to stuff I want to do sooner, but I clearly eventually get to it even if it's very slow

They could maybe help me with some of my feelings, but truthfully I know most of why I am the way I am and the trouble is just that I can't get access to the things that would meet my unmet needs

A therapist can't just fix that

So here's the question for whenever people see me saying even just "I'm suicidal but not planning on acting on it soon" and tell me to get help, and the question is "What will this help do for me and how will it accomplish it?"

I've done a lot of therapy over the years. I have rough ideas of the ways it would help me right now. I'm interested to hear what other people who keep recommending it think it would do

[steampoweredskeleton]

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Ignore

[grimandghoulish]

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[a-sleepy-ginger]

3/4/24

✿❈✿❈✿

Baby potato

Finished hime Sama goumon no jikan desu anime and it was really cute

Fruit

[giantkillerjack]

Today my therapist introduced me to a concept surrounding disability that she called "hLep".

Which is when you - in this case, you are a disabled person - ask someone for help ("I can't drink almond milk so can you get me some whole milk?", or "Please call Donna and ask her to pick up the car for me."), and they say yes, and then they do something that is not what you asked for but is what they think you should have asked for ("I know you said you wanted whole, but I got you skim milk because it's better for you!", "I didn't want to ruin Donna's day by asking her that, so I spent your money on an expensive towing service!") And then if you get annoyed at them for ignoring what you actually asked for - and often it has already happened repeatedly - they get angry because they "were just helping you! You should be grateful!!"

And my therapist pointed out that this is not "help", it's "hLep".

Sure, it looks like help; it kind of sounds like help too; and if it was adjusted just a little bit, it could be help. But it's not help. It's hLep.

At its best, it is patronizing and makes a person feel unvalued and un-listened-to. Always, it reinforces the false idea that disabled people can't be trusted with our own care. And at its worst, it results in disabled people losing our freedom and control over our lives, and also being unable to actually access what we need to survive.

So please, when a disabled person asks you for help on something, don't be a hLeper, be a helper! In other words: they know better than you what they need, and the best way you can honor the trust they've put in you is to believe that!

Also, I want to be very clear that the "getting angry at a disabled person's attempts to point out harmful behavior" part of this makes the whole thing WAY worse. Like it'd be one thing if my roommate bought me some passive-aggressive skim milk, but then they heard what I had to say, and they apologized and did better in the future - our relationship could bounce back from that. But it is very much another thing to have a crying shouting match with someone who is furious at you for saying something they did was ableist. Like, Christ, Jessica, remind me to never ask for your support ever again! You make me feel like if I asked you to call 911, you'd order a pizza because you know I'll feel better once I eat something!!

Edit: crediting my therapist by name with her permission - this term was coined by Nahime Aguirre Mtanous!

Edit again: I made an optional follow-up to this post after seeing the responses. Might help somebody. CW for me frankly talking about how dangerous hLep really is.

[moondirti]

blue collar simon x gn! reader. implied cnc.

Simon finds a journal on his lunch break.

It's inconspicuous. A5 black moleskin with an elastic holding it's contents together, bits of paper sticking out like nails on a poorly constructed house frame. He only notices it because his cooler slips off the bench when he blindly places it atop the fat book, sandwiches and packets of crisps now strewn across the dirty pedway.

The day's already been shit. A motley of blows, each made worse by the torrid sun overhead, sweat to cling to his grievances. An uptight site manager. A near loss of life after some tenderfoot got caught in between an excavation truck and the wall. Even his too-long hair, which curls around red ears – having not had a chance to buzz it off since being called in for this job. It's no wonder, then, that the tiny mishap stirs as severe of a reaction as it does; he chucks his hard hat across the road, satisfied only when it finds its fate mid-lane, an obstruction to inevitably fuck the tires on a white collar's new car.

When his rage settles as smouldering ash in his chest, he picks his food off the floor and cracks open the source of his animosity.

With no name or number, the first page holds just a chicken-scratch address. Interesting. Its owner hasn't made this easy on him, crafting it like one would a game. A skewing of traditional acquaintance. Granting nothing of their superficial identity, yet unrestricted access to their innermost thoughts. Thus he's forced to paint his own picture of the figure behind the words.

And what a picture indeed.

The first entry is brief.

13.02 – My therapist expects at least three pages a week. I'm not doing any of that, so don't get your hopes up.

It's evident that you don't stick to your guns. Though the next one is dated several months later, so he see's the attempt had been made. Written in a whole new hand, like you'd picked a dry pen off the floor and practiced your non-dominant grip:

08.05 – I broke my arm playing tennis. The umpire called a match-point in my opponent's favour and I threw the racket at his head.

I am no longer allowed to play tennis. What good is that resolution? My radius has a greenstick fracture. I'm already out of the game.

His laugh is abrasive and sudden, like it'd been pried from his chest by a pair of careless hands. Or as close to that analogy as it can get – your anger is intoxicating and only grows more potent across the pages. Inadvertently amusing. Simon chews through the tough crust of his torpedo roll as he reads, time wearing away under the stiff comb of your words.

There's hardly any variation in your cataloguing –

10.06 – The universe must need more bad people in it, because it tests my limits everyday. Can the fuck next door snore any louder? It's 2 am, goddammit. I wonder if it'd be overkill to ship nasal strips to his mailbox.

26.06 – Dad called today. Didn't pick up.

04.07 – I'm close to killing Kathleen. There's a reason the food in the fridge is labelled as MINE. GET YOUR GRUBBY PAWS OFF OF IT!

13.07 – The world is a shitty, stupid, crappy, icky, lousy, rotten, stinking, stinky, bad place. I hate my coworkers and friends and parents and landlord and etc etc. It's like everyone is out to get me.

– so it's like the honed curl of a hook. Whiplash-inducing, reeling his attention so quick that his neck strains in phantom pain. Simon stops everything, elbows settling onto his knees as he fixates on one entry in particular.

30.07 – I stand by what I said. The world is uniquely horrible. I think that's because I make it that way for myself. Whatever this exercise was meant to do for me, rage relief or introspection or whatever, it's clearly not working. I'm just as angry as I was before. Maybe burning these pages would help. I wish I could play tennis again. I don't know what to do with my hands anymore. I got fired last week. Need groceries. Eggs, spinach. Spinach always goes bad and I never make use of it. I keep buying it though. Dad keeps calling. I've got a migraine and I've run out of advil.

I just need someone to put me in my place.

And it ends there. No more entries after the fact, just a handful of blank pages before the journal wraps to a close.

He flips back over to the address at front. Looking at it a second time, he can tell the ink is still fresh.

Perhaps he misinterprets it. Perhaps it hits a little too close to home. It wouldn’t be the first time he looks for salvation in the empty lines someone leaves behind. Perhaps it’s just been a bad day, and he should go home before he does something he’ll regret. Perhaps it’s nothing at all.

Or–

Perhaps he sees it for what it is.

Here are all my colours. What you choose to do, or think, is no longer my concern.

[tkbrokkoli]

gotta get back to work tmorrow 😔

[thedisablednaturalist]

I think when people think of mental illness and what helps, especially with things like anxiety and depression, the treatment involves pushing yourself. Pushing yourself to get out of bed, to exercise, to take a shower, to go out in public, to order your own food from the cashier, etc.

And because the mental health movement has grown so much, people think that's the default of ALL illnesses. That the only way someone will get better is if they push themselves. That practice makes perfect. That you'll become more comfortable or strong over time the more you do something.

But what people need to realize is, with physical disabilities and chronic illnesses, pushing yourself in most cases is DETRIMENTAL. Pushing yourself past your limits can lead to flare ups or further injury. That's why it's important to know your limits, how certain activities may affect your condition, and learn how to either adapt or get help to complete the activity in question.

Also, most of us are already pushing ourselves. Most of us don't have access to the help or equipment we need. Most of us live in places where we frequently encounter inaccessible obstacles. Most of us NEED to rest.

So please don't try to be our physical therapists or doctors. There are people specifically trained to help us navigate our own conditions and limitations. There are people trained to help us strengthen our body's resilience without causing flare-ups or injury. Do not tell us "it'll be good for you" or "you need the exercise" when we say something is too heavy or too far or when we say we need our mobility aid(s). Your friend with depression may need to be encouraged to get out of bed, but your friend with chronic illness definitely doesn't.

Respect our rest.

[oshinsimblr]

hey friends! i was unable to post all of my early access content bc i'm sick. but i was able to post this video, which in my honest opinion are the major features in this 'romance' pack.

IS IT WORTH $40?

DEPENDS ON HOW BADLY YOU NEED THESE FEATURES TBH.

this review is brought to you by the ea creator network. all of my opinions are my own. i must disclose this per FTC guidelines #ad.

*i do not cover everything in the pack, only the things that stood out for me lol. i'm sorry i'm not used to doing full reviews up here

the attraction system is helpful and expands dating (which is great, but we've had mods that could do this for some time: pick your poison). the romantic satisfaction is the star here. i love being able to create one sided relationships and actually take care of our romantic relationships with sims. this is a valuable feature for me!

cupid's corner is a nice "hey i don't need this mod" anymore type of feature. prior to this i was using lumpinou's meet & mingle which allowed me to meet with sims (platonic and romantic). i dislike that you can not write custom bio's for your sims. i love the way the app functions, i love saving sims and adding them to our rel. panel - and getting to know them through the phone first. i wish we could've defined our sims favorite music/foods/color etc.

i'll admit it, i'm a sucker for dynamics. family dynamics from the sims 4 growing together are so good (minus the fact that everyone wants to be f*cking jokesters after one joke lol). but i love them! they really do impact my sims relationships. the different romance dynamics are interesting. for example: a strained romance dynamic makes it VERY hard for your sims to communicate. it's like your sims will randomly hug each other, but then 5 secs later they're upset. they want to love each other so badly but they can't lol.

now onto random things that excited me. you can go to cupid's couples counseling. i did not know we'd actually be able to answer questions. these sims had a strained romance dynamic and it was so bad - the therapist suggested we come back. but when i tried to schedule it again, they were booked and i had to wait to schedule another appt. which is great, because in the meantime your sims are going downhill fast and you have to keep the peace until then (if you choose).

there are new pop ups and invites. there's even one for a reality dating show lol. you can turn these off in game settings. (if you're wondering, mr. landgrabb never showed up at the motel he wanted to meet at. he stood my sim up. don't judge me, i thought there was simoleons involved).

new crafted dates are cool. you can choose whatever you want to do on them. there's new social interactions based on the activities you choose. you can also invite other sims to these (double dates woohoo!) you can also create crafted hangouts. i like these, i got this cute picture as a reward after a succesful crafted hangout. if you're familiar with mws weddings, it's the same idea. except this works well and isn't as glitchy lol..

another random feature i never needed, but now i find it useful. you can create your own relationship label that will appear in the rel. panel

it's unfair how gorgeous this world is... because there's nothing to do. this is all set dressing.

you can declare your love here.. at the wall of love.

you can buy flowers or edible sweet treats at this shop in the background.

you can get local food here. there are 3 new dishes and spicy hot chocolate. now, i'm not mexican (the world is inspired by mexico) BUT 3 new foods isn't cutting it for me. technically only 2, because one is a vegan option. no pozole, enchiladas, guacamole, tamales?? i'm a foodie, so i take full offense to that.

you can woohoo or sleep at the motel.

you can travel.

go fishing or enjoy a swim.

sit here and chat.

view this for a moodlet.

travel again.

check in a penthouse.

there's a nightclub, gym and lounge. but you get the idea.. there's nothing culturally unique about this world which makes me sad. no festivals? i'd love seeing a mariachi band play at the lounge. something. otherwise, keep the world and add more features right? i would've loved table proposals (sims 2 anyone?). or frisky couch makeouts. so many missed opportunities here.

there's more i could say but i feel like this post should be a little helpful in deciding wether this is a pack you need right now, or wait for a sale! i personally love having a complete colection, so i've always wanted every expansion. though i recieve the pack for free, i owe you my honesty and i want to start doing blog/written content because it's easier to process my thoughts through the excitment. i will enjoy this pack, i do like it, and only time will tell as i integrate it with my current gameplay. i hope this was helpful!

* if you remember, use my code OSHINSIMS at checkout if you decide to purchase this pack. that way, at least i get a % of your purchase and EA doesn't get all your coins 😉

thank you! just keeping simming, always stay wavy, peace x

[naamahdarling]

Maybe it isn't that I actually hate medical professionals? They just suck and are weird sometimes, and a lot of them shouldn't be practicing, but I don't hate them as a group, like, personally.

What I hate is their ability to make my life harder in ways that are often completely opaque to me, and a lot of the crap things they do are not really possible to challenge. And I hate the fact that holding them responsible fort dogshit behavior in any way that will actually benefit me is almost always impossible.

And I also hate the fact that they have to do stupid things sometimes because that's how the system is set up, and those things sometimes mean patients actually get harmed. They aren't fond of that part either! They don't want the system to be the way it is! But they don't have a choice, so sometimes people like me get forced by bureaucracy into doing things that are re-traumatizing. And I can't imagine that feels good for them at all, knowing that their patients are sometimes only "consenting" because that bureaucracy will not let them be helped in any other way. Which isn't consent at all. I imagine that must be pretty traumatizing for them, too, sometimes.

If it were easier to actually access medical care without tremendous delays in this country right now I would have much less trouble finding providers who are good at what they do and are not horrible people, and who have clinic staff who can do their fucking job.

Oh and I also don't appreciate how evasive and unwilling to commit they are out of fear of being held to an answer that turns out to be inaccurate, but I can't make an informed decision about my own care unless they give me at least some information about probabilities and trajectories and typicalities. Genuinely, how the fuck am I supposed to navigate that shit. I get that some patients are really fucking difficult, but I should be able to get a special stamp on my file or something that says I understand that sometimes medicine isn't an exact science and the best answers that my doctors can give may not always prove to be accurate in the long term. I know they don't like being in that situation either.

A lot of medical professionals are fucking assholes, and unfortunately the ones who are not are still hamstrung by a system set up to actively prevent people from getting care.

I miss my old doctor. He gave no shits about anything that wasn't the patient. He prescribed scheduled meds based on what the patient needed and not based on fear of consequences potentially being imposed on him by the punitive patient-hostile drugs-are-bad moral panic machine developed to force suffering people into buying more dangerous drugs off the street in order to prevent far fewer people from maybe getting high off of drugs that at least weren't laced with lethal substances. (The purpose of a system is what it does.) Did he get sanctioned and become locally unhireable? Unfortunately yes he did. Does he now provide concierge care to rich people? Yes he does. He found a way to make it work, God bless him.

Everything about the medical system in this country is fucked. Hospitals, doctors, nurses, pharmacies, pharmacists, pharmacy techs, phlebotomists, clinic administrative staff, insurance companies, medical schools and schooling, licensing boards, drug advertising to both providers and patients, pharmaceutical reps, researchers, research, publishing, medical trials, pharmaceutical companies, manufacturers and distributors, medical equipment, charting software, billing and billing codes, diagnostic criteria, charity and low income services, accessible transportation, home care, the lack of independent individual patient advocates, dietitians and nutritionists, access to physical and occupational therapy and physical and occupational therapists, the massive bigotry of every kind rampant in every corner of the medical field, social work, senior care and assisted living, deprioritization of informed consent and harm reduction, disability applications, inaccessibility of medical records, especially psychiatric notes which are specifically allowed to be withheld from patients, lack of continuity of care for disadvantaged people, care that is equitably accessible to disabled people, telemedicine, patient portals, phone systems, clinic hours, every single aspect of inpatient and outpatient psychiatry, facility security, all sorts of things going on with therapists who are nevertheless probably the least malicious group of people in this entire charade, aaaaaand patients themselves.

Also hospital toilets that are too tall and make it literally physically impossible for me to poop while I'm there waiting for somebody to come out of surgery. I just needed to take a crap, guys. You didn't need to make the toilets so tall that my feet didn't even touch the floor. It is very clean but there is no shitting for short people at St Francis.

[genderqueerdykes]

Testosterone HRT Overview, Guide & Information for All People Seeking It

Hello, we're a genderqueer person who's been taking testosterone HRT since 2015. I've also worked in a pharmacy and we've seen a lot of the roadblocks that comes with people trying to start HRT. Nobody really explains how difficult it can be, even when you get your prescription. Because testosterone is a controlled substance in many places, it creates hurdles. There can be a lot going on, and some folks become very disheartened if their T isn't covered by insurance. i get that. We wanted to create a relatively easy to digest and succinct post detailing some common hurdles people have to face on the doctor/prescriber and insurance level, as well as after getting their hormones. *please note that a lot of this information is United States centric as that's where i live, i can't give information for a country i've never lived in, unfortunately.*

The estrogen HRT version of this post is here!

Doctors, Insurance & Getting Your Prescription

If your primary care provider is already familiar and comfortable with prescribing HRT, you can go through them, find an informed consent clinic, or seek an endocrinologist or gender affirming care specialist. Planned Parenthood is a good option for many people. If you don't have insurance, check to see if your area offers medicaid or other low income insurance plans, T can get pricey in some areas, especially for topical. if you can't access insurance please look into services like GoodRx that offer coupons and discounted rates for prescriptions.

Here is a list of informed consent clinics in the US for HRT.

Your provider will ask you some questions about your experience with gender, any dysphoria, why you want to seek medical transition, if you'd like to seek surgeries, assess your mental health, and then screen you for potential health problems or roadblocks. Your liver enzymes will be screened, as will your hormone levels, blood pressure, and some other things. Make sure your doctor knows to note that you are a transgender patient so that your blood tests are not discarded because your gender says "F" instead of "M" on the paperwork.

In some areas it is required to seek treatment with a therapist who specializes in transgender care to make sure this avenue is right for you. Not everywhere requires this step.

Make sure you talk to whoever is prescribing the testosterone to you about insurance, and if they are aware that testosterone is a controlled substance. A controlled substance is a substance that has been restricted by your country's government or governing medical organization and has to be monitored carefully. You need what's called a "prior authorization" from your doctor in order to get your insurance to give you your hormones in most states. Talk to your doctor and pharmacy about prior authorizations for your testosterone and syringes if you need them.

Currently, the only forms of testosterone available for masculinizing HRT are testosterone cypionate (injectable), topical gel, and patches. Topical forms are usually applied daily, injections can be done once or twice a week, or even more or less frequently if a person needs it. There is no pill option available for masculinizing HRT currently.

Do NOT become disheartened if you do not see the effects you want to see right away. It can take several years for the full effects of certain aspects of medical transition to show themselves. Stay patient, talk with your provider, talk to other trans people!

Stay patient, Stay positive!

HRT and Administering Testosterone

When you get a prescription, how things go will depend on if you get your doses administered at the clinic, or if you choose to do them at home. If you are not comfortable self administering, ask if they will at the clinic. many places offer this service.

if you choose to administer at home, if you are using injectable T, note that pharmacies may give you the wrong gauges of needles because they don't often give out needles for HRT. You need two different sizes- a thicker, longer needle for drawing from the vial, as testosterone cypionate is thick. You will generally be given large 18g needle for drawing and a small 22 or 23g needle for injecting. Many people have preferences for different gauges so ymmv. Depending on if you are injecting intramuscularly or subcutaneously the gauge of the needle with vary. Sanitize your injection site and your hands, never using the same needle tips twice for any reason. Never use needles that have touched another surface, and get a sharps container.

Make sure you are injecting in different spots every time you inject. you do not want to inject into the same patches of skin every time, as this can cause tissue damage, tissue death (necrosis), and severe scarring after long periods of time of having to heal but being interrupted over and over again. inject into slightly different spots every time to make sure your skin and muscle tissue can heal.

Here is a guide on safely injecting your own testosterone, including steps on how to prepare your skin for the injection, hold the vial while drawing, change needles, and more.

Another guide for hormone injections.

Make sure to check with your provider to see what type of injection you are meant to do, many do intramuscular injections, but many opt for subcutaneous (just below the skin) injections because they are less painful and require less frequent injections.

If you receive topical testosterone like androgel or other alcohol based testosterone gels, make sure you read the informational packet that comes with it to ensure you are administering it in the correct areas- your exact formulation will need to be applied in a certain area, if you do not have the guide or packet that came with it, please read this page to figure out where you need to apply it. if your topical T isn't working you may be applying it in the wrong place.

When applying topical T, make sure you clean the skin before putting it on, and do not shower or go swimming for 2 - 5 hours after application. make sure you cover the skin with some kind of clothing. You want to make sure it doesn't rub off on other people, as other people can absorb it as well by touching you. Do not ever have someone else apply topical testosterone for you, even if they are also trans, as this can mess with their levels in a bad way.

After starting T you may have to adjust your dose over time to achieve desired effects. if so, you will start on a starter dose and then you can move up to higher doses as your body adjusts. This process is called titration.

No matter HOW tempting it is, NEVER TAKE MORE T THAN YOU ARE PRESCRIBED! It is processed through your liver, which can completely wreck it if you take more than it can handle. Slow and steady wins the race with HRT. If you take too much T at once, your body can also aromatize it, meaning your body will convert it and encourage the production of further estradiol, which will provide unwanted effects. Do not increase your dose without your doctor's advice or knowledge, and do not go any faster than advised.

Effects of Testosterone HRT

Growth and thickening of facial and body hair begins 3 - 6 months after treatment starts and the full effect happens within 3 - 5 years.

Menstruation (periods) stop. This occurs around 2 - 6 months within starting treatment, and is one of the most desired effects.

Voice deepens. The vocal cords thicken, which can cause uncomfortable sensations in the throat for a time, such as a scratchy feeling, dryness, tightness, pressure, and a 'sore' throat that isn't sore in an illness related way. This begins 3 - 6 months after treatment starts, and the full effect happens in 1 - 2 years.

Body fat redistribution begins 3 - 6 months after treatment starts and the full effect happens within 3 - 5 years.

Growth or enlargement of Adam's apple.

Clitoris grows larger, and vaginal lining can thin and become drier. Some experience vaginal atrophy and/or painful levels of dryness, while some maintain a healthy level of vaginal fluids without problem. This begins 3 - 12 months after treatment starts, and the full effect is usually seen within 1 - 2 years, though some experience growth over a long period of time if their dose is low.

Change in body odor and increased sweating occurs within 1 - 3 months of starting treatment.

Muscle mass and strength increase, this will begin within 6 - 12 months and the full effect will be seen within 2 - 5 years.

Possible libido increase, though some report no changes or even the inverse.

Potential but not guaranteed balding or receding hairline, which is treatable, and not seen in everyone.

Potential increase in energy in general, some report an almost antidepressant like effect.

Possible increase in red blood cell production leading to high blood pressure, which is treatable via medications and donating red blood cells when appropriate and safe.

There is not really a guide book to masculinizing HRT and medical transition, most of the information there is is passed along between each of us. We will continue to edit this post as we think of more important information.