#having to tell my patients i cant diagnose them with ptsd and there is a better diagnosis but i cant give it bc we only use the dsm IS

[rainagaintomorrow]

Every single person here deserves an accurate diagnosis and compassionate care. The way people with borderline personality disorder (and I would argue cluster b personality disorders in general) is extremely stigmatizing and straight up unethical. The lack of understanding for how borderline personality develops and what effective and compassionate treatment looks like is baffling for a field that keeps diagnosing it.

I had a professor in undergrad (who specialized in working with BPD) once say "if a patient is attention seeking, then they need attention. If they need attention, give it." And while she was many thing, she was certainly right about that. Calling people attention seeking so you can dismiss them seems counter-intuitive, but it's so predominant in medical and behavioral health fields as a way to push away "difficult" or time-consuming patients.

You all deserve good care. I'm sorry it's so difficult for you to get competent care when it's already difficult to start looking for care in the first place.

As a late diagnosed autist I will say one of the most damaging but transformative experiences I've ever had was being misdiagnosed with BPD.

Everyday my heart goes out to people with BPD.

The amount of stigma and silencing they face is astonishing and sickening.

I took DBT for years. Therapists use to turn me away because of my diagnosis.

I would be having full blown autistic meltdowns, crying for help literally - but because I was labeled as BPD ANY time I cried I was treated as manipulative and unstable.

As if the only reason I could be crying was if I was out to trick someone.

95% of the books out there with Borderline in the title are named shit like 'How to get away from a person with Borderline', 'How to stop walking on eggshells (with a person who has BPD)'

I was never allowed to feel true pain or panic or need.

That was 'attention seeking behavior', not me asking for help when a disability was literally inhibiting my ability to process emotions.

There were dozens of times where I had a full meltdown and was either threatened with institutionalization or told I was doing it for attention.

My failing relationships weren't due to a communication issue, or the inability to read social cues. No, because I was labeled borderline, my unstable relationships were my fault. Me beggong nuerotypicals to just be honest and blunt with what they meant was me pestering them for validation.

Borderline patients can't win.

And the funny thing is - I asked my therapist about autism. I told her I thought I was on the spectrum.

BPD is WILDLY misdiagnosed with those with autism and I had many clear signs.

Instead - she told me 'If you were autistic we wouldn't be able to have this conversation'. She made me go through a list of autistic traits made clearly for children, citing how I didn't fit each one.

And then she told me that me identifying with the autism community was the BPD making me search for identity to be accepted - and that I wasn't autistic, just desperate to fit in somewhere.

I didn't get diagnosed for another ten years. For ten years I avoided the autism community - feeling as if I were just a broken person who wanted to steal from people who 'really needed it'.

Because of my providers - I began to doubt my identity MORE, not less.

Ten years of thinking I was borderline and being emotionally neglected and demonized by a system meant to help me.

To this day, I still don't trust neurotypicals. Not fully.

I know I'm not borderline now - but my heart aches for them. Not for the usual stuff. But for the stigma. And the asshole doctors. And the dismissiveness and threatening and the idea of institutionalization hanging over their head.

I love Borderline people. I always will. I'm not Borderline but if you are I love you and I'm sorry.

You're not a bad person. You're not a therapists worst nightmare, you are a human with valid feelings and fears.

Borderline people I'm sorry.

[bl4z33467]

I am Blaze.

I do art commission for discord nitro. Pm for more info. (Open, single character only, no complex backgrounds)

Owner of the Fallout Tumblr Hivemind Server: https://discord.gg/SyrdbEpr2d

Woah learn more about me \/ \/ \/

Facts about me:

Im 17 years old. Im a senior in highschool. Im from Pennsylvania, EST.

Im Agender and use she/they/it. He if im comfortable with you. I present androgynous. Your welcome to guess what i was assigned at birth lol.

Im Asexual (double A battery). I like men. And non binary masc tbh- Im not here to date though. If you want me, befriend me first smh. Even though ik you dont lol. Also if you couldn't tell i like fat guys a lot- but I think everyone is beautiful the way they are ^^

I am diagnosed with PTSD. Please do not talk to me about car crashed or vehicle accident, or make fun of my vehicle.

I do not have any other diagnosis but im frequently legitimately asked if i have autism irl, so you can make inferences. I do not like self diagnosis. I also struggle with extreme emotions, like outbursts or anger. I probably do not mean to harm you but can just lose it.

Im very happy to make friends with you, but please be patient as sometimes i can be standoffish in fear of you.

My fursona is Blazeus. She is a Gar-Pheasant Monster. I use her to express myself. Here is their reference sheet:

Things I like:

Birds. I would consider them my "special interest." I have been obsessed with them for years and years. I have chickens, muscovies, and pigeons. I show pigeons. My favorite birds are large ground birds like peacocks and pheasants, also pigeons. Also i like birds with cool feet, like coots and sula nebouxii.

Art. I love drawing, painting, making perlers, writing, sewing, and crafting. I do not like crotchet and knitting is okay. I use my art to express my emotions and tell about who I am.

Fallout. Its a cool game, it has music I like and gameplay is fun. I love writing stories, drawing and making ocs with my friends about the fandom.

OSC. I love object shows. I like most of the "popular" ones, besides one. I did not really like one mostly cuz it was scary.

Furry Fandom. Despite my parents saying I cant use the term "furry" I still consider myself s staunch one. I love drawing and making anthropomorphic characters. I also make fur suits and love wearing paws, tails, and ears.

Cosplay. Along with fur suits, i make non-furry costumes. I love going to cons dressed up and hanging out with nerds and being silly. I mostly have made fallout cosplays, like my secuitron and t-60 helmet.

Planes. I love plane spotting, and going to plane museums. I also am a fan of the logistics of planes. My favorites are the Concorde and 747. I like commercial aircraft a lot more than military.

Barcodes. I am fascinated by barcode symbology. The science behind creating these 1d and 2d data structures is incredible fascinating to me. My favorite symbology is the PDF417

Animals. I love all animals, not just birds. I especially like bugs and fish. Some of my favorite non-avian animals include gar, trout, crickets, millipedes, hyenas, snow leopards, snakes, isopods, catfish, flounder and halibut, gharials, sharks, and eels. I also like prehistoric animals. My favorite is marrella splendens

Geography and Cultures. I love maps and flags. I also collect flags and can stare at maps forever. I memorized all the country flags. I also love countryballs. I also love learning about different cultures. If you want something to talk to me about, tell me a food unique to your culture! Im from amish country so I have some pretty cool ones. Also learning about different religions is cool too! Personally, im a christian (the nice kind who actually loves thy neighbor) but I find the differences and similarities in religions fascinating.

My friends. My best friend is @irenecatz. We met back in like 2022 in December. We have been friends ever since. We got to meet each other irl in the summer of 2024. That was the best day of my life. She means so much to me, and without her I may not even be around anymore.

Shows: Fallout, Spongebob, The Patrick Star Show, Earth Odyssey, Meltdown: Three Mile Island, Xavier Renegade Angel, Prehistoric Planet, Nasa's Unexplained Files.

Movies: The Truman Show, Chicken run 1&2, Rio, Cloudy with a Chance of Meatballs, 2001: A Space Odessy, Interstellar, Nacho Libere, Wall-e, Home on the range (with the cows by Disney) and Bicentennial Man.

Books/short stories: Fahrenheit 451, a sound of thunder, the veldt, the city, (can you tell i like Ray Bradbury?) Do androids dream of electric sheep?, repent harlequin, said the ticktockman, harrison bergeron, one flew over the cuckoo's nest, a lesson before dying, and dogman (ik in stark contrast).

Games: Fallout (ive played 1,4,NV,shelter) Pokemon, Minecraft, spore, SSB i main game and watch, Bang on balls, Mario Odessey, Gmod, and Roblox.

Activities: Tennis, Biking, Kayaking, walks, bird watching, photography, animal husbandry, fishing from time to time.

Music: I like 1950's rock and roll, ragtime, nerd core, pop, and "white boys singing about shit" genres. Artists include Tally Hall, They might be giants, Sabrina Carpenter, Englebert Humperdink, Gene McDaniels, and Duncan Lawrence. My favorite song is Holiday Road.

Collecting. Thing i collect: flags, bones, rocks, shells, feathers, Japanese chicken figurines, pokemon cards, bottlecaps, pokemon figurines, random bird figurines

Warhammer. Okay this one is new. I dont know too much yet so please dont call me a poser. Its cewl tho im getting into it lel

Other cool things about me

Im part of the National Pigeon Association, Trout Unlimited, and my local pigeon club.

I have won awards in photography and in pigeon shows

Ive been to many different US states and 5 Counties

Im going to school for Wildlife Technology, Wildlife and Fisheries science, and Poultry and Avian Science

Im good at public speaking but not a speaking face to face

Side blogs and other contacts

Yt channel: https://youtube.com/@sardiniastan?si=I9D2_u3ocoQRtU89

Art website: https://sites.google.com/view/six-foot-goose-art/home-page

@vulpesaltilis one of my fallout au oc

@vulpesnovos another fallout au oc

@genral-sir-blaze-s-hale my fallout 4 sole survivor

@evil-bl4z33467 my account is post fat art on cuz it can make ppl uncomfortable

Discord: bl4z33467

[just-vibingfr]

Ok ok I want 23 13, and i forgot the number but it said like I’m sorry I’m such a burden so yea with jj maybank im a sucker for angst

Same! Like mood 25/8 is angst, angst, angst!

WARNINGS: Mentions of rape, suicide, self harm, close friends and family thinking you are a liar, ANGST ANGST ANGST, cursing, reader will be using They/Them pronouns.

A/N: I went really angst in this one, this will be all angst with no fluff, at all, like none. Please do not read if anything mentioned will trigger you. This is going to be one of the last OBX fics for a few weeks, I’m going to finish the other four requests I have then I will be writing some Harry Potter Marauders Era stuff! Thank you all for being so patient! I love you guys ❤️ 💕 Bold will be flashbacks!

ABDUCTED

Prompts- 13:God I wish that you had thought this through before I went and fell in love with you. 23:I was kidnapped, I was r@ped! 49: I-I-I’m sorry I’m such a burden

JJ POV:

Thirteen weeks. Thirteen fucking weeks. That’s how long it’s been since they went missing. God, all I can think about is our last conversation.

“I slept with her okay?! I cheated on you and I don’t regret it. At all. You have been nothing but a pain in my ass trying to fix me. Setting me in a path to what, redemption?! Well guess what it’s never gonna fucking happen because I’m a no good, dirty, pogue! My whole family has been doomed to live here, always poor, always a bunch of dead beat losers! I cant be fixed, this is my destiny, so go fuck yourself and you pathetic hopes and dreams and morals! Because none of us liked you anyways, we were only using you to help us grieve after we lost John B. He’s back now, so we don’t fucking need you okay?! I don’t need you! I never have and I never will!”, I ranted. I’m angry at my dad, angry at myself for cheating, angry at Rafe for getting away with everything, angry at Ward for being a bastard, angry at Y/N for making me fall in love with them. I am just so angry. I didn’t mean to take it out on them, but they were there. They’ve always been there even when I treated them like shit. That’s the problem, they were there. I don’t know what to do, I’m so used to pointless hook ups, empty relationships, and abusive behavior, that when someone puts me in a freaking pedestal like I’m actually worth something I flip. I have been looking down for the past five minutes. All I know is their muffled sobs, how their eyes are probably red rimmed and bloodshot, how they’re probably pulling on their wrists like they do when they’re stressed. If I look up I might just crack. “God I wish that you had thought this the before I went and fell in love with you!”, they screamed, letting out all of their emotions. “You said I was different, you said you saw a future together! You told me you fucking loves me! You fucking piece of shit! I hope you get everything you want in the sickest sense! I hope you remember me and feel nothing but pain and guilt! I’m done with you Maybank!”,Those words cut deeper than any blade or bullet could. Being told those venomous words by the person I love most in the world hurts, but I deserve it. I hurt them more than anything, I broke them.

But, now I see truth in their words. Every time I think of them all I can feel is pain, guilt, and remorse. It was all my fault.

Y/N POV

I stumbled through woods. Safety. That’s all I can think. Safety. Safety. I kept stumbling around going anywhere, anywhere as long as it’s away from fucking Jules. That’s what they would call my kidnapper and rapist, Jules. He earned that name because he would take a piece of jewelry off of every virgin he raped. Pathetic. My lower half ached, my mind fuzzy, my wrists scarred. Thirteen weeks, that’s how long I’ve been missing. Thirteen weeks or rape and abuse. Twelve weeks of self harm. I started slitting vanes on my ankles, and the back of my knees, to feel something. Something other than the pain he caused. Self inflicted pain was a way out, a way to still have freedom and independence. Sick and twisted, I know, but it was my way of rebellion. I started to break down crying in the middle of, woods?! It these woods are familiar and I can hear the sound of the ocean. Outer Banks… Outer Banks! Thank God! I’m home. I’m safer, I’m back. I kept stumbling around, my tears making it harder to see. Up ahead I saw what looked like porch lights. “Help! Help!”, I yelled out, although the dryness of my throat mad it extremely difficult.I sped up, basically running to reach a sense of haven. Once I arrived at the house I realized where I was. The Chateau. Anywhere but here. But I needed help, and I was lucky I even found my way here. I knocked on the door, actually I pounded on the door. I was desperate. I heard shuffling and then the door opened revealing a very disheveled Pope, Kiara, Sarah, John B, and JJ.

“Y/N?! How-What-! Just- just come in!” Pope said frantically .

“What happened?!”, Kiara and Sarah said in unison. The boys nodding their heads in agreement to the question.

“I-erm- I was kidnapped, I was raped. I was held in a where house with the other girls. This bitch named Jules was the one in charge. He would take turn with the girls. It was terrifying. I thought he was going to kill me once he saw me helping one of the girls with her miscarriage. I had already had three or four myself and a few of the girls actually gave birth in that where house. The youngest to have a baby was eleven. Eleven fucking years old. I just ran out of the door one day, I got shot. It’s been a few days, maybe five or six? All I know is that I had to burn the wound to stop the bleeding. And I feel really sick right now. I think I’m going to vomit.”, I said before passing out.

I woke up in a hospital bed. The lights burning my eyes. The sheets clean. Someone had bathed me and changed my clothes. I felt clean, it felt good. Everyone scrambled to get up at my sudden consciousness. Looking at me with that pity in their eyes. That pitiful look that made me regret telling them. I didn’t want their fucking pity, I just wanted them to know I have new boundaries, and as my friends they deserved to know. The doctor came rushing in, asking me to explain what happened. I explained everything, the trauma bringing ugly sobs. I didn’t care. I had just been through hell and back, I was allowed to shed some god damn tears.

I was discharged later that day when they had diagnosed me with PTSD, anxiety, ADHD, and self harm. Yay. Weeks went by with my friends checking up on me, never leaving my side: I loved them all for it, but I could see the look of boredom in their eyes, the look that said as soon as I was good enough to be on my own they would leave me to my own devices. It hurt, everything did. I didn’t deserve to put them through this, watching me fall apart. I didn’t deserve this. I needed to end the pain. I had to. And I needed to do it now. I pulled out a piece of paper and a pen, went to the nearest flat surface and began writing.

“ I’m sorry I’m such a burden. But thank you for taking care of me. Thank you for supporting me. I didn’t really get to know you before John B and Sarah, I see that I really missed out on some good people. Kie, you have been nothing but amazing to me. I can’t thank you enough. Pope, you are like a workers mix of older brother, younger brother, and dad. It always amazes me how you can be protective as fuck, need protecting, and are always prepared with that mind of yours. JJ, I’m sorry. Sorry that we ended things on such terrible terms. You deserve the world and I couldn’t give that to you, I truly apologize for holding you back. But you did break me that night, I was going to end it then, but I was abducted. Ironic how I’m ending it now. I love you all and wish you the best! “

Love, Y/N ❤️

I folded the letter and set it on the island with the pen. Then I crawled into the tub, slit my wrists, and let the darkness take over, sweet, safe, darkness.

@hannahnikohl

[tierneytherapysblog]

TAR & FEATHERS.…..or THE WRATH OF GOD!

TIERNEY THERAPY

Just now·6 min read

There is a passage in the Bible ,I'm going to paraphrase it ,you can google it or better still get your hands on a Bible and check the correct wording but it goes something like this:

‘If you harm one hair on the head of a child of God, better for you to tie a milestone around your neck; climb the highest mountain; cast yourself into the deepest sea; than face The Wrath of God, on judgement day.’

Then check the Old Testament for examples of how The Wrath of God might be expressed.

Moses, a most faithful servant of god, his spokesman at that time, was told by god to touch the rock with his staff and water would flow for the tribe and without thinking he struck the rock for the same results; this caused god to condemn Moses to never seeing The Promise Land.

on the exodus from Egypt, it would have only taken a couple of days to reach the promise land, but because his chosen people kept doubting him an losing faith in him, the journey took 40 years and all the adults that came out of Egypt were condemned like Moses not to enter the promise land.

on this long journey, God arranged that they would win battles and overthrow those who stood against them but in one instance he told them when they overthrow this particular kingdom, do not take any plunder.

The two princes of the chief of one tribe were tempted, and they took plunder and hid it in their tents.

god confronted Moses telling him his commands were broken and he was going to smite the chosen people. Moses argued ,what would other nations think of his power if he were to have taken his people out of slavery and now to smite them.

God conceded on this point and stated

‘find the culprits, only they would be punished’.

Now reading this I imagined God meant the two princes who took the plunder for themselves; shock and horror when we learn that he thus charged that whole tribe with the crime of those two brother princes; separated that tribe from the rest of the chosen people; and caused the earth to open up an swallow the whole tribe, people, lock, stock and barrel.

[ I don't want to do all the work for you ,but check out how many innocent, unaware, persons were in that tribe]

In The New Testament, when Judas took his thirty pieces of silver to harm a hair of the head of The Son of Man, he suffered a horrible death.

When we do the math, it would be better to be ‘tarred and feathered’ in the present ‘than face The Wrath of God, for harming even one hair on the head of any one child of God.’

Its a frightening sobering thought.

Now, I am not a licensed clinical professional of the misused and abused mental health industry, but I want to present you with an imaginary situation and two possible responding scenarios.

A client comes to a therapy session suffering from nightmares and flashbacks, over an event they experienced in the past. They also present with other conditions caused as a reaction to the event, in their attempt to maintain some form of sanity. in the violation of their soul.

Scenario one:

Well done you!! You suffered a horrible event and you got through it to get here to tell your story. It shows how strong you are mentally and emotionally, that you staved off an event that would have floored an elephant. Take a bow! Congratulate yourself on how powerful you are! Now I know you feel broken and with feeling like you cant go on, but I don't want to damage your strength, destroy your fighting spirit by medicating you as the problem . No we are going to treat this as a Spiritual Illness; since it is in your past and cannot be treated in the present; we are going to surround you with the necessary people to empower you; its not going to be easiest not going to be nice; but you are going to come through this. Know you are not mentally ill, how you responded is not the problem, you were a victim, but we are going to help you change to become a victor.

Scenario two:

We fear for your sanity and well-being. You are presenting with PTSD, Depression, the need to Disassociate, we are worried about your Anger and the possibility of you Harming Yourself or Others. We are going to put you on a range of medications to manage these feelings, we suggest hospitalization until we can get the levels of medication worked out, and we then suggest working with our therapy team to learn how to cope with these feelings. This is going to he a long journey but over time with the right medication you should be able to have some form of a life in the future.

Looking at these two altogether different scenarios of the same situation:

Which in your opinion, offers hope and healing to the client, and which doesn’t?

Which empowers the client to stronger self belief and the ability to be part of the healing process and which doesn’t

Which of these scenarios might be construed to be part of the problem or part of the solution?

Which of these scenarios promotes the viewpoint that the client is the victim

Which of these scenarios offer the viewpoint of the client and their responses being the problem?

Which of these scenarios, is for both parties to be winners

Which of these scenarios suggest one winner and one loser?

Were your son or daughter to seek professional health, which scenario would you hope they would experience?

Which of these scenarios are likely to suffer The Wrath of God?

A third scenario:

I am sorry, I have to hold up my hands and admit we got it wrong. we were truly worried about your sanity and emotional wellbeing and felt the best course was to help you manage your feelings, but now seeing still in therapy [after weeks, months, years] we must admit we got it wrong.

‘Insanity is repeating the same actions over and over again expecting different results, and clearly this isn’t working.’

It has been suggested that all past trauma events cannot be treated in the present because they are a part of your history, that the belief is the only true way to heal this is spiritually. We would like to rectify this situation and your recover by hoping you would allow us to arrange this new therapy . There are a number of options, we an learn how to use this formula called

‘The Victory Principle’

and take you through the healing event; if you want to work with someone else; I would suggest we invite a Christian or Biblical psychologist to conduct the healing event; these are also licensed clinical professionals. Your third option is to work with the creator of this formula and if you choose this path; as he is not a licensed clinical professional; we would like to sit in on this event and see it through to the end.

It was never our intention to hurt or harm you and we fervently want you to recover fully, we will respect your decision.

It was suggested by a colleague of mine to take a course of ptsd and the underlying message was almost all the practitioners had huge workloads and many were close to burnout in relation to the supply and demand for therapy and solutions. I fear that there are cases; because of the huge caseload of therapists and the never-ending line of more patients suffering with mood disturbances, it is an unconscious decision to diagnose those with a mental illness to keep up with treating and helping as many as possible.

As mentioned before, I accept there are real cases of people who suffer from mental illness, but think there has been a misuse and abuse of the industry by persons; who take the easier softer option; of diagnosing such people as mentally ill, when the correct action would be too time consuming.

It is these people who for them, it would be better to be Tarred & Feathered; than face The Wrath of God; that would be Visited on Their Whole Tribe.

[myectjourney]

ECT Evaluation & current my medication list (2/28/2018)

This post will go over the questions asked during my evaluation and parts of the discussion.

Duration of appointment: 1 hour 30 minutes (hour and a half)

*** TW suicide/self harm mention/questions regarding suicide/self harm. TW for detailed medical procdures and sezuires***

Current Medication List:

Lithium (For depression. 2nd time around with no results. After this evaluation, I quit.)

Clonazepam (For anxiety and panic attacks)

Propranolol  (For anxiety)

Zolpidem (For insomnia)

Evaluation (first appointment):

Doctor introduces herself.

We go over my intake form (which I filled out 2 weeks before my appointment. It included an extensive questionnaire.)

I was upfront about my diagnoses and that I was interested in ECT not TMS because ECT has a history of being more effective despite of there being more side effects. She did listen to this and didn’t bring up TMS at all during the evaluation.

She asked about my prior history with therapy. How long have I been in therapy and what for?

“Tell me about your life. How do you spend your days?”

I talked about how my illnesses have been getting progressively worse and how different drugs I’ve taken have effected this because of bad reactions.

I explained that I have had a lot of breakdowns. I classify them as “psychotic breakdowns” not panic attacks because I felt they were different from when I have panic attacks. She asked me to clarify my word choices, just so she could get a better understanding of what I meant by that.

She asked “How often are these kinds of breakdowns are happening?”, “How long do they last?”, “Explain what your episodes are like.”, “What causes these episodes?”.

Talked about personality disorders. We talked about how I am suicidal and how long I’ve been this way.

Talked about how many times I’ve tried to commit suicide. “How did you try to commit suicide?”

Talked about past history with self harm. “When you cut yourself, were you intending to harm yourself for some relief or to bleed out and die?”, “What stopped you from dying?” I explained that people came to my aid or there were times where I stopped myself because of my own fear of death. Even though I longed for it, I also fear it. “How many times have you stopped yourself versus someone stopping you?”. Some point between asking about suicide and self harm, I was asked “Have you ever been hospitalized?”.

“How often do you have panic attacks?”, “What does a panic attack look like?”

“Have you ever heard voices that weren’t there or seen things that aren’t there?”

“How often do you see your therapist?”, “How long are your therapy sessions?” “In your current situation you are having disregulation episodes which you are calling ‘psychotic breaks’ that are happening sometimes daily, or at least one a week in which you are pulling your hair, screaming, being disassociate and during these episodes are you trying to kill yourself or saying you want to kill yourself?”

To my partner who was in the room with me (my request): “How often does she talk about suicide?”

“How many of your suicidal attempts or gestures are caused by social stressers or fear of rejection?”

“Do you get into conflicts often in your relationships with people?”

“Do you have a bit of a temper?”, “Do you lash out at people you love?”, “How often do you find yourself making suicidal statements to others?”

She asked about a situation that my therapist wrote in her notes regarding a past experience that set me off.

“Have you done additional therapy for your agoraphobia?” I explained that my therapist and I have tried to get me into DBT but my insurance won’t cover it so it was no dice. We talked about how my social anxiety has gotten worse and the agoraphobia has been more of a recent development with the progression of my social anxiety and traumatic experiences. I also talked about how I think I have Selective Mutism which is brought on primarily through PTSD attacks (when I am triggered) or under immense amounts of stress.

“How is your thinking and memory?”

“Have you held a job at any point?”

Talked about my family and abuse I suffered through them and my lack of contact with them.

Asked about my medical diagnosis. I informed her I was diagnosed with Fibromyalgia.

“Have you ever had a head injury, concussion, or seizure of any kind?” Nope.

“Any retinal detachments or metal implants in your face?” Nope.

“Any brain aneurysm, vascular clips in your head or neck, metal in your eyes, or pacemaker?” Nope.

“Any heart problems?” Not that I know of.

Confirmed where I was born and raised and who raised me (all questions answered on the intake form).

“Do you have any siblings?”

“How did you do in school?”, “What led to me not continuing my education?”

“Any religion?”, “Any military service?”, “Any legal problems?”

“How would you describe your mood today?”

We went over the meds I am currently on and my dosages. I told her that I won’t be on Lithium by the time we do the procedure. She said the lithium is less of a problem, I just need to be sure I don’t take it 2 days before we start the procedure. She was mostly concerned about the fact that almost all the meds I’m currently on are considered anti-seizure meds and a lot of them are highly addictive, especially the clonazepam and zolpidem. This is important because basically what ECT does is they induce seizures in the brain. This helps basically rewire your brain.

She informed me that LUCKILY they can reverse the effects of those 2 drugs with an antidote (pretty nifty) so they can get around that but she expressed concern that I might be “a little doped up”. I told her I was on a very low dose.

Talked about family history with mental illness. “Any one in your family commit suicide?” No. At least not that I’m aware of.

This is when we finally talked about diagnosis and treatment.

She said “Your diagnosis is relevant here because certain diagnosies respond better to ECT as compared to others. Based on your history, it seems like you have an expanding list of diagnosies and that can happen in psychiatry because they are checklist based and can be presented differently at different times. I think the over all picture is best captured by a personality disorder based on what you are telling me and that doesn’t mean you cant have ECT by any means but it does mean that there is a little more risk for you in a couple of ways. So people with a history with disassociation and a history of trauma, which very much goes with a personality disorder, have a harder time being put under repeatedly and hopelessness of ECT. It can be kind of re-traumatizing.”

She goes on to explain that there are cognitive side effects for people who have personality disorders (specifically similar to my symptoms), which can include something she called “Soap Opera” Amnesia where a patient will complete forget everything for a few days. It only has happened one in her experience but it was very scary for the person going through it and that patient did end up going to the hospital at some point. This wasn’t caused by the ECT though. Seizures do not cause this. This was basically psychosomatic; something this person developed as a result of the panic of being put under and having to go through that over and over again, hence why she disclosed this to me as someone with a personality disorder specifically issues with disassociation.  

She also explain that statistically, the effectiveness of ECT is a little lower for people with personality disorders versus those with just depression. It’s around 55% likely to be effective for people with personality disorders and around 87% likely to be effective for people who just have depression.

She said about a 3rd of people with just major depressive disorder that get ECT feel almost completely cured by it but with people with personality disorders, they might feel less suicidal and may be able to function better in day to day life but its way less likely to feel “cured” to that intensity.

We also talked about how she thinks I fit the description for BPD very much and that it looks different for different people. My favorite thing she said is that it doesn’t always look like “Girl Interrupted”. Luckily I already knew that and agreed with her on this matter. She talked about the stigma around it. Honestly, she was very understanding and knowledgeable (I mean, of course) but it was really nice to talk to someone who wasn’t bias about personality disorders.

Then we talked about the upsides and down sides of ECT in the most specific way we could.

Downsides being cognitive side effects, even if they are just doing the right side of my brain with pulses being as small as you can get and the dose being as low as possible, you can have cognitive slowing, feeling a little more spacey, attention is not “up to snuff”, and also short term memory problems. The most recent memories put in your brain are usually the ones that are effected first.

This can include the past couple week or months before the procedure.

During the course of ECT, 7-15 sometime 18 treatments, when youre having it 3-4 times a week, you might have trouble forming new memories.  It’s not that you won’t form any, just a little fuzzy.

All of things add up to a DRIVING RESTRICTION. They will not let you drive during the course of treatment. She said it doesn’t matter how you GET to the appointment but afterwards they will not allow you to take a cab/taxi, uber, lyft or by bus and you cannot drive yourself. You absolutely NEED SOMEONE TRUSTED/CLOSE TO YOU TO DRIVE YOU HOME.

ALSO, if you have a history of any heart problems, you are at risk of sudden death because when they induce the seizures, your blood pressure and heart rates goes up. For young healthy people, there is almost no risk of this happening.

There are the normal/common risk of anesthesia (Like waking up). They usually give you Brevital (which puts you to sleep) and Succinylcholine (to relax your muscles before the procedure). The muscle relaxant will stop your breathing but she said it’s nothing to worry about since they will be pumping air into your lungs manually via bag mask and will be closely monitoring you which luckily means no invasive breathing tube.Then they deliver the stimulus, which induces the seizure and then you slowly wake up after that. If the timing is wrong or the dosing is wrong, there is a SMALL but serious risk that you can wake up but still feel paralyzed. They monitor your heart rate and they try to make sure you are completely out beforehand but it’s still a risk.

The worst symptoms after the procedure is headaches and nausea, which they will usually give you medication for and usually is the worst after the first treatment.

You will have an IV in your hand, before you go in, the nurse will make sure you have not eaten or drank anything in 8 hours.

They will talk to you for a few minutes to make sure you are okay and know whats going on. During this time they will put the IV in and inform you if there is any changes they need to make with anesthesia, then they administer the anesthesia. They will then induce the seizure (they usually start with a right unilateral which means they just do the right side of your brain and can change it to a bilateral procedure which is both sides of the brain later in treatment if needed) and the way they tell if you have seizured is by:

1.) putting EEG leads on your head so they can see your brain waves and

2.) They use a blood pressure cuff as a tourniquet around your ankle to stop the muscle relaxant from going into your foot so they can see that foot have a seizure.

Afterwards, they roll you out to the recovery room where you come down from the anesthesia which takes about 20 minutes.

The medical work-up and requirements before you schedule the procedure is a signed document from your PCP (Primary Care Physician) which they fax over, bloodwork, pregnancy test, and an EKG test (they will need a physical copy of the EKG tracings).

-END OF APPOINTMENT-

I hope this is useful info for someone out there!

If anyone has any questions, feel free to ask.

[tumblunni]

I have a question that I hope is ok. I have had a suspicion that I might have some form of autism for quite a while now and when you reblog posts that say something along the line of just autism things like the one you just did I have to do a double take because I do all of those things + have them happen to me and am shocked when I see I'm not the only one who does these things especially the really abstract. I don't ever bring it up though in fear that people get upset that I'm "faking"

Oh man, mystery person, that’s pretty heavy!! I know the feeling, it took me a LONG time of self-examination to work out whether I might have autism, and I actually did have to deal with a less-than-optimal response when I tried to talk to someone about it. My doctor outright said ‘but you seem too smart for that’, like.. what the fuck?? So seriously, you need to be prepared to be PERSISTANT. Don’t lose confidence in your decision! Make sure you get to see an actual diagnosis, don’t let them lock you out of it based on dumb stereotypes. Cos seriously, general practitioners going ‘hey this person probably doesnt have this thing that’s completely out of my division, and I wont even let them talk to that division’.. thats just.. GOD I really get frustrated and scared thinking how much more messed up my life would be right now if I’d listened to him and not ever got help for my condition!

So my advice is basically.. even if you don’t want to ‘self-diagnose’, please do ‘self-diagnose’.You need to be abnormally prepared for this, you need to have a list of all your symptoms, you need to learn the terms and have reference to point to in the event of them denying you the ability to talk to an actual psychologist. And you need to be prepared for them even treating you like you cant be autistic if you were capable of doing this!You need to hand-hold your general practitioner through explaining what autism even is, and do whatever the fuck you can so you can get transferred over to someone who actually knows who they’re talking about.Oh and common ‘self-diagnosis’ type stuff can also help a lot in the meantime, because doing research on the subject can lead you to finding new coping methods, finding other people to ask about the subject, and just generally tiding you over until you’re able to get a professional diagnosis and (hopefully) access to things like therapy and local autism community groups.Also, just, in some countries medical care is way less accessable, so I know not eveyrone is even able to get a professional diagnosis at all.

Oh, and an important thing is that autism is a spectrum and there are many different symptoms you can have. it can even be hard to discover your own symptoms, you might find that they manifest in a weird way because you’ve been subconciously trying to hide them or using some form of unhealthy coping method for years. Going undiagnosed into your adult years is really like.. one of the primary causes for autism being REALLY disabling! Dear god my stage of treatment right now is just learning to untangle a bunch of bullshit I’ve done to myself over the years, and re-learn basic life skills and self confidence. I think if i’d been born into an environment with people who actually would have recognised it and cared about getting me help as a kid, i could have grown up without most of my anxiety issues!Another important fact is that adult autism is often co-morbid with anxiety issues, due to the circumstances of being left completely alone to deal with this thing for your entire life with no support. There’s also just a lot of ways certain anxiety disorders (as well as ADHD) can have overlapping symptoms with autism spectrum disorders. A lot of the ‘that feel when’ meme stuff can be relateable to all three of these otherwise quite different disorders. So I’d reccommend looking up info on ADHD, PTSD, generalized anxiety disorder, and related conditions too, and maybe seeing which disorder seems most similar to what you’re experiencing. And don’t be scared if it seems like you might have multiple of them! In real life being ‘all the tokens at once’ is VERY MUCH not ‘unrealistic’, man I really hate those people who’re like ‘hwaaa someone who’s black AND gay AND in a wheelchair? political correctness gone maaaad!’ Seriously, its very VERY possible to have more than one mental illness, especially ones that might have a knock-on effect causing another one. Going undiagnosed and untreated for ANYTHING can lead to developing anxiety and depression, but going undiagnosed for a social disability makes it especially likely to get specifically social anxiety.oh, and randomly for an example I happen to also have prosopagnosia, which means I can’t tell the difference between people’s faces. I literally cannot recognise my best friend if she changes her hairstyle or glasses. This is kinda Double Hell combined with autism, cos its already a challenge for me to judge people’s emotions, lol!

Oh man I’m kinda going offtopic and just rambling every damn fact I know, but I’m just hoping maybe something will be helpful??I really am not an expert on autism, I dont even know any good informative blogs to link you to. I’m just a regular person who happens to have the condition, and I don’t know how to give good advice when i’m still quite often suffering from denial and self hate myself...But I dunno, I just hope it could help to hear my personal experience, and know that you’re not alone.Though now I’m worrying maybe this post is a little intimidating so it might make you feel worse?? Seriously, this is just a worst case scenario thing, hopefully your doctor won’t be as casually gatekeepy as mine was. And I mean, he seemed like a good man who wasnt exactly rude about it and wasnt doing it on purpose. If anything that worries me more, tho, cos he was just politely saying ‘haha no you’re wrong’ to a patient, about a subject he wasnt remotely qualified in, and wouldnt have ever considered reccommending me to a professional if i hadnt kept nagging him about it and come back with a bunch of research and stuff. It felt SO damn cathartic to get that ‘YES, AUTISM’ in the end! Shame I couldnt show it to him and I probably would have had my entire healthcare cut forever if I boasted XDAlso, I was lucky that I had my charity support worker to help me through the stress of the assessment interviews. I hope you have at least one person who’d be able to be there for you and believe you, in times like these. Or, even if you’re like me and you dont’ have any family and stuff, I hope you end up meeting a surprisingly awesome governent worker lady who wears a cool hat and helps you out. Seriously, Amber, you’re a godsend!

So umm.. yeah.. i am REALLY sleep deprived and I am not good at words but i hope some of this helped?? I hope you’re okay, anon!And honestly, reading ‘lol relateable jokes’ type posts on people’s blogs was how I first started suspecting I was autistic, too. I’d grown up buried in so many stereotypes of mentally ill people, I never thought I was one of them until I actually got to read blogs from their perspective. Joke posts obviously aren’t a substitute for a diagnosis, but I think they kinda serve a valuable role in the self acceptance process, yknow? Thank you, joke posts!

[painhaver]

hey um, im sorry if this is weird. and if it is u don't have to reply. but i think im starting to realize i might have been experiencing psychosis for years. do you have any advice for someone who wants to seek help but doesn't know how?

im glad u feel comfortable reaching out to me lol ill def give u any advice that i can, disclaimer that im only speaking from my own experiences n also i live in the US so idk if yr medical system differs from mine

• in my experience w doctors in general, not just when seeking help for psychosis, it's a generally good idea to not only describe yr symptoms but also tell them specifically How theyre affecting u in yr day to day life. example: "i think im experiencing hallucinations, my hallucinations make it difficult for me to focus on everyday tasks n cause me anxiety that further limits my ability to do [insert task here]"

• b aware too that if u tell yr doc/psychiatrist that yr experiencing psychosis theyre likely gnna want to put u on antipsychotic medication. antipsychotics can have some weird side effects n every med is different, if u try one n it doesnt work for u or has side effects that worsen other symptoms/that u generally just dont like, tell yr doctor RIGHT AWAY. common side effects of antipsychotics r weight gain [n sometimes weight loss], dry mouth, drowsiness/sedation, and dizziness. in some cases u might also get tremors but if u do u shld def tell yr doctor right away. also know that u have the right to refuse any medication, yr doctor cannot force u to take anything u dont want to take n if they try to, find a new doctor n consider reporting them if u believe they cld b dangerous to other psychotic patients

• before speaking to yr doctor, write down yr symptoms. it doesnt have to b a clinical thing, esp cuz logging psychotic symptoms can b difficult [i often dont realize im having a delusional episode until after i break out of a delusion, n it can b hard to distinguish some hallucinations from reality]. if it's easier for u i suggest keeping a journal that u write in every day regardless of if u think yr having psychotic symptoms that day or not, just write down yr thoughts n maybe some things that youve seen/heard/experienced that day. u can go back later n might b able to pinpoint which days were heavy psychosis days n which ones werent. try journaling at different times of day too, psychosis can get worse at different times of day for different ppl. track yr moods too, psychosis can b caused by many different disorders, from bipolar to schizospec disorders to some personality disorders, even things like depression or ptsd can cause acute psychotic symptoms. many of these diagnoses r also dependant on a knowledge of yr mood symptoms as well so it's important to keep track of them as much as u can

• b as honest as u can w both yrself n yr doctor. tell them truthfully what yr symptoms r n how theyre affecting u n what u think yr treatment plan shld b. consider reaching out to close friends n trusted adults [if yr a minor] n tell them abt yr symptoms as much as yr comfortable doing so, let them know how they can help u if yr experiencing psychosis around them n ask for frequent reality checks if yr having difficulty distinguishing reality from psychosis. remember that there r ppl in yr life who love n care abt u, n u shld allow them to help u

• on a somewhat scary note [but it has to b said] b wary of ppl who u think might reject u bcuz of yr psychosis. im sad to say that ableism against psychotic ppl is v real n can b scary to experience. being psychotic can b isolating sometimes, esp when u experience lesser known symptoms such as disorganized thinking/speech. b wary of doctors who try to pressure u into treatments that yr unsure of or that r having negative effects on yr physical or mental health. remember that yr the patient n yr word is g-d, if u want a treatment to stop or if u think that u rnt being listened to, stand yr ground. speak up. report yr doctor for malpractice if u think it's necessary. in that same vein, b open-minded n willing to accept treatments, even on a trial basis. just keep in mind that u have the right to revoke yr medical consent at any time

srry that this post got rlly rlly long lmao but i hope it helps, feel free to shoot me another ask or dm me if u have any other questions ❤️ once again this is based on my own experiences so take it w a grain of salt but i think a good place for u to start wld b symptom tracking at the v least even if u cant/rnt ready to tell a doctor yet [though i encourage u to seek treatment]. stay safe out there :-)

[herriblog]

Patients

Types of patient. Working in a hospital has its perks. We get to meet people of all woks of life. They can range from a CEO of a company or a drug addict or a PTSD patient. I mean like when they come in, they have social history too. Social history is not very important to some people. But to me, I would like to know them a little better. Eg, how to remove secretions from a patient who refuses to open his/her mouth. We literally have to pry open this mouth to do suctioning (a procedure that we have to insert a thin long tube through the mouth down to their throat to clear the lungs from the secretions that she cant cough out. But after speaking to the family, they told us that if you were to tell her that I’m the dentist checking your teeth , she will willingly open her mouth. That did well with me. Made my job easier.

 Okay. So today’s story was about a 56year old lady who has lost her flow of thoughts. She has bipolar disorder. She doesn’t take her medication. All I kinda cared about was she was annoying the fuck out of me. Like whatever I said, she had to rebutt. An example of our conversation could go like this.

She came up to me and said, “Nurse ar, I never donate my blood. I want to donate my blood.” So I said, okay. But you don’t necessarily need to do it here. You can do it when they have a blood donation drive.” And her response was, “But I’m not donating it to you. Why are you so bothered?” I thought to myself,  Apa la sia. You sendiri tanya I and bila I jawab you….AHHHH…Malas nak layan kau la. Then I told her that blood donation would be given to her donee without either party knowing it and the lab needs to check the blood before it can be given to the donee. So she nodded and went off to the toilet.

At that point, the neighboring patient said, “Why did you even entertain her question? You do know that she is crazy” I nodded. Of course I knew she wasn’t of sound mind. But if I didn’t entertain her, she would go to someone else. She would target my filipina colleague and start scolding vulgarities and saying that you filipinos like to steal people’s husband. Don’t you have brains etc. I’ve heard her say that in the early morning. Honestly, It wasn’t nice. I’m not filipino but its hurtful to someone when they didn’t even do anything. So to avoid confrontation, I just entertained her as much as I could. She came up to me numerous times. I was still patient on the outside, but in the inside, I was gonna burst out in tears. I was already exhausted. I couldn’t handle it when she empties her 1.5liter Sprite bottle and put in a little soap and pouring in water till it was full. She went to go to a 90+ year old ah ma and give it to her to drink. The poor ah ma didn’t know what to do. She just held the come and said, “Kamsia ar. And she will drink it later. The mentally unsound mind lady almost drank it till I stopped her. Overnight she had gargled her mouth with alcohol. I didn’t want to raise a report over that. I had to leave early. But somehow or rather she was fine after a while. Her doctors had rounded without me realising. I called the House Officer and told her the situation. And she said, how did she get access to the soap. I slapped my own face while on the line with the Dr. Dei, you stupid or you very stupid lah Dr. Every fucking room got a sink and soap la, bodoh. But I told her nicely. Even though I snapped at her couple of days ago for raising her voice. So she said, it’s not a priority. And I said, Äre you planning to wait for her to swallow the entire soap bottle then you will do something?” And she said that she will let her team know. Okay, there is a limit for this bhai chick to tahan all this. So I told my boss and my boss called her and spoke to her. She was still reluctant till my boss explained to her that a potential issue that may come and hunt her later. But still our dear Madam didn’t  bother.

God must have been on my side. Her senior doctor rounded and I knew the senior doctor so I explained a tiny bit and he turned to her and said, “call the on call Psychiatrist and update her about this situation. She isn’t safe to being in the ward, she may harm the neighboring patient. Reluctantly she did call. And she gave me news that she will be transferred to IMH. I was over the moon. Hehe. I love the fact that when you have contacts and you know the doctors well and have a rapport, they have your back.

So we sorted her transfer. Her husband came and I explained to him the situation overnight and this morning. He agreed that she requires to be transferred to IMH but he isn’t going to see her because she may lose her temper. I was like okay. No issues. Then he said that he was afraid to pick up my call as she had been using the phone to call him and her parents multiple times and they are exhausted. He went on to explain that she had just been promoted and she couldn’t handle the pressure. I felt bad for her. I mean like honestly, I have been in that spot. I had anxiety issues when I was working in another place. I barely could sleep. I basically cried. I got so paranoid when I heard people calling my name. I think genuinely everyone has it. It’s just whether we choose to get it diagnosed or not. So her family left. I had to sedate her but she refused to let me jab her even though I lied to her that it was a Vitamin jab. She was going to lock herself in the bathroom. I took before her, not allowing her to go into the bath room. She said that she wanted to pray. I was like go ahead and pray. I don’t have any issues. She did. And that point, visitors were coming in and observing her. Staring at her, making fun of her etc. I felt bad so I screened her in the curtain. She went down on her knees and laid on her stomach and prayed for god to help her. IT went on for 15mins. Meanwhile, I got someone to get the security in, and we jabbed here. And sent her to IMH. In the ambulance, she was saying that the ambulance drivers were her personal driver. I said yea and I’m your bodyguard. Lol. When we arrived there, she figured it was IMH. But she didn’t create a ruckus but was calm and cooperative. Phew. Oh and I realised that not only 995 doesn medical stuff but so does private ambulance and they need to know what causes they are taking. I was stunned to find out that after sending me back, they were going to fetch a patient for a blood thinning procedure. I was like hmmmm. Something new I learnt. But overall, it was okay. HEhe