Question

[Donna]

Im not sure if this is in the right place, i wasnt sure where to put it sorry.

I have a few questions which are probably really dumb but the more ive read around here in regards to psychiatrists the more confused i am.

What exactly are psychiatrists supposed to do or be there for? are there different types and how exactly does the mental health system work?

ive seen quite a few different ones over the yrs and although one made a diagnosis of BPD but never bothered to tell me about it, i found out by chance in a casual comment which came as a bit of a shock.

all they ever did was spend a few hrs asking the same questions then say thankyou for coming and thats that except one who who wrote to my dr to suggest prescribing me some meds i was already on at the time.

i dont understand what any of it achieves? to me it seems like a waste of their time and mine.

my gps ask how did it go whenever i saw one and i didnt know what to say other than i went and answered the same old questions lol from comments the gps often make i am still under mental health care but if i am i know nothing about it and never see anyone.

i think i can ask for a cpn though im not overly sure besides which it seems a waste of resources the one i had used to come out ask how i am tell me how to keep any wounds clean and spend an hr discussing her dogs,my cats and nights out with her friends...and the odd indiscretion about other patients.

yet from things ive read around here most seem to usually do a lot more, i suppose it doesnt really matter but i am curious as to the different types of psychiatrists or purposes because i really dont know what they do and i feel kind of stranded like there's just nothing or anything out there to help me.

i also want to know exactly where i stand and what any reports etc say about me,i dont want any more surprises.

Edited September 16, 2009 by Donna

[David O]

Hi Donna,

What you’re describing seems to be the norm and has worsened b/c of managed care where it feels more like a you’re a number. The shocking part of this is that a psychiatrist may see your for 10-15 minutes and bill for $75-175 in that period!!!

There are several types of psychiatrist (Forensic, Neuro, Geriatric, Child and Adolescent, etc.); however, you’re likely seeing one who specializes in general or adult psychiatry. Their role has changed over the years, but overall, these are some things they typically do:

Diagnostics and testing- Psychiatrists take health histories, administer mental health screening questionnaires or order CAT scans or other imaging tests to diagnose disorders and illnesses.

Prescribe meds

Talk therapy— the lost art in the field now. Some continue to provide 45 minute sessions, but they are far and few between.

Other therapies- i n certain cases, psychiatrists may order other kinds of treatments, such as hospitalization or electroshock therapy.

Here’s the thing, you’re in charge, not the psychiatrist (a point 95% of clients miss). Next time you go in, you take control, express your concerns of how treatment is going and ask for what you need/want. You should be getting, at the very least, no less than 15 minutes of talk time so you can clearly discuss your concerns. If your psychiatrist can’t listen and pay attention, he’s not meeting your needs. At this point, it’s time to boot his behind out the door and find another one. Ask for a referral. If he becomes angry, he can’t simply turn you away, that’s patient abandonment and is a severe violation of their code.

Good luck. Hope this helps.

[Guest ASchwartz]

Hi Donna,

David has given you an excellent explanation about psychiatrists and about your rights. Good job, David.

You are also asking if there is any help out there for you and you do not seem to have been helped. That troubles me but let's see if I can help.

You are reporting that you have been diagnosed with Borderlline Personality Disorder. There are many Clinical Psychologists who treat people with BPD. Now, a Psychologist is different. A psychologist is not a medical doctor and does not use medication. For those people with BPD there is a type of psychotherapy called Dialectical Behavior Therapy. You need to find a psychologist who specializes in this type of treatment. In fact, there is group therapy, run by psychologists, where the whole group therapy is Dialectical Behavior Therapy.

You can ask your General Practitioner or one of the Psychiatrists for a referral to this type of group or to this type of psychologist.

Please ask more questions so we can help. This can be very confusing.

Allan

[Donna]

Thankyou David for explaining it all, no ive never had any talk time just hrs of repetitive questions in fact so repetitive i could just take a pre-written answer sheet with me if i ever go again to save time lol,and it sounds silly but i never really thought i had a right to ask anything.

ASchwartz, i was referred to a DBT group but it got kind of complicated..at the time i was seeing an ED consultant who wanted to give me day patient care amongst other things but when she found out i was possibly going for DBT felt it would be dangerous to (her words) take the Ed away from me until i had spent some time doing the DBT thing BUT the DBT counsellor who had by his own admission absolutely no knowledge or experience of ED's wanted to work on the ED first ..so i wasnt too comfortable with any of it, everything seemed to be at odds! and the DBT therapist and myself both agreed it wasnt going to work for me. So once again im kind of in limbo.

I seem to have an adverse effect on proffesionals of any kind :confused:

[David O]

Hi Donna,

Just a very quick note: DBT is energing as an effective treatment for ED (especially for Bulimia and the binge-purge cycle), not just BPD. It sounds like neither therapist (allow me to be blunt) knows their way around a shower curtain.:eek:

In your next visit to your psychiatrist say this:

I've never had any talk time just hrs of repetitive questions in fact so repetitive i could just take a pre-written answer sheet with me if i ever go again to save time lol,and it sounds silly but i never really thought i had a right to ask anything.

These are your words and this is his/her cue to listen up an these are the words he/she needs to hear. To continue to see your MD and be treated like this is like having the kid who mows your lawn only do an "X" on your front yard in 2 minutes and then ignore the rest of the lawn while he asks to be paid as if he mowed the entire lawn!! :eek: Request referral to a COMPETENT therapist, one your MD would feel comfortable sending their family to.

Finally, interview any prospective therapist like you would a job applicant and don't hire one until you're sure they know their "caca!" No you don't "have have an adverse effect on proffesionals of any kind," it's just that there are not as many competent ones out there as one imagines.

Hope this helps and good luck.

Edited September 17, 2009 by David O

[Donna]

thankyou,

im not doing very well right now,in fact im feeling pretty sh!t to be honest and am getting more and more scared of myself, i dont think im suicidal but i can feel myself heading in that directon again and in some ways it's worse than before.I dont even know how to begin to describe it.

normally my gp(s) prescribes me anti-depressants they dont help and i dont take them , the one time i did stick with them i quickly became actively suicidal and one of the gp's said there was a strong possibility that this could have been a side effect of those meds they also made me physically ill.

(im digresing here but interestingly they also have a side effect of weight gain which seems a strange thing to prescribe an anoretic and they know because of that i wont take them,maybe im a bit paranoid but im not sure that isnt the reason they are actually prescribed for)

Do i have the right here in the UK to request to see somebody preferably quickly rather than being placed on the 6mth waiting list? or do i have to go through the whole prescripton of anti-depressants thing again whch then is followed up with i cant help you you wont give the pills a chance, despite any side effects i dont want to rely on meds i know they're not the answer.

One more question,am i allowed to request a different form of therapy/counselling or whatever? ive been offered group therapy (DBT) but it's not right for me even the therapist who assessed me agreed it wouldnt work for me. It's taken me a hell of a lot simply to finally convince myself i need to get help and i need one on one not group i just couldnt handle that.

[Guest ASchwartz]

Hi Donna,

Actually, it is not so wierd that the Doctor wanted to try you on anti depressants for your eating disorder. It is true that peope with anorexial refuse the medication for two reasons: 1. They fear the weight gain that might come from the medication or, 2 They fear feeling better because they might eat more and gain weight.

Groups often do not work well with anorexial because people compare themselves to each other and feel fat compared to the others.

You really need intensive psychotherapy, a nutritionist, and an MD to weigh you regularly. It would really help you if you took the anti depressants. You become suicidal at first because of the fear of feeling better. If you could get over that it could really help.

Please, if you are feeling suicidal, do not hesitate to go to the hospital.

We do not want to lose you.

Allan

[Donna]

thanks for the advice but they dont do anything.

im in a bit of a mess again and scared of myself even cutting isnt helping,so i just called the hospital but they said make an appt at the gps (usually takes a week or so) and ask to be referred to a counsellor, the hospital treat ppl like me like dirt anyhow usually accuse you of wasting their time and leave you in a corridor for hrs with drunks,people who've been fighting etc where you just throw up anything you've taken.

[Donna]

im trying really hard not to do anything stupid which is why im on here posting in between pacing up and down the lounge talking to myself ,sorry if i sound pathetic.

[SweetSue]

Hey Donna,

Try and phone the G.P. again, and tell the recieptionist its to make an urgent appointment. They should be able to fit you in today, or at the very latest tomorrow morning.

You cant wait, a week or so to be seen, that is just "dumb". Make the call hun, ok.

We are all thinking of you and hope that you can get the help you need to feel a little better.

Please take care,

Stay strong

Jj

[SweetSue]

ps, you dont sound "pathetic", you are asking for help, there is nothing "pathetic" about that. Keep fighting ok

[mscat]

hi Donna,

Have you ever thought about going into a ED inpatient program? I don't know how long you have had the anorexia, or how much the ED has affected your life. However, I am very well aware of just how much damage an ED has on the body, mind, and spirit.

I've suffered both from anorexia and Bulimia for over 8 yrs of my life, at one time > Very familiar with ED's. I have to ask you , Do you want to get better from your ED? Not for anybody else but for yourself? i ask u this because , until you yourself are ready to , then no amount of professional help is going to do anything for u. BEEN THERE. ED's are about control . Nobody can control your body , but u . SO until the person is commited to stopping the ED, and REAADY 100% no matter what to get well, than it is a losing battle.

If you are seriously ready to overcome your ED once and for all , and change your thinking, and ED "habits" behaviors, and all that goes into the ED , and ALLOW some of that control to lessen , so u can fight to get well, because I know it is a real fight!!! then you are ready .

Ready for professional help. Going into a ED treatment program teaches the person how to eat again , learn new and healthy behaviors, and monitiers the persons weight. Anorexics need to gain weight, so it is a slow process. Their are speicalists constantly monitering the inviduals needs.

A good program is not a forced , GAIN WEIGHT program. their is none of that crap. Such as tube feedings, bed rest , and all the negative crap their is when it comes to treating anorexia.

A good program teaches the ED person new behaviors , and theri is group therapy, journal wriritng , and lots of support.

Than if you don;t want to go in a program , I suggest a therapist who specializes in ED's. BPD, just so u know, is common in people who also have ED's. it is a dual diagnoses, however it is common to have both. This just means your going to have to work extra hard.

The ED needs to get under control first. Because this is the most damaging to your health .

I had to see a endocrinolgist every month . BEcause this speiaclist monitered my electrolyes. when your electrolyes are off it cankill u. Potassium levels , especially. Since I had both builima and anorexia at the same time it was an issue for me. I also saw a LSW , and then went into a ED program. But, after getting out , I lost all the weight again, I was not ready to get well at that time. That is the reason for the long post. It is a struggle, I understand . Understand so well , even though i did manage to stop the ED, it really is something never forgotten.

[Donna]

I know im supposed to want to get rid of the ED but i dont, i really dont want treatment for that maybe later but right now thats just not an option for me, it's the worst thing i could do right now.

Ive gained a lot of weight lately way too much weight 10lbs in 2 weeks! the usual restrict starve and mess my metabolism up then gain 2 lbs just by eating a few tomatos or pickles and too much baileys, probably even the specialists would say too quickly it's making me physically ill.

I think im getting depressed again or just going crazy it's been going on a long time now eating every day and getting even fatter is just adding to it, it's my head which is just screaming all the time, and my moods or whatever that wants sorting it's hard to explain but i know the difference between the depression and other things that make me like this rather than the lack of food purging etc that causes it.

ive been doing and thinking stupid things, the cutting isnt helping and other things ive been doing it just makes me want more and i cant seem to stop...i recently had to put mouse posion down and i keep looking at it and think of taking it partly as a way to purge (i cant make myself sick anymore too many yrs of it has ruined my gag reflex) but mainly as a way of ..i dont know really, my make myself feel better or worse im not sure which.

So far ive not taken any yet whch is a good thing but each time i look it's getting harder my children are with me at w/ends which has stopped me but they go home tonight im scared of being alone and just scared of myself.

I called one of those helplines im not sure what i expected or what they do really, they said see my gp ask for counselling,i dont expect immediate appts but each day is getting harder and i think i need some kind of help asap, my heads tired and im not sure i can take much more...i called my mum straight after i spoke to them screaming crying ranting talking nonsense etc but it's not fair she was at work and she doesnt know how to handle it anyway and why should she, in the end i made myself stop crying and went for a long walk but i cant do that every time.

I know im supposed to do it all by myself but i dont know how and no-one in the med world wants to help, it takes me a long time to get myself to go ask for help and each time i do i just seem to get knocked back or stuck on some long waiting list 6 mths is a long time and i dont think i can last that long.

it would be easy for me to say that ive managed this long so im ok i'll keep on managing and getting through each day but i dont think i can anymore its frightening, it hurts and im just too tired.

sorry im whinging again

[SweetSue]

Hi Donna.

Your allowed to whinge, I do it quite often.

But your not whinging if thats how you feel, you are just expressing yourself !!!

Donna is there no way that you can see your gp, get a emergency appointment, they must be able to help you , right ?

I konw what you mean about waiting lists, if only we could know 6 months in advance, when we were going to feel poorly !!!

Yes, ultimatly things are down to you, I hope that you still have the strength to kkeep fighting. I think maybe you do. You are a strong person, you will make it.

We are all here to help support you, if we can, even if like me, its only to say hi, and to let you know that you are not alone.

Please take care

Jj

[mscat]

Donna you are right about how it is so easy to put on weight. Because the body is so used to being starved , when u eat it will hold onto anything to keep you alive.

Please know that most of the weight gain is not fat weight> It is from fluids. It is water weight, NOT FAT>

Before anything turns to fat, the body has to have had more than the body needs. Body fat takes a long time to acculamte. it does not happen quickly.

I remember when I was in a inpatient ED treatment program for my Anorexia, I freaked out when I saw how big my thighs were.

What had happened was that it was from edema, I was retaining water, not fat at all . Ihated it and it was awful . But, it did reslove itself .

I was severely anorexic , so treatment was very difficult for me. After getting out of the program, I had lost all the weight I gained , I was not ready to stop the ED, and let it continue controlling me, and who I was . However, from the program, I did learn valuable resources. I got into cycling, and long distance riding. I managed to become very muscular in my legs , they were very strong, muscle weighs more then fat, so I did get up to 92 LBS instead of 87Lbs, I had to do something so I could continue to keep cycling, so I started eating these power bars to keep up strength. that is all I kept down, along with diet sodas and water.

I still binged and purged, though. And did not have reg. monthly periods despite having estrogen replacement therapy, at the age of 22.

My lowest weight was 72Lbs , I am nearly 5'5, so that was really disgusting for me to look like that.

Problem was , that I myself never thought so, never felt sick, always had a huge amount of energy too.

I did get to a certain point that I had to stop the laxative abuse, I just got too thin, and it just drained me , really setting off electrolye imbalances , and dehydration .I had a number of bad experiences with that. Lokking back at those times, I feel very lucky that I did not end up having a heart attack, or rupturing my stomach, or go into a coma from electrolye imbalances so often.

Their were many times that I was so bad off I did not even make any sense talking, so I was told. Had to have a brain scan just to make sure I had no brain damage , from being anorexic so long.

Just my personal struggle with the ED, I know i was lucky , cause the way I was going I don't think I could of lasted out much longer.

I have major dental damage though, lost teeth too, so now wear fake teeth, lovely isn't it the teeth i have left are messed up badly too .

So is my stomach, ulcers all the time, and a thyroid disorder too.

I know when I was so into the ED, I never thought of the long term consequences it has on the body .

I am not even going to say anything about the ED, right now you are getting into a crisis mode> THings are getting serious, and Your going to need to go to the ER. If the sucicidal impulses contiune then you need to go to the ER , and let them help you stay safe. Your saftey is far more important then anything else.

Edited October 4, 2009 by mscat

[Donna]

thanks for your replies it helps just to know someones actually listening to me and taking me seriously for once.

i went to the gps an hr ago he told me go to hospital to be assesed by the crisis team whatever that means, before they just came to my home then go back and see him (gp) in a cpl of days.

i dont trust the crisis team, the last time i was involved with them they broke all my confidentiality to social services contacting them daily all the while telling me they wernt involved with them and i lost my children, so i'll wait a few days go back to gps and ask if he can refer me back to the cpn and psychs ive seen before hopefully asap but this time im going to ask them some questions and explain that id be more comfortable one to one rather than group therapy if they'll let me.

i dont think i really know how the whole system works or what to expect i just need to be safe and i dont feel it i am scared of myself, the crisis team didnt stop me doing anything before,id just answer their how are you feeling questions and say thx for coming when they left...but it didnt make any difference if i was going to s/h o/d or whatever i just waited till they'd gone nine times out of ten their visits made me want to do something anyway lol.

but im still here even if i am a bit divvy and fckd up lol ive managed this long so i'm sure i'll keep on managing guess im just being stupid.

sorry for the nonsensical waffling stuff my heads kind of buzzing.

Edited October 5, 2009 by Donna

[Guest ASchwartz]

Hi Donna,

Of course we are listening and we hear you. We are also worried about you. Very few people with eating disorders want to get better from them, especially since they think nothing is wrong with them and even if they do, they don't want to get better. As far as cutting is concerned, that is addictive and the more you do it the more you do it. Same with purging and other types of eating disorders. Its all closely related to addictions.

Don't you want to get better for you children's sake??

Allan

[mscat]

Donna it took a very long time for me to overcome the ED, anorexia and Bulimia. Despite treatment too.

In my case I did end up pregnant, and had to make a choice. Being to thin , and pregnant, I had to start to take care of myself , so that is what I did. Problem was that once I had gained the weight to have a normal weight , health baby, I was 65 LBS heavier. Then I went back to work full time less than 3 months later.

I had a good friend at the time, and we use to go out to lunch on work breaks all the time, I did not care about weight control issues anymore, the focus changed and that was being a single parent and working .

YEs, my weight ended up going from one extreme to the other. SO I am fat now, LOL . However their are still problems in my health from the long term effeects of the ED. Ulcers, Heartburn , rotting teeth, tooth loss , and it was easy to put on the LBS.

Some could say I still have an ED, because I am not a normal weight. Oh well, now a thyroid problem too, though.

I Self injure , and Allen is unfortunately right, about Si . It does become easier to continue the pattern of SI , once started.

It sucks , but that is the way it happens. hope things can get back under control for you. Being a parent and having some real difficult disorders to deal with is rough. Remember your children need you. My biggest fear is that when I do get "bad" that I'll lose my son , custody of him, or social services wll say I am unfit, or unable to care for him.

What I strongly suggest to you is to have others you can trust to step in and care for your children in times where you are in a crisis , and need to focus on yourself .

Always have a family member or if you are married , divorced , or what , be there for your kids, when You are not able to.

[Donna]

i only have my children at weekends unfortunately they live with their dad have done for nearly 4 yrs now ..social services dont like people who are 'down in the dumps' ''should pull their socks up'' and ask for help or god forbid disagree with them!

my dr called me a cpl of hours ago asking me to go to the hospital because i didnt go the other day,im not sure what to do,part of me wants to go but the other part tells me not to risk it.

im not suicidal i dont think, so all that will happen is an assessment, crisis team coming to visit who i do not trust (they totally broke my confidences last time) followed by if im lucky a follow up appt with a cpn or psychiatrist, other than with the ed i do want help i just dont want to be treat like dirt at the hospital which they usually do.

im also feeling pretty numb today and im not sure id be able to actually answer any questions properly or tell them anything, i switch off and just dont know or forget what i feel or have been thinking and doing, and can only say things like, im fine thankyou, i dont know, im not sure, i cant remember and so on.

i dont know if anyone else ever does that? then people tend to think im ok im just wasting their time or im stupid and being deliberately unhelpful,stubborn and wont answer their questions and if i explain beforehand they say im being defensive lol but im numb and even when im not im often physically unable to.

if im honest im also a bit scared of going although i dont know why.

arrgh i dont know, as always im just making things more complicated for myself

[Guest ASchwartz]

Hi Donna,

If you are feeling that numb then I would follow my doctor's advice and go to the hospital for an assessment. There is nothing to fear and, there, you can be helped to feel better and in a safe environment.

After all, Donna, we want you to feel good and we want to keep you with us.

Allan

[Donna]

hi,

thankyou everyone, i took your advice and went to the hospital and saw the on duty psychiatrist, he's referring me to the psychiatric team as it's not clear if im still under them and is going to contact my gp and ask him to arrange for me to see a counsellor one on one as soon as possible.

The crisis team will be contacting me today and if i become actively suicidal (unlikely) he wants me to call 999 and i will be admitted to the psych ward.

so i'll have to see how it goes from here..hopefully it's a step in the right direction, im still apprehensive about them being involved again but i know i cant keep on living lke this, it's too exhausting and frightening.

he also asked me if i would like him to arrange for me to go into the ED clinic or just be reffered to out-patient but ive refused that and he didnt push it just suggested that i consider it.

[SweetSue]

Hi Donna,

I'm pleased that you went to see the p/doc. Hopefully the crisis p/team will visit you over the weekend, and be able to help you.

Take good care

Jj

[Guest ASchwartz]

Hi Donna,

I agree withn JessicaJane and am glad you got help for yourself. Keep us posted on how you are doing. We are here for you and we care. By the way, the ED clinic might be a good idea. Ask about it and what they offer.

Allan

[mscat]

Hi Donna,

That was very brave of you to talk to the pdoc . He has the best interest in mind for you. I know it must have been very hard for you to do that. But, you did this for youself, and i think that it was great. Allow them to help you get well so you can start the on the road to recovery. You deserve to feel better and happier in your life.

Try not focusing on the labels , but on getting well for yourself and your family .

mscat

[Donna]

i had my appt yesterday and im not sure it was worth it.

it was a cpn i saw because there were no appts available with anyone else, he asked a cpl of questions then suggested the group therapy and to ask my gp for anti-depressants.

i explained that group therapy had already been offered to me but the counsellor had agreed with me that it wasnt suitable,so would it be possible to have a one on one type thing.

he then had a sudden shange of mind and said group therapy wouldnt help me because basically it involved people with emotional problems getting together and the majority not wanting to talk :confused:

then suggested i discharge myself from psychiatric care because there's nothing really out there other than group and long waiting lists,get a private counsellor which i explained i cant afford.

then he suggested i try looking for the holistic approach..whatever that is? i asked but he didnt seem to know.

so THEN he suggested finding some kind of social womens well being group where women get together and talk about there past experiences,they're not actually groups to help but you can socialise with people of similar commonalitys.

the appt ended with him saying he will have a 'dabble' and 'delve' around on the net to see what he can come up with and write to my gp tomorrow (yesterday) and in the meantime stay with my b/f so im 'safe' although he agrees its a bit of an akward situation because he's caring for me but i dont want sex (yet another problem i have right now!) which he implied was unfair on my b/f and not a conducive situation,which to be fair i know he is right about that.

he asked if id thought about being re-refferred to the ed clinic which i turned down and didnt want to discuss,he didnt push it thank god although he did surprse me a bit when he told me that it wouldnt do my health any harm even though he knows i swallowing dozens of laxes diet pills supplements restrict purge with bleach on occasion etc supposedly have a low bmi and have a history of health problems.

i dont have a problem with that and am relieved he didnt go on about it but i am surprised he said it when everyone else has warned me about my health and the problems its caused me! i was a bit taken aback lol

so again im not 100% sure what if anything will happen next, and im a bit confused again and beginning to think it's a waste of time.

so im sat here back at home feeling really low and tired still and trying to get through the w/end with my children..which i should be enjoying not finding difficult.

sorry about the rambling but im a bit confused and wondered if anyone has had the same sort of experience with all this and can understand it all and point out anything im missing or misinterrpreting?