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Not sure whether to post here, or anywhere else, or even at all.

I've been feeling quite down since the beginning of December.  I've been struggling a lot more in the past month or two.  Yesterday I saw a psychiatrist for the first time in approx. three years.  I've come away feeling even more dejected than usual.  I've been thinking of suicide a lot lately and have been managing impulses as best as I can.  To me my psych appt. just reinforced that this is the best option for me at this time.

The doctor said that I had two options.  I could not change or I could take medication and attend counselling.  The doctor said that even 20 years of therapy may not change anything and could make things worse.  He said that I could kill myself and that, "It is what it is."

I doubt I needed his permission for anything but the lack of caring and hope made me feel much worse.

I have felt burnt out and can't seem to generate that degree of care or motivation to change.  The doctor suggested I go back in three weeks (or not) to confirm what I'm wanting to do.

Due to my history with the mhs accepting help is difficult but at this point I don't have the enegry to even fight just one more time.

I feel like my best option at this time is to work through grief and loss and to accept death (before I act, or not, depending on how I feel at the time).

I have plans in my head that are reappearing.  In the past they had become automatic.  I use to go through days only seeing ways to hurt myself.

I actually only came on the net to research ways to harm myself.  I'm not sure that I can make three weeks or attend without first hurting myself.  I'm not sure how to work through this.

The doctor didn't seem all that happy that I was receiving emotional support from my GP.  I considered not going anymore.  I have a GP appt for next week.  Was going to cancel but are running low on lorazepam and feel I need this in order to cope.  I have a feeling it is something I could abuse though.

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1308134_tn?1295191219
You have so much to give to others. I am so sorry for the experience you had with that psychiatrist. It is appalling and disturbing and I am embarrassed for the profession.

Obviously you should get emotional support wherever you can. So I definitely think you should go see your GP.

When the doctor said that you had two options, I think he was wrong and he was right. He was wrong that the paths to change are never as clear as he claims. If years of practice have taught me anything it is that I never quite know what it is that is going to be most effective.

But he was right that you have to do something.... Although I guess you already did since you posted this message.

How are you doing with taking care of yourself? Little things that you can do to improve your health can sometimes make a big difference and help to address the sense of discouragement. I know that exercise has played a big role. How about sleep? And diet?

For me music also has been a source of inspiration, but again there are so many paths to hope and to positive change that it is hard to know where to begin.

Keep in touch, though.
15 Comments
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Is there hope?  What can I do?  How can I manage this?
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Thanks!  I guess it helps me to feel less alone in all this.  Less wrong like it's all my fault.

Maybe not seeing my GP would precipitate a crisis that the mhs would then have to deal with.  I don't understand why they attack the appts.  I would prefer that the mhs provided the psychological/ emotional support.  Maybe I'm not suppose to receive support?

I think you're right.  I've changed based on things that have gone on/ are going on around me.  Even if I have been largely a passive participant.

I understand that I have to be more proactive and start making some better decisions for myself.  Decisions that will hopefully help me move forward.

Self-care has been challenging.  Maybe slightly less difficult than the beginning of the year though.  Sleep has been a lot better.  Before I was extremely anxious and having nightmares.  Now I feel like I could sleep all day.  I try not too.  My mood gets worse during the day and leaves me feeling more vulnerable in the evenings.
I joined a running club earlier in the year but haven't done any exercise consistently for the past four weeks.  
My GP said that I was burnt out and he said that stress was affecting my running.  I guess maybe I panic and hyperventilate.  ??
With the club I got caught up in their goals which took me further from my own.  This left me feeling anxious and uncontained.
Diet has been shocking.  Aside from the major binges I feel overwhelmed by as to what to do with the healthy food and end up eating rubbish.

I've tried to establish some structure and goals but my family seem to sabotage those with their needs and demands.

The doctor said to look at the big picture.  That's depressing so maybe not such a good idea.  The basics are probably a better idea.  Maybe not quite so overwhelming.

I guess the plan at this stage is to see my GP on Wednesday.  Maybe accept the offer of medication from the psychiatrist.  Not sure how to deal with the therapy aspect because what I'm being offered has made things worse in the past (plus has all my history attached to it).
I understand that that is in the past.  I can't dismiss it as readily as the doctor though.  I was thinking about this yesterday.  It is a bit like me accidentally running him over and leaving him a tetraplegic and telling him to get over it because it is what it is.  Some people can leave it but for others it is pretty patronising and invalidating.

I just need to take everything second by second if I have too and try and get through it as best as I can without making things worse.

My philosophy:  Everything happens for a reason.

Thank you for listening and talking to me.  It's helped a bit for now.
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Hey there. Just wanted to let you know I read this and am so glad you reached out. That tells me that you don't really want to kill yourself, you just want the pain to end.

Therapy is a mixed bag, but right now could it make things worse? Things seem pretty horrible right now. It is worth a shot. I've been to a few therapists, (we move a lot), two adequate, one was extremely horrible, and 1 was fantastic. The one I am seeing right now is good, and is helping me with my social anxiety. Sometimes therapy makes you feel worse for a while, and then you get to the 'a ha' breakthrough moments and it gets easier.

And if your GP can provide comfort, than do that. My thought is you find support where it occurs. And my understanding NHS is a nightmare sometimes when it comes to mental health and GP's pick up the slack. Just from comments I've heard on other boards. I am Canadian so we have a slightly different system.

Try to take really good care of yourself. Try really hard to eat right, and if you can take all the willpower you can muster and exercise. It will help a lot. Even if all you can do is walk a few blocks. Just to get outside is really important.
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I see exactly where you are coming from now, i think seeing your GP is great he has always been so supportive of you, i get why you feel they don't want you to have support thats the way Tina makes me feel when she cut my contact and now my social worker has placed other things in place i fear she will take them too, i have no idea why they feel we need less support they wouldn't deprive it from anyone else so why us.

I agree you give so much to others and me espically and you deserve the same in return and i am sorry the psychiatrist was uncaring and useless but it seems to happen alot, and i know its hard to forgive what they done. I hope you are ok.
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I don't want to give people the satisfaction of saying that I hurt myself because I have mental health issues.  Mostly I don't care but I hate that they break people and then put them in the too hard basket.  Death only reinforces their opinion of things and solidifies it as fact.

The honest answer is that yes, therapy can make things worse.
Shot?  Yes, that could be useful.

GP's show more compassion and then are attacked by the mhs for making themselves available.
There have been significant cost cutting in the mhs but as long as they are seen to be PC who cares about the patient?

I went for a run but feel worse.  I just want everything to go away.
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Supportive but not helpful.  He said the other day he wondered if I am appreciative of his efforts.  I always take the time to thank him, etc.  The truth is, I think that if he were a good doctor he wouldn't have left me so long without support and would have actioned things sooner.

Or support on their terms.  Like I have the same needs as the person next to me.  I feel like they're trying to squeeze me into some hole that I don't fit.

It seems that not too many people can cope with splitting and containment.

Because we're needy and demanding and manipulative and useless and not worthy.  Because we don't matter as much as others do.

I don't feel like I contribute and I don't feel like I have anything constructive to offer.

The psychiatrist was probably the best and worst one I have seen.  Some things I believe he did well, other things I believe he did poorly.

I'm not OK.  I'm having a major melt-down.  I don't know how to work through this.  I can't deal with any of it.  I'm trying but ...

Sorry for taking all my anger and frustration out on this forum.
I hope my mood doesn't affect other vulnerable people here.
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1308134_tn?1295191219
I know it is a cliche but reading what you had to say I found myself once again thinking about the supposed formation of the Chinese word for crisis (wei ji) from the symbols for danger and opportunity.
That led me into a small digression as I read some more about this issue online and learned that the ji part is not necessarily opportunity... it really means change, which may or may not be good.
In any event, this is a crisis for you and it may be possible to turn it into the beginning of some positive change... But the nature of a crisis is that it is a dangerous time... For that reason I am very glad that you have been touching base with others. All of us are susceptible to misperceiving things when we are in crisis, and we need the help of people who care about us to avoid misperception.
My analogy for this is theater lighting... imagine an actor on stage with just a single spotlight focused on the face, that view is distorted because it is one dimensional, even assuming that the spotlight is pure white (not distorted by emotion), but add in other lights (even if they are red and blue and yellow - in other words distorted by their own emotions) and the picture becomes clearer. So too, we need to listen to others, even though they may see things distorted by their own preconceptions. And listening is not the same as hearing, it involves really trying to understand that other perspective. Then from these many perspectives a picture of what needs to be done will often emerge.
Two types of misperceptions are especially common in a crisis - the view that others feel ill will towards us and the view that others do not care for us or do not understand us at all (fear and anger). Make sure that you look for these potential biases in how you view others.
Fear of others can make those others afraid of us, wary of us, which can confirm our view that they are not trustworthy (as a therapist I find I have to be constantly vigilant about this, and even so it is hard not to get caught up in the trap of feeling that the person I am trying to help doesn't trust me... and then thinking how can I trust them).
The same with anger, when someone comes in and tells me that all of the psychiatrists they have seen have been no good and psychiatry is no good, it is hard not (as a psychiatrist) to feel defensive... which then leads to struggle. I have to work hard to sit beside them looking out at the hard things they have had to cope with, rather than to sit across from them trying to defend myself from the possibility that I am another one of those bad psychiatrists...
I think that this crisis has come about because your life situation has not been OK for quite a while. You are very bright, thoughtful and intuitive, and yet you have been more or less alone. Also, you need to have a sense of your own purpose and value.
In other words some things that are important are missing. And some of those things are not to be found in the mental health system... which is not to say that it wouldn't be very helpful to have a therapist (or companion) who could help you with your life quest.
So, some things need to change... although exactly how is not clear... but the key to this crisis is not to pretend that big changes aren't necessary. On the other hand, to weather this crisis you need to devote attention also to those daily activities that sustain the body and mind - you know this too, that is why you have been trying to get up and out of bed in the morning and thinking about exercise and diet.
And stay engaged in the dialog with yourself and with others as you try to see a solution, or possible solutions.
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Its sacry you are sounding like me these days, but you know as well as i do sometimes our perception of things and people can be wrong, i know also at times it can be right. Anyway i know i talk crap i'm not good at saying whats in my head but for what its worth i will always be here to listen anytime and i have great faith in your strength and ability to get through this.
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Very sage advice.

I shall view it as danger and opportunity for there is growth, and opportunity, in change (and good and bad are just labels).

I feel scared, hurt, angry, frustrated and powerless.

I don't believe that there was any malice from the psychiatrist I saw last week.  Am I then feeling fear and anger because the doctor failed to meet my needs?  Does this failure then reinforce my insecurities (of not feeling adequate or loveable)?

I am more inclined to listen and respect someone who listens and respects me.  I am more apt to trust someone who has strong boundaries.  I guess someone who projects confidence in both themself and me.

The consult didn't start well.  I had been sent an appointment letter that indicated the appointment would be outside of the mhs.  I rang to clarify this and was told that was because another individual was attending.  Someone who I have a history with.  Due to my anxiety and lack of containment I changed the venue and who attended.  I don't believe the mhs should have put me in that position.  I feel I had a right to be informed that others would be attending and I felt it was wrong to arrange the appt outside of the mhs.  The mhs was the most appropriate place for the appt.  My GP said that people thought they were doing me a favour by not inconveniencing me.  It evoked a lot of unresolved issues for me plus guilt concerning the changes.
At the start of the consult I apologised to the doctor for the changes.  He didn't care but he also didn't take the time to listen to my concerns.

I believe I have legitimate concerns about the services provided to me by the mhs and it hurt to have these dismissed.  They are important to me being able to feel safe and to access treatment.

Purpose and value are hard to experience either through lack of skill or lack of boundries.  It compounds the problem.

I told the doctor that independence was important to me.  Maybe I need to start looking at what is right for me and not what is right for everyone else.

My outburst may have given me renewed motivation to try that bit harder.  I couldn't get my head around fighting for anything anymore.  I'm tired and was feeling demoralised.

If I look at the reality of the situation then accepting that help could be my best option at this time.
I just called the mhs to enquire about medication (what type, what dose, for how long, etc) and therapy (who with).  The receptionist said that the doctor would call me back, which wasn't what I was wanting, but at least I will have answers and they will help me to make an informed decision.

I also made a query in the weekend about private therapy.

Thank you for putting up with me.
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Thanks.  You say a good job of what you think.
I've found it really hard accessing support from medhelp and I think this breakdown has just helped me to feel heard (without the mask and superficial stuff).
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I asked the doctor about the medication and therapy option.
He said we'd have to discuss it but maybe Mirtazapine at a middle dose for six weeks and if that worked then for two years or indefinitely.

Therapy with a different T with a possible four week wait period for me.

He said he would make another appt to see me (sooner than the three weeks) and introduce this person, new T, to me then.

Not sure if I can do this but it's all that's being offered at this time.
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I really hope it works out, who knows it could be really good. At least you will be able to say you tried it.
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1308134_tn?1295191219
If you have another question that you want my comment on please start another thread.
I am glad that you are hanging in there, for now. You are a very special person.
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Thank you.  Lots of questions.  Have been posting lots of random questions in different forums.
I felt a little bit happy last night but probably shouldn't be excited by that.  From that psych consult I learnt that people can die from hypothermia (details maybe a little sensitive for the forum) and that maybe I am bargaining with the mhs for my life.  Bargaining and anger as stages of grief?  Not sure.  Anticipatory grief?
I figured that meds and therapy are win-win for me.  I either get better or have a stash of meds plus may have a greater acceptance of my own mortality.  Maybe this is my way of taking back control?

I think I may be seeing and hearing things so I think this may have pushed me a little too far.

I see my GP today.  Not sure how this discussion will go with him.

Thanks for the opportunity to ask and vent.
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