Mood Disorders Expert Forum
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Welcome to the Mood Disorders Forum. Questions in this forum are being answered by Peter Forster, MD and topics covered are anxiety, bipolar, depression, panic disorder, post traumatic stress disorder and stress.

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Accessing support

Thank you for the opportunity to ask another question.

I saw my GP today and we spoke of my psych appt.  He was pretty shocked that the psychiatrist made some of the comments he did.  They had been in contact and the psychiatrist had thought the appt went well.

I was telling my GP how I was struggling and he said it would be sad if I topped myself.  I have that follow up psych appt to discuss meds and therapy on Friday 13 April.  It seems a life time away when things are so bad now.  I guess I even felt a little angry and rejected that the appt was scheduled for later than organised, which was to be earlier than the three weeks.  It brings up old stuff.

I'm not sure how to work through my current problem of accessing help.  I feel like I need it but then when confronted by others I feel that maybe I can cope or that maybe things aren't that bad.  I feel scared of any help and the terms on which it may be given.
At the moment I would say that the chances of me hurting myself or worse are pretty high.  That's based on a sense more than anything else.  At home I kind of feel that I have to pretend.  I feel really, really bad yet my parents have absolutely no idea.  I live with these people and they don't get it.  How do you get help when you're suppose to be alright?  Mum use to call me schizophrenic because she perceives me to have two personalities.  How I interact with them (where I hide behind a mask.  They have said that they don't want to talk about mh.) and how I interact with my GP, etc (where I feel more able to relax and be my true self.).

I expect I don't share as much about how I struggle with my treatment team as I could.  My GP once told me he was blunted to suicidal stuff so maybe occasionally when things are bad I'll just say that I have safety issues.

I was wondering about that med, ?Mitrazapine.  Feeling pretty irritiable now I can't see me accepting it.  I was worried about potential sedation and weight gain.

I'm doing this push/ pull thing
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Given the situation you have had to deal with over the years of not getting all that much help from the health system I think it is especially important for you to keep track of your mood shifts... in part to try to understand them, but also just to see the range of feelings and emotions that you experience.
There isn't an ideal way of doing that but I would be happy to share with you some of the options.
One of the things that I have been interested in over the years is the concept of state dependent memory... The notion that what we remember depends on the mood state we are in now and the mood we were in when the memories were formed. When we are in same mood state, memory is facilitated, and when we are in very different states memory is impaired. This helps to explain the common experience of people not being able to remember times when they were in a different mood state than the one they are in now. For instance, when one is depressed not being able to remember a time when one was not depressed...
Mood charting is one way of helping to remember when everything is dark and frightening that there have been other times and there will be other moods again.
Also, your comments about how your moods vary made me think that seeing how they vary might help you think about medications.
Information is power, and you need more power as you wrestle with a difficult set of personal challenges, as well as the challenges of getting help from the health care system...
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with help and don't know how to overcome it.  My anxiety becomes high and I push everything away.

I'm not sure if any of this is making any sense.  I'm having trouble describing it.

My mood has also switched a little and is maybe a little higher but I think that that is because i am gambling with things.  The help has almost become like a game but it isn't because it's extremely serious. Maybe control thing, maybe a power struggle, maybe something else entirely.  It's confusing and hurting me more.

My GP was going to phone the doctor again and give me any feedback.

I am so scared and angry and frustrated and sick.
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I can understand a bit about mood state because that is something that seems to have come up a bit for me at times.  My last T had me try to sit with these and remember things.  I think she referred to this as preverbal.
This was something that happened in my recent psych consult too.  The doctor asked what I ate during a binge.  It was hard for me to sit with that.  It was easier for me to quantify them by saying I had put on 4 kg in four days.  Still didn't really answer the question though.

When he was dictating his report he mentioned psychological freezes.  I'm not sure what these are but they sound like they could be related.

My T thought that I might have associated other stuff during periods of trauma.  Hence them acting as triggers too.

I get that depression is just a state and will pass.  I read that if left untreated it will likely clear up by itself within months.

That's like the dbt stuff and not attaching judgments to thoughts, feelings and experiences.

Usually my moods are pretty consistent but they do seem to be up (which is still actually down) and down more.  The doctor was asking about diurnal mood variation.  For me that is worse in the evening.  A lot worse.
The mood changes wouldn't likely represent something like bipolar would it?  I might have to read up on hypomania.  I'm guessing my mood is just reactive to events.  And suddenly I feel like I do have bpd (the pd).  Cringe.

Mood charting.  I'll give it a go.  Are not a huge fan but I'll give it a go.

I hope this makes sense.  I feel hung over from lorazapam and lack of sleep (due to anxiety plus storm -I think).

Now I'm stressed about what my moods are doing.  What do you see them doing, representing?

Thanks for your time and expertise.
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They do have an impact on us but I do believe a lot of the time that the adversity does make us stronger.

My family are in denial or view my ilness as a personal attack on them.

Thank you.  I wish you all the best too.
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You are right to note the importance of the attitude one takes toward keeping track of one's mood. Those who are most successful take a reflective, descriptive or mindful attitude towards the process. There is value in both an energetic and enthusiastic mood as well as one that is more pensive or somber... having the experience of a range of moods can help us understand the world and ourselves better.

This is in contrast with the judgmental (good or bad mood) attitude which is so common in the world. "I am in a good mood today"...

Generally I find it helpful to think of four dimensions of mood - Hopeful or optimistic versus doubtful or skeptical. Quick (in thought,  tending to be more impulsive with decisions) as opposed to Slow (not making decisions, thinking about similar things repeatedly). Anxious or carefree (some amount of anxiety is a good thing). Sensitive (to others, to the world around) versus unconcerned about how people feel or react to us.

For each of these there is a "normal" range and an extreme range. It is at the extremes that there is the most danger of feeling overwhelmed.

What we do in psychiatry is mostly about trying to help people stay within a range that they can use or manage. This is a good first step... but we often neglect to help people learn how to use or manage a fuller range... thus our efforts become focused on limiting a person's range of feeling...

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I'm really sorry but I can't take on board this info at this time.

I sent my GP an e-mail last night which I think, in hindsight, was a very, very dumb move.  I explained a bit about how I was feeling, etc.  Today I received the dictated report from the psychiatrist.  It just made me feel that reaching out to someone who got a lot wrong wasn't a good idea.  The intention had been to phone on Friday morning, which I then put off till Monday, but I can't see that happening anymore.

At this stage I see myself taking the meds my GP gave me.  I can't see myself being in a position to not do this anymore.

I just wanted help without being put in the position of having to prove that something was wrong.  I just want the nothingness for a while.  I'm just tired.  I should be OK till Monday when my GP is back at work.  It's now Saturday evening.

Sorry for not being able to appreciate the effort you put into your post.

J
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