Apparently I've Run Out Of Options... Can You Give Me Some?

[Jen93]

Okay, so my appointment with my psychiatrist last week REALLY bugged me. I'm really trying hard to get help. I've apparently run out of options. He said that I'm rejecting all the medications (I had major suicidal ideation on the last one, and I'm dealing with withdrawal effects right now.) I've been on Seroquel, Ativan, and Cipralex, they all made me either a) sleepy to the point where I was just a little step up from a dissociation fog- or b) suicidal to the point where I was thinking that everything would be great if my life ended- of course that was a trigger, and so the stupid flashbacks were either gone because of the sleepiness or they came in emotional flashbacks.

He also said that I was mean to my therapist. I understand that, truly I do. I seemed to connect my therapist and the clinic with my teachers and the school I was traumatized at. She just seemed to have such a position of authority, and authority figures REALLY scare me. I'd dissociate during sessions, get the "slideshow flashbacks" prior to dissociating, and I'd dissociate on email and get completely confused by the emails I sent- it was like yelling-emails telling off my principal in middle school, and my teacher in middle school.

So I'm apparently medication resistant and therapy resistant. I also CAN NOT meditate. That's a HUGE no-no for me. I'd have meditation during drama class in high school, and I'd end up in a hypnagogic state (It's a state between awake and asleep.) (Here's some info on it: [DLMURL]http://www.wisegeek.com/what-are-hypnagogic-hallucinations.htm[/DLMURL]) And then afterwards I would dissociate and SI to try to keep myself knowing where I was- which would bring on confusion and flashbacks.

So yeah, it seems as if I'm out of options. I've got an intake session for a counsellor next Friday, I'm wondering if there's any other options I could bring up for other ways to help, because the only options I know of are medication which I'm resistant to, therapy- which apparently I am also resistant to, and meditation- which TERRIFIES me and leaves me dissociative and really scared and sad and flashback-y.

Thank you. I appreciate any insight and/or other options regarding this. Also, I don't know if I posted in the right section- I had a really hard time posting this just because I didn't know what section to post it in.

 

[intothelight]

Jen. you posted this in the right section.

At this point my only suggestion to you is to educate yourself about therapy and different types in general. Read and then evaluate which approaches you feel make the most sense for you and fit where you are at. Discuss the various options with your therapist. Remember to look at them as more of a mentor and a resource. They are not an authority figure as they do not tell the client what to do. They can give you suggestions, but it is up to you to do the work, with their support and guidance.

The other step is to educate yourself about medications, what they do and don't do, and their side effects. Ask your P to explain what they are suppose to do and then again about the side effects. Ask her to explain why she/he believes this type would benefit you.

Don't forget to examine alternatives. Lifestyle changes can bring huge benefits. Simple things like getting the proper amount of sleep, sunshine, diet, and hydration are changes that do not have side affects. There are actually ways to increase your serotonin levels through diet. I've been doing this for months now and have to admit that my depression has decreased substantially.

I guess what I am trying to say is that you need to find what works and fits for you. Therapy will not be effective unless there is a good fit between you, the type of therapy and the therapist.

Just my .02.

Deb

 

[maddog]

Agree with everything that Deb said. Would just add to also bear in mind that not all professionals are a good fit with all clients. If you are not comfortable with either your T or doc, it is your right to seek alternatives. Not to say that you simply run away from anyone who doesn't tell you what you want to hear, but don't forget that you have control over who constitutes your treatment team, and if it isn't working for you, it may be possible to seek alternatives who may be more attuned and professionally competent in the areas in which you most require support.

Maddog

 

[anthony]

Why do you think you're cited as therapy resistant?

Medication resistant is quite normal for PTSD... and many anti-depressants and such actually make you suicidal, nothing new there. The reason typically for that is because the depression is not chemical, like has been cited by pharmaceutical companies, which more therapists and psychiatrists are progressively learning through new information. PTSD depression is majority a-typical, which means mood based, not serotonin, which is what anti-depressants target. More and more psychiatrists are progressively shifting to anxiety medication alone, which targets the mood by proxy, or mood stabilisers... either way, steering clear of anti-depressants even though depression is present due to anxiety / mood.

Don't feel bad for that one... perfectly normal learning experience that many fit in the scope of having medication resistant PTSD.

The therapy resistance is either you, or your therapist. Which one is the question!

 

[PTSD sufferer]

Hi Jen,

Sorry to hear you are having a tough time sweetheart. I'm going through withdrawals at the moment too, so I know how much it sucks. I think you have had some great advice from Debbie, Maddog and Anthony. And, I agree with what they have said.

I went on antipsychotics for the mood stabilising and sleep sedating properties. I tried Olanzapine (2nd gen), Aripiprazole (3rd gen) and it turned out that Quetiapine (2nd gen) worked best for me. I think for PTSD patients antipsychotics can have good results, at least in my case the Quetiapine was the best for me probably becuase it is a powerful sedative :p. I am also a one med at a time type girl, so I have a pretty good idea of what worked for me.

There are side effects as with all medications, and they can be annoying like joint pain, weight gain, etc. Anti psychotics target dopamine receptors in the brain primarily, but some also work on serotonin in a milder form than anti-depressants I believe (I'm sure Anthony will correct me if I am wrong here). For me, it took a while to find the right medication, I had to try different things, and eventually found one that was right for me.

I don't think anyone can be therapy resistant...unless you don't turn up at all. It takes time to find the right T, and it also takes time to develop trust with a T. You are unwell and you have problems with authority figures (I get that) so have you told your T that you have a problem with authority figures? That you are uncomfortable with pressure and bullying? These were some of the first 'warning stickers' I put on the table with my Ts.

How long have you been in T with this person? I agree with Maddog that the personality and attitude of the T is so very important. I found a really good T who spoke on the same wave length as me - that is he wasn't pushy or anything and I put my trust in him, because he let me always be in control. He never spoke down to me, and never made me feel like I was being examined, and that was really important to me - because of my anti-bullying and anti-trusting nature.

But I would like to add that for me it was important to approach T, how I approach most people in my life.....that is I always tell myself that all I have to do is to 'consider' what others are saying, but that does not mean I have to agree with them. Considering is about just thinking about what they have to say and trying to understand what they are saying. They have no control over you, only you have control over you and that is why we have to take responsibility and chose to do the work to get better.

I assure you there were a couple of occasions when I kicked back at my T and told him he was wrong and on the wrong track, to later discover that well he was right (egg on my face and apologies made). Then there was a couple of occasions where I was right and he was wrong, and he accepted that he was wrong in his own time. But, we go on the idea that we don't need to agree with each other, we can 'beg to differ' on some matters.

Regardless of what they say about being 'resistant' (???) don't give up on Therapy sweetheart, there is much healing to come from it. All my love and hugs PS xxoo

 

[anthony]

Absolutely... medication really is trial and error, no doubt about it. What works for one may not work for another, yet may partially for another, not for the next person, etc. It really is a crap approach to mental health IMHO... one which the patient suffers further consequences of the trial and error approach if one of the many unlucky ones that must endure the process. It seems very few strike it lucky with the first round of meds.

 

[Jen93]

Remember to look at them as more of a mentor and a resource. They are not an authority figure as they do not tell the client what to do. They can give you suggestions, but it is up to you to do the work, with their support and guidance.

Yeah, it's really hard for me, because of the fact that I was bullied by teachers and such- I'm still in that weird I'm not sure what to call it... "Bad girl-Good girl" trap? I don't know why I seemed to just sort of push them into that position, the T. The first time I met her was sort of okay- we talked about the first traumatic event- she did some exposure therapy in the bathroom there- I'd walk in and wash my hands- etc. etc. but then she accused me of not opening up and said that I was therapy resistant. I didn't know that there was anything else going on. I knew that I was dissociating in emails- I'd be yelling through emails that she only worked there for the money and blah blah blah-I was always apologetic the next time I met her. The thing about those emails was that I sent them and felt I was watching myself type them. It was weird. She told me that I was dissociating, but she never taught me how to get out of it.

When I was re-traumatized that's when I remembered more. (I took a long break, like 8 months.) When I got back- I'd dissociate IN THE ROOM. She didn't seem so forgiving anymore. She just took notes most of the time, and didn't appear to be listening to me. We stopped all exposure therapy- and when I'd go dissociative IN THE ROOM- she'd snap at me. My school counsellor- yes, it got so bad I tried to get someone else involved- he suggested that she snapped at me to get me out of dissociation. But she never acknowledged that I was dissociating, and she just seemed to want to FIGHT about being in denial, and not listen to a word I said. It got so bad, I actually spent like half an hour writing a note: "I dissociate when you do this, this is what happened in my past to make me dissociate, this is how I feel when you do that." She told me that she didn't read any of it and she gave it back to me- I'd given it to my psychiatrist and he said that he'd read it and give it to her. I was so angry at not being listened to. She laughed at me when I dissociated with the psychiatrist and her and I took out my hearing aids- THAT was awful. I felt terrible. It felt like some warped exposure therapy thing. She didn't tell me though first. She also told me not to email her, and phone if I had to- I can't hear the phone.

Still, I don't know if this is therapy resistance on my part or hers. My brain sort of won't allow me to bash anyone without paying for it later in flashbacks, so I'm thinking that maybe it is me. My psychiatrist says it's me. My mother says it's me. They say she's nice and she knows what she's doing. That's the only reason I decided to continue after she told me I was therapy resistant.

Don't forget to examine alternatives. Lifestyle changes can bring huge benefits. Simple things like getting the proper amount of sleep, sunshine, diet, and hydration are changes that do not have side affects. There are actually ways to increase your serotonin levels through diet. I've been doing this for months now and have to admit that my depression has decreased substantially.

Deb

Thanks for that! :D Do you have any good websites that can help me get started on that- the diet thing I mean. I'm also a vegetarian, so I'm wondering how that would factor into it. I'm definitely up for that!

PTSD sufferer, I've been with this therapist for four years now I believe. It's really odd though, how she turned from a human into a monster almost overnight. I've never been to another therapist before, so I don't know whether it's like a warped exposure therapy thing she was trying to do, or whether she really is that emotionally abusive. It's no wonder I think she's going to hit me; I'm surprised that my psychiatrist is shocked at that.

Anyway, I'm going to another one next week- my first session- we'll see later on if I really am therapy resistant!

 

[PTSD sufferer]

Anyway, I'm going to another one next week- my first session- we'll see later on if I really am therapy resistant!

Good work Jen!!! Find the right T for you, and then find the right therapy / treatment for you.

People like to say that it is 'us', but if we think about it logically, is it those that traumatised us that did this, not 'us'. But, we are the ones who have to learn to manage it.

We are unwell and we take responsibility for our healing and that means we take the driving seat and no-one else...

...if you don't like the T and the T is not helping, then you need to give yourself permission to find the right one. The same goes for medication. This is your life, no-one else's, and you know what is and is not working for you. You are in the driving seat.

Let us know how you get on with the new T. I hope life will be much brighter soon. PS xxoo

 

[Jen93]

I'm also trying to do a lot of work by myself- I joined up here when I was re traumatized. I've written in my trauma diary, and I took a break from here for about five days when it got to be too much, like in Anthony's suggestion about how PTSD forum increases symptoms. I came back, and it's still high. But I am trying. I'm trying to do my own work, and to not have someone who understands or even wants to- she could have at least pretended to humour me when I got re-traumatized, made the effort to let me know that she was listening. Taught me grounding skills again- she didn't go over them with me like we were supposed to. So it just hurt when I so suddenly turned into like... talking not to a person but a brick wall instead.

I think it is her. I don't know why that change in attitude. It's always in my nature to give everybody the benefit of the doubt, but it really was her. Whoa.

I hate being manipulated. I DESPISE it. I didn't deserve the way that SHE was treating me. I tried everything I could. People like that... they should be jailed. :cry: She certainly made it so the next one has a lot of work cut out for her however. I'm not giving up. I'm going to the next one, and I'll tell her and warn her about my dissociation right from the start. As well as my problems with authority figures and feeling like I'm always supposed to be getting in trouble.

Now I just have to wait for next week! Fingers crossed it goes well.

 

[intothelight]

Thanks for that! :D Do you have any good websites that can help me get started on that- the diet thing I mean. I'm also a vegetarian, so I'm wondering how that would factor into it. I'm definitely up for that!

Jen,

If you would like, I will PC you the list foods with the highest levels of trytophans, omega's and B-complex. I pretty much follow a vegetarian diet, except for fish twice a week. It also involves getting rid of any thing that is refined, such as white flour, sugar, and high fructose corn syrup. Pretty much all organic.

I hope things go well with your new therapist. Sounds like she/he should work with you on grounding techniques so you can stop the disassociation. Personally, I think you old therapist was a horrible match for you.

I also had a therapist that told me I couldn't get better. Basically that I was too much of a mess to handle so I quit therapy for a year and worked on my own. I am back in therapy now and this time it is a whole different experience. It is much better. The sad thing is, what I did on my own is what my therapist should have worked with me on, and not have just written me off.

Don't let them write you off. It is definitely a team effort, and I hope you find the right mentor.

Deb

 

[Hashi]

Sometimes I think it's healthy to resist certain therapists or types of therapy, if they're not right for you. I had to find a new T this year and the one I found first was too focussed on by-the-book exposure therapy (I have my own way of approaching things and it isn't that way). I felt defensive with her and soon left. If I'd stayed I think I'd have been labelled resistant before too long. But I worked really well with the T I had before, and I'm already fine with the T I've found now.

I think it depends on the person and their approach. Also, on how you approach the relationship and the sessions. I'm sorry you've had horrible experiences of being bullied, and I can understand that you might regard a therapist as an authority figure. Maybe it could be very healing for you to work with a new therapist in a different way, as a partnership. I'd suggest you to keep talking with the new T about your relationship, how you want to interract with her, what concerns you have about a therapy relationship given your history and so on.

I'd also encourage you to do a lot of work on your own around grounding and safety. I agree that T's should be mindful and responsible about this. At the same time, we know better than anyone else what works for us and when we need to do it. It sounds like you tend to dissociate a lot. I don't know how much grounding you do but if I had that situation I'd be doing it frequently through the day, not just in reaction to dissociating, but to work on keeping present so I'd be less likely to dissociate at all.

Related to that, if you have bad experiences meditating could you find guided visualisations or relaxation exercises like counting breath that don't take you into a hypnagogic state? I've had problems with meditation (and with hypnagogia). Alongside a lot of work on grounding and safety, I've found recorded visualisations that were better for me and have edited them myself so what I listen to will help me relax without that happening.

 

[Deleted member 12723]

Hi I am late to this one. My 2 cents is that dissociation happens when a person does'nt feel safe. You are not supposed to be dissociating so much. I agree with what Hashi had to say all of it. You do need help.
Can you make a list ahead of time about what you are looking for in a therapist and the therapy process?

I know when I am armed with written questions in advance I get it all taken care of and I do not forget to cover a subjectt. I wish you well with the diet and everything else.

It is better to do a face to face instead of a e-mail. That way you get to take care of everything while you are there. you have alot going on. I do not think you are therapy resistant. You are a skillful communicator here on the forums. I do not know how you are when you are triggered.

I am really hoping that you do not give up on your search for a good match.

I am getting ready to do emdr, I had a long list of questions, and she really took her time answering them very carefully. I liked her and know I can trust her. She took my concerns seriously and she is friendly and really easygoing. I even liked the way she was dressed and how her ofice was decorated.

You have a stong self to do this. I believe in you. I know you can do this. you are worth it. Good luck in whatever you decide. Take care of you, and work on making yourself feel safe no matter where you are.