Done everything but IOP / ECT

[beansj]

Still in the worst and most intense flashback of my life. Everything on thin ice. I have no one. I can try to do an IOP but I think it is not going to work.

Has anyone actually gone far enough with PTSD to push it into remission?

I am on my last legs, and I'm deadly serious now. When I go to get my issues treated it makes me worse and the doctors abandon me. The treatments make me function worse and the abandonment is horrifying.

I am not sure what exactly I should do. I can do an IOP but at 4hr/day that is a pretty huge opportunity cost for things such as exercise. most day i think there would have been nothing wrong with me if i only had a trusted support network.

Is an IOP recommended? Or what should I do to recover?
Has anyone escaped this hell?
Do I need an IOP that's trauma-focused? how important is that?
Do I need an IOP that does psychiatry?

 

[Sideways]

My life is nothing like what it used to be. I’m not symptom free, but I live a life that’s pretty unburdened by my condition.

In terms of IOP - have you explored the options in your area? I’ve done both trauma-focused and generalised IOPs. Both had value. I got more from the trauma-focused programs, but at times when I was really white-knuckling, I basically took any and all support that I could get my hands on.

 

[beansj]

I have been trying to explore options. I did this a few years ago and found nothing. Now I have maybe two IOPs nearby one with psychiatry and one without. There is a trauma focused program but it is a 1hr+ drive and I think it’s between 9-12 or 1-4pm so really not possible with work

But I am a f*cking moron, I have a toxic job, it’s just that leaving means I ruin my career. Maybe I need insurance for the IOP especially if it fails I need to do something else.

I can’t get my brain to figure it out. Wish I had a friend or spouse who would tell me what to do but the girl I like betrayed me and I’m beyond f*cked right now.

All the ppl at work figured out I have serious mental issues now and it’s going to get even more toxic really soon.

Anyway I write all that because I don’t know what it means. Go all in on trauma-focused? Or just trauma-informed, realizing that I’ll spend 3mos raising eyebrows (leaving work at 2:45pm every day could get me fired).

 

[Sideways]

It sounds like a lot of this is being magnified by work stuff.

I don’t know why changing jobs means ruining your career, but maybe that’s where your energy is best spent short term?

 

[beansj]

Niche career, high cost of living city. Used to be amazing when I did real engineering work (was my life goal). But it was hard work and my PTSD is like an anchor. In consulting now pays well, ‘stable’ in that no one does anything (also why they have time to be toxic). Niche career also means it will be hard to make a change

Ultimately there’s a good chance I’m just rationalizing it. But I can’t make decisions for myself I think I’m insane. Which also lends to a worry that changing jobs will just mean my life is harder somewhere else.

I have a boss now who is running cover for me but he’s also a jerk (keeps confronting me telling me everyone knew I was severely mentally disturbed after getting back stateside after getting in a life threatening situation in Egypt when Israel-Hamas war broke out). He also told me the other day I must have been voted most likely to get shot in college when my behavior was bizarre (seeking dopamine hit).

This boss indicates that our company is a gravy train and I have path to free graduate school and I make probably 2x what I would elsewhere and can come late / leave early.

I have no “centeredness”. I have no family or friends. So I can’t really evaluate the situation. Several people have told me to quit, even quit without a job lined up. But I suppose I just can’t tell what is going on - probably true for my whole life - it’s like I’m in a constant dream and I have no executive functioning.

Before I got catastrophically bad again a couple weeks ago, I literally had to program a checklist of stuff to do every morning/evening because I never had a routine and I can’t even remember

Rather lost. Point of writing all this is I don’t know how to untangle it all. What if I go to another toxic job (studies show 80% are toxic) and all I did was cut my pay by 100% and have less flexible hours so I can’t get treatment

 

[Sideways]

There’s a lot of worst-case-scenario going on there.

And you’re right, it could go badly.

But planning, getting organised, and moving sideways, hell, even planning to restart from the ground up if you decide to - things rarely turn out worst-case when they’re backed by a strong plan.

Get some people on your side. There are people who are paid to find jobs for people like you. This doesn’t have to a be done alone. Make an appointment with someone who knows the industry and see how it goes.

Talk to a therapist and work through the cognitive distortions that are keeping you from making decisions about this.

Changing direction in life is normal. And planned in advance, could bring about change that makes your life meaningful.

 

[beansj]

I think everybody including you underestimates how dysfunctional I am in certain ways. It’s not a dig. Just that the advice people give it seems like it assumes a certain baseline competency or capability in an area.

I am exceptionally capable in certain ways, I bet as a desperate measure to try to compensate for the things I lack.

The cognitive distortions you describe, I can’t think of a time I didn’t have them. My entire life I think. I’m very confused.

I wholeheartedly agree about planned change, I am trying to use my toxic job as a launching point. Just very deflated

 

[beansj]

If you have been to different IOPs, does that imply you’ve relapsed ? I hope I’m not asking to much please tell me to stop if I need.

If it’s okay can you share more? Did they help much, are they flawed, are there other better programs? Did they lead you to remission for a while?

 

[Sideways]

All good.

I was very unwell for over a decade. Of that, about 6 years was in and out of hospital. Then slowly clawing my way back to function.

Which was shit, because I’d been pretty durn functional.

So, over the years. I’ve done inpatient, outpatient. Trauma focused, general “how to stay alive”, and everything in between. There’s been dozens of doctors, trying out over 25 different meds, 3 different types of ECT, various kinds of Ts. The works.

If there’s a rock bottom, I’ve been there. Started out as a professional, doing life really well. Ended up homeless for a while, and I was on disability for years.

If they’re available near you, both CBT and ACT were immensely helpful for me. I did CBT mostly as an inpatient, and ACT a couple of different ways, including IOP (not trauma focused). Both helped a lot, and I’d recommend them in almost any form you can get. The trick with anything involving a group is either (1) make sure they’re trauma-focused; or (2) make sure they have an exceptional person leading them. The rest will likely be chaff.

The most helpful program for me, though, was an inpatient program I did at a trauma unit. That changed the game a lot. And I repeated the program several times (which most of their patients did). I would (and will) go back to it if I get sick again.

I ditched the professional career I had. I started again, from scratch, in an entirely different field.

I now have a career I love. And I’ve been saying that same trope (“I have my dream job”) for over a year and so far it’s still true.

So can it happen? Yeah. It’s hard work, but it definitely can. And if you launch into IOP, and come out the other end living a different life, is that a bad thing? Maybe. Scary as hell, but sometimes the risk is worth it.

 

[beansj]

“The most helpful program for me, though, was an inpatient program I did at a trauma unit. That changed the game a lot. And I repeated the program several times (which most of their patients did). I would (and will) go back to it if I get sick again.”

What kind of program? What made it effective?

I have been able to make a dent in some very prestigious circles. It’s just hard to tell whether the true narrative is that I’m a brilliant individual, or a bizarre freak. I’d think both are true, but the further I get from age 18, the less I’m able to commit whole heartedly to being an edgelord okay with rubbing people the wrong way if they don’t believe in me.

In other words, maybe I have to go “full send” into my approach or maybe I’m severely damaged and need to take the opportunity to reevaluate everything.

I’m sorry about your homelessness. I did a 3 month stint living in a garage I rented. I had some money saved up, but only one years rent so I would’ve been broke if I lost my job. As sick as all that was, maybe I delude myself to stay at my $162k/yr position just for stability. If I stayed, I could retire at 45. With memories full of trauma, more than likely.

The whole thing is very confusing. I’ve been drinking alcohol this week to self medicate (I don’t usually drink). Maybe the IOP will give me smal doses of benzos or something.

 

[Sideways]

What kind of program? What made it effective?

It was a specialist unit for people with complex trauma. I’m in Australia, and there’s only a handful of them around. It was 3 weeks of pretty intense, mostly group-based trauma work, supplemented by a pdoc that I saw throughout the program and afterwards.

It included a range of treatment modalities, which I think is the way most of those places are these days, because there’s no one silver bullet. I couldn’t really describe the program in a way that did it justice - I had journals and journals of work from it by the end.

And it wasn’t easy. I didn’t come out fixed, or really even patched up after my first go.

I guess what it did was start to help me unpack my stuff sufficiently that I was able to rebuild something else. That’s what I needed at the time.

Most people who were there had started there from a similar place - not much left to lose. Or having one thing left that they couldn’t afford to lose - usually a partner or child.

You can look these places up. They vary in their approach and reputation and intake process. My guess is the US versions are pretty different, but folks who have been there come by the forum occasionally and so far, I don’t recall too many folks here who have reported back “the specialised complex trauma inpatient program I did was a waste of time”.

 

[beansj]

Thanks.

I don’t think I could do an inpatient program. Maybe I’m rationalizing but these things would derail the career I once cared deeply about.

I could afford to take year(s) off work, but again, this would derail my career and while it may be great for my mental health it would be maladaptive over all. It would be different perhaps if I had anything else going in life.

I can go to the IOP program, but after reading more I am pretty confident it is not going to help me. Maybe I can try on the off chance that 1) there’s a bipolar comorbidity I haven’t treated or 2) there’s something they can teach me about DID or 3) someone will give me practical life advice and mentorship like quit this job instead of “get ECT”

Pretty sure I’ve lost my mind. Very low mood lately. 85% certain the girl who blindsided me last week did it intentionally, but in my grief I am sure I hurt her (deservedly or undeservedly) and it’s pretty shameful. That at 34 I have nothing, that things get worse, and that I can’t protect others from myself even if they hurt me grievously. Any apology id give is shallow, because it seems I’m incapable of doing anything about it.