How can a psychiatrist help me?

[MyWillow]

Had (another) rough session with my psychologist on Tuesday. In session, I'm still battling dissociation with no memory for anything I'd class as trauma, some very disconcerting co-conscious experiences and dissociative flashbacks. Outside therapy I'm working myself into the ground trying to avoid (yep trying to fix this), having some inexplicable visual and olfactory flashbacks, sleeping poorly and my nightmares are extremely realistic - more like flashbacks - but, again, with no attached memory. I told all this to my T and she gently noticed that my hands were shaking when I was describing the olfactory flashbacks, which are very distressing and don't make any sense. Probably a smidge of anxiety and depression as a consequence but let's not talk about that because then it might be true ;)

Anyway my T asked if I'd thought about talking to a psychiatrist about my dissociative symptoms. She gave me a recommendation - said she's a bit "quirky" but her clients that she's sent to her have liked her - so I've made an appointment with my GP to get a referral. My T and GP understand that I really am not keen on medication for anxiety as I really do seem to get side effects to most everything. And I really don't need another layer of sh!t to deal with.

My T is away for a month so I can't follow up with her....how else can a psychiatrist help me if they are not doling out drugs? Is it just that she might have a better knowledge of dissociative symptoms than my T? Can she make me feel a little less crazy? I'm just so weary of explaining what's going on (can describe the what but no idea why) and I am very wary of medical specialists. I really like my T and my GP but I'm only just realising how little I trust people. I am fiercely independent.

I'm fine. I'm fine. I'm fine.

 

[EveHarrington]

If you already have a diagnosis and you don’t want meds, seeing a psychiatrist is a waste of time. Their primary function is medication management, and if you want to handle things without meds, there’s not really anything they can do to help you.

 

[Still Standing]

The compliant "me" would follow through, if for nothing else, than to show my T and doc I am willing to hear what someone else might have to say concerning how to help me. The psych doc may have a different view or treatment plan that will actually help you. You will never know if you brush him off.

 

[blackemerald1]

Well with great respect @EveHarrington that is not my experience with my psydoc. ;)

Granted med's were once a part of my treatment & he monitored me closely on them bc I have a long history of not tolerating meds.

However that is no longer and I still see him quite regularly. Actually he was the first to tell me I had come to the end of the road with psych med's & assisted me to withdraw off some med's prescribed by another doc. But that's another story.

It is very much an individual approach & dependent on the psydoc. I know a lot want to medicate first and ask later.. but some do not. I cannot just be that individual and lucky.

So, it is a further step in your journey @MyWillow and it could reap some benefits to just get a psydoc's opinion. She may recommend some medication but remember you are in control, can ask lots of questions about side-effects, short term, long term benefits. All the pros & cons. But that is just part of the equation with a psydoc except in an acute inpatient setting which is a different type of treatment approach entirely and not the issue here.

Is it just that she might have a better knowledge of dissociative symptoms than my T? Can she make me feel a little less crazy?

I think it might be constructive to see the psydoc for a few reasons. Some will take you on in-conjunction with a T. Just to keep an eye on your progress. A psydoc may recommend a different style of treatment that is not medication as well. Some do this themselves or assist/refer you in other therapies that may help reduce your dissociation symptoms, general anxiety etc.

I think it is important to consider that you need to get a foot in the door of your mind some how, some way and get through the acute nature of those symptoms so longer term therapy can begin to work. This might simply be some sessions where she works through some major obstacles with you that are causing your T some concern. The psydoc may report back to your T that it's a case of going more slowly or just keep on ploughing through. There are a lot of outcomes I cannot forecast.

I don't think your T would have suggested you see a psydoc she knows unless she believed there was some benefit. It sounds as though your T has faith and knowledge of this particular psydoc she's suggested you to see.

Give it a chance. It may not work out. I believe a healthy dose of critical appraisal never goes astray with any expert when it comes to my mind and body. However at the same time it may be just what you need right now.

olfactory flashbacks, which are very distressing and don't make any sense

Olfactory flashbacks can be one of the most lingering and persistent to resolve. I know that I can still get them & I am not sure what triggers them. Something to do with it being a very strong 'sense' that our minds can lock down and never forget. For instance I can watch something on telly that has a dash of blood in it and I will immediately taste it and smell it. Yet I am not dissociating. I recall being taught that our sense of smell is extremely primal. I cannot recall why that is more so than other 'sense's' but it is true for me. It is very powerful.

smidge of anxiety and depression as a consequence

This may need some attention from a med. Even a short dose can alleviate the acuteness of symptoms and at least allow you to rest properly. It can get to the 'chicken and egg' problem time. Idk. It has worked for me a few times. Just given me a little bit of respite from the assault of being so symptomatic? And I was not prescribed anti-depressants.

'm only just realising how little I trust people. I am fiercely independent.

And your GP and T will probably convey this to the psydoc in the referral. Or you can ask your GP to convey this to the psydoc in the referral. Or you can say that to the psydoc straight up. You need to be brutally honest or this may be a lost opportunity?

As for feeling a little less crazy. Well you are not crazy you know. I know that is cold comfort in the middle of the night when being assailed by yet another nonsensical terror. But still I have to tell you...you are not crazy.:hug:

 

[ILoveLife]

I agree that a psychiatrist prescribes medication, but in all fairness I also agree that's not all they do.
In my experience, Ts and psychiatrists that work together in our behalf usually help one another with different clinical expertise, and they're both necessary for our improvement.

Maybe you relunctacy in taking meds and the lack of trust in doctors is having more of a say here. @blackemerald1 is right though, it's your ultimate say on the matter, if you don't want meds or if you're willing to try them it's your decision.

My psychiatrist does psychotherapy as well, for example.

 

[MyWillow]

Thank you so much to you all for your considered responses. Very much appreciated.

@EveHarrington yes that’s what I was a bit concerned about but it sounds like there a variety of experiences out there. At least I know that if it’s a case of “a 15 min med adjustment” is all she can offer long term then I’m going to be very cautious.

@Still Standing that’s kinda what I was thinking. I’m so desperate to get off this running wheel. We try to keep a lid on stuff in session and my T is super careful but I keep getting flooded or triggered but without knowing why.

@blackemerald1 I’m so grateful you took the time to reply at length. I’m just kinda nodding all the way through. I started seeing my T for pain management FFS (2 nasty accidents and injuries) and suddenly I’m discovering a side of me that I didn’t know existed. That said my symptoms have been floating around on and off for a very, very long time I suspect. Getting a foot in the door to my mind really hit home. Because at the moment I have NFI what is going on. I have these big chunks of my childhood missing - no birthdays, Christmas or holidays for a start but I know I had them. And that in itself is distressing. Ok I might be a bit of a control freak too lol. We have been working through some family stuff in session and certainly any discussion of my childhood triggers dissociation. We only talk about current family issues now. And hmmm yes what you say about olfactory being so strong and primal makes sense. Sometimes in the shower I’m overwhelmed by the smell of vomit and I can’t stop shaking.

@Sietz yeah the whole trust in the medical field is a bit raw at the moment. I think partly because I’ve had SO much rehab for my injuries and seen so many people - my hand specialist was simply amazing, my physios have been nice but a bit “this is the best we can do” and the shoulder surgeon was so damned horrible that I think I started dissociating through that appointment. And I do seem to be a bit sensitive to side effects which frustrates me no end. Thanks for getting me thinking about that.

 

[ILoveLife]

I get it... I'm so burned out with with mental health field of speciallists that my head is spinning.

But I agree that if your T recommended that psychiatrist, they're probably going to help. If not, that's fine too, at least you tried.

 

[MyWillow]

I get it... I'm so burned out with with mental health field of speciallists that my head is spinning.

B...

Yes exactly! I really like my T and I have told her sooooo many times that I really hate that she always turns out to be f*cking right lol She gently suggests idea after idea but she never pressures me and asks if I did it. She gives me the space to decide to try it and then tell her if I want to. In that alone it tells me she’s nailed my personality and needs. I finally spoke to my GP about the poor sleep and she gave me 3 repeats for slow release melatonin. T suggested it MONTHS ago. Oh and the thing I like that my T and GP do is they always ask me to read anything they write on my behalf (referrals, supporting documents etc) and give it to me unsealed. I didn’t realise how much that helps build trust.

 

[ILoveLife]

Maybe try to focus on the good in the medical field. Well, that's what I'm trying to do.. trying to balance it out. There's more good than bad, that comes off either medical or mental health fields. We should focus on that.

I too tried melatonin. It didn't take away the nightmares, but at least I'm sleeping the whole night.

 

[MyWillow]

Yes I’m still walking up in a panic but I go back to sleep more quickly. And I’m definitely drinking much less alcohol. Yeah I know alcohol’s not helpful but that’s the choice I made in an attempt to drown the symptoms.

 

[ILoveLife]

I can't drink booze. Since I also don't consume sugar, it's only water, or coffee, or tea for me :)

A lot of folks do well with melatonin, I was barely sleeping all the way from january to march, walking zombie in the daylight. Melatonin did the trick.

Have to go to work now. Nice chatting with you :)

 

[MyWillow]

And you are 100% about looking for the good. I’m a scientist. I should know it’s about probability lol. And I’m a good dog trainer and yet I know there are terrible ones. I have a great vet and chiro for my dogs and yet some you couldn’t pay me to see them. Got to be careful of that old black & white thinking ;)