Medication and new therapist

[KathK]

Medication aspect is that although of course it’s an adjunct and different things work for different people, but wondering how helpful people have found clonidine for hyperarousal? I’ve found propranolol very helpful before and my psychiatrist agrees it’s beneficial but doesn’t want me on it (long story), and prasocin has been helpful to an extent but since recent trauma it’s not helping and psychiatrist won’t adjust what I know works so it’s stick with current doses which aren’t doing much or try this new one, reportedly can help with ptsd but I’m nervous (at least not trying to fiddle with other meds like antidepressants most of which I’ve had adverse reactions even when friends haven’t).

Ok rambling. The therapist question is I guess reassurance, or guidance, about if a single session is enough to decide a therapist isn’t suitable? Through NDIS I’ve been linked with a new psychologist after my last one moved out of area, and whilst she seems nice enough if felt like I was teaching her and she is less than a year into her provisional practice and hasn’t worked with adults or trauma/survivors, nor how to leave things alone when not wanting to discuss a trauma (especially during first session). She’s probably just not experienced enough, but it’s also a lengthy wait for therapy and hard to find one with trauma understanding.

Maybe I’m just needing reassurance about trying a new medication, well trusting a clinician after recent medical trauma, and speaking up for suitability of therapist. I’m still very panicky, and having to attend the hospital yesterday didn’t help with the high arousal levels.

 

[somerandomguy]

she is less than a year into her provisional practice and hasn’t worked with adults or trauma/survivors, nor how to leave things alone when not wanting to discuss a trauma

Sounds entirely unhelpful. Are there any guarantees that if you fire her and wait to be reassigned, you'll get someone better?

 

[KathK]

Sounds entirely unhelpful. Are there any guarantees that if you fire her and wait to be reassigned, you'll get someone better?

No guarantees and had to wait 3mths after the last left before this one came up, though I could insist on someone with at least a basic level of working experience with trauma. Given my history then having her allocated I’m really not sure though. Probably better to have no one than a therapist getting paid for me to teach her though

 

[Sideways]

though I could insist on someone with at least a basic level of working experience with trauma

Can you find someone? Trauma specialists in Australia are often connected to the private hospitals that offer trauma therapy, so looking through their website is often a good start. With funding, you may need to pay up front and get reimbursed, but it may be a much better way to get a good match.

 

[KathK]

Can you find someone? Trauma specialists in Australia are often connected to the private hospitals that offer trauma therapy, so looking through their website is often a good start. With funding, you may need to pay up front and get reimbursed, but it may be a much better way to get a good match.

I don’t know. I asked my psychiatrist yesterday for suggestions and he’ll get back to me. I’ve had therapists with trauma experience before, in fact my first after disclosure to a safe friend was at a women’s health centre in regional QLD who specialised with sexual abuse survivors, then the old VCT (now victims services) counselling and a therapist through Vinnies who had professional and personal trauma experience. The one time I was in a private hospital the psychologist didn’t have trauma experience but the psychiatrist was fabulous and after years of misdiagnosis and ignoring the trauma/ptsd symptoms he crossed out most of the previous labels and changed to cptsd, and a GP who used to work in public psych hospitals in NZ was even more aware and helped with the dissociation. So through word of mouth there are clinicians not linked to private hospitals, they’re just not easy to find, plus I’m on DSP and NDIS so I can’t pay upfront, and even if they agreed to bulk bill the Medicare plan doesn’t offer enough sessions, but I can ask if they’ll work with wNDIS or know someone who does.

I’ll check a couple of the private hospital websites and maybe the survivor service associated with my local public hospital. Thanks for that idea, I’ve only once briefly had private health coverage so limited exposure to those facilities (plus most are 45-60minutes minimum drive from me)

 

[EveHarrington]

The meds that have helped me the most for hyperarousal have been antipsychotics and mood stabilizers (in the anticonvulsant class). I stopped my antipsychotic because of side effects (it was damaging my muscles). I’m currently on 2 different anticonvulsants, Gabapentin & Trileptal. I don’t think I could function without the gabapentin as it really calms down my system. I will say that I have ptsd and sensory issues, and they play off each other. In other words, my nerves are shot! (The sensory issues went through the roof when my ptsd went full blown.)

 

[KathK]

The meds that have helped me the most for hyperarousal have been antipsychotics and mood stabilizers (in the anticonvulsant class). I stopped my antipsychotic because of side effects (it was damaging my muscles). I’m currently on 2 different anticonvulsants, Gabapentin & Trileptal. I don’t think I could function without the gabapentin as it really calms down my system. I will say that I have ptsd and sensory issues, and they play off each other. In other words, my nerves are shot! (The sensory issues went through the roof when my ptsd went full blown.)

I’ve tried most groups of antidepressants, some antipsychotics and lyrica and gabapentin, but what helped me are the ones typically used for cardiac issues, initially propranolol which the GP who had been a psychiatrist in NZ put me on, it took the edge of the ANS arousal so I could utilise grounding techniques rather than go straight to full dissociation or fugue states; prasocin has helped too and my psychiatrist wants me to try clonidine which is similar but works on a slightly different pathway. So many psychiatry ‘experts’ forget that trauma changes brain activity and the physical responses such as with the sympathetic nervous system staying over-active and cortisol often being released so much that the sensitivity to it changes. I read so many books and journals over the decades but ‘the body keeps the score’ was such a validating summary in an accessible way for the public and consumers that it helped bring all the pieces I was aware of together and I’m encouraging any clinicians I speak with to have a read as a thorough introduction to the effects and treatment of trauma, though some patient examples used can be a triggering read. I react badly to so many medications that the ones modulating heart rate and blood pressure seem to work best for me with next to no side effects, we just debate dosing, especially when flare from acute/recent traumas.

Definitely know what you mean re sensory and ptsd playing into each other; I was fortunate to briefly work with a sensory OT and she did a full sensory profile which gave me further non-meditation options to help manage high arousal. Even some things like certain smells, touch locations and sounds trigger flashbacks so using sensory tools that are calming/soothing help reducing the arousal. I’m lucky I was able to work through ideas with a specialist as alone I don’t know how I would’ve managed trialling them.

 

[EveHarrington]

How did you find a sensory OT?

 

[KathK]

How did you find a sensory OT?

It was by chance through my community mental health service. She’s working somewhere else now. I don’t know how easy they are to find but they definitely exist and she was so helpful

 

[EveHarrington]

It was by chance through my community mental health service. She’s working somewhere else now. I don’t know how easy they are to find but they definitely exist and she was so helpful

I’ve had to learn everything on my own, which kind of stinks. My old therapist gave me a test for autism which just annoyed the hell out of me as I don’t have any traits. The automatic assumption is that sensory issues = autism but in reality while the majority of people who have autism also have sensory issues, the majority of people with sensory issues do not have autism.

 

[KathK]

I’ve had to learn everything on my own, which kind of stinks. My old therapist gave me a test for autism which just annoyed the hell out of me as I don’t have any traits. The automatic assumption is that sensory issues = autism but in reality while the majority of people who have autism also have sensory issues, the majority of people with sensory issues do not have autism.

I hear you. I had to muddle through and figure things out by trial and error or hearing from other survivors, and even educating MH clinicians on dissociation. I got lucky with that OT and it helped me get a lot of sensory things together, and I’m one of those who can’t use a weighted blanket due to physical medical condition so lucky I hadn’t followed the psychologist telling me to get one. It really sucks. The medical model is moving so slowly especially regarding trauma awareness and survivors and how trauma impacts the whole body not just MH

 

[Friday]

The automatic assumption is that sensory issues = autism but in reality while the majority of people who have autism also have sensory issues, the majority of people with sensory issues do not have autism.

Truth.

Even if the therapist knows full well it’s not autism, that’s how to get insurance companies to pay for it &/or public schools to provide accommodations or it (which they’re legally required to anyway, but without a well recognized name, they can also legally claim that there’s no “way” for them to ‘reasonably’ blah blah blah. Meanwhile if it’s autism, they get told to suck it up and hire a speech pathologist already, and that they should have had one on staff for yonks)…. which is why the diagnostic code is now essentially useless.

There are couple dozen disorders that share sensory processing “issues” (in various directions!) as a symptom… but the black hole of Autism sucking everything in… is making it increasingly difficult to find people who specialize in best treatments for sensory issues from other disorders, or as a stand alone issue.