Hi everyone,
First of all, I think I'm making sense but apologies if its hard to grasp what I'm trying to tell, because I'm having pretty heavy dissociative symptoms right now (and English isn't my native language).
Its a while since I posted here. Things have gone in a great direction, at times I felt like I had no symptoms at all, I managed to get an internship at a software company as a programmer, generally things have just been great and I have been doing really well at work, it looks pretty certain that I will get a job in the industry (unless all the stuff that comes next messes up everything).
So I have schizoaffective disorder in addition to ptsd and because of that I am under a lot of medication and have a regular contact at an outpatient-clinic (of course I also have my therapist). My treatment provider changed something like two months ago because I no longer needed that regular contact. This was actually in many ways good because the treatment I was receiving had no focus on my ptsd and had been actually re-traumatizing in many ways. However, things started to go in the wrong direction when they decided that it would be good for me to have the same psychiatrist since he had been moved to the same clinic because of some organizational changes. I initially agreed because I did not realize what would happen as a result but then my ptsd-symptoms started slowly return and in the end I was totally preoccupied with thoughts and memories about the retraumatizing events that were related to this psychiatrist. In the end I managed to switch to a different psychiatrist and this took the edge off the ptsd-symptoms, but they still kept coming. With the help of my therapist I managed to get access to the feelings related to all this and reduce the symptoms, but at this point my migraine had already been triggered by the stress and I spent the last 1,5 weeks having a migraine almost all the time (now they're gone thank god).
So this brings me to the biggest thing, my old psychiatrist had this obsession about reducing my medications. At one point it was good because I was on too much medication, but nowadays that's no longer the situation and the attempts to reduce my medications have led to a severe depression half-a-year ago and to many more minor setbacks. What scares me the most is the lorazepam (Ativan is the US brand name, I have been taking 1-3mg daily for the last 1,5 years) because with that I get horrible withdrawal symptoms that seem to drag me towards a psychosis, and also the lorazepam is the only thing that makes me bounce out of really triggered or otherwise extreme states where I feel like hurting myself or others. Also, I sometimes get these extreme dissociative episodes (that seem to have a psychotic component) and heavy psychosomatic symptoms when I try to reduce it. So sudden reductions in my medications is basically my biggest fear at this point, especially since everyone agrees that if I get a full-blown psychosis I will never recover (it would be my third one). My therapist also says that she thinks reducing my medication at this point of recovery is like the worst idea ever.
And my biggest fears seem to always have a way of becoming reality... So I had been taking occasionally 0,5-1mg of lorazepam during the migraines because I often start to feel really horrible mentally during them and I had like e.g. fairly serious thoughts of taking a knife and repeatedly stabbing myself with it. This lead to me needing a new prescription (I have one for 30 1mg pills that refills at every 11th day) and my psychiatric nurse said on Wednesday that it will not be a problem. However, I did not get a new prescription so in order to make it until I can get more of the medication I had to reduce the dosage to 2,5mg on Friday.
So on Friday I take the reduced dose on morning and pretty soon if feel a bit unstable. On midday I try calling the clinic to see whats happening with the prescription thing, and they basically say that they can't help me because in my medical records it says that the dose is 2mg (my old psychiatrist said that he will write down that its 2mg because "that's the goal") and that its supposed to be reduced (we agreed that it should not be done in the near future, but apparently that's not what it says in the medical records). So at this point I am a bit volatile already and after the phonecall I start throwing things in a rage and hitting myself with scissors (didn't hid that hard luckily, only caused bruises). At this point I have also already lost my appetite and soon I throw up for the first time. Then I have a meeting with my therapist who is pretty horrified by the situation and we agree that I should call the "acute clinic" (its like a place where you get help on the weekends if its an acute issue) if I start to feel too bad, however after the meeting I feel a bit better. So at 6pm the withdrawal starts to kick in, at first I get heart palpitations and chest pain and by 9pm my hands are shaking, I'm feeling extremely cold even though its more like hot in the house, I can't eat and I throw up several times, I have a headache, all my muscles are stiff as hell and the list goes on... And then the psychotic symptoms start to kick in and I start to feel exactly like just before my first psychosis kicked in (like I'm extremely fearful and a bit paranoid, I'm having heavy de-realization, objects are looking either very big or very small and slightly changing shape, everything is like "fluctuating", I think I also heard some stuff that wasn't real). On the morning I feel like I just want to isolate in my room and not even take my meds but I manage force myself to call the "acute clinic". What do they say? They say this is not an acute thing! They just tell me to go to the pharmacy and take some lorazepam, so I force myself to go to the pharmacy with my hands shaking, feeling very disoriented and with something strange happening with my voice and manage to nevertheless get the meds. I immediately take 2mg of lorazepam and luckily in 24 hours the withdrawal and the psychotic symptoms were gone.
So now I have enough lorazepam for the next eight days but after that I will run out. I think I will call the outpatient clinic tomorrow but I'm extremely nervous about whether I get the prescription and because of what just happened I'm having pretty heavy ptsd-symptoms, I had to take sickleave from work today. I just hope that this turns out okay but I have always had trouble trusting especially psychiatrists and this thing has definitely destroyed the trust that I had managed to build. I'm feeling pretty awful but I think writing this down helped a bit and I think I might call the clinic soon to see if I could get a phone appointment with the psychiatrist (the first face-to-face appointment is set to be at the end of the next month and it unfortunately can't be done any earlier).
First of all, I think I'm making sense but apologies if its hard to grasp what I'm trying to tell, because I'm having pretty heavy dissociative symptoms right now (and English isn't my native language).
Its a while since I posted here. Things have gone in a great direction, at times I felt like I had no symptoms at all, I managed to get an internship at a software company as a programmer, generally things have just been great and I have been doing really well at work, it looks pretty certain that I will get a job in the industry (unless all the stuff that comes next messes up everything).
So I have schizoaffective disorder in addition to ptsd and because of that I am under a lot of medication and have a regular contact at an outpatient-clinic (of course I also have my therapist). My treatment provider changed something like two months ago because I no longer needed that regular contact. This was actually in many ways good because the treatment I was receiving had no focus on my ptsd and had been actually re-traumatizing in many ways. However, things started to go in the wrong direction when they decided that it would be good for me to have the same psychiatrist since he had been moved to the same clinic because of some organizational changes. I initially agreed because I did not realize what would happen as a result but then my ptsd-symptoms started slowly return and in the end I was totally preoccupied with thoughts and memories about the retraumatizing events that were related to this psychiatrist. In the end I managed to switch to a different psychiatrist and this took the edge off the ptsd-symptoms, but they still kept coming. With the help of my therapist I managed to get access to the feelings related to all this and reduce the symptoms, but at this point my migraine had already been triggered by the stress and I spent the last 1,5 weeks having a migraine almost all the time (now they're gone thank god).
So this brings me to the biggest thing, my old psychiatrist had this obsession about reducing my medications. At one point it was good because I was on too much medication, but nowadays that's no longer the situation and the attempts to reduce my medications have led to a severe depression half-a-year ago and to many more minor setbacks. What scares me the most is the lorazepam (Ativan is the US brand name, I have been taking 1-3mg daily for the last 1,5 years) because with that I get horrible withdrawal symptoms that seem to drag me towards a psychosis, and also the lorazepam is the only thing that makes me bounce out of really triggered or otherwise extreme states where I feel like hurting myself or others. Also, I sometimes get these extreme dissociative episodes (that seem to have a psychotic component) and heavy psychosomatic symptoms when I try to reduce it. So sudden reductions in my medications is basically my biggest fear at this point, especially since everyone agrees that if I get a full-blown psychosis I will never recover (it would be my third one). My therapist also says that she thinks reducing my medication at this point of recovery is like the worst idea ever.
And my biggest fears seem to always have a way of becoming reality... So I had been taking occasionally 0,5-1mg of lorazepam during the migraines because I often start to feel really horrible mentally during them and I had like e.g. fairly serious thoughts of taking a knife and repeatedly stabbing myself with it. This lead to me needing a new prescription (I have one for 30 1mg pills that refills at every 11th day) and my psychiatric nurse said on Wednesday that it will not be a problem. However, I did not get a new prescription so in order to make it until I can get more of the medication I had to reduce the dosage to 2,5mg on Friday.
So on Friday I take the reduced dose on morning and pretty soon if feel a bit unstable. On midday I try calling the clinic to see whats happening with the prescription thing, and they basically say that they can't help me because in my medical records it says that the dose is 2mg (my old psychiatrist said that he will write down that its 2mg because "that's the goal") and that its supposed to be reduced (we agreed that it should not be done in the near future, but apparently that's not what it says in the medical records). So at this point I am a bit volatile already and after the phonecall I start throwing things in a rage and hitting myself with scissors (didn't hid that hard luckily, only caused bruises). At this point I have also already lost my appetite and soon I throw up for the first time. Then I have a meeting with my therapist who is pretty horrified by the situation and we agree that I should call the "acute clinic" (its like a place where you get help on the weekends if its an acute issue) if I start to feel too bad, however after the meeting I feel a bit better. So at 6pm the withdrawal starts to kick in, at first I get heart palpitations and chest pain and by 9pm my hands are shaking, I'm feeling extremely cold even though its more like hot in the house, I can't eat and I throw up several times, I have a headache, all my muscles are stiff as hell and the list goes on... And then the psychotic symptoms start to kick in and I start to feel exactly like just before my first psychosis kicked in (like I'm extremely fearful and a bit paranoid, I'm having heavy de-realization, objects are looking either very big or very small and slightly changing shape, everything is like "fluctuating", I think I also heard some stuff that wasn't real). On the morning I feel like I just want to isolate in my room and not even take my meds but I manage force myself to call the "acute clinic". What do they say? They say this is not an acute thing! They just tell me to go to the pharmacy and take some lorazepam, so I force myself to go to the pharmacy with my hands shaking, feeling very disoriented and with something strange happening with my voice and manage to nevertheless get the meds. I immediately take 2mg of lorazepam and luckily in 24 hours the withdrawal and the psychotic symptoms were gone.
So now I have enough lorazepam for the next eight days but after that I will run out. I think I will call the outpatient clinic tomorrow but I'm extremely nervous about whether I get the prescription and because of what just happened I'm having pretty heavy ptsd-symptoms, I had to take sickleave from work today. I just hope that this turns out okay but I have always had trouble trusting especially psychiatrists and this thing has definitely destroyed the trust that I had managed to build. I'm feeling pretty awful but I think writing this down helped a bit and I think I might call the clinic soon to see if I could get a phone appointment with the psychiatrist (the first face-to-face appointment is set to be at the end of the next month and it unfortunately can't be done any earlier).
