subscribe to the RSS Feed

Saturday, July 31, 2010

Second Story

Posted by fxckfeelings on June 14, 2010

While most people have multifaceted personalities (or should), there are an unlucky group whose personalities aren’t so much nuanced as they are binary; fewer shades of grey, more Jeckyll and Hyde. If you’re dealing with someone who’s double sided, or trying to hide a part of yourself from the world, it can feel like a never ending battle to reconcile and/or expose both halves. Occasionally, it’s worth exposing your secret side to end your own torment. Other times, it’s better to let people keep their Mr. Hydes to themselves if it means keeping their drama out of your own life.
-Dr. Lastname

Most people thing my mom is really fun, if a little flaky and emo, but they don’t see how crazy and mean she gets when there’s no one around but my brother and me (my parents are divorced). When she’s in a bad mood, she tells us we’ve been mean to her, and reminds us of things we’ve said that hurt her, and tells us how bad we are until we’ve apologized, and then she forgets it ever happened. There’s one cousin who’s seen what she gets like and I rely on him to remind me that it’s OK, she’s crazy, but the other day he seemed charmed by her and then, when I complained, he told me I had to get over her and not be so angry, and now I feel totally unsupported. My goal is to get someone to understand what’s going on.

Nothing gets people more stirred up than dramatically pitched false accusations and punishments by a powerful, inescapable, totally two-faced authority, like your mama.

The good news is that, while you’ve got the makings of a perfect soap opera, it sounds like you’re not getting swept away by it.

The trouble with soap operas, of course, is that they trap the good guys into endless rounds of angry, hurt reactions to crazy bad guys. In the process, they take up huge amounts of time and energy for tears and talk, talk, talk before, finally, there’s a glimmer of comfort and validation…before the cycle starts all over again.

WAIT! There is more to read… read on »

Doctor Dependent

Posted by fxckfeelings on June 7, 2010

Most people panic if their mental health goes south, and if/when they find a doctor to help them recover, they assume that treatment is a mystery about which doctors know best. If you’re in that situation and disagree with your doctor’s decisions, don’t act like a helpless child challenging an all-knowing parent. Learn what you need to know to make well-informed decisions and stand by them, whether or not your doctor agrees. It’s the best way to cure yourself of panic, and it makes refuting your doctor’s advice a discussion between equals, not a pleading.
-Dr. Lastname

My psychiatrist thinks I should increase my medication, but it already makes me sleepy and has caused me to gain 10 lbs. If anything, I’d really feel better getting off it entirely, because I hate being dependent on it. For the time being, I know I need it, because I’ve barely recovered from my last depression, but even thinking about increasing the dose makes me feel depressed. I’ve seen this doctor throughout my entire illness and she’s been very good with me up to this point, but now that I don’t agree with her I don’t know what to do. I don’t want to have to take more medication.

It’s much easier to have an agreeable disagreement if you’re not pushing someone with your emotions; after all, lawyers use evidence, not tantrums, to win a case.

Still, it’s hard not to push with your emotions when the issue is personal and scary. Unfortunately, you don’t have a choice.

WAIT! There is more to read… read on »

Demon Season

Posted by fxckfeelings on May 31, 2010

Most good people find themselves doing the same old bad things over and over. For some of us, said bad habits don’t go beyond excessive chocolate or videogame usage, but for others, “bad things” result in horrible consequences. Understanding why people are like that seldom helps, but recognizing when people are like that (whether it’s you or the other guy) can be very helpful if you accept the fact that the problem won’t go away and take responsibility for managing it as it is. You can’t change urges, but you can sure try to change results.
-Dr. Lastname

I love my work, my kids, and my wife, but I have bipolar mood swings (and I’ve taken medication for years) that lead me to do things that get me into trouble. Recently, in spite of the medication, I felt a surge of energy and started to stay up late, sneak into my studio and paint. I’ve also started to drink again. I don’t want to change meds or let people know what’s happening because I want to keep my options open. I love the highs and the freedom, and I hate being told what to do, but I’ve got a demanding day job that doesn’t involve painting, and a wife who doesn’t like it, to say the least, when I’m not honest. So my goal is to get myself under control before people catch on to what’s really happening.

There are few fathers and husbands who can’t identify with the goal of wanting to feel special, have time to themselves, and avoid humiliating comments about eating, drinking, toileting or sleeping habits from their next of kin.

The fraction of these fathers who are dealing with mental illness and addiction to alcohol don’t want to be asked if they’ve been taking their medication or started drinking.

So, if your goal is to avoid immediate disrespect and hang on to your secret Van Gogh identity a little longer, then keep doing just what you’re doing.

WAIT! There is more to read… read on »

Therapists’ Turn

Posted by fxckfeelings on May 3, 2010

Poor, well-meaning, dedicated therapists and the patients who love/destroy them. After all, it’s enticing to let someone persuade you that you’re their guardian angel and the only therapist that can help. It’s a fun ride for everyone, at least until you realize that you’re responsible for something you don’t control, and they’re even less responsible than before for dealing with reality as it is. While this is a shrink-based site, we are the first to admit that therapists are not perfect people, especially when they get in in their heads that they actually are.
-Dr. Lastname

I have a 30-year-old patient whom I’ve been seeing in weekly psychotherapy for 6 months and he had a terrible history of sexual and physical abuse and years in state care. Amazingly, despite all his trauma and several prior failed treatments, he settled into a trusting relationship with me. He tells me I’m the first person he’s bonded with, and he’s been able to stop using cocaine, and, for the first time, sees some hope for himself. The problem is that he just got a new job, and I’m not covered by his new insurance plan. He wrote me a letter telling me how much he feels his recovery depends on continuing the treatment we’ve started and I feel professionally obliged to put his welfare ahead of my financial needs, but I’d like to get paid. My goal is to do right by my patient, and not trigger the feelings of abandonment that underlie much of his negative behavior, but I’m not sure how long I can afford to see him for nothing.

There are many therapists who believe the best thing you can do for a troubled patient like this is to “be there,” providing the steady acceptance and secure relationship that they need for healing. I’m not one of them.

The sad fact is that the healing power of currently available treatments is vastly over-rated and a good example of false hope and the harm it can cause.

WAIT! There is more to read… read on »

Crazy Scared

Posted by fxckfeelings on April 1, 2010

We began this week with people paralyzed by fear of the unknown. We now end it with people who get stuck, not due to fear of the unknown, but rather fear of the untenable; their lives are blocked by the effects, or even just the possibility, of mental illness. Everyone’s lives, even for the few of us who are sane, are fraught with danger, so there’s no point in letting any illness ruin you, at least not without a fight.
-Dr. Lastname

I know that my depression is one of the main obstacles keeping me from getting a new job; I got laid off three months ago, and even though my meds had stopped working way before that, I had enough discipline to push through. Now I don’t have a workplace to go to, I have trouble getting motivated enough to do anything, so between my inability to get out of bed and the fact I look like a mess, interviews aren’t happening. My wife is pissed because I’m not motivated to get new work and I won’t go back to see the psychiatrist, but I don’t see the point in trying this new prescription, because it’s my fourth medication so far, and I don’t understand why the first medication I took, which worked the best, stopped working, and why none of the others since has done the job. I don’t see why I should waste my time getting treatment if it isn’t going to work, but my wife thinks I’m being complacent and lazy. My goal is to find some way to get better or at least get her off my back.

You’re reinforcing something I’ve been telling my children their whole lives; life is unfair.

It was unfair for them when I wouldn’t by them a Happy Meal or the latest Nintendo game, even when they deserved it, and it’s unfair for you now that you’ve lost your job and can’t find the right meds. Unfair is unfair, as they say (or at least as I say).

The trouble is, it isn’t a fair world for anyone, young or old, and you won’t survive if you can’t take your lumps and keep on going.

WAIT! There is more to read… read on »

Parenting Under/Overkill

Posted by fxckfeelings on March 15, 2010

Part of being a kid is testing your limits with your parents-how late can you stay up, how many times can you hit your sister, how frequently can you have keggers in the garage-but what’s discussed less frequently is how parents have to test their own limits with their kids. While you might not want to be too forceful with your kid, part of being a parent is making choices and enforcing them. On the other hand, you don’t have to be so pushy that you go from parent to endless nag. It’s a careful balance, but the family buck stops with you, so you’ve got to make the call. Besides, if you don’t get it right, then those keggers will be the least of your problems.
-Dr. Lastname

My son was diagnosed with severe depression when he was a freshman in high school. I know it’s supposed to be a hereditary disease, but neither I nor my husband have any history of it; we both come from stiff-upper-lip backgrounds, and when our son attempted suicide, we were completely taken by surprise. He was also doing drugs, and we didn’t know it. He’s doing much better now, seeing a therapist weekly, but I still worry about his going off to college next year. He doesn’t share much with us, but I know he wants to do what’s “normal.” I don’t want to intrude on his relationship with his therapist or undermine his confidence or make him feel pressured, but we need to decide whether he’s ready to go. My goal is to make the right decision without hurting him in the process.

You can’t protect your son from of having an illness and all the trauma that goes with it, so for your own sake, and against all your instincts, don’t try.

On the other hand, if you try too hard to avoid all potentially painful issues with your son and stick to being stoic and reserved, you’ll be helping him avoid the hard choices he has to make, instead of doing your job.

Life is hard, precisely because it includes illness and drug abuse on top of the usual high stresses of being adolescent and finding a way to be independent. It’s a clusterfuck, and you’re the motherclusterfucker; you’re all in this together.

WAIT! There is more to read… read on »

ADD 101

Posted by fxckfeelings on March 8, 2010

In my practice, I give patients with ADD a special appointment option. Instead of their taking responsibility for keeping a regularly scheduled appointment (which means they’re obliged to pay full freight, with no insurance support, if they don’t show up), I encourage them to line up for a walk-in appointment which may keep them waiting longer, but won’t cost them a cent if they forget to come. It’s not that I discriminate, I’m just trying to make the best of things. That, to me, exemplifies the best way to deal with Attention Deficit Disorder, both for my patients and as a third party; keep your expectations reasonable, your appetite for shit bottomless, and your shrink understanding.
-Dr. Lastname

My roommate calls me the Ritalin vampire, because once my meds run out around 5, I become a different person (or really just a depressed, anxious mess). My mood drops so low so fast, and my nerves become so raw, that I have to drink just to get through the evening and get some sleep. It’s obviously driving my roommate crazy, but more than that, it’s messing up my life—I wake up hung-over, my boss is pissed, I feel sick all the time, so even when I’m not anxious and wired when I’m on my meds, I still feel like shit. My goal is to figure out how to get my ADD under control when the sun is down.

Most Ritalin users don’t have a terrible comedown with severe anxiety every time their meds wear off—what you have isn’t normal ADD, but ADD plus anxiety, plus, probably, alcohol dependence.

The medical term for your three-pronged disorder is a trifuckedta. Surprise, the prognosis ain’t so hot.

WAIT! There is more to read… read on »

Rehab Redux

Posted by fxckfeelings on March 4, 2010

We all have different standards for bad behavior; some people hate themselves for eating more than 1000 calories a day, while others don’t understand why you think it’s such a big deal that they drive drunk. While the opinions of those close to you are worth considering, the only true judge for what’s right and wrong is, surprise, you. Just as long as you weigh all the risks and benefits (and eat a cookie and/or call a taxi).
-Dr. Lastname

Do you think sex addiction is a real disease that needs therapy, or is it a way to make a big deal out of nothing that helps cheaters and the people they cheat on feel better while people in your business get paid? I love my wife—we’ve been together for almost 20 years—but I don’t think anyone would say I have an disease because I grab a little extra action if the opportunity comes along. I don’t think she knows I’m not faithful, it doesn’t happen that often, and I don’t think it hurts our marriage at all. It’s not like I have a steady mistress; I just end up going home with women I meet when I’m traveling sometimes, because it’s nice to feel young and like I haven’t lost it, whatever it is. As far as I can tell, everyone wins, because I feel better and my wife is less annoyed by my constant begging for sex. So my goal is to figure out if the way I live my life, which seems to be A-OK, is actually reason to go into rehab.

To rehab, or not to rehab. That is the question.

You’re raising the timeless question, and obviously, we’re not going to tell you to let your feelings be your guide, or, for that matter, your daddy, your minister, your rehab counselor, or your parakeet, Ray.

As to the validity of sex addiction, it either doesn’t matter, or it depends on your definition of illness. I define illness as something wrong with your body that’s personal, important, and out-of-control, and it doesn’t matter whether it’s cellular or behavioral, neurological or psychiatric. Or kinky.

WAIT! There is more to read… read on »

Diagnose This, *sshole.

Posted by fxckfeelings on March 1, 2010

A lot has been made recently about how it seems like every child is being diagnosed with autism; celebrities like Jenny McCarthy, whose son is autistic, have led the charge to blame and outlaw vaccines in order to protect kids. In reality, as science progresses and our understanding of the autism spectrum deepens, the disease hasn’t expanded, just the diagnosis, i.e., there aren’t more autistic kids, just more kids being called autistic. While today’s cases aren’t autism-related, they both illustrate the myth of the power of diagnosis. Focusing too much on what your disease is does nothing to improve your health. Incidentally, Jenny McCarthy has revisited her take on vaccines—it turns out her son’s diagnosis was wrong.
-Dr. Lastname

In the last ten years, I’ve heard voices in my head and most doctors describe my symptoms as psychosis, but nobody can tell me exactly what’s wrong, or find a medication that makes them go away, or really do anything but listen to me give them my laundry list of “how I’m crazy” and try to take the problem apart. In the meantime, I’m struggling to hold onto my job, my wife is struggling to put up with me, and my kids (now grown) just worry and get more distant. My disease stays the same, my life gets worse, my diagnosis goes nowhere. My goal is to figure out what is causing the symptoms, get a real diagnosis, and make real progress.

I wish the word diagnosis meant “we know what’s wrong and what to do,” but it often doesn’t, except in certain special cases. (Like, right now I feel safe diagnosing your reaction as disappointment.)

Very often, all a diagnosis means is that we recognize a group of symptoms that often travel together in the same social circle, and often get a little bit better when they’re treated with a particular group of medications. Tada.

That’s almost always true when the doctor making the diagnosis is a psychiatrist, because we know less about mental illnesses than almost every other kind of illness (and less about the brain then we do about any other part of the body).

We really should use some other word than “diagnosis,” but we don’t, because we love to think we know more than we do, which goes to prove that doctors are just as vulnerable to idiot false hopes as everyone else.

Some people put a premium on hope of any kind, but false hope is dangerous, because we pay for it with unrealistic expectations that lead to feelings of failure. You expect that, once you get the right diagnosis, you’ll get the right treatment, but I diagnose that assumption as bullshit.

WAIT! There is more to read… read on »

Big, Bad Business

Posted by fxckfeelings on February 22, 2010

Very few people leave their jobs everyday feeling great—it is called “work” for a reason, after all—but it’s extra difficult to accept when a boss or business partner leaves you feeling betrayed, used and screwed (unless you’re in the actual sex trade, where upon, it’s just another day at the office). Ultimately, even for sex workers, the job isn’t personal, and it’s not worth taking it that way.
-Dr. Lastname

For a long time, I truly believed that my boss was my mentor, if not a father figure; he seemed to look out for me, take a special interest in my career, and generally groom me for promotion within his company. After I did well with responsibility, he’d come through with reasonable raises and he liked to tell people that he believes in promoting women. Recently, though, I’ve noticed that he does little more than flatter me now that he has me doing all the dirty jobs and he keeps all the interesting stuff for himself and two of his favorite “old boys.” He gets irritated whenever I suggest I could do more and likes to bask in the gratitude of his new favorite girl, a secretary with big tits and not much else. I’ve worked hard here over the years, and I don’t really want to find a new job, but I feel like I’ve been used and misled, and generally wasted my time under false pretenses. My goal is to get the recognition I deserve, even if it’s not from the mentor I thought I had.

Wanting recognition at work is a reasonable wish and, if it was just a problem of your learning how to speak up, dress up, and get rid of your braces, then more power to you.

Many people are familiar with the usual fairy stories, and have pushed themselves to be more assertive and reach their dreams. Not only hasn’t it worked, but it brought down crap on their heads to insure an unhappily ever after-style result.

WAIT! There is more to read… read on »

Site Meter