Posted by fxckfeelings on July 19, 2010
Today’s post tackles a common, yet heretofore-not-submitted question about therapy, namely, how to find good help without breaking the bank in the process. While it’s a simple question, the answer isn’t, so we’ve dedicated the entire post to helping those who want help with their mental illness, but don’t have a dime to spare.
-Dr. Lastname
I’ve been depressed for some time and could use some treatment, but my insurance has a big deductible, so I’ll be paying everything out of my pocket, which isn’t deep. My goal is to get treated for the least amount of money.
I’ll assume from your tone that depression isn’t making you suicidal or putting you at immediate danger of losing your job and/or family because, if it is, you need to forget about the cost of treatment and value the cost of your survival.
If depression is putting your life/work/family in danger, get a psychiatric evaluation, in an emergency room if necessary. Do not pass go, do not collect $200 (no matter how much you need it).
If that isn’t the case, there’s lots you can do to reduce the amount of money you spend on treatment…if you’re willing to spend some time, do some research, and use your common sense.
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Posted by fxckfeelings on July 15, 2010
We Americans love our stuff, but the lust for said stuff can cause individuals to behave badly (see: the demonic/orgasmic audience reaction to Oprah’s car giveaway). Usually, when someone goes overboard with longing for/accumulation of stuff, it’s a family member who steps up to put the breaks on, but when anyone, family or no, gets between someone and their stuff, things can get uglier than anything Oprah could imagine. If family members put limits on their responsibilities, however, there are still ways for stuff-addicted loved ones to break the stuff cycle.
-Dr. Lastname
My parents have decided to retire, sell the big house I grew up in and move into a smaller condo closer to my sister and me. The move makes sense—my sister and I are adults with our own families—but it’s brought up a sort of taboo issue for my parents, which is my mother’s attachment to stuff. She’s not a hoarder, but if my dad wasn’t around to put his foot down, I sometimes worry it could be, because my mother has trouble throwing anything away. She says that moving all the time as a child has given her a different appreciation of objects, and that it’s better to regret having too much stuff than to miss something you threw away and can’t get back. Problem is, there’s no room for this stuff in the new condo, they won’t have the budget for storage, and my sister and I aren’t able to put all of her old work files, souvenir spoons, and elementary school textbooks (seriously) in our basements. What I’m afraid will happen is that my father, who has always taken responsibility for managing their money, will try to get my mother to agree that they can’t afford to move and store her stuff when they move, she’ll keep complaining, and he’ll get nasty. How can we get my mother to learn to let go?
I know you and your father want to make your mother happy and have harmony, but it looks like she’s not eager to adapt a sparse, Zen lifestyle.
The problem is, trying to make someone happy when it’s just not possible usually causes more unhappiness. False hope is dangerous, no good deed goes unpunished, and stuff happens (sometimes in great quantities).
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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.
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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.
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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.
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Posted by fxckfeelings on April 15, 2010
While Shut Up! Week began with us doing the up-shutting, it concludes with the more fun exercise of instructing others when they can utilize their own “shut up!” skills. After all, a friend might want to help you, or you might want to help a friend yourself, but sometimes the best thing you can do to help someone is get them to keep their mouth closed. And with that, Shut Up! week shuts down.
-Dr. Lastname
For years, I’ve talked to a friend of mine about my problems who’s also a counselor, and during that time, he’s urged me to seek professional help. I used to brush off that advice, mostly because this friend lives in another city and only ever really talks to me on the phone when I have problems, but in the last few months, I’ve begun to consider taking his advice. I don’t know what to say when I call to make the appointment, however, because I haven’t the faintest how to explain the unknown in my head (which is the main issue that frustrates me). I want to scream, but don’t know why or what. Do you have any advice as far as how to ask for help when I’m not sure what I’m really asking help for?
Remember, funny feelings in your head cause fear, which causes funny feelings, which cause fear, which create a spiral that will flush you down the toilet of needless worry. The first thing to do then is shut up and think about whether you need help.
If you’ve had funny feelings in your head for years, they’re not about to kill you; they’re not telling you to kill yourself or anyone else, and they’re not annoying you to death. WAIT! There is more to read… read on »
Posted by fxckfeelings on April 8, 2010
Many jobs, especially those involving leadership or sales, depend on making a good impression with the public. The risk is becoming so focused on public reaction that you end up like Ed Koch, asking “How’m I doin?” with such frequency that you lose track of exactly what you’re supposed to do (aside from getting people to curb their dogs). Most public jobs, however, involve lots of duties that only make an impression when done very poorly, so success can’t be defined by accolades, and you’re the only one who knows best. It’s up to you to be your own best judge before you end up so hungry for approval that you get stuck in deep dog shit.
-Dr. Lastname
As rabbi of a medium-sized temple for 10 years, I’ve enjoyed a good relationship with my congregation and I love the work. My problem is that I rely on the temple Board to decide whether I get a raise, and, during the last recession, there wasn’t one because everyone felt too poor to pay more dues. When, recently, I began looking at what rabbis of comparable congregations are making, however, I found that my salary is well below the mean, so I’ve been wondering how to become more active without appearing to be greedy, selfish or unresponsive to the problems of the congregation. One way that occurred to me was to do a “360 degree review” and ask everyone to give me feedback on how I’m doing, including the congregation, the board, and people who work for me. My goal is to get a high approval rating and use that to get a raise.
Unlike the woman earlier this week who was too afraid to rock the boat by asking for a raise (until anger made her want to torpedo the ship), you’re inhibited by guilt, empathy, and that certain Jewish ne sais quoi.
Still, no matter how tempting it is, don’t ask the congregation to clap if they think the rabbi deserves a raise. You’re a scholar and a leader, not Tinkerbell.
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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.
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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.
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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.
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