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No point to therapy says Doc


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#1 trg247

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Posted 05 December 2007 - 04:06 PM

Hi:

Right off the bat my diagnosis is severe major depressive disorder, BPD, PTSD, GAD

At my appointment today I told him I sent off a couple of referrals to the Canadian Mental Health Association and a mood and anxiety group. Both got back to me initially saying they would look into it but nothing since. It has been over a month. My doctor said there is no point to therapy as no one is qualified to treat some one with my diagnosis in the area and that I am too borderline for therapy to be effective. Outside of meds, which I am taking, what are my options here? I know I am not an easy case but should that rule me out of therapy? He said the only place he can think of that could handle someone in my position is in Vancouver where they use DBT (? I think this is right) but that is out of the question as Vancouver is days away, for you americans think Detroit to LA. For me to get better doesn't my depression and PTSD need to be addressed? The meds can help me be stable to a certain degree but they can't "cure" me. Any ideas

take care
trg247
dx: severe MDD with psychotic features, BPD, C-PTSD, GAD, lengthy Self Harm history
rx: Seroquel 100mg 3 times daily + 50mg as needed, Temazapam
past rx: Nardil, Effexor, Wellbutrin, Remeron, Lithium, Zyprexa, Ativan, Paxil, Celexa, Klonopin, Xanax, Trazadone and a few others
alias: untreatableonline, untreatable


#2 Wooster

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Posted 05 December 2007 - 04:19 PM

Hey Trg247,

"Too borderline" for therapy??? Sounds like code for "I don't know a therapist who is competent enough with good enough boundaries" or code for "an inpatient DBT program would really be helpful but either a) we don't have one here, b) your depression needs to get kicked in the ass first, or c) must develop safety net and coping skills for any other therapy to be effective."

That's my uninformed random nut on the internet perspective.

I can understand not wanting to muck around with the ptsd until the borderline/depressive/anxiety things have better coping skills wrapped around them. Sometimes its time to stir shit up and sometimes it's time to self-soothe and let things settle. But to say that you're "too borderline" for therapy makes the problem a moral or character issue about you... not a system failure to be able to provide the right services to the right people... it's clearly a systems issue and I'm sorry you're caught up in it.

Could you get referred to an intensive inpatient DBT program even if it's far away from home for a while?

Peace,
Wooster

Boards I mod on: self harm, panic/anxiety, ptsd, ocd, dissociative, sleep, not otherwise specified, benzos, lifestyle alternatives, therapy, health care system

Current meds: 60# golden retriever service dog, (swellbutrin, light box, vitamin D for the impending lack of sunlight blahs)

*disclaimer--Nothing I write should be construed as professional advice or creating a therapeutic relationship.*

Hurray! I *finally* figured out how to correct my starting weight on MFP!
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#3 karuna

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Posted 05 December 2007 - 04:31 PM

That sounds really crappy.

But I couldn't have done any other therapy (which I have later done) without doing DBT first, it would have destroyed me. I had no clue how to cope with my own emotions. I'd seriously consider moving. DBT was that good for me.
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#4 dreamingagain

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Posted 05 December 2007 - 04:34 PM

I second wooster's opinion. You can NOT be *too* borderline to benefit from therapy. You just need the right therapist. DBT is great, but even if you can't get it nearby, there ought to be someone in Ontario who can help you. Do you live anywhere near Toronto? If so, I know that there are DBT programs/treatment options there. Keep looking until you find appropriate care and do not accept any ideas that you can't be helped!

#5 trg247

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Posted 05 December 2007 - 04:34 PM

Hi:

Thanks for the quick response.
I am not sure how the health care system works in this country when you cross into another province.
I spent November in the hospital in the hospital and was discharged as they were not equipped to handle some one of my need and the hope was I would find it in the community as therapy was a main issue- this came from the same doctor who today said I was too borderline to treat.
To me everything comes from the depression, I have always had depression and I am 33 now, a few years ago it just stepped up as my past came roaring back sending me to the world I am in now. I have gone to work on the BPD aspect and for the most part it is in check and I understand it but my past where the depression comes from I don't think I can take on alone without putting myself into a dangerous position ... again.
I would think if a therapist had a basic understanding on how BPD works and causes different reactions related to thought process it shouldn't be that big of a factor just a matter of adjustment.
If the past is treated then three of my diagnosis may not disappear completely but I would be a lot better off then I am now.
Sorry for running around in circles. I just can't make sense of this.

take care
trg247
dx: severe MDD with psychotic features, BPD, C-PTSD, GAD, lengthy Self Harm history
rx: Seroquel 100mg 3 times daily + 50mg as needed, Temazapam
past rx: Nardil, Effexor, Wellbutrin, Remeron, Lithium, Zyprexa, Ativan, Paxil, Celexa, Klonopin, Xanax, Trazadone and a few others
alias: untreatableonline, untreatable

#6 trg247

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Posted 05 December 2007 - 04:37 PM

Hi:

Moving is not an option I have a three year old son who lives with my exwife here. I am about four hours North of Toronto. I know the BPD is what is scaring people away but I can't believe it has scared everyone away.

take care
trg247
dx: severe MDD with psychotic features, BPD, C-PTSD, GAD, lengthy Self Harm history
rx: Seroquel 100mg 3 times daily + 50mg as needed, Temazapam
past rx: Nardil, Effexor, Wellbutrin, Remeron, Lithium, Zyprexa, Ativan, Paxil, Celexa, Klonopin, Xanax, Trazadone and a few others
alias: untreatableonline, untreatable

#7 Wooster

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Posted 05 December 2007 - 05:26 PM

How about a little reframe...

There are two primary activities in therapy:
1) improving your self-soothing, coping, management skills... increasing your ability to be present with yourself even though you are feeling distressed, and
2) moving through things that are distressing so they aren't as distressing as they were before.

In the first case, you increase the size of your coping skills, which makes the problems feel smaller and you feel more able to cope.

In the second case, you decrease your distress about the problems so the problems feel smaller and you feel more able to cope.

In either case, you get the same result.

Would it help to look for a therapist that could work with that model and not just look at the labels (the names given to the clusters of symptoms you have)?

Peace,
Wooster

Boards I mod on: self harm, panic/anxiety, ptsd, ocd, dissociative, sleep, not otherwise specified, benzos, lifestyle alternatives, therapy, health care system

Current meds: 60# golden retriever service dog, (swellbutrin, light box, vitamin D for the impending lack of sunlight blahs)

*disclaimer--Nothing I write should be construed as professional advice or creating a therapeutic relationship.*

Hurray! I *finally* figured out how to correct my starting weight on MFP!
21850981.png
Created by MyFitnessPal.com - Nutrition Facts For Foods


#8 Penny Century

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Posted 05 December 2007 - 10:27 PM

That sounds really crappy.

But I couldn't have done any other therapy (which I have later done) without doing DBT first, it would have destroyed me. I had no clue how to cope with my own emotions. I'd seriously consider moving. DBT was that good for me.

i second this.

DBT saved my life. seriously.

i know "move" isn't practical advice but you do need DBT somehow.
"Participation without awareness is a characteristic of impulsive and mood dependent behaviors... The ability to apply verbal labels to behavioral and enviornental events is essential for both communication and self-control. Learning to describe requires that a person learn not to take emotions and thoughts literally-- that is, as literal reflections of environmental events."

~Marsha M. Linehan


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#9 Earthcalling

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Posted 06 December 2007 - 07:35 AM

Hiya

I thought the guy sounded like an ignorant twat - I bet therapists would not be to happy with what he said either. That's like saying oh by the way there is no hope for you - which is crap. DBT is being "sold" as the latest and only type of therapy avaliable which is so not true - I'm not having a go at DBT but there are other ways to climb the mountain as it were.

I was in the same position with DBT not being avaliable to me either. However I did find out from a psych who ran a Personality Group I use to attend that he described DBT as very similar to Cognitive Behavioural Therapy (CBT) with Mindful Meditations from Buddhism. The therapist I see practices CBT - is intelligent and very on the ball - he even practices schema therapy which is suppose to be the new "latest" type of therapy!

Personally I would be getting the phone book out and going down the list of therapists and giving them a ring. You can usually get a first appointment to meet them without being charged - check first. Look for CBT and then go and talk to them. Or ask the nurse at your doctors - they may know.

There are many therapy options open to you and as Wooster said if you break it down rather than going with labels you will have a better chance of finding someone.

Anyway please don't give up hope and keep us posted ;)

Hawk
Please don't suggest taking ADs when I talk about being depressed. I'm just letting off steam and find it more helpful if you suggest things to do eg. take a bath, tidy up, housework, go through my activity list... Cheers!!

I
nsanity is repeating the same thing over and over and expecting the result to be different....

The only sane response to an insane world is to lose your mind....(Bollywood Bride)

Do not adjust your mind, there's a fault in reality......(Alan Fletcher)

Dx : BPD, voices and hallucinations, General anxiety about everything and obsessive thinking
Meds - _-Zyprexa, Risperidone

#10 dangergirl

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Posted 06 December 2007 - 08:41 AM

I'm with Hawk - I think it's great that DBT worked for everyone else here - I'd never heard of it before and don't really pay attention to labels. I think there's lots of different styles of therapy that can work - it depends on the doctor and the individual patient. I think you've just got a good case of a bad doc - I think everyone here can tell you a story or two (one of mine told me to wrap my car around a tree or drive it off a cliff - nice, right?). My current tdoc told me that there's something human in everyone - even the most criminally insane, and therefore help for everyone. If mass murderers can get help through therapy, so can you.

I don't know if you like this doc or not - I guess that could be the worst part - if it's someone you've come to know and trust and now need to leave, but it sounds like someone new who's just given you a dx. I would also question anyone who says that you're TOO borderline - WTF does that mean?!!? A competent professional should be prepared to treat you.

dx: BP2, ADHD, OCD, dermatillomania
Rx: 200mg of Wellbutrin XL (generic), 100mg of Lamictal (generic) and I take Ritalin when I feel like it, which is hardly ever (ok, so maybe I forget to take it)...and sometimes 2mg of Lunesta for sleep.


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#11 trg247

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Posted 06 December 2007 - 11:57 AM

Hi;

Thanks for all of the responses. I have had the same doctor for almost three years. During November 2007 I spent in the hospital and basically seen him every day. I went through every single borderline thought or reaction and put it down on paper and handed it to him. Finally we were on the same page or so I thought til now. The hospital could no longer help me and this was evident by the end. So I created my discharge plan and it basically it said I need long term therapy with someone who understands the BPD concept, to which the doctor fully agreed with and signed off on my discharge. Now a month later he says therapy will not work for me because I am too Borderline what the fuck. The reason I went to CHMA is they have the list of all therapists in the area and I have income issues being on long term disability due to severe depression so I figured that CHMA would be the best place to start. I can be very difficult to treat if the person does not have a grasp on my boundaries but I am pretty quick to lay down the rules my brain goes by just to make sure all the doors are open. I have been through my head and things are pretty organized by this point but I can not tackle them on my own there is just too much back there and I would get lost without help. When someone dropped a client at the grouphome I never had the option of saying nope this one is to difficult to treat, I just treated the kid. I wonder if my career choice is a threat to them in addition to the BPD? Sensitive egos in the medical/therapy world. Sorry for the ramble.


* My doctor only deals with meds and will have nothing to do with talk therapy

take care
trg247

Edited by trg247, 06 December 2007 - 12:00 PM.

dx: severe MDD with psychotic features, BPD, C-PTSD, GAD, lengthy Self Harm history
rx: Seroquel 100mg 3 times daily + 50mg as needed, Temazapam
past rx: Nardil, Effexor, Wellbutrin, Remeron, Lithium, Zyprexa, Ativan, Paxil, Celexa, Klonopin, Xanax, Trazadone and a few others
alias: untreatableonline, untreatable

#12 Guest_Mostly Sane_*

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Posted 07 December 2007 - 08:12 PM

Ever heard of Dialectical Behavior Therapy? It is supposed to be very effective for Borderlines.

http://en.wikipedia....avioral_therapy

Doing meditation to learn to see the beliefs behind my feelings and then using logic (real logic, not common sense logic) on those beliefs to challenge the ones that are painful has helped me A LOT! It seems to have undone tons of psychological damage. What I will do is when I have discovered a painful belief I am suffering from (or have a painful argument with someone) I will read the fallacies list and see if there is anything that invalidates the belief. Most of the painful beliefs I have had were totally invalid. Really cool stuff. An internet search for "logical fallacies list" will bring up lots of them. Wiki includes them. I have undergone an immense amount of healing this way - all by myself.

You could also try searching for a psychologist online who will do phone counseling.

A BPD support group may be very helpful.

#13 r.mcmurphy

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Posted 07 December 2007 - 11:51 PM

do the pmeds that you take put a dent in your MI? for some of us that's all it took to slay the dragon.
plenty meds, drugs and mental troubles in the past 40 years. no end in sight for depression.

eat a fish!

#14 trg247

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Posted 08 December 2007 - 12:44 AM

Hi:

Seroquel seems to be making the most diffrence just by slowing my brain down and keeping the urges away

I was contacted by a local care center today about the possibility of them taking my case. They are a multi facet team that seem to cover every area. Their counseling is ten to fifteen sessions long but if at the end I am need of more therapy then they will connect me with someone and pick up the bill. I need to attend three modules and then there is an interview so they can determine the best way to attack my current difficulties. The only draw back is the four to six month waiting list for the counseling but at least it is something positive on the horizon.

take care
trg247
dx: severe MDD with psychotic features, BPD, C-PTSD, GAD, lengthy Self Harm history
rx: Seroquel 100mg 3 times daily + 50mg as needed, Temazapam
past rx: Nardil, Effexor, Wellbutrin, Remeron, Lithium, Zyprexa, Ativan, Paxil, Celexa, Klonopin, Xanax, Trazadone and a few others
alias: untreatableonline, untreatable

#15 Earthcalling

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Posted 08 December 2007 - 06:12 AM

That does sound positive.

The most important thing is that something is happening - and there always is a waiting list. Another thing the Mental Health service sucks at. By the sounds of it though they're picking up the tab which is cool.

In the mean time there's us ;)

We may be crazy, we may be nutters - but together we're an army!!!

Hawk
Please don't suggest taking ADs when I talk about being depressed. I'm just letting off steam and find it more helpful if you suggest things to do eg. take a bath, tidy up, housework, go through my activity list... Cheers!!

I
nsanity is repeating the same thing over and over and expecting the result to be different....

The only sane response to an insane world is to lose your mind....(Bollywood Bride)

Do not adjust your mind, there's a fault in reality......(Alan Fletcher)

Dx : BPD, voices and hallucinations, General anxiety about everything and obsessive thinking
Meds - _-Zyprexa, Risperidone





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