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tryp

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Everything posted by tryp

  1. Psychopathy is a clinical construct with specific criteria - there is a psychopathy checklist. Psychopathy is likely a subset of people with ASPD. Many people with ASPD would not meet threshold for psychopathy but most people who do also meet criteria for ASPD. Sociopath is actually not a clinical term. It’s a colloquial term that is not really used in psychiatry. Or at least that’s my understanding.
  2. That being said, the confidence interval for most of the medications listed under “weight gain” crosses zero, which limits significance.
  3. Your girl needs you, melli. Nobody else will ever be the same for her. There is no replacement for her having you as she grows up. I know your life isn’t how you want it and that is terribly unfair. And I also know that there’s a part of you that is determined to be there for your kid and build the best life for yourself that you can. Thinking of you.
  4. Yeah some psychiatrists will say that the weight gain is dose dependent and maybe it is worse at high doses, but low ones will do it too unfortunately.
  5. It typically causes neither. Every so often someone gains some weight on SSRIs but it's atypical.
  6. therapists and gifts

    Just ask. Therapists tend to have pretty idiosyncratic policies, beyond that gifts of substantial value are always a no. Some therapists have a no gifts policy and some will accept nominal value gifts. Almost all accept cards. Most professional organizations for therapists stipulate nominal value only but there are definitely some therapists with a no gift policy.
  7. I'm not sure that it's the law (I believe some states do have laws requiring periodic UDS for controlled substances but not sure about Michigan specifically) - but it may be part of that doctor's practice. Some doctors don't feel comfortable prescribing substances with significant street value/abuse potential without hard proof that the person is actually taking them themselves and not diverting them. That said, even a UDS isn't proof that someone is taking the entire prescription consistently themselves - but it is what it is. And it's basically garbage that insurance won't cover it. Kind of sucks, I wouldn't feel good about it myself, but it's not totally out of left field, especially non-psychiatrists, who are sometimes more nervous about those medications.
  8. I honestly think that's amazing - I keep all of the info in a word document, which works well for me, but I love your overlapping timeline.
  9. To be honest, diagnosis in psychiatry is a muddy business, because it's phenomenological, which means that it's based on constellations of symptoms rather than anything objective, like a blood test or scan or something. Now, there's nothing wrong with that, nor does it mean that the diagnosis is invalid. However, in my opinion, MDD is probably not a single illness. It's probably a whole bunch of endophenotypes. So long story short, it doesn't surprise me that anticonvulsants work better than antidepressants for some people.
  10. I don't think it's a red flag in terms of competence or ethics. However I'd have a hard time working within that frame, so I'd probably pass and move on.
  11. So over it! A rant

    That does sound really awful. Worth maybe talking to your doc on a day when you haven’t self harmed to make some kind of preemptive plan in advance for how to handle it in a way you can both live with? I’d be upset too in your shoes.
  12. Heavy opposite action + setting an alarm for a smaller chunk of time like five minutes and telling myself I can stop in five minutes if it’s intolerable.
  13. It’s an interesting paper that will definitely continue to affect clinical practice. There is a move away from opiates. Worth noting that they studied a very specific type of chronic pain, mostly in men, and excluded people with severe mental illness, among other things. So that does change the ability to generalize. Like benzodiazepines, opiates are a tool that can be used or misused. Neither good nor bad inherently. They certainly have a role, but I think part of what this study is looking at is that the role is not as large as previously thought.
  14. My experience is somewhat similar though maybe milder. I’ve exclusively dated and been sexually active with women and I have no desire to ever date men but wouldn’t rule out being purely sexually attracted to one.
  15. That really does suck. Makes total sense to feel disappointed. Appointments can be a source of comfort in hard times.
  16. Shitty situation

    Fuck that sucks.
  17. That sucks. I’m really sorry
  18. I’d expect a call.
  19. DBT skill of the day!

    Nice 3 minutes sounds like a really doable goal. Lots of anxiety provoking transitions for me right now - working ACCEPTS today.
  20. How do you prepare for PDOC appointment

    To see a new one, or my current one? When I see a new one, I bring a list of all of my past medication trials with approximate dates/durations, side effects, whether it worked. I have a lot, and it helps not to have to verbally explain it all. I also bring a list of my allergies, and current medical problems and surgeries, and past psychiatrists and therapists I've seen. It's basic questions that they all ask every single time and it's easier to just hand them a list. With my current doctor, I keep a running document on my computer where I just jot down things I want to mention at the next appointment as they come to mind, and then I read it briefly before I go in.
  21. When I have voices that are related to other parts, there's usually also a sense of something inside, like a presence, or an image, or something. Like a strong sense of "not me" like the words come out of the blue sort of. But I don't know what it would be like to have adult voices. I only have child ones. You could try asking inside and seeing what you find out.
  22. DBT skill of the day!

    Used opposite action to load my dishwasher even though I really didn't want to. Also managed to engage in balanced eating from PLEASE today. Trying for radical acceptance but not quite getting there.
  23. You’re welcome I remember being in that position and having the diagnosis did help me for a long time. I hope this conversation if you have it can lead to something productive and healing for you too.
  24. Self diagnosing isn’t the worst thing in the world. I think that when it becomes trouble is when you get so sure you know what’s going on that you don’t even engage in a discussion with your psych about it or listen to their knowledge/experience at all. But I think it’s totally appropriate to bring it as a question - “I read about this and it really feels like it could apply to me for XYZ reason, what do you think?” Particularly with BPD sometimes people don’t diagnose it or bring it up because of the stigma. So if it feels useful for you it makes total sense to ask.
  25. Yeah it totally depends where you are. Here, physicians are legally required to report anybody who has a medical condition that could interfere with their ability to drive safely, but it's not clearly defined where that line is. So if you were psychotic and due to symptoms couldn't focus on the road, or had delusions about driving that caused you to speed or if you were suicidal with a clear plan/history of causing collisions, you'd probably get reported. But if you had a stable psychotic disorder and your driving wasn't impacted you'd probably be okay.
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