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  1. Every school is going to be different in exactly what they offer as far as mental health services and how they structure these. In my experience, disability services are usually separate. In college, I saw a therapist & pdoc at our student health center. My grad school had more limited student health services and I used a community clinic. In school I never identified myself as having a disability or used any sort of accommodations, partly because I did well academically, and partly because I had a lot of internalized stigma around mental illness. I now work at a community college as an academic advisor and specifically work with students who are or have struggled academically, so I often refer students to our disability services and collaborate with these staff. Assuming you are in the US, you should always be able to seek out or choose not to use any disability services at any point during your education. Legally, all they can ever reveal to your professors without additional written consent is that you are eligible for XY&Z accommodations. They cannot tell your professors what medical conditions you have. Our process is that students schedule an appointment with our disability services coordinator, which they can do right when they register, or at any point afterward. They bring in any relevant medical documents and then discuss what accommodations are appropriate to their needs. These are considered "approved accommodations," but then each quarter the student has indicate to this office that they would like to arrange accommodations for their classes. Your professor will only get notified if you have requested accommodations for that class. So, if you are approved for extended test time, you could decide to request it for math, but maybe you feel you don't need it for psychology. In that case, your psychology professor would not even be notified that you have a disability. We do have a question in our enrollment forms as to whether you identify as an individual with a disability, but this is only for statistical purposes (like the way collecting info on race or gender is), and it generates a pop-up window when completing the form online with the contact information for our disability services office. Indicating no there does not impact your ability to later pursue accommodations; likewise, some students may indicate yes there choose never to meet with disability services.
  2. Control the Cravings

    I've been dealing with this recently too. I haven't found a full solution - I'm seeing my doc in a few days so we'll see if I might need something med wise to bring me down a bit. Putting as many steps between you and hooking up helps. I'm a gay man, so its super easy to find quick sex using several different apps. I've tried deleting apps (but have a few times ended up re-downloading them in moments where I lack self-control), since it's my main way of identifying partners, but it might be harder for someone who is straight since most men could be a potential partner - maybe some others can come up with suggestions here. Also, masturbation helps take the edge off. TMI, but doing it before situations where I might be tempted or opportunities to find a partner helps control the "need" to find someone.
  3. Evaluating possible therapists

    Before I even schedule the first appointment, I check about general availability to make sure I'm going to be able to see them consistently. Then I have a couple of specific things I ask about. What's their experience and approach to working with people with mood disorders & potential suicidality? Even if suicidality is a current concern, I have enough experience with it, that I want to know someones ability to handle it if it comes up. What's their experience working with transgender individuals? Even though I'm long past transition, I still want to make sure someone is knowledgeable and sensitive to trans-issues so I don't feel like I have to monitor if/how it comes up. What's their general approach to sessions? I don't do well with purely psycho-dynamic talk therapy. I need someone who is a little more actively involved, and I like some goals and structure, but I also don't want super rigid CBT or such where I I can't have a couple of free-form sessions where I just talk about what's on my mind. Beyond those, I mostly just go with my gut feeling.
  4. CHanging therapists

    You say that half the session is spent on more-or-less checking in how things are going and, "what's next" rather than addressing your goals. Does he actively steer you away from these goals, or just not bring them up on his own? Would it be possible at the start of the session when he askes how you are/how your week has been/whatever opening question he asks to give a brief summary and then explicitly bring up your goals? Like give a one or two-minute summaries of your week and then transition and say something like, "what I'd really like to talk today is [whatever it is you want to talk about]." If he steers you back to other topics then that's bad, but otherwise it might be just his style to let the session evolve naturally, so he might be assuming that if you're not referencing back to prior goals, that it's not what's on your mind on a given day.
  5. If it's a therapist you genuinely like, I would try to have a direct conversation with her. Tell her that you don't feel like you're getting anywhere or getting anything out of therapy other than a sounding board. See what she has to say and see whether you two can come up with some concrete goals. I'd then probably give it a few more sessions to see if you see a change in direction at your appointment or if it's still the same. At that point, it might be worth mentioning to her that you'd like to try someone else with experience in other techniques, such as CBT. If she's truly a good therapist, she should have no problem referring you to someone who might be a better fit for where you are at now.
  6. It can be helpful to think of it as "I cut for the first time in 7 years" rather than "I am cutting again." This can help you view it as a one-time or brief slip, rather than feeling like have gone back to square one. It also makes the action past tense, something you did and are now moving on. Whereas "am cutting" is open-ended and implies an openness to continuing the action.
  7. You can always bring it up first in a very general manner to feel out your pdocs reaction. For example, you could say you were reading an article online about it and were wondering what his thoughts were about current research into using it for anxiety. Then you're asking an intellectual question first rather than saying, "hey I'd like to try this, what do you think?"
  8. Help me sleep

    I know you were experiencing issues with sedation before and made some changes based on that, but is it possible that you overshot and are now on the other end of the spectrum. Since you both added the vraylar and decreased the seroquel, it's difficult to know if the insomnia is only because of the vraylar or because the seroquel, which was originally helping you sleep, was decreased. Would it be possible to increase your seroquel back to closer to your old dose to see if the two can balance each other out? Since they are both AAPs I don't know if this is reasonable, but on the sleep side of things, it would seem to make sense to try adjust the doses of your current & recent meds to find a middle ground between the previous sedation and the current activation.
  9. It seems like your pdoc may be answering a different question or addressing a different problem than what is relevant in your case. When I've discussed medication specifically to address sleep, I've had a couple pdocs who consider getting someone to 6-7 hours of sleep good enough since while it's often not enough for optimal functioning, it's enough to meet general biological needs for a decent duration of time and trying to use medication to increase past this amount often tips to the point where increasing the medications have more side effects (sedation, hangover, etc.) than benefits. So he might be saying that it's "enough" meaning he doesn't think at 6.5 hours it's worth it to increase the doses since that would generally be the response to "not enough" sleep. I've basically gotten to the point after many episodes & several sleep med trials that I have decided it's not worth it for me, personally, to take anything specifically for sleep while depressed. I'd do it if I'm hypo and need the sedation. But personally, for me, being groggy and sedated while depressed feels worse than depressed and tired from lack of sleep.
  10. I've had sleep issues in the past, and I sympathize with the struggle to find something that helps. For me, trazodone did nothing for sleep and increased my suicidal thoughts. I can take Benedryl for allergic reactions and be perfectly wide awake the rest of the day. Vistiril made me tired but didn't help me fall asleep and still left me really groggy in the morning. Ativan helps me sleep only when it is specifically my anxiety that is keeping me and does help me wind-down a bit if I'm hypo, but for random or depression related insomnia it doesn't do much. I always seem to start sleeping better once I get my general mood state under control with non-sleep-specific meds. I know that doesn't help, but I just wanted to say that you're not the only one that doesn't seem to get the intended effects from sleep meds
  11. It seems like your pdoc has been making a lot of pretty rapid changes without really describing to you what his intention with each change is, and without a lot of improvement in your symptoms. What generally do your appointments look like? What sorts of things do you tell him about your symptoms, and how does he respond? When he does make changes, is it usually specifically in response to certain symptoms you describe or is it more like you give an overview of how you're doing and then he says, "do this." It's hard to constantly have to advocate for yourself, but it is important to know what your doctor is trying to treat because you want to make sure it aligns with your most pressing problems at the moment. If the medications don't seem to be lining up, it's important to ask whether they are going to help your anxiety/suicidality thoughts/lack of motivation/whatever is most concerning at the moment.
  12. Driving on the freeway. Gulp

    Would it help to do a practice drive or drives? Maybe drive the route sometime not during rush hour so you are familiar with where your exit is, any lane changes (construction, lanes becoming exit only) and anything like that. That way, you're not trying to figure out when to merge and how to recognize your exit while also worrying about making it to work on time on day one.
  13. How do I find a doc??

    When you do get places that aren't taking new patients or only take Medicare/Medicaid, you can try asking if they have anywhere they recommend. I found a therapist that way one time.
  14. How do I find a doc??

    Do you know what insurance company your insurance will be through once you are eligible? You can usually still go to the website for that company and look through the doctors they contract with in your area. That way, also, once you do get insurance, you'll know that your doctor is in network.
  15. God Do I Need Help

    Have you asked why they aren't increasing your doses of what you're already on before adding a new drug? Does your pdoc tell you, specifically, what symptoms they are hoping to address each time you change or add a new medicine? If not, I would be asking so that you do know what the plan is and to make sure that the symptoms your pdoc is prioritizing treatment-wise match your main concerns. Knowing what a particular med is supposed to be doing will also help you figure out if it's working, especially when you've got multiple moving pieces.