Jump to content
CrazyBoards.org

Sign in to follow this  
umekoshungi

my pdoc asked me if I need therapy...

Recommended Posts

First off- Hi. I was diagnosed bipolar 1 last month.  I'm changing to yet another med combo, I guess this is normal. My pcd has been treating me for MDD since November. Then felt great for a while I'm told this was euphoric mania... then bought a motorcycle. My PCD referred me to Pdoc where the diagnosis was made of BP1 and GAD. 

 

I had a 2nd appt today with the Pdoc he changed my meds again. I don't know why, but I'll take them. I've been on lamictal for 3 weeks, not at 100mg yet- was on welbutrin, and he switched me to lexapro.

 

I'm fine with all that, but... he asked me if I wanted therapy... I asked him if I needed therapy, he didn't respond. so my question is this... does anyone here rely solely on meds? From my reading it sounds like therapy is a given.

 

Thoughts?

Share this post


Link to post
Share on other sites

I pretty much rely solely on meds, exercise, trying to keep a healthy diet and getting sunlight and human contact. I am completely stable right now and have been for 4ish months, so what I'm doing seems to be working!

 

I needed a therapist while I was in a depressive episode and if/when I go through another depressive episode, I'll probably go to therapy again. 

 

The reason I went to therapy during my depressive episode was cause I thought everyone who is depressed needs therapy. However, my therapist even said I needed to be managed by my doctor. 

 

Benefits of going to therapy while depressed: I had routine human contact. I couldn't isolate myself completely. I had someone to check-in with weekly or more. My thinking was completely distorted by the depression, and in retrospect, having my therapist around to counter the depressive thoughts is what kept me alive. I learned ways to cope with depression, so that maybe the next depressive episode won't feel as bad. I learned a lot about myself. I don't really wanna get into it all here, but I learned a lot about my coping methods and how my family interacts with my illness. I learned A LOT about my illness. I learned the "how" of my depression. Finally, it helped me to stop cutting, which was something I'd only ever do during depressive episodes. 

 

So, even though I need to be primarily medically managed, therapy did benefit me, and I believe it can benefit everyone at the right time.

 

Right now, I don't feel I need therapy. Maybe one day, whether I'm well or not, I'll feel I need therapy again. I probably will return to therapy one day, cause there's some things I want to talk about with someone and I'd only feel safe telling a therapist. 

 

But yeah. I hope that answers your question somewhat. :)

 

Edited to add: Psychosis is a big part of my illness, and I have never found therapy to be helpful for psychosis. It was helpful to have someone to reality-check my delusional thoughts. But, what really helped me was medication.  Some people might find therapy helpful for psychosis but I just personally find it pointless. My therapist actually agreed that there wasn't much she could do for my psychosis, other than help to keep me safe. 

 

That's the main benefit of therapy for me: Someone is there to keep me safe.

Edited by Parapluie

Share this post


Link to post
Share on other sites

I don't have therapy now, just the med appts with pdoc.  I've been in it before and depending on the person it has helped/not helped; it helped talking everything out when I was in therapy, but at the moment I don't have any need to do that.

Share this post


Link to post
Share on other sites

If you have been newly diagnosed it may be helpful to have therapy. You can ask all the questions you havent been able to ask your pdoc. I had so many questions when I was first diagnosed I found therapy helpful. I have been diagnosed now for 25 years but still ocasionally find the need to talk with someone, especially when depressed or having been recently psychotic. I carried guilt around regarding the way I acted and treated my ex husband before I was properly medicated. The therapist helped me see it wasnt me, but the illness and then I could finally forgive myself and move on.

Share this post


Link to post
Share on other sites

I am also BP1.  I have done a lot of therapy.  Currently I am not in therapy but I expect at some point to resume it.

 

I think for someone newly diagnosed it can be very, very helpful.  A BP dx is huge - there is a lot to process.

Share this post


Link to post
Share on other sites

I guess I am now officially BP1. I feel almost like I am lying, but I'm having manias now.

 

I am someone who does best with goal oriented schools of therapy. I did really well in treatment for PTSD. CBT was a little annoying, but also had a clear goal that I could measure myself against. At the end I felt I had accomplished something in both cases.

 

I cannot stand the kind of therapy where you and your tdoc discuss Important Things, and there are supposed to be epiphanies, however small. It makes me uncomfortable to have all that emotional space exposed and available. I'll keep a little more control over what I put on display, thank you. Maybe that was just my experience.

 

I also tried group therapy, but it isn't fair for me to assess it, because the pdoc was a dick who created a horrible environment for the women (plus he stuck me in a wives of gay men group. Huh?). He shamed them by shaming their husbands. I had never liked him, but I really hated him after that experience.

 

So my opinion is try therapy. If one modality doesn't work for you, try a different one. There is almost certainly a type of therapy that would be helpful for you.

 

I took the CBT class because of my GAD diagnosis, by the way. It was not GAD specific because otherwise they couldn't fill out a class. But it really helped. I actually think it helped me a little more than some of the people who were there for the "correct" illness.

 

 

Share this post


Link to post
Share on other sites

I'm not in therapy now but it really helped in the past, particularly with questions about BP, dealing with things I'd done, accepting that I had in fact been nuts, and probably most important, learning to recognize first signs of an episode. This last thing is invaluable and it took going manic with a good therapist who worked with me to identify what the first signs were, to write them down, and then to refer back to them as a yardstick for gauging my mood state over the next year or so that I saw her. Look for a therapist who is well experienced with bipolar in particular and is results oriented. The endless talking with no objectives can lead to endless talking with no meaningful results, IMHO.

 

ETA: Ask your pdoc for referrals. It's generally good to have a psychiatrist and therapist who work together. If the first one doesn't leave a positive impression, move on to the next one.

Edited by AnneMarie

Share this post


Link to post
Share on other sites

I have been in relatively unstructured psychodynamic therapy for 2 1/2 years, at the insistence of others. I had been vehemently opposed to the method, I hated it when I started, and it still sometimes feels invasive (or, alternately, silly).  But I have also been very stable and happy or 2 years (it took a while to recover from my last hospitalization).

 

I needed to be there:

to try to accept and repair the damage I'd inflicted;

to set new standards for my own behavior;

to reflect on the causes of past episodes;

to deal with meds, which I have fought against pretty hard;

to stop missing the intensity, and to find it in real life rather than craziness;

to regain a sense of autonomy, even if my mood does start to change;

and generally not to feel sad or angry or confused or entitled or invincible. 

 

I'd had many years of treatment resistance, and the coping skills I'd developed during that time were ugly, and are mostly gone. I've had cognitive/behavioral improvements as a result, but it isn't CBT, which I've never tried and can't speak to.  If I hadn't been in so much trouble for so long, a shorter and less intrusive therapy might have worked, but I'd gotten really messed up.

 

I'd still love to be too good for this. But the team isn't ready for that yet, and while I am much improved, my judgment and self-control could be better.

 

I agree that therapy has to show results.  Whatever the method, if you're not seeing any progress in a few months (you don't have to be perfect), it's time to move on.  If you don't like or respect the person, move sooner. 

 

By the way, any kind of weekly contact is vital for me, both as a motivator and as a reality check for me and for the doctor.  Before I did this, I saw my prescribing doctor for an hour a week.  He didn't fix me, but I kept showing up, which stopped me from doing some awful things.  He's made mistakes and I've hated him sometimes, but he may well have saved my life and the things I love in it.

 

Well, there's a novel for you.  Sorry to run on.  Hope some of that is useful.

Share this post


Link to post
Share on other sites

Right now I am going to a tdoc who specializes in clinical psychology, so we talk about my brain a lot. Anyway, for a long time I never went to therapy because for the most part I never found it truly helpful, but I've had a few good experiences. I think everyone could benefit from a little therapy for a while.. even non-mentally ill people should go see a therapist, I truly believe. 

Share this post


Link to post
Share on other sites

Thanks so much for all your replies. 

 

Part of me feels that if I needed therapy my pdoc would have just told me I needed it, and I should just man up and deal. Resume my life, and go back to work since i'm not dangerous to anyone.

 

The other part desperately wants to figure all this out before I go back. I mean, bp is a big thing, right? I should pay attention to it and get totally stable before I try to go back to my life. I've made so many giant life choices in the last few months and I even find myself wondering if I made these choices in a moment of clarity or a moment of crazy... I've been second guessing everything. It dawns on me now that I don't know exactly what therapy is for. there are different types of therapy.

 

I'm not in therapy now but it really helped in the past, particularly with questions about BP, dealing with things I'd done, accepting that I had in fact been nuts, and probably most important, learning to recognize first signs of an episode. This last thing is invaluable and it took going manic with a good therapist who worked with me to identify what the first signs were, to write them down, and then to refer back to them as a yardstick for gauging my mood state over the next year or so that I saw her. Look for a therapist who is well experienced with bipolar in particular and is results oriented. The endless talking with no objectives can lead to endless talking with no meaningful results, IMHO.

 

ETA: Ask your pdoc for referrals. It's generally good to have a psychiatrist and therapist who work together. If the first one doesn't leave a positive impression, move on to the next one.

 

What kind of therapist is this? It sounds like what I need. I have sooo many questions. 

Share this post


Link to post
Share on other sites

I have worked with my psychologist forever he does CBT.  He finally referred me to my current psychiatrist two years ago.  I was diagnosed with BP Disorder two years ago.  My appointments with my psychiatrist are anywhere from 30 -50 minutes long, every single time. In crisis, I would be able to get a hold of them.  I have their personal cell number. I also see the same psychologist for 50 minutes at a time.  Currently every other week, on the weeks I don't see my psychiatrist.  I did go a 6 month period that I did not see my psychologist because I was relatively stable.

 

Anyway, IMO, I don't think I could possibly do just meds alone, but that is just me.  I have way too many things to work through that meds alone are not going to miraculously fix.  No meds are going to fix the heartache I felt when my close friend committed suicide, or when my marriage of 18 years ended.

 

Sometimes I read the kind of service that fellow board members receive here by their Doctors.  Some of it  seems substandard and I realize how fortunate I am with my setup.

 

So in my opinion, yes you could benefit from therapy. Everyone could benefit from some kind of therapy I think.

 

All the best!

Share this post


Link to post
Share on other sites

I did want to add that I have phenomenol insurance.  However, it is COBRA and the premiums are quite high.  Some months I worry a lot as to how I will pay for other bills, but dang, I have health insurance!  LOL

Share this post


Link to post
Share on other sites

Thanks so much for all your replies. 

 

Part of me feels that if I needed therapy my pdoc would have just told me I needed it, and I should just man up and deal. Resume my life, and go back to work since i'm not dangerous to anyone.

 

The other part desperately wants to figure all this out before I go back. I mean, bp is a big thing, right? I should pay attention to it and get totally stable before I try to go back to my life. I've made so many giant life choices in the last few months and I even find myself wondering if I made these choices in a moment of clarity or a moment of crazy... I've been second guessing everything. It dawns on me now that I don't know exactly what therapy is for. there are different types of therapy.

 

I'm not in therapy now but it really helped in the past, particularly with questions about BP, dealing with things I'd done, accepting that I had in fact been nuts, and probably most important, learning to recognize first signs of an episode. This last thing is invaluable and it took going manic with a good therapist who worked with me to identify what the first signs were, to write them down, and then to refer back to them as a yardstick for gauging my mood state over the next year or so that I saw her. Look for a therapist who is well experienced with bipolar in particular and is results oriented. The endless talking with no objectives can lead to endless talking with no meaningful results, IMHO.

 

ETA: Ask your pdoc for referrals. It's generally good to have a psychiatrist and therapist who work together. If the first one doesn't leave a positive impression, move on to the next one.

 

What kind of therapist is this? It sounds like what I need. I have sooo many questions. 

 

First I want to say that BP and having an MI are new to you. Your pdoc may not want to overwhelm you with yet more treatment. Also, your pdoc may appreciate that some people (maybe you) have a stigma about therapy and again not want to put that on you now, too. These are positive guesses. A few pdocs don't value therapy, and if that's the case, I'd consider it a warning sign. Many, many studies show that a combination of meds and therapy is the most effective treatment. I don't think this has to mean lifetime therapy, but it certainly is useful for gaining understanding of the illness, yourself, and centering when unstable.

 

I totally agree with 2Spirals that almost all non-MI people could benefit from some time with a good therapist!

 

To your question... My therapist was CBT oriented. CBT stands for Cognitive Behavioral Therapy. Actually, she still is my therapist in that she'll see me whenever I feel the need. I'm stable now and don't see one. If I destabilize, I'll see her again. Anyway, she was trained in a variety of therapy approaches and is not a hard core CBT therapist. I never had homework or workbooks or some of the other stuff that comes with a CBT purist. I think the multi-modal training is valuable.

 

The biggest thing, however, was that she worked with a lot of patients with bipolar disorder. She knew what to look for in terms of symptom signs, and for example, did not assume that I was an egocentric person because I was a bit grandiose when I started seeing her. (I was hypo at the time.) Instead we'd talk about whether it was an indication of BP symptoms and she'd let me draw my own conclusions. Equally important, we talked about the grandiosity after I stabilized in terms of what it indicated for me personally. For me, it is a symptom but one that is hard for me to recognize when unstable. Instead, we worked out that I had to look for more obvious sign posts like getting angry at other drivers and thinking my ideas at work were better than everyone else's. ( :) Some of them are but certainly not all of them!)

 

IMO, her approach only comes from understanding bipolar in particular. A lot of therapists mostly deal with marriage counseling type issues, unipolar depression and/or anxiety. They don't necessarily have the skill set to really help someone with BP.

 

Two questions I will always ask and weight greatly when interviewing a new therapist are: How many people with bipolar have you treated? How much experience do you have working with psychiatrists who treat people with bipolar? So, that's my suggestion to you. Ask those two questions and place importance on the answers. 

Share this post


Link to post
Share on other sites

I had therapy for many years when younger mainly for an eating disorder. Later I went through many therapists- none of which seemed effective (the last one was a joke: she seemed as if she was trying to "outdo" me in issues she herself had) for a Lon while after that I didn't have much hope to find someone effective and I felt I was all "talked out" it wasn't fun and it was embarrassing to outline my history and experiences over and over again. Last Monday I finally made the move to another group o therapists and doctors and am looking forward to getting into the system. My BP issues have been escalating and additionally I am not sure of the accuracy of my other diagnosises. I was with previous doctor around 13 years and he is overwhelmingly ineffective- I should have moved on long ago but was fearful of making the move. I had come to the conclusion reluctantly that I can't work with anyone or anywhere, but I am hoping things will change with new docs and therapist

Share this post


Link to post
Share on other sites

i'm finding that solely relying on meds doesn't work. i'm coming out of a~2 month stay from IP and i'm learning that therapy will be an important component for my outpatient treatment. i've been receiving one on one therapy in the hospital which has been integral in my recovery. many are able to do it on meds alone, but i suppose it depends on the person and what their needs are. IMO therapy can't hurt, especially if you find the right therapist.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

  • Similar Content

    • By thebakerbunny
      Hi, all. I feel like a newb oldie: been on here a while, still feel dumb as shit with all the o chem breakdowns and acronyms.
      Anyway- I've been maxed out on effexor xr for years now. I've taken it pretty consistently for...12 years? with a few breaks to try something new. There aren't many details I can remember well (always had a bad memory, now it's basically a vestigial feature), but here's what I've garnered: 
      *SSRIs and i seem to not mix. Not just some side effects, but all the side effects, and no or negative improvement.
      *wellbutrin did nothing for me. Not good, not bad- just nothing. 
      *Effexor was good- great, even- before I tapped out. I've just been staying with it till I can figure something out.
      *currently, I take 225 mg Effexor (and several doctors have told me now that they flat out won't go above that), 150 lamictal, and klonopin and Ambien as needed. (And as I've been mightily depressed lately...I've been "as needing" them a lot more.)
       
      I've been wanting to change for a while now, and I've been studying up to see what might be some better options, but haven't had a tdoc or pdoc in the meantime. I'm meeting new ones shortly and I want to take some suggestions to them. Problem is that I'm allergic to a few things, with varying degrees of severity and type of allergic reactions. Any suggestions of SNRIs, TCAs, or MAOIs that aren't: 
      *sulfa-meds (full body hives. Like...full body- between my toes, in my buttcrack...😬)
      *compazine (difficult breathing, light anaphylaxis.)
      *darvocet, Vicodin (full-blown anaphylaxis.)
       
      I have been given morphine with no reaction (so, what- does this mean that synethics cause issues, but cleaner natural versions don't?), and take imitrex regularly. I'm not smart enough to understand all of the individual components, and too ADD to have the patience to learn which causes what.
      I feel like it's got be something pretty potent, since I've been middling- to severely-depressed pretty constantly (easily 8 out those 12 years), but I also don't need anything that's going to make me lethargic. Apathetic, fine- just please, no serious drowsiness.  
      I defer to you guys and gals and pals for what your thoughts are on what might be most effective, but also won't send me to the ER.
       
    • By Blahblah
      Just bailed on my teletherapy with a new therapist.... I'm trying this online therapy site (due to quarantine) and I really want to quit. Every week I dread the call and feel like it's not helping me. I don't feel upset, I just feel avoidant, bugged, apathetic, like I'm not "in the mood" to talk at all.... Yet I know it's "good for me" and I'm stuck. Feeling guilty...
      The initial therapist I had (6 sessions with) said she is making a "career transition" and is suddenly no longer be available. She was nice & whatever, but really too green,( I was about to switch anyway). They assigned me to another person  and I don't really connect with her profile (haven't talked to her yet) I just feel so much resistance right now....
      Maybe I'm not committed enough at the moment. I don't know what's going on...?
    • By Adolf
      "Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
      Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
    • By Blahblah
      I've seen dozens of therapists for 20+ years, it feels totally counter-productive at this point (at least for chronic depression). I always end up feeling worse (before session and after session)....I've read most of the books they suggest, tried all the CBT, DBT, Mindfulness....Longterm therapy is also a huge financial burden. 
      I'm feeling really done with processing shit, repeating stuff over & over. All the talking and tracking moods makes me much more self-absorbed than I already am. Then nothing really changes!!! Despite my efforts.
      Meds are not helping either, so I feel like a hopeless case. Maybe I just stick to the emotionally numbing meds and just accept that this is my life and I can't change?
      What are your experiences?
    • By CookieN
      Are dizziness and vertigo a warning sign that an episode is starting?
×
×
  • Create New...