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Organizing everyday life + getting a pdoc


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Hi!

Not sure I am posting in the right place, please redirect me if I'm not, as my post is not specific to bipolar, at least not entirely. I'm also not sure whether I should split the topic in two different subjects or not, so... please let me know if I'm doing something wrong, it is probably unintended.

 

Summary: I was diagnosed this year with either BP2 or cyclic depression (so, I don't know if it's actually a dx) while I was in Canada, haven't started any meds yet. I wanted to have a second opinion in France (my home country), to make sure that language would not cause any confusion and because a second opinion cannot hurt. But I am quite unsure about how to actually find a pdoc: in Canada I didn't have a choice at all because I had to go through the university referral, but now... So basically, I think I can see a random pdoc in my (small) town. Or one I've heard about online, and therefore I'm sure they know about BP (not as well known in France than in the US or the UK), but they work in clinics, and I do not plan on going inpatient anytime soon... so, I'm not sure I can actually meet them. Any advice? 

Question 1: how on earth are we supposed to find pdocs?

 

Second part: So I am back with my parents for the summer. My father is depressed and my mother does not live in the same house but is my biggest anxiety trigger ^^ And I am basically stuck in an empty home all day, feeling guilty because I am not studying or working. And I basically don't do a thing. I feel lame all day, useless. The only moment I don't feel I am a terrible person/guilty is when I sleep. And I have big trouble going to sleep because I feel anxious/guilty I have been useless. But from the morning I don't find the energy to get out of the bed, to read, to go out and buy food... I just wait trying to avoid feeling, with an increase of bad thoughts during the night (I should not exist, I am hatable, I am hurtful to my friends....) and SI urges. 

 

So... any ideas how I can structure my days to avoid this a little?

The village where I live is mostly empty, so I can't go anywhere without a car. I do have one, but I just never find the energy to take it and go somewhere. + it would require me to decide where to go, and knowing I can ponder for hours on what I want to eat, because I don't actually want anything + it would cost money and I would feel guilty of spending money in order to feel better. I am also currently on a therapy break, not because I wanted to be, but the 7000 km between my tdoc and me does make the appointments a bit complicated.

Question 2: So, do you have any activities/things to do to deal with it?

 

Sorry for the length and thanks to you if you have the courage to read it!

 

 

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Hi,

 

I can offer suggestions that worked for me. Unfortunately, the way I finally found a pdoc I liked was trial and error, starting with #1 the phone book who had a name I liked. He turned out to be not for me, but the good news is that it was try #3 that got it. But, I live in a very small town, and the good pdoc is 45 minutes away. But there's a bus. So, YMMV. You might get the perfect pdoc on try #1, and he's in walking distance, so stay positive. Word of mouth is the other way, but it doesn't sound like you're in a place for that. It wasn't for me.

 

Activities -- when I am depressed, I can't read. At all. Which is too bad because that would be perfect, right? This sounds cheesy, but I have taken a meditation course. There are actually some on YouTube for free. It's almost like sleeping (lol) and if you are like me, it will give you a lift, especially in dealing with SI. I really feel for you, and I'm sorry you feel adrift. If this meditation is not your thing, I really hope you find something that is. Take care. Good luck.

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Things to do to deal with it: Exercise. If a gym or yoga studio is not an option, look into workout DVDs. Meditation/mindfulness exercises are good, too. You can find them online or in DBT and ACT workbooks. Or you can get some John Kabat-Zinn CDs. All will help. 

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I'd check for pdoc's covered by your insurance if an option. Then I'd call and specifically ask if they treat many people with bipolar disorder. Some docs are more focused on it than others. That is useful info. I'd then assess the doc on the doc's assessment of me at the first appt - was she self-assured, knowledgeable, empathic, was there a bond or dislike. You know, gut instinct. If I didn't care for the person, I'd move on to the next on the list. Your pdoc should be someone you can grow to trust.

 

As for activities... It totally sucks to be unmotivated and apathetic. I'm sorry you are there. I find that if I set up a routine and then just do it without thinking about doing it first (!!!!!), I actually do something with my day. My version of routine can be very simple. Breakfast should be some fruit or eggs or cereal or whatever your thing is, say, within an hour of waking. Ding. Time's up. Eat. Do that automatically whether you feel like it or not. Shower and dress. Don't think about it, just do it. Rest after if it is taxing. Then go for a walk. Exercise and getting out in the sun are important for a lot of reasons. Exercise can be as easy as walking a half hour. If you have nothing else to do, once you start, you may find it easy to continue to roam around. Then, voila, it's lunch time. Eat. Relax. Maybe walk again. Run errands, whatever. But have a set point where you have certain activities to do and then automatically do them. My challenge, obviously, is not getting stuck thinking about doing something and talking myself out of it. Many things actually are easy if you do them reflexively.

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Thank you for your suggestions.

 

Goldfish and Bookgirl: would you have any link for the lessons? But I am not sure I will dare to try right now, exercising is good but... frightening! So I will probably start with small steps, if I want to have a chance to actually do it.

 

AnneMarie: thank you a lot, this seems very useful, I usually get "stuck" in stupid choices, like "what should I take for breakfast" for hours (and then it's too late for breakfast, and so I go to the "lunch" step and get stuck until dinner, and end up with one more day spent with slices of bread and without being able to choose my clothes, because... choices!) so sticking to a simple schedule with little choice might be a good idea.

 

Thank you a lot.

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I sometimes use a planner to map out my week. I take it hour by hour if I need to. Then I don't get stuck doing nothing for hours and hours or doing nothing all day or napping all day. It doesn't give me much room to deviate and I don't have to sit there deciding what to do or what not to do. Feeling stuck, you know? I know how hard decision making can be. I'm horrible at it!

 

For example, here is my schedule today:

 

6-6:30 ... wake up

7:00-7:45 ... Walk outside

8-9:30 ... internet time

9:30-10:45 ... shower and get ready and cereal for breakfast

11-1:30 ... knitting or crocheting

2-3 ... Late lunch

3:30-5 ... nap

5-6 ... cleaning

6-9 ... internet/spend time with husband

9 ... bedtime

 

Now I don't always stick to that 100% because obviously if something comes up I have to be flexible, you know? But that is just one example of a day. I don't beat myself up either if I did not do everything on that schedule. But I really find that if I at least *try* to structure my day I feel more accomplished and competent.

 

I hope that helps some.

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Thank you for your suggestions.

 

Goldfish and Bookgirl: would you have any link for the lessons? But I am not sure I will dare to try right now, exercising is good but... frightening! So I will probably start with small steps, if I want to have a chance to actually do it.

Here is a place to start for beginners, some about 30 minutes, some longer:

 

http://www.youtube.com/results?search_query=meditation+for+beginners&oq=medi&gs_l=youtube.3.0.35i39j0l9.3164.5346.0.7561.8.6.2.0.0.0.89.432.6.6.0...0.0...1ac.1.11.youtube.Dn8TIxmBRlo

 

You can do other searches for "meditation" on YouTube and different types will come up.

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Thank you for your answers. 

I will definitely try Goldfish (but... tomorrow. It's always better tomorrow ^^)

Wonderful Cheese: it looks exactly like what I would need, I will try! (I keep slipping into "what to do next" every moment, if I do succeed making the decision "shower", then, I get stuck at "then dress", it is... a big waste of time).

 

Oh, and I have another question, but maybe it would be better in the "Therapy" section, so please, let me know and I'll move it if necessary.

 

So I'm trying to confirm my diagnosis in my home country (since English is not my first language, I'd rather not be misdiagnosed because I used the wrong word at the wrong time... ) But getting a pdoc appointment "just for a diagnosis" is epic.
They ask a letter from my psychiatrist and/or T. So I can a) try to get in touch with the psychiatrist I had seen, but... I have seen her twice, and I have no idea how to reach her (she was temporarily working in the hospital where my insurance allowed me to go... ) or b) to my T. But... she's not a psychiatrist + we had "made a deal" I was allowed to send her one email a month (but not now) to check she was still here, and... I'm afraid it's a break of the deal/then I won't be allowed to have this mail. But since I am only here for 3 months, I can't wait until the end of the month if I want to have a chance to have an appointment... so... what should I do? (being a grown up is difficult!) I know, it's ridiculous.

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Thank you for your answer. I still need to decide what I am going to do. 

 

I can't call her (being very far abroad + afraid of phone calls + no chance I can ever succeed in daring to do so)

 

Most of pdocs are covered by my insurance company (France is awesome from this point of view), but waiting lists are quite long anyway... 

 

And... I wanted to ask my pdoc, but I stupidly sent mixed signals like 'I want to see a pdoc but I am very fine' and forgetting to talk about anything "negative"... It's a new gdoc, and I was shy. I know. Stupid me. So, I'm not sure she can actually help. + she did not seem to know what "bipolar" meant, since she answered "you don't look crazy" ... yeah. Thanks.... 

 

Thank you for your answers!

Edited by inabook
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I was going to suggest gdoc for a referral, since that's how I got mine (I'm in Toronto) - I don't know what France's system is like though, and your gdoc sounds like she wasn't all that helpful. 

 

Where are you going to school in Canada?  I guess not Quebec or the language thing wouldn't be an issue?  You don't have to answer, I'm just trying to think of whether there would be other places where you could tap into the local Francophone community to see if there were doctors, but I suppose university insurance is then an issue. 

 

Though - maybe look into what residency requirements are for provincial health insurance where you go to school for when you are back?  My cousin is going to McGill but has been living in the Netherlands, and I think she had to wait 4-6 months and then was able to apply to be covered by provincial health insurance.  It might open more options to you next year at school for pdoc choices. 

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