Psychiatric treatment

[spiderowl]

Not sure where to post this. I have a friend who has a psychiatric illness. This has been totally disabling for friend. Friend has been in hospital and a further unit but is still suffering. Treatment in my country appears to revolve around drugs, behaviour therapy and CBT (which is another form of behaviour therapy as far as I can see). There doesn't seem to be any in-depth approach like psychotherapy available here unless you pay privately.

 

I am really frustrated by this whole thing. If these approaches worked, my friend would have come out of hospital better. Instead, the worse symptoms are dampened down by the drugs and my friend is barely functioning. Care in the Community services are struggling to provide any service (and mostly unskilled) and they have long waiting lists. The whole situation is appalling and puts my friend at risk.

 

What I would like to know is if anyone here has examples of psychiatric care which goes beyond CBT and behaviour modification (I view behaviour modification as merely scratching the surface and glossing over the presenting problem). In fact, it is insulting as it tries to get the patient to pretend they haven't got a problem and are better when they don't feel that is the case. It is insulting, patronising, degrading and a form of denial.

 

I feel we need something new - new approaches for odd psychiatric symptoms, such as anxiety, depression, conversion disorder. All these is bad enough are beyond the scope of CBT. I fear these treatments are entrenched in the culture and (basically) because they are cheap compared to counselling or psychotherapy. Does anyone know of countries where they have a better approach? What is that approach? There must be better practice somewhere.

 

Thanks

[amaysngrace]

Do you have socialized medicine in your country?

[spiderowl]

Thank for your reply. Yes we do, but it is very much 'top down', i.e., this is the treatment on offer, take it or leave it.

[amaysngrace]

Thank for your reply. Yes we do, but it is very much 'top down', i.e., this is the treatment on offer, take it or leave it.

 

I'm not really sure I know the difference between CBT and psychotherapy. I thought that cognitive behavior therapy fell in the psychotherapy category to be honest.

 

I'm not sure how great the treatment offered in your country is though. I've heard bad things about the quality of care in countries with socialized medicine.

 

But to be fair, in this country without it, patients are put away while in crisis and jacked up with meds the whole time then are released to be followed up with a doc to prescribe meds and counseling to talk it out and learn new ways to cope.

 

Which to me sounds a lot like what your friend is getting. Not sure about the quality or frequency in which she receives care though, with it being a socialized system and all.

 

In America you can go as often as you want. At least that's true with private insurance. I'm not sure how it is with Obamacare though.

[spiderowl]

Yes, that's pretty much the same approach here, except there seems to be no follow-up counselling. On the one hand, friend is being told that symptoms are psychosomatic. On the other hand, docs have adopted a behavior modification approach. If psychosomatic symptoms are not under the conscious control of a patient, then how is behaviour modification supposed to help? It's useless and illogical!

 

You can tell I'm frustrated and angry about all this

[preraph]

I think CBT is the best approach for depression and to get the root cause of acquired disorders such as anxiety. And then behavior modification is the discipline to change the behavior once you understand where it stems from and why it affects you so much. Medicine is a very valuable tool to combat both anxiety and depression, but I know what you mean about this dragging her down. Just keep in mind these few things:

 

Psychotropic drugs can take even a couple of months to reach a level in the system to be of benefit. Others don't take as long, but they all have to be adjusted per each individual person. That means report all effects to the psychiatrist who prescribes it and let them decide to keep waiting to give it a chance or whether to up the dosage or lower it or change medications altogether.

 

She must have patience. There are hundreds if not thousands of combinations of drugs and one will help her. She can't withdraw and just reject the therapy or meds if she wants to work on getting healthy again.

 

I beg you not to poison her mind by being negative about the therapy or medications she is taking but to support it and encourage it so she feels good about it instead of rejecting it. She must give feedback to the psychiatrist and they will have to keep tweaking her meds.

 

She should never just stop taking any of it or take more or less than she is supposed to, and unfortunately that is what 85 percent of mental patients do and why they fail. Neither you nor she know as much as the doctor. So keep him informed and keep her motivated to keep trying.

[Buddhist]

Okay I'll give you my cents here. By way of background my life was just fine until a seemingly innocuous event caused me to suddenly develop panic disorder co-morbid with my depression which had been running for around 13yrs. I have spent the better part of the last year working through this. Like the UK, standard treatment in Oz is CBT & antidepressants and mood stabilisers.

 

My thoughts on my own situation is this.....

 

- My depression was caused by childhood trauma and not realising I was a victim of narcissistic manipulation from my mother. This background led me to be socially underdeveloped and also seek out partnerships with narcissistic abusers. The whole thing caused my life to go into an emotional death spiral where I became convinced I was simply cursed or being punished for no reason at all. The outcome was I isolated myself from society believing at best that this was karma and at worst that I was crazy or fundamentally defective.

 

- When I developed panic disorder I finally was put on antidepressants and mood stabilisers I also began a weekly therapy based on CBT for the panic disorder. I came off the medication in the last 4 months and am now on dietary supplements consisting of St Johns Wort in a fairly high dose and some nervine tonics ) Schisandra & Skullcap) in combination. I do find that this particular combination of dietary supplements to be as effective as the medication I was taking. And I find the side effects to be far fewer.

 

- CBT is useful for dealing with emotional reactions such as panic. It does teach you to recognise the symptoms of panic and to then accept and manage them so that eventually they become less important and devastating to your day to day existence. Through CBT I did learn how to manage agoraphobia and to be able to function out there in society without falling into states of panic. So from that point of view it does have some utility. Without that I could still be locked into my home, probably would have quit my job and become a dysfunctional recluse on a disability pension. So while I do agree it doesn't fix the underlying issue, it is useful to learning to function despite the underlying issue.

 

- Now in regards to the underlying issues I took a somewhat unconventional route. Rather than psychotherapy I instead started kundalini yoga practice in combination with my existing knowledge of tarot. Yeah I know it sounds extremely woo, but here's my honest experience of it. Kundalini yoga is very intense, this is different to just physical yoga, it is physical yoga in combination with spiritual development. What's happened with me is that my body is now extremely physically fit and strong. I look amazing, but more importantly the underlying emotional issues I was suffering have now become conscious. Before I was unaware of what the real issues are, now I know exactly what they are, where they stem from and through tarot I do garner practical advice on how to heal these issues. I won't say it's been easy, it hasn't. Many times I've thought myself on the brink of a psychotic break from reality. I do have periods of labile emotional states that are difficult to deal with but not life threatening nor harmful if I'm being honest. I just feel overwhelmed by what I feel and know.

 

- In the past year I have learned more about myself and what went on in my childhood and how that affects me today than I think 10yrs worth of psychotherapy would have achieved. I don't tend to heal by talking about things, that kind of thing just tends to frustrate me and build resentment about my past. I do better by coming to personal realisations then processing that in my own time while learning to care for myself properly rather than repeat the cycle of abuse my mother heaped upon me.

 

If your friend is not in a stable state I do NOT recommend this route at all. For me, I was basically stable but chronically depressed. If your friend is being hospitalised and I can only imagine the reason for that is psychotic breaks from reality or perhaps a tendency towards serious self harm, then absolutely professional intervention is required until they achieve independence again. The route I have chosen is for people who haven't gotten that far and are still functioning and able to maintain connections with reality. It's a path of self awareness but requires a lot of emotional strength and commitment to self. It's very demanding and could easily tip someone over the edge. Kundalini is no joke, it's a rapid release and purging of internal issues. If you are not stable in life it can lead to breakdown.

 

Anyway I don't know how helpful this is, but it's my experience.

[amaysngrace]

Yes, that's pretty much the same approach here, except there seems to be no follow-up counselling. On the one hand, friend is being told that symptoms are psychosomatic. On the other hand, docs have adopted a behavior modification approach. If psychosomatic symptoms are not under the conscious control of a patient, then how is behaviour modification supposed to help? It's useless and illogical!

 

You can tell I'm frustrated and angry about all this

 

Anxiety is psychosomatic and so is stress that can cause depression so in addressing these two symptoms through cbt maybe they are hoping for a positive response.

[spiderowl]

Preraph, I appreciate your post and there is some very sound advice in there. My friend has been in treatment for three months now. Her symptoms are the same and she feels lost and despairing. She is barely functioning and can't seem to understand how to eat and do the simplest of things without being told what to do. I do not think this is anywhere near a cure and feel it is well beyond behavioural modification techniques.

 

I would not agree that CBT is the best treatment. Proponents of CBT have offered proof that it works. Well they would, wouldn't they!

 

My friend has co-operated with treatment offered, just none of it has worked. The drugs keep the worst of the panic at bay and that's about it. My friend is taking all the medication she has been advised to take and I certainly would not poison anyone's mind about it. It's all they have offered. I am trying to encourage her and be supportive but friend has become childlike.

 

Here, you get discharged from psychiatric treatment as quickly as possible. She has been discharged. I am seriously concerned for her welfare and feel this is a disaster in the making.

Edited February 21, 2016 by spiderowl

[spiderowl]

Thanks for your input Buddhist, very interesting to hear about the Yoga. I agree my friend would not cope with this at the moment. Although not psychotic, there are very strange disconnects going on so it would not be wise.

 

I am interested that you say that the reasons for your problems have surfaced more since you started the Yoga. This sounds like a kind of psychotherapy in itself in that you are dealing with things previously unconscious. Why do you think they surfaced due to the Yoga? I'm intrigued by that.

[newmoon]

seems like you need to further educate yourself about psychiatric/mental illness in general. your friend will never just be better in a few months b/c if it's a true psyhiatric illness it is lifelong and tends to worsen over time, even when the person is on treatment/meds. and no one will be able to lead her through life from now forward. it will be on her (and her family/support network) to stay on top of her treatments. unless someone gets to the point of being completely institutionalized - which is quite rare - they are left alone to self-medicate, attend therapy sessions and etc. her problems are only just beginning.

[Tayla]

Unsure its realistic to assume that progress no matter how slow in aiding is to be disgarded. A psychiatric illness doesn't heal with a magic therepy. Its a long road to stablization.

Because we can only share our experiences or laymens knowledge I would suggest contacting a hospital or medical college. They would be able to direct you to sources that are versed in this arena.

My former spouse was a phd in this field and he often stressed that its not a quick fix result for the ails of the mind. As fascinating as it is to understand the chemical changes and how it effects the mind... Its a delicate maze of treatments to get the patient on the right track.

 

To the one poster... St johns wart has been taken off the homeopathy regime due to high risk of heart damage.

[Buddhist]

I am interested that you say that the reasons for your problems have surfaced more since you started the Yoga. This sounds like a kind of psychotherapy in itself in that you are dealing with things previously unconscious. Why do you think they surfaced due to the Yoga? I'm intrigued by that.

 

Yoga isn't just a physical exercise but also a mental one by focusing on breath and mindfulness. The result is long buried trauma is eventually released through daily practice and comes back to the conscious mind for processing. I've been doing it daily now for around eight months and to be honest the speed with which subconscious stuff unravels can be unnerving and feel overwhelming. Traditionally kundalini techniques were only taught to initiates under the guidance of a master for exactly this reason.

 

It is also believed that the body holds stress within certain muscles. By flexing and stretching these muscles stress is released. It's quite common to experience emotionality during a yoga pose periodically.

[Buddhist]

To the one poster... St johns wart has been taken off the homeopathy regime due to high risk of heart damage.

 

Meh! I'll take notice when my own country comes up with some warning about it. I don't trust the US medical establishment, I generally find it alarmist, particularly in regards to anything non-pharmaceutical.

[candie13]

hum... exactly three years ago, I've been through the worst experience of my life, failing both emotionally and professionally and ending up with a huge depressive episode that lasted over a year.

 

I have actually tried psychotherapy, OP and... it's long and it does nothing. No, not true, what it did, it made me talk. That's huge, because I was repressing everything. However, the psychiatrist was just... mediocre. Really mediocre. And I was suffering so much, she had increased the frequency of the sessions from one to two per week and it was costing me so much money, that I just ... I've had enough of that. Really.

 

I was still in deep depression but I decided it was just over. I had enough of suffering like a dog. I had found a therapist that was specialized in CBT and I have felt that my interaction with her was better. She was doing EMDR's which are really powerful - making patients relieve an intensely traumatic episode from their past, brining it to the consciousness to heal it. That lasted for about a year, a year and a half.

 

Again, CBT helped a bit better because it made me more aware of my faulty behaviour, but like you say, I was missing the bigger picture, the "why". Why was I so f*cked up.

 

Turns out I am a child of alcoholic parents. It took me another year to get to Al Anon and they are the driving force of my life now. Their spiritual program is helping me tremendously. That and Reiki. But that is when she is in better shape. Now she just needs to learn how to function.

 

-------------------------------

 

If I had three words of advice for your friend, these would be: make a routine she is religious about:

- RUNNING - everyday, 20-30 min.

- St. John's Wort - everyday

- sleeping - 8h - everyday

 

These are MUSTS. I am sorry, depression is crippling but it is not that complicated. Tell her to get a therapist she gets along with just fine. Therapy + running are the best combination ever. I would also suggest mindful meditation - I use an app called Headspace (paid app). Totally worth it.

 

All these details are within her reach. She can't think about it. She just needs to run everyday. She needs to take those pills everyday. She needs to sleep properly. Discipline with regard to this. Make her do these things for one month. Everyday. Her life will completely transform

[Satu]

No method of treating any illness is guaranteed to work.

 

Not every person can be 'cured.'

 

Your friend might just be one of those people who respond to treatment poorly, if they respond at all.

[candie13]

No method of treating any illness is guaranteed to work.

 

Not every person can be 'cured.'

 

Your friend might just be one of those people who respond to treatment poorly, if they respond at all.

I respectfully disagree.

 

One thing is certain: we are all very very different. One approach may work with one person, another approach completely different may work wonders on someone else, when it comes to psychiatry.

 

I think mental diseases scare a lot of people. Are mystified by a lot of specialists and by the media, because no one can take it, dissect it to understand exactly how it works. I think that is the worse news ever.

 

However, it has been proven, over and over again, that the mind is correlated to the body. If you read scientific books, they say that actually, our consciousness is a byproduct of our brain. Today's doctors are guilty of thinking in sections - doctors specialized in bones structure, ignoring the afflictions caused by the intestines (directly pressuring on the spinal bone) etc etc. I think psychiatry does the same with the body, it dissociates itself from the body.

 

Our moods are ridden by our hormones. That is the truth - medically speaking. When you run, your body produces endorphins which are also called the "happiness" hormones. They are the ones fixing the crippling effects of depression - because depression is the manifestation of a chemical imbalance in the brain. It is this chemical imbalance that produces the erratic thinking, which we slowly lose control over and that in the end, gets us blocked. Makes us stop - stop meeting people, stop talking to people, stop all physical exercise. And the more we get paralyzed, the deeper we sink in depression.

 

1. RUNNING. Running is the best thing that keeps us moving, and keeps us outside the house. I am not saying that it's the universal answer to depression, but read all articles about it. It stimulates the brain, it tires the body which means it makes sure that we will sleep better.

 

2. SLEEP. Again, the quality of sleep - and the quantity of sleep we get - is paramount to our recovery. Making sure we SLEEP as best as we can, experimenting with herbs and teas, can only help.

3. CONNECTION. And then, there's talking. Connecting to people. People suffering from depression need to talk so much. They feel isolated, their self esteem is shattered, they are moody and have NO idea that they can alter their mood.

 

I think this is the most horrible & crippling thing, about depression. It steals our capacity to realize that we are in charge. We can amend it. It takes away our empowerment.

 

I've never experimented with drugs, but I do feel my mood has stabilized ever since I have started taking St John's Warts. I admit that it may or may not work on other people. Having sunk deeply into depression, having been unable to even move from the couch for months, having dragged myself to the therapist, I can tell you: you can heal yourself. By viewing yourself as a whole - body and spirit. By being gentle with yourself and securing the quality of your sleep. And by talking to specialits, by connecting to people who genuinely understand what you're going through. By reading yourself about how depression works. By testing out, little by little, different things.

 

It all starts with getting moving, in my humble opinion. The moment you start moving, the body will start working on the brain which will start working on the mind. Running is the best kept secret by psychiatrists, because they can't charge for that.

 

Best of luck

Edited February 21, 2016 by candie13

[Satu]

I respectfully disagree.

 

One thing is certain: we are all very very different. One approach may work with one person, another approach completely different may work wonders on someone else, when it comes to psychiatry.

 

I think mental diseases scare a lot of people. Are mystified by a lot of specialists and by the media, because no one can take it, dissect it to understand exactly how it works. I think that is the worse news ever.

 

However, it has been proven, over and over again, that the mind is correlated to the body. If you read scientific books, they say that actually, our consciousness is a byproduct of our brain. Today's doctors are guilty of thinking in sections - doctors specialized in bones structure, ignoring the afflictions caused by the intestines (directly pressuring on the spinal bone) etc etc. I think psychiatry does the same with the body, it dissociates itself from the body.

 

Our moods are ridden by our hormones. That is the truth - medically speaking. When you run, your body produces endorphins which are also called the "happiness" hormones. They are the ones fixing the crippling effects of depression - because depression is the manifestation of a chemical imbalance in the brain. It is this chemical imbalance that produces the erratic thinking, which we slowly lose control over and that in the end, gets us blocked. Makes us stop - stop meeting people, stop talking to people, stop all physical exercise. And the more we get paralyzed, the deeper we sink in depression.

 

1. RUNNING. Running is the best thing that keeps us moving, and keeps us outside the house. I am not saying that it's the universal answer to depression, but read all articles about it. It stimulates the brain, it tires the body which means it makes sure that we will sleep better.

 

2. SLEEP. Again, the quality of sleep - and the quantity of sleep we get - is paramount to our recovery. Making sure we SLEEP as best as we can, experimenting with herbs and teas, can only help.

3. CONNECTION. And then, there's talking. Connecting to people. People suffering from depression need to talk so much. They feel isolated, their self esteem is shattered, they are moody and have NO idea that they can alter their mood.

 

I think this is the most horrible & crippling thing, about depression. It steals our capacity to realize that we are in charge. We can amend it. It takes away our empowerment.

 

I've never experimented with drugs, but I do feel my mood has stabilized ever since I have started taking St John's Warts. I admit that it may or may not work on other people. Having sunk deeply into depression, having been unable to even move from the couch for months, having dragged myself to the therapist, I can tell you: you can heal yourself. By viewing yourself as a whole - body and spirit. By being gentle with yourself and securing the quality of your sleep. And by talking to specialits, by connecting to people who genuinely understand what you're going through. By reading yourself about how depression works. By testing out, little by little, different things.

 

It all starts with getting moving, in my humble opinion. The moment you start moving, the body will start working on the brain which will start working on the mind. Running is the best kept secret by psychiatrists, because they can't charge for that.

 

Best of luck

 

 

If you were to visit a medium to long stay psychiatric ward, you would see some people who are so profoundly ill that they cannot bring a spoon to their mouth, raise a glass to their lips, go to the toilet, dress themselves, or carry out any normal daily activity. This is the ultimate rock bottom of what we call depression. A catatonic state.

 

Many of these will have had every treatment in the book to no result.

 

Then there are those who are crippled by terrifying hallucinations that seem more real than what you would consider real. They might look at you and see a demon. They are completely unable to distinguish between the real and the unreal. They can't hear what you're saying, because the *voices* are so much louder than you. This a full blown psychosis.

 

Many of those will also have had every treatment in the book.

 

Then there the severe trauma cases, people who have been tortured, who spend every night screaming out in terror, because they think they are back in the torture situation. This is the worst kind of PTSD, which is very rare.

 

Many of those will also have had every treatment in the book.

 

The vast majority of people do recover when given the right treatment, but there exists a small percentage of people who simply do not respond to any kind of treatment, such as:

 

Psychotherapy/counselling

Drug therapy

Occupational therapy

Group therapy

Remedial exercise

Hypnotherapy

Nutritional therapy

Herbal medicine/St John's Wort, et al.

Homoeopathy

 

etc, etc, etc.

 

Most people improve or fully recover, but some don't.

 

These are the facts, and this is the reality.

 

If you know how cure these people, please go ahead and cure them.

 

The world will be very grateful.

Edited February 21, 2016 by Satu

[candie13]

This thread is about DEPRESSION, and so was my post.

 

This it is not about healing the world of mental diseases. It is extremely disempowering to cast allegation as to how this particular disease might be impossible to treat. The despair of people suffering from it is enough to not have to add to it.

 

THIS ONE can be treated. OP's friend CAN get better and I am doing my best in sharing my experience that might help in that direction - and especially in the direction of NOT LOSING HOPE. EMPOWERING people suffering from depression to take positive action to improve the quality of their lives.

 

What's your positive contribution in that direction, exactly - other than pointing out at the misery of the world that cannot be solved? Because I can easily point out that most of people suffering from undiagnosed mental diseases aren't in fancy hospitals, they are in the streets or in society, fending for themselves, isolated, humiliated, abused and utterly alone. So? How's that gonna help OP's friend cope with her depression?

[candie13]

Please read again my last post. I am mentioning depression in every paragraph in which I suggest solutions.

Edited February 21, 2016 by candie13

[spiderowl]

seems like you need to further educate yourself about psychiatric/mental illness in general. your friend will never just be better in a few months b/c if it's a true psyhiatric illness it is lifelong and tends to worsen over time, even when the person is on treatment/meds. and no one will be able to lead her through life from now forward. it will be on her (and her family/support network) to stay on top of her treatments. unless someone gets to the point of being completely institutionalized - which is quite rare - they are left alone to self-medicate, attend therapy sessions and etc. her problems are only just beginning.

 

I actually know quite a lot about it, but I see your point that you don't see any optimistic future. She didn't have this illness before - it just crept up.

[spiderowl]

Yoga isn't just a physical exercise but also a mental one by focusing on breath and mindfulness. The result is long buried trauma is eventually released through daily practice and comes back to the conscious mind for processing. I've been doing it daily now for around eight months and to be honest the speed with which subconscious stuff unravels can be unnerving and feel overwhelming. Traditionally kundalini techniques were only taught to initiates under the guidance of a master for exactly this reason.

 

It is also believed that the body holds stress within certain muscles. By flexing and stretching these muscles stress is released. It's quite common to experience emotionality during a yoga pose periodically.

 

Interesting. Do you think that is particularly the case with Kundalini yoga or does it happen with all? It's just I haven't heard of this being a form of therapy like this.

[spiderowl]

Thank you Candie, I am sorry you've had such a difficult time. EMDR seems really interesting. I doubt CBT therapists here use it, but who knows?

 

I'm afraid she is not likely to be running as she finds herself barely able to walk.

[spiderowl]

Just to mention that this illness is not just depression. There is more to it with bizarre symptoms. I cannot spell them out for obvious reasons. Even severe depression would not explain the symptoms.

[Satu]

 

I'm afraid she is not likely to be running as *she finds herself barely able to walk.

 

When people are that fragile, its important not to place expectations on them, because everything they do for themselves is a little miracle. They need to be validated and acknowledged for what they can do. As unwell as she may be, there are people who have come back from far worse states.

 

Keep talking to the medics.