Mental Health Support Thread (NOT for giving medical advice, or debating)

Okay, now for the story which is sure to make you shrug off any career fuckup you've ever committed.

My aunt works for an insurance company, and her role is essentially to partner calling customers with in-network doctors for whatever ails them. She had a man call in a few weeks ago from the middle east. There was a huge language barrier, but throughout the conversation, she gathered that he was recently married and trying to find a doctor in his network to perform a vasectomy for him. It was clear enough as he explained (as best he could) what he was looking for, and they seemed to be on the same page. So she sets up an appointment for him at a urologist clinic, and explains to the doctor that he needs a vasectomy. The man then goes to his appointment, and he and the doctor have a very lengthy discussion where, again, the language barrier is an issue. But again, they seem to be in agreement and the doctor's plans seem to line up with what the patient is after, and the doctor goes ahead with the vasectomy.

The next week, my aunt gets a call from a very upset woman who says that her fiancé called the week prior, looking for a doctor in his network to perform a circumcision, as they were planning to be wed and as she is Jewish and he just converted. This needed to be in place before the wedding. The woman absolutely wants children and she's seeing red, screaming and yelling at my aunt who set up an appointment to get a vasectomy, rather than a circumcision.

So, @Tenderiser, no matter how badly your day went, at least you didn't sterilize someone.

 

Like you, I daily struggle with anxiety, and then I get bouts of severe depression that lasts for a couple of weeks. As it's continued to happen, I've noticed that it seems to be cyclical. Also, I've noticed a pattern with Wednesdays, which is strange. But I swear, every Wednesday I put myself through a ridiculous amount of shame and guilt to the point that I can't sleep. But the Wednesday thing is unimportant. My point is, have you noticed that it's cyclical at all? It helps me just to know that it will pass as my hormones begin to regulate. Also, birth control has helped me, but I can't take it because of contraindications with breast cancer history in my family, but perhaps getting on the right form of BC would help you, if it is cyclical like mine?

 

Unfortunately it's not cyclical like yours - it just comes and goes if my thoughts get a little too crazy. : /

 

If it's cyclical you might have bipolar disorder.

 

Yeah, I've looked into that a lot, actually. I've never been evaluated or anything, but I don't think I have BPD (at least right now I don't, since my anxiety isn't acting up). It seems to be more related to hormonal changes. But who knows? I've been trying to get in with a psychiatrist for forever, but I don't have insurance, and it's unbelievably expensive.

 

Lithium was outdated 20 years ago. We have much better meds now, with less than a 50% chance of weight gain, or tardive. And there are a ton of effective mood stabilizers out there for you to choose from.

Cycling is a part of all depression, and is not in any way indicative of bipolar disorder (Which is just BD. BPD is Borderline Personality Disorder).

Mania (or more likely hypomania), is indicative of bipolar. If you've had an episode in the last six months where you couldn't sleep for a couple of days, couldn't concentrate, alienated or offended a lot of people, and made a bunch of really shitty decisions, that would be something to look out for.

If you're serious about it, I'll help you find some mental health outreach.

 

Actually I have a family member who takes lithium. It's a good choice for severe Bipolar disorder. Also cycling between depression and mania is a feature of bipolar disorder. Which is what I was referring too.

 

I knew BPD wasn't quite right when I wrote it. Thanks!

I always have a hard time concentrating and while I think I have a constant tendency to make relatively shitty decisions, I'm not sure if that's true or if it's my anxiety talking. Lol. Honestly, the only thing that's ever really resonated with me about BP is the energy I sometimes get where I'm cleaning everything in sight, taking on restoration projects, etc. and then a couple weeks later have a total crash where I can't even imagine doing a dish.

I am very serious about it, actually. My recent run-in with the police has me having full on panic attacks every time I see a cop car, to the point where I have to pull over to try and calm down. Aside from that, I have been told by counselors that it's likely I have PTSD from trauma from years ago, and my anxiety and has become completely out of control. Sometimes I wonder if I'm ADHD, or if those behaviors, too, are a part of my anxiety. I've only ever been unofficially diagnosed with generalized anxiety disorder and panic disorders by my general practitioner, and subscribed medication through her. I'm at the point, though, where I feel like that's not enough and I want to see a specialist and have an actual evaluation so I can stop feeling completely overwhelmed and exhausted by normal, everyday life all the time.

 

I feel really bad for your family member. They should find a better psychiatrist. It's not a good choice for any bipolar disorder being treated this century.

Lithium started out as a treatment for bipolar disorder for the simple fact that bipolar patients don't have as much lithium in their blood as do neuro-typicals. In the same way that people figure if the oil light is on in your car, you should put more oil in it, this solves the physical problem without a real understanding of what's actually wrong.

And lithium has a ton of side effects! A 75% incidence of is insane for a drug still being prescribed. 50% incidence of weight gain isn't healthy in any population. Most modern psychiatrist use mood stabilizers now, like lamictal, which has a 5% incidence of weight gain, and that minor. I have yet to meet anyone who switched away from lithium and regretted it.

And Babs mentioned that her depression comes in cycles, not that she cycles with mania. You could use the same argument to justify telling her that she's schizophrenic, because neither you nor she mentioned hallucinations, but hallucinations usually come in cycles.

I didn't mention the crash on purpose. That's a pretty serious indicator. A couple of weeks is a bit long to be elevated but not unheard of. When you talk to your doctor, talk a lot about the elevated episode, but even more about the crash. How long they are, what it takes to get out of them, what you do when you've crashed and most importantly if they are getting worse.

Okay, I'm gonna look into outreach programs in Dallas later tonight and see what I can find. Here's the process:
You need to see a psychologist. One who specializes in diagnosis would be optimal, but probably not possible. He's the one who is actually going to diagnose what may or may not be wrong with your brain. That's gonna take at least three months, and if he's good, he'll want to run a couple of tests, and maybe interview some of your family.
Depending on what he says, you then find a psychiatrist, and they do all the drugging.

Without insurance here are the options to consider: Community outreach programs usually have a state funded mental health component. They'll work on a scale, sometimes for free. Teaching hospitals can usually see you for cheap. And there are always crisis centers.

I'll look at all of those in Dallas, and try to see which ones look good. As a general rule you want to look out for anyone using "innovative" or "new" techniques; and stay the fuck away from any program that specifically mentions Jesus or meets in a church.

 

Oh, shit! @No-Name Slob, you aren't taking any anti-depressants, are you? Even herbal shit like st. Johns wart. If you are bipolar, anti-depresants will send your mood through the roof, and your anxiety will get much worse.

 

@Jack Asher -- thank you. I've been trying to find alternatives to healthcare coverage, but since Texas didn't expand medicaid with Obamacare, my income level falls within this terrible gap where I don't qualify for any breaks, but don't make enough money to afford regular Obamacare or private insurance. "Middle class" problems.

 

I was prescribed Wellbutrin last year and took it for about 10 days. My depression leveled out, but my anxiety was so bad that I'd find myself occasionally covering my ears because, and this is the only way I can explain it, my thoughts were too loud. Like, I wasn't hearing voices, per say, but my thoughts would race so fast I couldn't focus on anything else and just wanted to sit in a corner and cry. I didn't stop taking it until I noticed that I felt like I was getting the flu for forever, but never officially got sick, nor did anyone in my family. Finally, I researched it and flu-like symptoms is a side effect of Wellbutrin, so I stopped taking it. I never related the anxiety to the medication, but I haven't had an episode quite like that ever since. I didn't experience any manic symptoms though, unless that qualifies, I suppose ... lol.

 

Yes, extreme anxiety can be a part of a manic episode.

 

Well I learned a lot of tricks since before 2014 when bipolar was considered a pre-existing condition, and I didn't qualify for any health insurance, ever.

 

Ugh, that's such bullshit.

 

Okay, SO

Texas works a little differently than Colorado, no surprise there. Here's some backstory though. The National Institute of Mental Health is a federal agency that distributes funds to the states so that they can care for the mentally ill. By law this has to be as low cost as possible (thought rarely free) and provided regardless of healthcare.

Each state uses these funds in their own (stupid) way. Texas' way appear to be meted out through a program called NorthStar, for which you will have to apply.
Here's an explanation from the Something Something Something Texas Crazy People Help Department
http://www.ntbha.org/northstar.aspx
But I'll quote it here for you:

Because you don't qualify for medicaid you have to apply in person at one a location. I can't find a list of locations, so you have to call this number: One-888-eight hundred-6799. Yeah, it's an 888 and an 800 number.
If you're making 200% of the poverty line for your family size, you're in. I'm almost positive I recall you mentioning two kids, so you'll need to be making under $46,000. I'm pretty sure that if you were making more, you'd be able to afford your insurance. Here's a link to a chart just in case:
http://www.ntbha.org/enrollment.aspx
After you get enrolled you have to find a provider. In Colorado all our mental health services come out of a single building, but it looks like Texas wants their poor crazy people to experience some old fashioned rugged individualism, and find their own free fucking head shrinker.
That phone number up there has the provider information as well, but here is also a .pdf with a list of providers, on pages 20-36.
http://www.valueoptions.com/northstar/members/resources/NorthSTAR_Provider_Directory.pdf
It looks like Metrocare Services might be the best one
https://www.metrocareservices.org/our-services/adult/adult-medical-services/mental-healthcare-clinics
I don't know where in Dallas you live, but the Westmoreland location has a pharmacy, and we'll talk about that below.

This information applies to everyone here, not just the ones from Texas. Pretty much anyone using the NIMH can learn from it.
From there:
You need to see a psychologist. In a perfect world, you see someone with a PhD, but that's not always possible. It's most likely a therapist (master's) or a counselor (bachelor's). You also don't get to choose how much experience they have, and the less time they've spent on a degree the more likely they'll burn out. You might have someone who only has only two to four years or diagnosing under their belt.

So what you tell them is really dependent on how much experience you have. An inexperienced shrink is going to go over whatever bullet-points you hit, and probably come away with something you can deal with. Or they might just tell you you have Alzheimers.

Either way, experienced or non, they're going to neglect any opinions you have about any mental illness.
Usually NIMH workers overworked to hell, and they might make a decision over a single meeting. It would not be uncommon for you to see two or three over the course of a couple of years and get your diagnosis changed every time.

Go in with an open mind about how you feel and what you might have. But if someone tells you something that doesn't feel right, or they make you feel uncomfortable for some reason, don't hesitate to fire their fucking ass. My wife saw a psych-nurse for a year that made her cry after every appointment. She saw her four times, before she noticed the pattern and got a referral for someone that wasn't a cunt the next day.

That's the next thing, seeing a pdoc. Probably a psych-nurse, and probably burnt out too. NIHM loves to just pitch out meds, and because they don't answer to an HMO review board about what they can prescribe, there isn't a lot that they won't just throw a pill at. I've met people who were on two or three psychotropics, and then another four or five to control the side effects. Just like with the diagnosis you have to go with your gut feeling about what is working and what isn't. But here's some things to keep in mind:

1. Stick with your med for at least four weeks. For those four weeks you are going to be all over the place, but you can't tell how a med is affecting you for at least six weeks. But if the pros don't outweigh the cons by week four, they're not gonna get different in two weeks.
2. Every med you take will have side effects. Look them over, but don't make a serious decisions until you've tried one. Pretty much all of the side effects are the same, they just have different incidences. Whatever you do, don't research the side effects on a forum until you are having one of them. Researching side effects will show you a comic-book horror story of people who have been fucked by that med. But most of them are listing side effects that have an incidence of 1%-.01%
   
3. Do not stick with the first med they give you. Try it. See how you feel? If you feel nice you can come back to it. But what if something else makes you feel even better? They'll probably put you on the latest meds, and most of the time they're the most effective. Sometimes they suck balls. But you need some experience with what's out there before you can really understand how you feel.

Oh, and here's the best part about trying a new med: it will fuck with your head.
Not in a "suddenly I see sounds" or "colors are more musical now." No they'll fuck with your sensations. See all of your feelings are inside your brain, and your brain has the wrong chemicals inside of it. When you change the chemicals, two things change.

Hungry and tired don't feel the same any more.

You will have to relearn how you feel when you feel tired, and what your stomach feels like when it's empty. This means for about a week after you change your med you will forget to eat, and won't even be able to keep track of how long you've been awake. I always think it's kind of cool, in a really fucked up kind of way. You'd be surprised what you can accomplish when eating isn't important to you anymore.

One of those things is dying of starvation, so maybe it's not all good.

If you are bipolar, the APA standard is an a-typical anti-psychotic and a mood stabilizer. They usually come out with a new one of each every five years or so. Looking them up beforehand seems useful, but it's really not. The only thing you need to be worried about how strong they are. Abilify is pretty low strength and probably more appropriate for cyclothymia. If you aren't under control at the max dose, something stronger is probably a good idea. Seroquel is much stronger, and usually better for bipolar I. If you're II it'll probably be very sedating for you. So keep that in mind when you're picking one out.

There is no APA recognized treatment for bipolar disorder that does not involve medication, and anyone who tries to tell you differently is actively trying to harm you. You're more likely to kill yourself when you're experiencing intense anxiety, or a serious depressive phase. The longer you're unmedicated the longer those episodes will go on and the more intense they will get. Bipolar disorder kills people. You are literally risking your life every day you don't take your meds.

Sorry if that got a little intense, but there you are.

The meds cost a lot. Without insurance it's really easy to drop $200 dollars a month or more. Unfortunately with what you make it's unlikely that you qualify for any relief programs. This thing can help
http://www.rxassist.org/coupon/generic?type=patients
The discounts are pretty randomly distributed, and may vary from between 5% and 85%. Sometimes that means your $300 med is 35 dollars. Sometimes that means your 500 dollar med is $480 dollars. There really isn't any logic to it. And you won't know which one is what until you take it to a pharmacy and they put it in their computer and tell you. So it' not like you can sit down with your doctor and decide on an antipsychotic together and then check the price. With your financials you'll usually want meds that are at least 10 years old, because their patent has expired and they have a cheaper generic. Sometimes that RxRelief card has a larger discount on the genuine than the generic. Basically, your hosed.

Canadian pharmacies on the other hand, are all over online. I have no experience with any of them, so I can't tell you much, other than that they can turn a $1200 Rx into $30. You have to be careful and choose a reputable one though. There are counterfeiters out there, and you'd be surprised how lucrative counterfeit pills are.

And that's 1,300 words, so I'll take questions now, Babs.

Edited to add: Oh, and if for some reason Northstar declines you, there's still things you can do. Come back here and I'll explain how to work with a crisis center. It's sort of the nuclear option, but it'll work.

 

Now @Nicole-tan, what do you think you can tell me about being bipolar?

 

@No-Name Slob

Considering she's had thee different psychs in the last 7-8 years since shes been diagnosed. I doubt it's just the doctor. Of course who knows maybe it is wrong and all those psychiatrists are sorely mistaken. Or maybe it's because she takes 10 other drugs with severe side effects to keep her stable and the lithium is the least of her problems. I don't know, but I do not that it works.

 

@Jack Asher Correction: I suggested that she try new generation meds and mentioned potentially lower side effects. She said that she tried most of them and they did not work so she went back to lithium. She was an untreated bipolar alcoholic for 15+ years and it damaged her neural pathways. So I guess that makes treatment for her a bit harder or something i dunno.

 

Oh, you should read all that stuff I read up there. I've had 6 different pdocs in the last three years. Not by choice, that's just the breaks when you're surfing the system. And holy hell can three different pdocs be mistaken as total fuck.

Remember all that stuff where I talked about how you have to experiment with meds? And how you shouldn't be taking a bunch of meds to deal with the side effects of all the other meds? I think I implied that lots of different meds to control your side effects from one pyschotropic < one psychotropic that works. If I didn't imply that hard enough, I'll just state it now:
Lots of different meds to control your side effects from one pyschotropic < one psychotropic that works.

But if it does work for her, I'm glad. Finding the right med is a real treasure.

But that's not what I'm talking about. Please don't tell people to take meds you don't understand, about a disease you don't understand, and then defend the statement you made, that you don't understand.

 

Are you saying I can't suggest that a family member investigate a med that might be helpful simply because I don't have bipolar disorder? Because I will always suggest things that might be helpful to my family. As well the fact that I understand bipolar very well. Considering that I've lived her my entire life, and I've read most of her books on living with and treating bipolar disorder. So do not say I do not understand, because I do. It's something I've been around everyday of my life.

 

Yes. I am saying that unless you are a medical professional, or have used the drug yourself, you should not be recommending any psych drugs to anyone, ever.

But hey, I lived with someone who had lost his leg. I guess I know everything about coping with limb loss, because I did that and read a book. I'm probably qualified to tell everyone about how they should deal with that since it happened to someone I knew, and not me.

 

For the first part of that, your logic is objectively incorrect. It is recommended that people investigate medications on their own then discuss them with their doctors. So me providing her with potentially useful information that could lead to her exploring new treatment options is a positive thing.
As for the second, if you live with someone lost their leg then you would know a bit more about the realities of being an amputee. Now if a very close family member were an amputee you would probably know even more. So while I don't know exactly what it's like, I know a lot more than most. It is a fallacy to say that just because I do not have a disease that I can't know what a person is going through.

 

NOPE.

:chill:

This is a Mental Health Support thread. I think the thread you two are looking for is this one:
Mental Health Discussion

Let's use this thread for supporting each other when we're struggling with our mental health and the other one for arguing over what kind of advice is okay and who can give it etc.

 

Sorry mod, I'll be good.