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Interesting. I have a negative bias towards psychiatrists myself. Experiences with psychologists weren't that great either until I went into therapy with an ana

Interesting. I have a negative bias towards psychiatrists myself. Experiences with psychologists weren't that great either until I went into therapy with an analytical psychologist. None of this mindfulness stuff, which I practiced myself for years already, but a complete focus on actually figuring things out and understanding why I see things the way I do. I don't think there is a single answer for everyone (not implying that you think so). The psychologist doesn't really stop me from talking about experiences with drugs, but doesn't really see it as something helpful. I currently see my illness as existing of two components; genetic and environmental triggers. Stress and drugs, together with past trauma interact with my genetic disposition towards psychosis/mania. Drinking less coffee, sticking to a routine, no drugs (particularly psychedelics), and sorting through my internal web of views with a psychologist, it looks liek that's the solution for me. Medication is part of it, mainly to provide some stabilization while I sort things out. It doesn't really jive well with how psychiatrists go about things though, in my experience, since they seem to think I have to be on it til the end of time. I would love to have contact with a psychiatrist I trust, so I could make some sense out of the medication part of my healing process.

kayodelycaon 6y ago
> In my experience, since they seem to think I have to be on it til the end of time. Easily explained by survivorship bias. They only see the people who need to be on it for the rest of their lives. There are people who will need to be on medication their entire lives. I'm probably one of them. My psychosis and primary insomnia hasn't been treatable with anything else.
- reify_null 6y ago
  Thanks for that perspective. That could explain it indeed. The psychiatrists I saw were the ones working the ward, not outpatients. So they really do see the worst of it. That being said, I really do admire the work they do, the people there are typically not easy to work with, at least not while they are on the ward. I am lucky in that I'm on a low dose of not too strong medication (valproate acid, 600mg slow release daily). If I go off (I've weaned off it myself before) nothing really extreme seems to happen. Hope you are doing well with your medication.
cmehdy 6y ago
Our stories have more in common than you might think. I've always had a focus on trying to understand things, but I've also encountered people who would throw pragmatism and logic out the window as soon as I'd get real. For me, (recreational) drugs are not the solution at all but they've been a part of my life and they're part of an explanation of things, so any therapist who would dismiss the experience entirely also dismisses the nature of my approach to those experiences, and in doing so they create their own blind spot and less useful to me because they've already established that they're unwilling or incapable of looking at the big picture. The psychiatrist I'm talking about never mentions drugs actively, never sings praises of any of those experiences or even makes any particularly positive comment about them, but he doesn't disparage them and he inquires about what the experiences were ("what pills? what dosage?" etc, usually when relevant - otherwise I'll volunteer what I think is relevant without fear). And he is willing to answer my questions ("what are the advantages/drawbacks when taking a little bit more than the nominal dose for this treatment?"), and is willing to try different approaches that we discuss and reflect on. This builds a trust relationship that does more for treatment than people might think. I don't need to amplify the meds using doses of Abilify and whatnot, I don't need to deal with side-effects that go unadressed, etc. If there are issues, I can talk to someone who isn't prejudiced, who is willing to offer alternatives, willing to discuss the compromises related to those alternatives, and willing to devise a plan that is medically sound to get from A to B. As for the psychiatric help, I'm glad that for you not taking coffee and doing sports is enough. I've mistakenly thought that for years (more vitamin D, "it's S.A.D", no coffee for months, more exercise, etc etc), but I had to hit a wall hard before I encountered the help that I realized I needed my whole life. For people who relate to this thread (with BPD) or people with severe depression and other psychiatric issues, proper psychiatric help is not really an optional thing but much more like the knee surgery required to walk properly or the wheelchair that is required to be autonomous: whether temporary (former) or permanent (latter), it's an essential element that can enable some people to actually live, and live well.
- reify_null 6y ago
  > As for the psychiatric help, I'm glad that for you not taking coffee and doing sports is enough. I've mistakenly thought that for years (more vitamin D, "it's S.A.D", no coffee for months, more exercise, etc etc), but I had to hit a wall hard before I encountered the help that I realized I needed my whole life. This is actually what I'm afraid of. I haven't confirmed it yet, I'm still on my medication now. I might be developing some kidney problems (VPA is hard on kidneys and liver), so who knows. Based on your experience, and what others have mentioned, I might look for a psychiatrist I trust as an out-patient and see what my options are. I'm still not convinced the medication is stopping any psychosis either, but I'd rather not find that out the hard way.

kayodelycaon 6y ago

> In my experience, since they seem to think I have to be on it til the end of time. Easily explained by survivorship bias. They only see the people who need to be on it for the rest of their lives. There are people who will need to be on medication their entire lives. I'm probably one of them. My psychosis and primary insomnia hasn't been treatable with anything else.

reify_null 6y ago
Thanks for that perspective. That could explain it indeed. The psychiatrists I saw were the ones working the ward, not outpatients. So they really do see the worst of it. That being said, I really do admire the work they do, the people there are typically not easy to work with, at least not while they are on the ward. I am lucky in that I'm on a low dose of not too strong medication (valproate acid, 600mg slow release daily). If I go off (I've weaned off it myself before) nothing really extreme seems to happen. Hope you are doing well with your medication.

cmehdy 6y ago

Our stories have more in common than you might think. I've always had a focus on trying to understand things, but I've also encountered people who would throw pragmatism and logic out the window as soon as I'd get real. For me, (recreational) drugs are not the solution at all but they've been a part of my life and they're part of an explanation of things, so any therapist who would dismiss the experience entirely also dismisses the nature of my approach to those experiences, and in doing so they create their own blind spot and less useful to me because they've already established that they're unwilling or incapable of looking at the big picture. The psychiatrist I'm talking about never mentions drugs actively, never sings praises of any of those experiences or even makes any particularly positive comment about them, but he doesn't disparage them and he inquires about what the experiences were ("what pills? what dosage?" etc, usually when relevant - otherwise I'll volunteer what I think is relevant without fear). And he is willing to answer my questions ("what are the advantages/drawbacks when taking a little bit more than the nominal dose for this treatment?"), and is willing to try different approaches that we discuss and reflect on. This builds a trust relationship that does more for treatment than people might think. I don't need to amplify the meds using doses of Abilify and whatnot, I don't need to deal with side-effects that go unadressed, etc. If there are issues, I can talk to someone who isn't prejudiced, who is willing to offer alternatives, willing to discuss the compromises related to those alternatives, and willing to devise a plan that is medically sound to get from A to B. As for the psychiatric help, I'm glad that for you not taking coffee and doing sports is enough. I've mistakenly thought that for years (more vitamin D, "it's S.A.D", no coffee for months, more exercise, etc etc), but I had to hit a wall hard before I encountered the help that I realized I needed my whole life. For people who relate to this thread (with BPD) or people with severe depression and other psychiatric issues, proper psychiatric help is not really an optional thing but much more like the knee surgery required to walk properly or the wheelchair that is required to be autonomous: whether temporary (former) or permanent (latter), it's an essential element that can enable some people to actually live, and live well.

reify_null 6y ago
> As for the psychiatric help, I'm glad that for you not taking coffee and doing sports is enough. I've mistakenly thought that for years (more vitamin D, "it's S.A.D", no coffee for months, more exercise, etc etc), but I had to hit a wall hard before I encountered the help that I realized I needed my whole life. This is actually what I'm afraid of. I haven't confirmed it yet, I'm still on my medication now. I might be developing some kidney problems (VPA is hard on kidneys and liver), so who knows. Based on your experience, and what others have mentioned, I might look for a psychiatrist I trust as an out-patient and see what my options are. I'm still not convinced the medication is stopping any psychosis either, but I'd rather not find that out the hard way.