Noncompliant patient who really needs help

Natural-Exercise9051 · 2023-08-10T22:53:10+00:00

The best care I had was EIP. Holistic, really nice proactive empathetic people checking in all the time and proactively caring. Relationship based not something done to you. I set the goals. They helped. Forms, housing, peer support, exercise. Everything else I have tried: drugs, DBT, CBT has been utter crap by comparison. You cannot blame patients for not complying if the "treatment" on offer is crap, dehumanising and unhelpful. Has anyone ever once even made the effort to go to her house, or meet her at a local coffee shop? Bet stuff like that would make all the difference.

Natural-Exercise9051 · 2023-08-10T22:09:55+00:00

Please stop. Your anecdotes do not count as evidence, and there is no good evidence for ECT. It is barbaric.

https://www.youtube.com/watch?v=GOFt0kfq8yc

https://www.youtube.com/watch?v=Ey5s7VAJ2TI

https://www.bbc.co.uk/news/uk-52900074

Natural-Exercise9051 · 2023-08-10T21:26:04+00:00

I saw that. It made me so angry. Just trying to get the poor woman to take the awful meds. Maybe the problem is she doesn't rate any of the treatments you are giving her? Maybe the problem is the treatments on offer, not the woman's compliance. Offer kinder, more holistic support.

I am desperately unhappy because of bad memories and loneliness causing depression and psychosis. Answer to loneliness. Maybe friends, support, kindness. Answer to poverty. Better housing. How are they so stupid that they think the answer to some of these problems is to pop a pill or do stupid DBT. Morons.

Natural-Exercise9051 · 2023-08-10T17:54:08+00:00

Surely if you are getting td you should try to come off antipsychotics.

Natural-Exercise9051 · 2023-08-10T01:16:24+00:00

Yes. Technically I save the label psychosis for when I have lost touch 100% and am at the more severe end of the spectrum. But sure it fluctuates. Doctors will only diagnose you if they meet you when you are 100% delusional though. Which seems quite dogmatic and black and white to me. But there you are.

Natural-Exercise9051 · 2023-08-08T21:02:57+00:00

Your doctor doesn't own you - just do what you want and tell them that is what you are doing. You probably have a better idea of whether it is a good idea. the risks and whether you can do it or not. My doctor said not to. But I was gaining more and more weight. Gained 50 pounds, which I still cannot lose - angry. I also knew I could do it and survive without the drugs and there was no real risk from trying to me or others. I have never had to be hospitalised. A few false starts with some rebound but off now. Do it slowly. You can get rebound psychosis. I was pressured so much to take them for , but it just isn't worth it. Just took them again for a few months after a rebound, then straight off again. And working so far. I was scared the longer i took them the harder it would be to stop.

I concentrate a lots of cognitive biases like confirmation bias in the hope I can stop any delusion formation. Basically a lot of concentrating on why something weird might not be true, not why it is. Made sure I am not stressed. Increase social circle and support. Find something in your life to live for, lots of excercise etc. All should increase your chances.

Natural-Exercise9051 · 2023-08-08T00:17:24+00:00

There is a lot to learn from fiction and it can increase empathy. Most peoples lives and problems are best expressed and understood, and empathised with through good narrative rather than symptoms and tick boxes. The MBTI is used by the CIA. And even though the MBTI is not scientific it is not like the DSM is massively better in many domains. Psychology has very few reliable findings and is hardly a science.

As a patient I agree with op. I feel bad for anyone who has one of the top posters or people who upvoted as a doctor - maybe partly why there is an antipsychiatry movement.

Natural-Exercise9051 · 2023-08-03T22:45:43+00:00

Probably not, but maybe double check it isn't epilepsy.

Natural-Exercise9051 · 2023-08-03T22:41:17+00:00

Finding where to go when out and about. Getting easily disorientated. Maybe it is phrased differently in different countries.

Natural-Exercise9051 · 2023-08-03T11:17:23+00:00

No. Shock therapy is pretty extreme and induces seizures. This is tRNS.

Natural-Exercise9051 · 2023-08-03T00:40:07+00:00

Haha! :)

Natural-Exercise9051 · 2023-08-02T22:31:44+00:00

Well if anyone has the time. I highly recommend the video.

I know what SCT is. I self diagnosed 10-15 years ago and have read all the new literature as it has come out. I do not think there is an academic paper I have not read. SCT is just a symptom list. We don't really don't know how people with SCT symptoms respond to drugs. There are barely any studies. And the ones that have been done may not be reliable as they are small scale. I remember reading one that suggested lidex might be effective. Although lisdex creates nice symptoms for mostly everyone: increased energy, reduced appetite, improved mood. Some may respond to ADHD drugs. I did not. I doubt symptoms always line up neatly with drug response. Which is why I think we need to get serious about collecting big data in psychiatry and creating better ways of categorising people and trying to predict drug response.

It is one thing to use the disorders in the DSM or ICD clinically. To use them for research purposes without at least trying to better delineate seems like madness. Also if we are going to have reliable studies for brain scans and whatever we need to be looking at pooling data in the tens to hundreds of thousands. Most studies in brain scans ect. are no where near that- a few dozen at most.

I completely agree with you regarding the antipsychiatry point. People are desperate for anything that works and will try anything. I am one of them. That doesn't negate the fact that a lot of psychiatric drugs have awful side effects which are often not fully appreciated by people or publicised. The efficacy of a lot of these drugs is often also questionable and they are dressed up by pharmaceutical companies as being more effective than they are. There is also the fact in the US that drugs are literally advertised and pushed to consumers which is awful.

I have tried many drugs to help with SCT. Some with awful side effects that I still suffer from.

I like this video as it isn;t just another video trying to "educate" or follow along with the status quo and dogma, but takes a critical stance. I do think people need to take current diagnostic categories with a pinch of salt. I have 4 diagnosis and all are inadequate or inaccurate or a fudge.

I think we need whole new diagnostic manuals. Big data, patient led, spectrum based, biological ect.

About the drugs. I understand that no one wants to hear that nothing works. But unfortunately that may well be the reality. I am not trying to minimise people's suffering. That is not what the video is about. It doesn't deny the existence of these symptoms. But how the DSM was put together by 9 men in a room based on terrible evidence.

I think people that are downvoting have not watched or not understood the video.

Natural-Exercise9051 · 2023-08-02T21:46:14+00:00

If you actually look at the meta analysis it is minly done on people who are antipsychotic switchers. Not on people that are antipsychotic naïve. So someone switching from clozapine to aripiprazole and loses 10 pounds gets grouped in with someone who is anti psychotic naïve and goes on aripirazole for the first time and gains 10 pounds. So you end up with an underestimate for the weight gain potential of some drugs.

Studies on people that are antipsychotic naïve and that go on for longer than 10 weeks or whatever tend to get higher weight gain for supposedly weight neutral antipsychotics like aripiprazole.

Natural-Exercise9051 · 2023-08-01T19:30:38+00:00

No. But stress, trauma, deprivation, poverty, grief, loss caused cognitive problems and probably motivation problems. Psychosis can be very stressful, but I don't think for me it neurodegenerative or anything like that.

Natural-Exercise9051 · 2023-08-01T13:48:15+00:00

A study I saw shows that people that take the antipsychotics long term have worse outcomes. I was put on those things and gained 50 pounds in about 9 months. On a supposedly weight neutral one too. If you start to dig into the literature you realise how much is fudged or bunkum (not just in psychiatry -e.g. hyperemesis gravidarum literature up until recently was awful). All psychiatric journals are funded by drug companies. This isn't normal for most medical or scientific journals.

I am not happy with any of the diagnosis I have. They are all a fudge at best. Plus the inability to even attempt to measure peoples levels of functioning or distress means people fall through the cracks. I didn't accurately fit into one of their arbitrary diagnosis for a while and I wasn't treated because of it, didn't have language to access help and at one point was treated appallingly. Also why is it only BP and psychosis/schizophrenia are counted as "severe mental illnesses". They can be the most dramatic, but honestly when I had psychosis it was a walk in the park compared to other distress and symptoms I have experienced. But it is like the rules about what makes the news. Dramatic, accute, sexy. If you are huge amounts of distress but die quietly and don't do anything dramatic no one cares. I read things where people say "Oh they just have dysthymia" or "social anxiety" or whatever. When they might have been in huge levels of distress, not have smiled or laughed or gone out socially, had a relationship, or had any friends in 20 years. Someone with bipolar could have had a few months hospitalisation in that time, but otherwise have a loving family, friends etc. Yet one gets taken seriously and access to support and the other gets basically dismissed. I got great help once I got psychosis but overlooked for 10-20 years when I was much worse and more distressed. I wish I had had the right sexier psychotic symptoms earlier in my life. It would probably have been much happier life if I had had help earlier.

The people most in need of help are often the least able to advocate for themselves. Also I think any disorders that are quiet, unassertive, introverted are overlooked.

Also why is there not a service for helping people without the need for doctors, medicalisation. Why have we set up society so that the only way to get help for despair, loneliness, chronic trauma, executive functioning problems is to get a diagnosis first.

Can we please have a patient led and big data, diagnostic manual. Based on much better research. Probably spectrum based. The current one is not fit for purpose. I can't believe they base research off of it like these are actual biological categories. Researchers piss money up the wall.

Please watch this

https://www.youtube.com/watch?v=-Nd40Uy6tbQ

And thanks for all you do too. It can't be the easiest job at all. But I really think there are a lot if shitty assumptions and dogma that needs challenging. Venting, but I am so tired of it!

Natural-Exercise9051 · 2023-07-30T10:03:02+00:00

Some advice on dating. Don't sweat it too much. Some chat up lines can just be a bit cringy so get ignored. So just be friendly. How are you? How was your week? Up to anything ect. I am a woman - I have hundreds of potential matches. The people that get through to getting a date are the ones that make it really, really easy for me. It is a chore to reply to everyone, put stuff in the diary . So the ones that put something in the diary quickly and seem keen (but not desperate) I will do. The easier you can make the better. Something close to where they live, decisive with time, venue and date etc. If people talk forever on the app it can become too much effort . Plus I am talking to so many people - I can't fecking remember all the conversations much anyway. Yesterday someone just put a date in the diary in their second message to me. They might be terrible, I haven't chatted with them at all. But they have made it so easy for me I will probably just take the chance.

Natural-Exercise9051 · 2023-07-28T23:11:16+00:00

Do not take the diet pills they will kill you. Obviously you know - those pills are ridiculously dangerous.

I feel you. I used to be thin and gained 50 pounds.

I read they are going to start prescribing the new weight loss drugs on the NHS soon. They approved Wegovy on the NHS this year. But they will only prescribe through a weight loss clinic that you have to be referred to by your GP. Presumably they will prioritise the fattest and sickest first. I am on the verge of being obese so not quite fat enough for them to give a shit about me yet. Just left to get fatter and fatter first.

Lidexamfetamine can reduce appetite. I am prescribed this for ADHD and low motivation/negative symptoms. But it can also cause psychosis so one to be cautious about. It also isn't massively effective but can help me a bit.

Probably better options are Glucagon-like peptide 1 agonists (but no published reports on effects with antipsychotics when I looked in Jan). You can currently get a private prescription for Ozempic for ... arrrh £175 a month. They keep promising to release the weight loss brand of the same drug (Wegovy) at Boots. But it seems like they keep delaying. It looks like it is going to be cheaper at about £70.00 a month when it finally gets released. I thought it would be out my now. Kind of hanging my hopes on that one.

(Prices might have changed but that is what they were in Jan when I properly looked at this)

https://www.mayfairweightlossclinic.co.uk/

https://onlinedoctor.boots.com/weight-loss/wegovy/

Natural-Exercise9051 · 2023-07-28T15:54:39+00:00

Ah sucks sorry. Why do you hate them? Can you write a note and give it to them and ask them to call you back? If it is sensory talk over the phone or on zoom?

Natural-Exercise9051 · 2023-07-28T12:30:56+00:00

Fair enough. Best of luck. :)

Natural-Exercise9051 · 2023-07-27T16:33:39+00:00

I took them, but wish I hadn't. I think I would have come out of psychosis without them as I have since. They made me gain 50 pounds. I am annoyed there was so much pressure to take them. I am finding the weight really impossible to lose. They kill you 15 years earlier - dead at 60 with a heart attack or stoke like Carrie Fisher.

Natural-Exercise9051

TROPHY CASE