Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Friday, June 05, 2009
Oh, not really, I'm almost never at a loss for words.
But this is the thing: For three years now I go through my days and when I see or hear something interesting, I think "I'm going to blog about that!" or....I think, "Oh, I wish I could blog about that" but I can't because it would reveal something about a patient.
So I get lots of ideas, but then I get to the computer and sometimes I've forgotten them. Last night, I was with Clink and Roy and we were having an animated (hmmm, is that the right word?) discussion about Richard the Internet Porn Fan (a fictional patient in our book) when one of them said something totally random and I thought "What a great blog post title." What ever it was, it was pretty random, but I wanted to use it, and it was gone. Neither of them remembered what they'd said. Sometimes, I make notes about ideas I've gotten, but ....
And I'm twittering now. Half-heartedly. Roy's been asking me to follow him, so I started. Actually, I'm a total failure. Someone has Un-followed me for being snarky about Twitter. I don't really get it, and being limited to 140 characters is my idea of suffocation. Plus, it's not like a blog were everyone has access to the same info: I twitter about someone's tweet and then realize he doesn't follow me, I just follow him. Or someone else responds to a tweet I never read. And there's really not so much to say in short bursts. But during dinner last night, we had a lengthy discussion on cremation and the interesting disposal of ashes (one friend helped scatter his uncle on the 14th hole where uncle had gotten 3 holes in one!) and I twittered that the temperature used for cremation is 3,500 degrees, per ClinkShrink. Why does she know all these random things.
My brain needs more coffee.
Posted by Dinah on Friday, June 05, 2009
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Hi, 3 shrinks. Not sure if its Dinah or Roy etc. Im not a psychiatrist, but I had a question & was hoping one of you might be able to help.
I'm a 26 years old & have Treatment Resistant Depression(along with what I think is either fairly extensive Social Phobia or Avoidant Personality Disorder) & have been prescribed over 30 different medications over the last 5 years. No SSRI/SNRI/NRIs worked, No TCA's worked(tried at least 6 of each). The only things that have helped a little bit have been Klonopin & an opiate agonist/antagonist called Suboxone.
There is one exception to this, which was Nardil(Phenelzine Sulfate). When I took it, it took away my depression and 80% of my Social Anxiety for 24 hours a day. I eat extremely healthy and exercise frequently, so the diet restrictions were no problem. After awhile I developed Hypomania, which progressed into Mania after they took me off of it and Klonopin simultaneously, with no tapering. The Mania only lasted about as long as the withdrawals did. They tried again shortly and it pooped out.
Now, several years and several dozen high-powered Bi-lateral ECT treatments later(which did nothing except very thorough damage my memory. Nothing really works. As you can imagine, not leaving the house except for the absolute necessity is not a healthy state to be in. Even this, I have to use 2mg of Klonopin to not feel like my body is ripping out of my skin in anxiety.
I asked my Psychiatrist about trying Nardil, since it really my only hope until the Pharma industry comes out with something that works. He said its too risky to try *ever*, because of the risk of psychosis. I told him I would be willing to try a high dosage of something like Seroquel, Zyprexa, Lithium or something to prevent Mania. But he said its too unpredictable. This sticks me in a terrible place, because the one medication that can help me...is(besides opioid narcotics) the one medication he won't prescribe. My former psychiatrist agrees. I'm a difficult case of having Endogenous Atypical Depression, and my former psych basically gave up and has nothing in the playbook. My new one is very good, but refuses the MAOI route, even though he is willing to try things like Ketamine, B6 injections, or Xyrem if necessary. He even acknowledged that I might just have to wait year after year, for the meds industry to come out with something.
I've tried virtually every normal antidepressant there is. What should I do with a client in this situation?? Thankyou, I would really appreciate your advice.
If you're looking for a topic to blog about: I'm reading "The Man with a Shattered World" and it got me thinking. Has anyone ever done a book featuring first-person accounts from people with various diagnoses from the DSM, annotated by the psychiatrists who treated them?
I've read some books that are first-person accounts of depression or psychosis, but they lack the objective analysis. And I've read books of case histories, but that's not the same as reading a description from inside the sufferer's head.
Does such a book exist? It would be a fascinating trip through the variations of the human mind, I'd think.
Dear Anon with Treatment resistant depression-- not knowing you or your psychiatrist, might I suggest a one-time consultation with someone at an academic center who specializes in TRD?
Anon 2: Wow, what a cool idea! Closest thing I know is that Yalom wrote a book with a patient about her therapy: Every day gets a little closer.
What an idea. Bet it would be easier to find the patients then the psychiatrists wanting to write about them....
I tend to go on hiatus when the weather's nice... Gives me time to smell the roses (and crush the caterpillars!)
Don't be hard on yourself - we're here waiting for you
Yeah, I totally don't get Twitter either. They say you have to use it, and they say not to say things like "trying to understand this Twitter thing," but that's the only thing I can think of to say. Thus, post count=0. Actually, tonight it did come in handy: search.twitter.com helped me learn that yes, Facebook was having photo problems and it wasn't just me. I guess it comes in handy for a laugh when my officemate says she's just made a twit (sic).
Also sounded cool for organizing impromptu parties, but I no longer live in a city.
Errr, for those of us who aren't news hounds, social butterflies, or have thoughts that come in nice discrete 140ch packages, I think we may never get it.
There are so many posts that I wish I could write about my students - whether positive, negative, or neutral - but simply cannot because the it would not make sense without back story or defining characteristics about the child.
Also, I loved reading Yalom, but I wondered the same thing about privacy. Even if I was simply approached with the idea, after that I would always be leery that I would end up in the book.
what happens if they only fire you up to 3450F?
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