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Suggest Treatment For Severe Depression, Anxiety And Insomnia

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Posted on Fri, 19 Feb 2016
Question: What the hell do I have and how do I fix it or start fixing my life? I'm currently diagnosed with depression, mild ptsd and depersonalization. Oh and insomnia. I question the depression and depersonalization diagnosis and that my ptsd was/is mild. I have been misdiagnosed (labelled misdiagnosed by psychiatrists not myself) with paranoid schizophrenia, schizo-affective, SAD, GAD, panic disorder and an undisclosed eating disorder (I think that's what it was called but I was only diagnosed with it for about a month so I don't think that really counts). I suspect I might have complex ptsd though I'm not really sure, I tick a lot of things on it from required causes and symptoms by I also know I'm not educated on this crap at all so I could very well be misunderstanding what the symptoms are and the full extent of the cause requirements. I thought mentioning it might be helpful as it may give you a brief idea of experienced similarities which maybe not at whole but could help with getting a better idea of wtf this is. Oh also I can't remember what the symptom was called but I do think I'm different from everyone else though I think these difference are caused from learned behaviour or mental instability I only see them as a benefit to me, I like myself because of it (so despite having depression I don't hate myself or have little worth of myself at all or any kind of self esteem issue or personal insecurities) and I kind ( to be honest not kind of) of think I'm better then everyone else because of it despite the fact that I know I'm an arsehole (which I don't give a crap about) but I consider everyone else to be arseholes too (just a different kind of arsehole) and I have no functionality or life (but I know realistically this can't last forever so I will eventually be back on track, doesn't sound depressionic to me), but I don't think I'm narcissistic because I don't enact on this belief and I don't straight away think I'm better then a specific person until I get to know them and I know I'm not better then them at everything but I see maybe 1 or 2 things that I think is better and those things are more superior then the other things. Anyway I had a shit childhood which I never blamed myself for I understood that other peoples actions were them and not me. I have a history of drug/alcohol abuse/addiction and I want to still continue however I don't have the money right now so can't, I'm not trying escape anything I just like being fucked off my face at a constant moderate level. I was in a DV relationship that I used as a tool to punish myself because I accidentally fucked over someone I really cared about and I need to be punished for it so I could forgive myself but then the dv relationship got complicated and it was hard to leave though it luckily only lasted 1 yr. After I finally managed to completely cut the relationship off basically there was stalking, brake in to home, held in home for 3 weeks, physical assault, rape and mild torcher and at the end he tried to kill me and I was left for dead. Obviously still alive, lol, don't know how the fuck though and don't really care or think about it that much. Any way police did nothing just said coz we were in a relationship before all I could do was put a dvo against him. So I was kind of stuck being around him to ensure he didn't try it again if I removed all contact. About a year later I went a bit funny saw a psychologist and she said I had mild ptsd because I don't have nightmares from it but to be fair I don't have dreams period, as child till about 16 I always had nightmares usually to do with running then dreaming stoped all together though over the last year I have been told I occasional fling myself out of bed screaming profanities then either crawl back into bed or walk around doing shit while talking jibberish so idk maybe I do dream I just don't recollect them at all. Then my ex caused a fucked situation with the police which resulted in unjustified and illegal constant harassment, detainment and threats (also had my car illegal taken from me but then it stopped mostly after that) by the local police station for about 1.5yrs (the harassment was pretty much every day and my friends had all witnessed just incase you think I'm crazy on this because one nurse thought I was when I said it) which really fucked me in the head. I got justifiably paranoid by it however my paranoia slowly snowballed and became illogical but still completely centred around this situation and 3 yrs of this I ended up being taken to a mental hospital where I was diagnosed with a psychosis, I was not in reality that much. The psychosis never went away (though amisulphride, I think that what it's called, subdued it) and I was diagnosed with schizophrenia however I didn't have any negative symptoms. 6 months after this I then got "depression". diagnosises and misdiagnosis followed. Then 3 yrs later can't remember what happened but I was called for a reassessment by a different psych and he said I didn't have schizo-affective or schizophrenia because no negative symptoms, wasn't having proper delusions because after being initially told it was in my head I knew it was in my head, like I still had delusions but I knew they weren't real and didn't believe them and it was just something paranoia caused by the previous situation and my hallucinations were just something pseudo echo most likely caused by anxiety from the ptsd. After this it turned my perspective on it from being a psychiatric problem to psychological so I went off my meds and I started basically when I had a delusion I would sit there and think if it was logical and what would required for it to happen and always what was required was impossible and then after this thought the delusion immediately went away and continued this every time I had a delusion and they gradually got less and less and along with it the voices subside to nothing at all. I still get a little (illogically paranoid though I am suspiscious of others and their intents and actions but I've been like that for much longer then the psychosis crap) paranoid everynow and then but it gets nipped in the butt quickly. Right now I have fuck all ptsd symptoms I had before but it's heavily due to the fact that I have realised the effectiveness/importance of avoidance and use it a lot well vastly more then I did before which saves me a lot of grief. Anyway sorry for all the long crap but I thought it could be useful in this. I don't think I have depression but the depression symptoms I supossedly have is what's fucking up my life, I couldn't give a crap about the other stuff in fact I find some of useful and beneficial ( and I understand thinking that way is insane but there is logic to it and I don't care if it is abnormal) and I only really want to just get rid of these symptoms if possible and leave the rest or as many as possible though I also want to get ride of the time distortion whatever the hell that is coz the impacts on my day. The time distortion (not sure if that is what it's called) is weird. It can feel like half the day has gone by and when I check the time it's only been 2hrs and vice versa 2 hours when actually half the day. Overall it feels like time is slipping through my hands like sand yet a day will feel so far away and a few weeks ago feels like yesterday but year/s feel like a life time ago. These last 4 yrs feel like it's been around 15 yrs maybe more and despite this time feels like it's slipping through my hands. On to the depression, I'm not suicidal but I did try killing myself once and it's kind of retarded but I wasn't sad (I don't feel sad, don't even remember the last time I was sad or even happy even when looking all the way back to my teen years and what I can remember of my childhood but I know what they feel like so I have experienced them at some point I just don't remember) I was bored. I don't cope well being bored and had been sick with something so was restricted to bed for about 2-3weeks and I ran out of things to entertain myself with in my head and I got bored and the boredom got worse and worse over a week and then I couldn't taken it any more so I tried to hang myself though it was a snap decision so it wasn't thought out at all and my mum found me relatively quickly (probably from the sound of the coat hangers banging around or something) however I have figured a previous thinking method that I use to use to entertain myself and I perfected it (well nothing's perfect but you get it) so I don't think that'll ever happen again though it's not as effective as before because I think I've used too much and too frequently and so my creativity with it is starting to dry up. my symptoms for depression are emotional numbness (but I've had that ages/years before depression and I don't want to fix it), lack of motivation and low energy. Lack of motivation and low energy I can poke holes in but the results of those symptoms are the same results I'm having. Well I do now have no motivation but it's only started about 4-6 months ago I just couldn't fucked doing anything even if I need to or want to just can't initiate it. Before recentely it was always I wanted or needed to do something and if/when I started not just thinking about it but actually plan to do it that instant though without physically initiating I would get a weird distressing (may be not the best word to use) heavy feeling in my chest (I've had anxiety attacks plenty of times before and I don't think this has anything to do with anxiety) then as I physically went into it it just got worse. It was like walking into a wall and pushing myself harder and harder into until it was physically impossible to push any harder into it. Then once it hit break point all I could do was lay in bed for ages after it with this heavy feeling in my chest. However I could push through this consistant with lots of little things but it was chewing up a piece of string and eventually I would end up in bed for a couple of days after this with the heavy feeling in my chest but now Idon't get it because I don't initiate anything as I legitamitely couldn't be fucked despite wanting to do it or needing to do it. This has absolutely fucked up my life, I don't know what this is and it's been described a depression yet I don't think this is anything emotional and even the lack of motivation was more of a physical thing well that's how see it, until now which I have no motivation but I still heavily have interested like I want be able to play my bass and improve my skills while I have the down time I love my bass and it's fun but I just can't bring myself to pick it up and this goes for a lot of other things like reading, dirt jumping, gaming oh and this not doing much included and includes not being about to cook (which I enjoy and want to do) so I eat out of cans and not showering though I showered yesterday but Idon't think I showered for about 2 weeks before that and going back maybe a couple of years ago I didn't shower for maybe 5-7 months straight so full hairy and black dirt all up my legs and some on my hands/arms. Also Idon't have low engery levels. My energy levels feel the same as they always have even when I haven't slept for 2-3 days straight I still feel awake but my brain is really, really unfocused, my thoughts are slow and messy and behaviours are really slow due to lack of focus and lots of forgetfulness but not tired and not really lacking energy also I'm currently not on drugs so it's not drug influenced haven't been able to afford drugs for about 5 yrs though I still occasionaly do drugs like last year I did dmt once and speed twice and smoked weed a few times like maybe 6 times tops. Oh and I do on the odd to maybe rare (I think I cried like 3 times tops last year) occasion cry but I don't feel sad or anything really and it only happens when I think about something fucked up that has happened or something that I'm worried about like just before I was worried (and still worried) that you'll say that this is all schizophrenia then I will be left with no hope of ever really fixing it and the medication is fucking horrendous I'm more worried about the medication then not being about to get it fix. Though when I cry it's weird. I instantly do a full face scrunch and the heavy cry weezing sound (don't know if that describes it right) and my eyes start to water maybe a tear or two falls at most and then it instantly stops like it never happened and that's it. So basically when I do cry it's like for (just a guess) 20-30 seconds and it goes from instantly drastic to instantly stops face immediately goes back to normal and all watering/tearing stops. I know/acknowledge that I'm nuts but I don't think it's that bad and many people have it a crap load worse then me but at the same I know the fact that because I can sit there and justify and add a crap top of pros to issues and symptoms and don't want to change or remove them ever that that is a whole level of crazy, lol, but I don't really care because there are more benefits to it then cons.Oh forgot to mention I had extensive ECT done for months. I found improvements with ECT more so then with Endep. I could shower everday, I could to the litter tray everyday, could to the washing dishes/laundry, could do pilates for 20mins most days and I could read a book. I still wasn't 100% as wouldn't have been able to work or do part time/ full time study but it was definitely a large improvement from where I was and am now. However it was always short term the effects only lasted about a week. I did initially a few courses of 3x a week then 1x a week then another course of 3x a week then 1 x week and this was about for 6 months maybe a little. Then my whatever paper for it was up so I had to get a new one and there was only a temp psych available not my one at the time or a permanent one and turns out that that was way to many times for someone my age and some crap about aging the brain and causing permanent problems/damage. I was sent to a neuropsychologist and got test on some crap twice 1 time then 6 months later. First time I was pretty much retarded on everything The last one showed that I was variations of average on pretty much everything but I was superior on a 2 things I think it's called perceptual reasoning and the other one wasn't told by the neuropsychologist but was later told something about matrix reasoning not sure if it was separate from perceptual reasoning or a part of it and superior on something else though I'm completely retarded on indecisive memory and my other forms of memory were low average bordering below average.
doctor
Answered by Dr. Alexander H. Sheppe (7 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks very much for your question.

I've read over your comment in detail. I think I now have a good understanding of your history, your symptoms, what has helped and what has not helped.

Can you try to formulate one or two questions out of what you have stated? I'm not sure exactly what are you asking. When I have a specific question, I can be more helpful.

One thing I will say that psychiatry in general is not good when it comes to diagnoses. Sometimes a label doesn't matter. You describe your symptoms, and we try our best to help.

It seems like ECT and maintenance ECT worked well for you. You are young and you don't have serious memory deficits. Why not simply continue ECT?

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Alexander H. Sheppe (56 minutes later)
Sorry that was a follow-up question coz I forgot to add it in with the first question which was "What the hell do I have and how do I fix it or start fixing my life?" which had a good amount of details on my current diagnosis's and why they don't seem to fit and how a majority of treatment for them have done nothing along with the list of misdiagnosis's I've had over the years and brief background history. You see an appropriate diagnosis IS important and not just a label because then there is an appropriate and work able treatment for it. No label = no treatment, wrong label = wrong treatment, no treatment or wrong treatment = not getting better. ECT while was the best that worked didn't help me be able to get back out into the workforce or finish my bachelor which I have a year left on it you see these things like having a job and education are apart of living and not just fucking existing. While I can't really complain about existing because it's better then not existing however it is certainly not anywhere near as good as being able to live which was what I was doing up until idk like 4 yrs agos. I don't really feel ECT is an option considering that my brain's supposedly young for it and add that I would have to do it every week for my entire life not just 6 months when 6 months could have been a problem so I guess if 6 months could have been a problem then decades certainly wouldn't be at all and I guess I could just stick with and not ever fucking live, thanks. Fuck, I really hope you honestly missed the first question and didn't notice anything odd about the reply starting with "Oh forgot to mention"...... You went to university right? You're fucking trolling right? Either you're retarded or I'm fucking retarded for bothering to reply when this is not legitimate probably some fucking money scam BS.
Sorry, Sorry, I was pissed off and that was totally uncalled for but I couldn't fucked re-writing everything. Clearly you had missed the first response/question and only saw the reply question and that would have been completely my fault because I added the extra info after submitting the question. Sorry this is my first time using this and I think I might have used something similar before once plus I'm pretty internet retarded so I didn't figure at the time that adding the reply question would have blocked the view (or whatever the technical thing for it is) for the initial question. Sorry again and I appreciate your time and the fact that I have access to your expertise because I pretty much couldn't stay I the public health system and I can't really afford a psych in the private sector so I actually have seen/talked to a psych in quiet sometime and I'm actually stringing quiet a bit of hope on this. So sorry again and thanks for your time.
doctor
Answered by Dr. Alexander H. Sheppe (2 hours later)
Brief Answer:
Consultation

Detailed Answer:
It seems your question is related to your diagnosis. Let me give you my opinion based on the information available to me.

I believe you have a combination of bipolar disorder and an unspecified personality disorder with narcissistic and borderline elements.

Treatment for bipolar disorder typically involves a mood stabilizer, a neuroleptic, and/or ECT. In my experience, weekly maintenance ECT does not cause long-term cognitive side effects, and I believe this would be effective for you. I highly recommend you continue this.

Treatment for a personality disorder includes psychodynamic psychotherapy, and various behavioral therapies including CBT and DBT. Finding a therapist that matches your personality is very important, so it may take a few tries.

I appreciate your apology. I hope you realize I am only trying to help. Your case is complex. My view is that putting a label on things is not as important as figuring out what is helpful. If ECT is the most helpful thing in your experience, then it should be continued.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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Suggest Treatment For Severe Depression, Anxiety And Insomnia

Brief Answer: Consultation Detailed Answer: Hello, and thanks very much for your question. I've read over your comment in detail. I think I now have a good understanding of your history, your symptoms, what has helped and what has not helped. Can you try to formulate one or two questions out of what you have stated? I'm not sure exactly what are you asking. When I have a specific question, I can be more helpful. One thing I will say that psychiatry in general is not good when it comes to diagnoses. Sometimes a label doesn't matter. You describe your symptoms, and we try our best to help. It seems like ECT and maintenance ECT worked well for you. You are young and you don't have serious memory deficits. Why not simply continue ECT? Dr. Sheppe