Armchair Diagnosis

I normally do not write on the weekends but with this latest saga with Effexor I never know when the urge is going to hit so I better take advantage of it when it does show up. Yep that made a lot of sense. Anyway I have been spending a lot of time over at healthboards recently not actually participating but reading what others have written and I see a trend that is starting to reappear once again which is people trying to diagnose others with some variety of mental illness.

It is damn near impossible to diagnose someone from one post and to be quite honest it is a little bit irresponsible at the same time. Telling someone they may have a specific diagnosis may seem helpful but it also sends the person to doing mass research on the diagnosis and even if the label is wrong by the time they are done going through all of the material they will convince themselves it is a perfect fit. On a good/bad day I basically meet the standard for close to every diagnosis out there from the way the criteria is spelled out.

To get a proper diagnosis done it is essential that you do the following:

(A) Seek out a qualified mental health professional hopefully one that answers to the name doctor.
(B) Provide as much information as possible in order to get a clear diagnosis. The doctor is looking for long standing patterns which will help him/her match up the right diagnosis. There is no such thing as too much information.
(C) Ask questions. If you do not think the diagnosis is correct ask the doctor for a better explanation/clarification remember you are paying him for his service.

The proper diagnosis leads to a proper treatment plan which will hopefully put you back into the game. The wrong diagnosis leads to increase levels of anxiety which is never a good thing on any level. Take care.

June Mental Health Report

I should be sleeping at the moment but I have hesitated taking my pills. Don't tell the doctor but after spending the day lost in the Seroquel fog my brain taking off at full speed is a rather joyous occasion. Anyway I have an appointment early next week so I might as well get this month's report ready. I wrote up last month but never gave it to him as he pissed me off the month before so I decided I was not going to cooperate and shot myself in the foot at the same time ....

Medication -
Morning (roughly 12pm)- 100mg of Seroquel
Afternoon (4pm) - 50mg of Seroquel - this is suppose to be as needed and apparently I need it everyday at 4pm
Supper/Dinner (call it what you want)somewhere between 6pm and 7pm - 100mg of Seroquel
Bedtime (normally I take it around 11:00pm unless something is good on TV) 100mg of Seroquel + 30mg of Temazaepam. It takes roughly an hour and a half to kick in.

Weight -
I think it is lower then it was a month ago but I don't have a working scale but I did have to add a new hole to the belt in the last week or so

Exercise -
Normally three or four times a week for about thirty to forty minutes a session. Have not gone longer then two days without exercising for the month of June so that is a good thing.

Moods -
All over the bloody map. When the depression shows up I am basically getting my ass kicked and there is no nicer way to put it. Seems to be following a weird pattern of about four days of darkness and then one good day of sunshine so I can remember what I am suppose to feel like and then a slide back down for another four days or so. More then a few times this month I longed for the wonderful effects of Effexor or one of his/her/? buddies.

Thought Patterns -
A) Paranoia - For no reason whatsoever I keep getting this feeling that everyone is watching or spying on me which leads to me not leaving the house some days. *On a side note I get it with this blog that there is a huge conspiracy in the works to shut me down or to rip down the blinds so my true identity is known. Irrational thought? You bet it is but a pain in the ass all the same. This is a side note for the doctor to my knowledge does not know this blog exists so this little blurb and anything else related to this site will not be in the written report*
B) Self Destructive - Nothing new here just the same impulses to make a bad situation even worse.
C) The lower I feel the stronger and longer lasting the irrational thoughts are but again no surprise
D) Suicidal thoughts are still present, no better no worse then the last few months

Self Harm -
I am incident free but the temptations and urges are still not decreasing as fast as I hope they would. Dreamed about it a couple of weeks ago and woke up with scratches all over my forearms. The dream was about getting all of the bad out of me so that I would be good or something along those lines

Sleep -
I average over ten hours a night. Tried to get under a better routine so I set the alarm and slept for eight hours or so for two nights in a row which led to a rather unpleasant couple of days. Body responded by sleeping for over twelve hours the few days that followed.

Overall -
To be completely honest it is getting to be difficult to tell one month apart from the next. Nothing seems to change and for the most part June was a carbon copy of May. Have been really trying to focus more on the long term but for whatever the reason it is just not happening as all of my attention seems to be on today and I will deal with tomorrow when it gets here.

Well there is June's rough report and this type of thing my doctor does appreciate as apparently I am not a very good talker and on top of that when the wrong mood or thought strikes all you will get out of me is name, rank and serial number. Take care.

The Making Of A Mental Health Professional

I was thinking of all the common characteristics that make up a good mental health worker in my opinion and came up with the following list:

1. Real Life Experience - No book has ever been written that can truly cover what it is like to be at your absolute bottom, to fight for your own life, to understand the emotional turmoil that shows up when the people who are suppose to love you turn around and stab you in the back. There is good reasons why a high number of drug and alcohol counselors are recovered addicts.

2. The Ability To Empathize - Basically to have a heart. If you are unable to feel what the client is expressing then you have no business being in this field. I am not a book or a diagnosis but a person who would love to be cured but even more important I need you to understand where I am coming from and what I am feeling.

3. The Ability To Think Outside Of The Box - Not everyone with depression or any other disorder is going to respond to the same treatment. This field is not like an office where every time problem A shows up the person uses solution A to fix it. The worker needs to see the situation from every possible angle to come up with the best course of action. The DSM is a book of guidelines regarding a diagnosis not a set of instructions.

4. Nonjudgmental - During on of the first classes I took in college the teacher asked who in the room would not treat sex offenders and child molesters. When a couple of people raised their hands the professor responded "Then you should not be in this field for every single person who has a mental or behavioral problem deserves to be treated and seen as a fellow human being who deserves help". The ability to see the person behind the illness is essential for if all you see is the problem then nothing will be accomplished.

5. Consistent - A major problem with mental illness is it tends to be chaotic with everything in the persons life in a constant state of change. The worker needs to be a rock instead of another piece in the clients life that is unpredictable.

Well I believe that the above criteria are essential to anyone in the mental health field. Any others? Take care.

Scary Article

Four million Canadians with no family doc
StatsCan survey finds

By THE CANADIAN PRESS


TORONTO — A new report from Statistics Canada says an estimated 4.1 million Canadians aged 12 or older are without a family doctor.

The 2007 Canadian Community Health Survey found that among those who have no primary-care physician, about 78 per cent seek medical care elsewhere.

The federal agency says 64 per cent reported going to walk-in or appointment clinics, 12 per cent went to a hospital emergency room, while about 10 per cent went to a community health centre.

The remaining 14 per cent chose to use other types of health-care facilities or services such as hospital out-patient clinics, telephone health lines or doctor’s offices.

The president of the College of Family Physicians of Canada says walk-in clinics, emergency departments and other alternatives are a good safety valve in the system for those unable to access medical care any other way.


But Dr. Ruth Wilson says they are not the best choice for patients who need long-term management of chronic diseases like diabetes and high blood pressure.

Where Canadians without a family doctor went for health care varied across the country. In Ontario and most of the western provinces, the choice was a clinic. In New Brunswick and Nova Scotia, nearly one-quarter of residents sought help in a hospital emergency room.

The use of community health centres by those who did not have a regular medical doctor was significantly higher in Quebec and in Newfoundland and Labrador than in the rest of Canada.

The annual survey takes the pulse of 65,000 Canadians on a wide range of health issues.
(end of article)



Original article

* I wrote about this increasing problem in the last week or so and can be seen here*

A Big Problem

Every time that I hear that the Canadian health system is world class I tend to snicker then begin to wonder how bad it must be around the world if we are considered near the top of the heap. The problem that has been showing its ugly face around this beautiful country in the last decade of so is lack of doctors. Turns out not a whole hell of a lot of people really want to become Dr. Doe anymore and it is really beginning to show.

I decided yesterday that in the middle of my current health fad that the next logical step would be to book an appointment with my family physician to get a complete physical done for it has been at least four years since the last one. I called up the office and relayed my request which the head nurse responded "I think I am booking for November but lets see if we can get you in earlier". Well it turns out earlier was October so the wait is only five months instead of six. After getting off the phone I was thinking that it was a long time to wait for a check up when a reality check showed up and I realized that I should be grateful that I have a family doctor at all for many people in this community have been without one for a long time. The woman did say if a problem showed up earlier that I could call back and they would figure out a way to get me to see the doctor earlier for the specific problem.

If you are left without a family physician the only two choices left are walk in clinics and the hospital waiting room. Now there are a number of walk in clinics available around the city that are open during specific times but you are going to see a doctor who is not familiar with your history plus chances are the wait is going to be a few hours at least. The next step if you are in crisis that needs more immediate care would be the emergency room at the city hospital and hopefully you are not too sick for the wait tends to average over eight plus hours. There are specific criteria that will move you to the front of the line such as not breathing, your heart trying to stop beating plus a few other similar options.

eThe city that I live in recently built its own medical school with the hope that the doctors in training will get attached to this area and actually stay here after graduation but this school is brand new so it is going to be awhile before this assumption can be proven.

Different areas of the country are now offering to pay for the training to become a doctor if the person agrees and signs a contract that will ensure they will stay in the specific area upon graduation which has shown some success. A friend of mine in another part of the country recently told me that a hospital located in a population of around fifty thousand did not have an emergency room doctor for the longest time so people in severe crisis were transferred by helicopter to one of the major city hospital an hour away which is just down right scary let alone the actual cost of the flight.

Basically every part of the health system in Canada comes with a waiting list and the wait can be pretty long. Back in the early nineties I waited four months to get an MRI done to reveal the damage in my lower back and now the wait would have been closer to six to nine months. Unless the problem is considered life threatening you are going to wait for some time.

Another problem that has really showed up is the lack of beds in nursing homes for the elderly. Many hospital beds that should be used for people in immediate crisis are being used by a section of the population that really does not need that level of care but there is no where else to put them. Seems like every time I turn around another nursing home or long term care facility is being built but it is still not fast enough to keep up with the population in need for one of these beds so it is not unheard of that people are sent to other towns or cities away from their families in order to get a long term bed.

Now don't get me wrong there is obviously another side to this coin and that would be the financial. I spent a total of three months on two different psych wards, see my mental doctor once a month, can get in to see my family doctor all without worrying about how much it is going to cost. A very good percentage of Canada health care system is covered by the provincial governments and there are a number of programs to help with those areas that are not covered and to be perfectly honest I am not sure how my American friends manage without the safety net of health insurance.

To give you an idea about the doctor shortage in closing a couple of days ago the city newspaper had as its front page feature that this community is going to have five new doctors start up a practice over the course of the next three years or so. Front page news. Take care.

Trust

I have a massive issue when it comes to trust which is a major hurdle that I need to overcome if I ever want a clear shot at recovery. The mere thought of putting my well being into the hands of others sends shivers down my spine. This is something that did not appear when my breakdown occurred but probably started sometime in early childhood and is a main factor in the development of what later became Borderline Personality Disorder.

Right off the bat the first people you are suppose to trust is your parents as they are responsible for damn near everything right off the bat but when certain circumstances happen this is put into jeopardy creating a sort of movement that is going to take a long time to get past. I could never figure out why the people who were suppose to love me and keep me safe would repeatedly put me into situations that caused me harm. My father who could go from fun loving dad to pissed off at the world in a heartbeat created an enviroment that was a long way from being safe for a child. I never knew what mood he was going to be in so it kept my anxiety level sky high and helped mold my BPD false self in order to eliminate as many factors as possible that would set him off. You can not trust someone you fear.

Both of my parents like many around the world worked full time so my primary care giver was someone outside of the home. It was my parents responsibility to make sure that all of the proper steps were taken in order to ensure my safety and well being needless to say this did not happen. I went through a number of different sitters and I would imagine some were wonderful people but the others should have picked a different occupation. Again my view of trust was distorted for how can I trust someone who is suppose to ensure my wellbeing but continues to cause harm on a way to regular basis. Too many days were spent wondering if I was going to get my ass beat at home or at the sitters or both.

Depending on the year teachers were the closest thing I had to a responsible adult in my life but like everything else there were exceptions to the rule. Finally gathered the nerve to tell the teacher about the abuse I was taking outside of school to only be told if I was a better behaved child it would never happen. Basically the same situation repeated a year later and I learned a lesson that I would hang on to for years to come "The only person who I can trust with my wellbeing and safety is me for no one else cares what happens".

Doctors are a difficult group of people to trust as a whole. The first appointment they basically promise the world in terms of recovery then over the next period of time repeatedly fail to come through. I would imagine part of this is my expectations are off base but it seems every time I try to combat these negative thoughts with logic the only thing that comes to mind is examples from the past which are far from positive..

Therapists and I do not have the best relationships. In a therapy setting you need to be completely open in order for the best possible result but I have found out the hard way that there is something known as too much information. After my first psych stay I was set up with a therapist who has a wonderful reputation of helping those with historical abuse issues. Everything was going well for the first couple of visits until I made a mistake in the third. She asked the typical question on any progress or setbacks since the last appointment and I admitted that I hit a rough patch where I turned to self harm. Almost instantaneously this therapist decided that I was not in a stable enough place mentally to go through therapy and that was the last time I ever saw her. She was followed by two more therapists who basically came to the same conclusion after my self harm issues came out into the open. Since then I have tried to contact a dozen more therapists but once I mention that I do have the Borderline Personality Disorder all communication is cut off and this is before any of them actually took the time to meet me in person to judge for themselves how well I may respond to treatment. I have come to the conclusion in order for me to obtain treatment in a therapeutic setting in this community I am going to have to fail to mention that I am BPD and I have a lengthy self harm history. Not sure how I am going to be able to be open with someone when I believe I need to lie from the onset in order to get proper care.

Nurses. Well if you have read yesterdays post you will have a fair idea of where the relationship stands with that specific group of people. This area tends to be more separated then others as I try to figure out pretty quickly early on which are in it for the money and which are in there to help. My communication with the two groups is totally different and it has to do with trust. Very difficult to trust someone that does not look at you as a person but what is written down in a file and on paper I past the crazy line a long time ago plus that damn word untreatable is probably in capital letters.

I do try to give everyone I meet a chance to show me what kind of person they are in and more then once my original assumption was proven wrong. The problem is when the little warning flags start to appear and with the way my brain works situations from the past are quickly linked which ends up putting up the walls to keep me safe. Like I said earlier this is an area I am going to have to figure out how to get around but I am basically clueless on how to do so. Take care.

Sorting Out The Mess

Just came back from my monthly appointment with the mental doc. As mentioned earlier and rather obvious from the post earlier today it tends to get under my skin. This time he had a medical student with him so I knew right off the bat that he was wearing the good doctor face where he at least had to appear somewhat concerned of my well being. Alright on with the highlights:

- Little discussion about therapy and he actually admitted that some therapists do not feel comfortable treating Borderline clients. I said that every therapist I have encountered or have asked for help in this city of ours meets that criteria. I then said when people entered this field it is to help those in need and not to pick and choose who is worthy of treatment. The doctor again tried to bring up the difficulty of BPD clients which I responded that yes I would take some time to treat but if a therapist is going to determine who they treat by the difficulty of the case they need to find a different line of work. He was not too trilled by this comment and immediately switched the topic.

- The doc asked if I was cutting and I said no then later on he asked if I was burning and I responded with a dirty look and then he asked later on how often I was cutting and he received another dirty look. Normally he never asks so it is a little bit weird him asking repeatedly and especially about different methods but I have a feeling this was more for the students benefits.

- The doc then said that I use to counsel people before and because of this I am basically an expert on Borderline Personality Disorder. Now I have no idea where this is coming from and I can not remember having a child in my care with the BPD diagnosis nor do I remember ever taking it in school. Weird statement that I chose to ignore.

- Then treatment or the lack of it became a topic of conversation. I said they only thing that has happened in the last three years is different experimentation of meds and the first response to every crisis has been to increase the dosage. Therapy or the lack of it was brought back out into the open to which I replied I had three therapists who stopped seeing me once I made the mistake of admitting to a self harm problem which in their eyes made me seem unstable for therapy. I brought up that someone I know who is a patient of his is seeing someone who uses DBT as part of the treatment which he completely played dumb on (or maybe he was not playing). He said a number of people who work in the hospital (his office is in a mental hospital) have taken the training for DBT but he does not know of anyone who actually uses it. Have an odd feeling he thinks I am making up this therapist with DBT training so I need to get the name by the next meeting.

- Suicidal ideation came up like it always does and I like usual admit to constant thoughts about suicide which then is followed by asking if I had any specific plans which I do not. Like always I replied my child is the reason that keeps me on this side of the playing field and then he asked if I decided if it was time to go would I take my child with me. Now he has never asked this before and I quickly denied this as being an even remote possibility but of all the questions asked today this one is going to stick with me for awhile. Everything that I do in terms of recovery is to get to a better place in order to be the best parent possible and this has been my focus since day one. I understand why he did ask but this question caught me completely off guard.

Anyway that was the majority of the appointment and I do apologize for the whirlwind matter in which I tried to express it but at the moment it is difficult to tell which way is up. Oh the doctors amazing treatment suggestion was the same as always I need to get out of the house more and once all of my dental work is finally complete "we" are going to retry Nardil or another MAOI antidepressant. Thanks doc see you in a month. Take care.

Keeping The Monster Quiet

Since I have started this blog one of the main purposes was to hopefully lessen the stigma that surrounds mental illness for the main reason is that it is killing people. Depression and I am talking about Major Depressive Disorder hits with such a force that it literally sends you spinning for a long time to come but it is treatable. The problem is there is so much garbage out there regarding depression that a lot of people are basically ashamed that they are ill so they try to keep the battle a very private one and in some cases this leads to suicide.

I have been fighting depression for the majority of my life and for the most part I keep it a quiet one. Year after year I tried to figure out why I was never happy and why the smallest thing would send me to an awful place. I went to college for Social Work and the two main reasons were (1) To help others (2) To help myself. I thought if I could learn all of the counseling techniques, a strong understanding of mental illness and the "secrets" to getting people over that hump I would be able to fix my own situation. It did not work and if anything it made it worse.

I went back to the old pattern of any difficult emotion instead of dealing with it I just would push it way back into my brain with the dumb belief that it would just disappear which obviously did not work. I was recently married, a father to a very young baby and I spent my work week with teens who were dealing with a high volume of problems both behavioral and emotional yet for a long time I put forward a image that I was in control and stable but I was far from it.

During the six months before my eventual break I was having nightmare after nightmare and it was becoming increasingly difficult to control my emotions. I knew I needed help and made an appointment with my family doctor to get a prescription for an anti depressant which I thought would fix the problem. The days before the appointment I was still trying to convince myself that the problem was small and ignoring all of the signs that I was in a battle that had the ability to destroy me.

My family doctor lives in on the outskirts of the city I live in so I had to drive on a highway to get to his office. On the way there my thoughts went from this is a small problem to if I swerved in front of that eighteen wheeler then my problems would be gone. By the time I reached his office I was a complete wreck. This doctor who has known me for a long time realized that even though I was trying to put across a small problem the situation was much larger. The doctor pulled me off of work, prescribed an anti depressant (Celexa) and referred me to a mental health doctor. It has been three years since this appointment.

*Bonus* Here is the website that is putting out a documentary detailing the battle of the high rate of suicide of doctors (Struggling in Silence)

BPD Series Three

Another older post I brought out of the archives for Borderline Personality awareness month. This post I took a lot of flack for but I believe it does serve a valuable purpose when it comes to BPD.

A Crash Course On Manipulation And Borderline Personality Disorder

Manipulation is used on a regular basis when in comes to Borderline Personality Disorder but how it is done and why often differs from person to person. For some reason I will go through the various ways I have used manipulation to serve my false self image.

Ending A Relationship -
- For reasons that only the BPD person knows someone in their life needs to go away and in some cases stay away. The problem is if you hastily end it then you look like the bad guy and chances are guilt will appear both which are not allowed in my mind. I will basically set a trap, leading the other person into a confrontation that will appear to set off a rage (which I completely control) by the time the confrontation is over the other person is in a complete state of shock and confusion while running out the door. Now my mind justifies this as it was the other persons actions that led to the rage and if this person knew me better then they would have respected my boundaries then the confrontation would not have happened. The part where I arranged the whole thing my mind just conveniently forgets. So if I did nothing wrong then there is no reason for guilt and I am still the good guy. My fragile false self image is still intact.

Doctors/Therapists -
- The goal is to keep myself out of the hospital and to do that I need to make sure my risk factor is in check even when its not. My doctor is very predictable and tends to ask the same series of questions every time so I basically rehearse my answers long before the appointment happens. If I feel that I need a med change then I make sure the answers are there to support it but mainly it is about keeping that risk factor low. The questions that I need to watch are those about suicidal ideation and self harm. Suicidal ideation questions are answered with a "No more then normal" which is a complete truth but I also know I have been answering this question the same way for so long I doubt my doctor knows what normal is. Self harm is a bit trickier especially when your still cutting so I make sure it is down played with answers such as "I have it in control" or with the answer "Not very often" but again I know my doctor has asked once to see the marks in the fifty plus times I have seen him so the odds are one my side. Right now I am nearing the four month anniversary of no marks what so ever so the answer is no and it is actually no. I don't lie I just don't show the whole picture and the way the system is designed it is very easy to get away with it

Nurses and Others -
- When I was in the hospital a number of staff believed I was manipulating the nurses and in a way they were right but I will try to show you the reason behind it. I am someone who remembers damn near everything and I appreciate people who are honest and open with me. People are basically classified in two sections safe and not safe. If a person is safe then that is who I will go to with any problem, that is who I will go to with any question or concern and when I am half a step away from crossing the danger line that is who I will seek out. If a nurse is classified as unsafe I will do whatever is possible to avoid any interaction with them as I don't feel like I can trust them so what they get is a bunch of yes or no answers and if they try to push it then chances are a confrontation will happen that will send a clear message it is better to just let me be. How does the classification work? Good question. I ask the same questions to a lot of people then take their answers that forms the groundwork. If the person gives me some generic answer then chances are they are going to the unsafe category for my brain sees it as them looking at the disorder and not at me. I watch them interact with other patients and I can see whether or not their heart is in it. Everything to me is about safety as in keeping myself safe so the people in my life need to care about my well being or they need to go away and everything comes back to trust. If I can not trust you to give me an honest answer on something small then why would I trust you on something big such as my health and well being. I believe everyone in the world does this and if you don't think so ask yourself out of all of the people in your life why do you always go to a select few when you need help. When I am in a hospital setting I need to figure out very quickly who my rocks are so to speak because chances are I am going to need them when the wrong situation arises. It pays to know who are safe and who are not but unfortunately I do not create the work schedule. Therapists and doctors will say that the way I see someone will differ from the perspective I am in but that is only half right, the way I see someone that day may differ but I always remember who is safe and unsafe at the core level. The people in my life I try to protect with every ounce of energy that I have and make sure that the relationship is strong and healthy in all areas. To reach that level other people have to go through the testing level and the majority do not make it or last long as my personality is either to strong. My mother does not understand how one second a person can be part of my life then the next second they are gone and I have tried to explain the whole safe and unsafe thing to her but she was raised in a manner where it is important to make everyone happy. I have my fathers viewpoint on this one which is there is six billion people on this planet so there is no sense keeping the wrong ones around as there are a lot more to choose from.

A major problem is that a group of people use both self harm and suicidal gestures to gain attention through a form of manipulation which has led others to believe that everyone with Borderline Personality Disorder does this which is not only wrong but dangerous. What happens if what you saw as attention seeking was an actual warning sign of imminent danger? I don't take the chance as if someone tells me they are in danger I pick up the phone and call 911 for my conscious can not handle a missed warning sign. If someone in your life does this call 911 or drag them to the hospital every single time and if it was for attention chances are they will find a new way to get it where the consequences don't involve a police car and a psych ward. take care

That Is Going To Leave A Mark

There has been a number of different studies showing the connection between head injuries and mental illness. The last big case that comes to mind is that of Chris Benoit the WWE wrestler who took the lives of his wife and child before ultimately taking his own. An autopsy on his brain revealed that it resembled that of an eighty year old man with dementia. Sure some are going to say that steroids played a role in this tragic event but I believe the effect of concussion after concussion is the main guilty party here. In case you are wondering I stopped watching wrestling after that tragedy as the body count with that sport entertainment was getting to hard to ignore.

When I decided to write out my life story for my doctor I devoted a section of it to head injuries that I have gone through over the course of life thinking maybe this will answer some of those unanswered questions. By the time the list was done I was surprised I still had the ability to remember my name. Anyway lets look at the list of the main bumps to my head.

1. Three years old ran full force in to the corner of a protruding wall and split open my forehead. Number of stitches and thirty years later the damn scar is still there.

2. Four years old a family friend slammed a metal bar over the top of my head causing a good amount of damage and more stitches.

3. Eleven years old I was pushing up the garage door and I thought it was all the way up. My mother yelled out "Duck" and in my youthful brilliance I looked for the bird and the heavy garage door hit me on the top of the head.

4. Started skateboarding at twelve or so and in the process of learning took many bumps to the head. The worse one was I ollied off a high curb, pulled off a 180 mid air turn then landed cleanly until one of the wheels hit a rock and I fell backwards cracking the back of my head on the road. Was sick for almost a week after that one.

5. Started snowboarding at fourteen and I can tell you ice is about as soft as concrete. Hit a jump that turned into a back flip without enough speed so I landed on the back of my head. At least this is what my buddy told me as I still don't remember what happened.

6. The family was driving back through the states and I was lying down on the back seat of the mini van. Some ninety year old lady decided to do a u-turn in the middle of the highway and struck the side of the van. My sleeping head went up and came down on the corner of the metal cooler that was beside my seat. Freaking dent is still in my forehead. Mom wanted me to go tho the hospital but because we were in the USA I was worried that the bill would be sky high so I said no.

7. The second year after I received my drivers license a group of us were heading to the mall when I hit a patch of black ice and rammed into the back of another car going about eighty kilometers an hour (55 mph I think). My head hit the drivers side window and managed to crack it.

Well those are the major ones and the ones I can remember. About five years ago I went into the emergency room with a severe migraine and the doctor did a CAT scan to see if there was anything wrong and my brain appeared to be very healthy so I guess I have been fortunate considering the number of bumps to the head I have taken. Oh the migraine was due to heat stroke.

Is there a connection between my head injuries and the situation that I am currently in? Well I guess it is a possibility but what the connection is my doctor nor I have figured it out yet. Take care.

A report on Chris Benoit's autopsy

The Difficulty Of Treatment

I wish I had broken every single bone in my body instead of having a mental illness. If I had broken my bones the doctors would have been able to take an xray, ordered surgery or place the broken pieces in a cast and then would have been able to tell me how long it was going to take for me to be whole again. With mental illness there is the probability of being misdiagnosed, a wide assortment of medication may need to be tried until one was found that worked and the doctors do not have a clue how long it will take for me to get back to a better state in life.

Diagnosing - Certain mental disorders are not that easy to diagnose and a large reason is that there are numerous disorders that have similar symptoms and accompanied behavior. Two of my diagnosis are severe Major Depressive Disorder and Borderline Personality Disorder but my doctor is not sure if the depression is a stand alone issue or is it the result of the Borderline condition. The main problem that this causes is if it is a stand alone issue then medication can go along way to helping me overcome the issue but if it is Borderline then medication is not going to make a whole lot of difference as one is a chemical problem and the other is a result of a personality quirk that needs to be unlearned through therapy.

Medication - To get off to the right start with medication the diagnosis needs to be correct or else it is not going to be that effective. The medication game is not an easy one as the right med can bring you to a better place but the wrong one can be dangerous. I was put on the drug Paxil pretty early in and this drug put me into a manic state where the self harm session looked a lot like a suicide attempt which landed me in the hospital for a couple of months. The next step was a combination of Effexor, Wellbutrin, Remeron, Lithium, Zyprexa and Temazapam that did appear to work at some level for about six months or so. I took myself off the Zyprexa due to massive weight gain in a very short amount of time and within the five months that followed I slowly spiraled back out of control until a cutting session looked like another suicide attempt which led to another hospital stay. While in the hospital they took me off Effexor, Wellbutrin, Remeron, Lithium in under a week then all I could take for two weeks was a variety of different anti psychotic meds as my doctor wanted to try Nardil an MAOI antidepressant but I needed my blood to be clean before it was introduced as the drug interactions can be deadly. Through numerous cutting sessions as a inpatient led to finding Seroquel which seems to be the perfect fit as it handles the psychotic end of my illness. I was on Nardil for about four months I guess and the initial dose had to be lowered as it was causing my blood pressure to get out of whack. The realization that I needed to get my teeth fixed led to Nardil being stopped as the drug interactions were too dangerous so this left me on Seroquel and Temazapam. The Seroquel dosage has been raised pretty much every month and I started at 25mg twice a day and now it is 100mg three times a day plus an additional 50mg when I need it. Problem is my depression still has not changed and I still fight suicidal ideations on a daily basis. The doctor wants me to go back to Nardil once my dental work is done (due to the disability program limitations the process is really drawn out) which should be by September. Of course with any mental med there are going to be side effects which is a whole different battle.

Treatment - I have gone through Electro Convulsive Therapy on two separate occasions for a total of seven sessions which did not produce any major changes plus I stopped breathing during the last session so it is no longer an option. I saw a therapist three times a week during my first hospital admission who was very helpful. Outside of the hospital I have had very little luck when three of the therapists stopped treating me once they learned of my self harm tendencies/history for they believed this proved that I was not stable enough to go through therapy (I don't get it either) and since the Borderline Personality diagnosis showed up I am unable to get through the doors of a therapist office let alone set up an appointment. So the majority of psychological treatment I have gone through consists of this blog and the various forums I frequent across the web such as healthboards and crazyboards.

So that is a brief answer to why I had wished I had broken every bone in my body instead of going through the chaos that is mental illness. As far as it goes to recovery time my doctor does not believe it is possible hence the name of this blog. Take care.

Appointment Aftermath

Yesterday was the doctors appointment that I have mentioned for the last few weeks. The intention was to walk through his door and just let him have it. The problem was I had to wait for the appointment, not for long mind you, surrounded by other people in various states of mental distress. By the time I was invited into his office my mindset had switched from confrontational to getting the hell out of that place before my anxiety had a chance to completely take over.

I did hand over the report which he was mildly surprised to see and he actually took the time to read through it. New treatment options were added to keep me more stable through out the day, read more Seroquel, and I did question him about what I was told about the availability of Dialectical behavioral therapy (DBT) which was designed to treat primarily people with Borderline Personality Disorder. What my doctor did with this information was play dumb. At first he said he was not aware of any psychologist in the area that was using DBT in their practice which may be possible if he keeps his head completely buried in the sand at all times. Then he said a number of doctors from the mental hospital had undergone DBT training but for one reason or another it was not being implemented into the program, this area being so ass backwards to be honest this almost made sense. The doctor then said DBT is a useful tool but how effective it actually is still remains to be seen and even though there has been a push for it there is no concrete evidence that really supports it ... I just let it go as I was still staring pretty hard at my escape route.

In the report that I handed over I mentioned my little slip in regards to self harm a few weeks ago and the doctor made an odd comment. I was wearing a short sleeve shirt and he said "It is amazing how fast that you heal" to which I replied that I have a four year old son who I do not want to see the marks so I make sure that they are in places that can not be seen easily. You would think as a doctor and with someone like me whose self harm history can be measured in decades plus the initial admission report from the first psych ward stay that remarks of the wide variety of scars that lace my body in all sorts of areas that this would not be something a doctor would spout out. I wonder if my doctor only takes self harm seriously when it is in an obvious place? A theory is the stupid belief that people only harm for attention and not for the other obvious reasons such as it being an indicator of a major mental illness at play but what do I know.

There is some positive news coming out of this complete waste of time of an appointment which is my scale is wrong and I weigh ten pounds less then I thought I did so that is good. Especially when anti psychotics are notorious for weight gain which puts such ailments like diabetes into play. So far on my almost six month span on this med I have managed to lose close to thirty pounds. Take care.

Preparation For The Appointment

For a long time before every psych appointment I would sit down and write out basically a report of where I was mentally, physically and other areas that I felt the doctor should know about to ensure the best possible outcome. Unfortunately a few months ago I handed my doctor a three page report which he barely glanced at which my Borderline brain did not appreciate and I stopped using this valuable tool. Since I stopped with the reports my appointments have been basically a waste of time as the meetings depend on where I am in my head and I tend to respond from an emotional base and not a logical one so nothing is accomplished. I need to find a way to get the doctor back too fighting for me and not against me so I am hoping the return of the monthly report will go along way to doing that. Here is a section of a typical report:

Weight: 205 lbs. Fluctuates a couple of pounds above or below but remains pretty stable.

Exercise: Inline skating four to five days a week. Approximately thirty minutes per session and average close to three kilometers in distance.

Sleep: Takes a long time to fall asleep. Sleep times vary from as low as six hours a night to almost twelve hours. Nightmares are present numerous times per week.

Self Harm: Thoughts and urges are present most days. One slip that lasted for a few days but then stopped.

Suicidal Ideation: Present most days.

Moods: Tend to go from almost withdrawn to an anger that is very easily set off. Moods tend to cycle through out the day and are very difficult to predict and some days control. The depression is always present and ranges between a seven and nine out of ten for severity. Periods were I am almost too happy and full of energy do happen normally in the hour or so before my next dose of Seroquel is due.

Medication: Seroquel three times a day at 100mg per dose, Temazapam 30mg at bedtime.

Side effects: Vision problems in the evening that seem to appear no matter what I did during the day, ie. eight hours at the computer or none at all the same vision difficulties appear.

Major Events: In the process of getting my place ready to put on the market and trying to figure out where I am going to next. Trying to get into programs that will help with both finding a new place that is affordable on my disability pension and for the actual move. Mother is down for ten days to help get the place ready which has caused some difficulty as I am use to being alone for the majority of the time.

(end of report)

Well there you have it. This tool does go a long way in helping strengthen the doctor patient relationship and it also serves as a benchmark to show any improvements. Normally I would end the report with a couple of topics that I wanted to discuss or available options and this report will do the same once I can figure out which ones are the most important. Take care.

My Quirky Personality

I have an addictive personality and this is something I recognized a long time ago so I am pretty careful around anything that can become habit forming for the most part. A part of this lead to this blog at first it was just a way to release all the pent up garbage I carry with me and the hope someone will understand but pretty soon it grew to an obsession. Checking the traffic sites on an hourly basis and trying to figure out new ways to find new readers but like the majority of my life there was no much reason behind this drive. I don't make money off of this blogs so what difference does it make if I get one visitor per day or a thousand. The simple justification is the more people who read it then maybe it will leave a mark on a number of people which then may lead to the better treatment of the mentally ill but like the majority of my logic there are a number of holes to this theory and the knowledge knowing I have set a goal that can not be measured at least with any accuracy.

Then the obsession with this blog was gone and quickly replaced with a new addiction. Now my days are spent creating what I hope to be a blanket by the end of April. I learned how to crochet when I was working in a jail for young offenders and there is something therapeutic in the process of creating something from nothing plus I am constantly counting the next row so my mind does not have an opportunity to wander which is basically what the doctor ordered.

The problem with my so called addictions is I never know how long they will last for and my residence is full of projects that will never see completion. In a way it is like my life as I have all the best intentions in the world when it comes to recovery but I never see it completely through as something always will happen that will throw me off course and once I lose sight of the final goal then that is it until I can figure out how to restart the process again. Once again I am my biggest enemy or monster. Mind you I am not the only one guilty of this and the amount of money that people throw at self improvement and weight loss programs backs this up.

What To Do

I have been avoiding this blog for the last few days for the most part. Normally I am trying to push the traffic of this site in one way or another but the urge to watch this site grow is not there. See this blog like the majority of my life has its good side but it also comes with a price. This blog enables me to put all of my raw emotions and thoughts down on to paper or at least the modern day version of it but to do so it also means I have to spend time in my brain which is not the healthiest thing to do.

I am mentally ill and no matter on how positive I make it seem it does not change the fact that I am sick. My brain is a vortex of emotions of all varieties, memories that refuse to die and me trying to find a way to bring everything back neatly onto the shelves while catching pieces that are falling to the floor. The goal in my life has never been to achieve some great level of happiness but to have a future that is nice and simple. No more having to screen every thought in my head, no more energy spent fighting demons that I can not see and no more wondering when the next emotional down spiral is going to occur. I just can not figure out how this can be accomplished.

My doctor believes the answer is I some how keep myself completely occupied that I do not have the time to spend in my head which is not the dumbest piece of advice I have ever been given but it is really close. My brain does not turn off and it never has. Even in my sleep my brain is working as all my dreams have a running commentary and analysis. I guess the goal would be to limit the amount of time I do spend wandering around the darkness of my mind but again I am not sure how to do this.

Until I can figure out what my next step is going to be this blog needs to take a step back. The goal is still to update this site on a daily basis but if the post is not already written in my head I am not going to go searching for it. Apparently this blog has reached a fair number of people and I hope it continues to do so but right now the priority is the illness which I need to regain some kind of control over before I end up in a place that I really do not want to be. Take care.

Searching For Positives

A few hours after the initial reaction to the doctors appointment I began to think about what he said. His theory about therapy being useless as the second someone crosses an invisible line then I would completely shut down may have applied a while back but it really does not carry any water now. The best example of this would be when the jack ass always turns to "Your too borderline for treatment to be effective" for that statement challenges every inner boundary that I have but it does not get a reaction from me, well besides me thinking my doctor found his degree in a cracker jack box. See that statement, at least to me, says that the disorder has control and not me which the BPD brain would interpret as being weak so chances are it would set off a rage in the untreated BPD brain but when he said it to me it brought up nothing in terms of emotional response. According to my doctor I am untreatable but to me this is a sign of progress even if my doctor is to blind to see it.

Take care.

What To Do Now

Had a doctors appointment late this afternoon and like normal I left a lot more frustrated then I walked in. The doctor has his mind set on me returning to the MAOI antidepressant class and he is willing to wait a good number of months until my dental work is complete of course this is easy for him to do as he does not have to live in this chaos that I call life.

He asked what I am going to do to change the situation and my frustration towards the therapeutic community in this city came flying through. The doctor said therapy would be a waste of time because in his words "I am too borderline". His theory is that once the therapist says something that I do no like that I would stop listening and would end up fighting against the professional. Which is a complete load of garbage but my doctor deemed me untreatable a long time ago and nothing is going to change his opinion.

The bright idea that the doctor came up with is I need to get involved in some sort of job or volunteer capacity that would not allow me the opportunity to think. I responded that the work I want to do is what I use to which is social work and the brilliant doctor responded as long as I could concentrate on the other persons emotions and not my own their should not be an issue. Neat trick walk into a situation that caters to young people whose life stories are very similar to my own and not be triggered, this suggestion is not only dangerous for me but for anyone who happens to cross my path as the main issues behind my illness have not been dealt with to a level where they are no longer a factor.

So why is he still my doctor? The simple answer is I need the prescriptions for Seroquel and Temazapam for some kind of order in my life and if I fire him I then have to go on a waiting list for another doctor which could be a very long time. Also every doctor in the city works out of the same office so not much point. He actually said I should stop any behavior which would lead to me thinking about the mess in my head which means this blog is history plus the numerous forums that I participate on which is essentially my support system. Doctors. Take care.

What To Do Before Seeing Your Doctor

A very important relationship when your dealing with mental health quirks is with your doctor. The problem is most people do not feel that their doctor is not holding up their end of the bargain so here are some tips to get the mental health professional on board and get the most out of relationship.

1. Write all your concerns down before hand. A common situation is you walk into the doctors office and after a few minutes of conversation your main concerns seem to take a backseat. By writing your concerns down and handing them over at the start of the appointment this will make sure your needs are addressed.

2. Not enough information. There is no such thing as too much information when it comes to the doctor patient relationship. A symptom that may seem small and unimportant to you may possibly be the clue your doctor has been looking for to tailor your treatment which will speed up your recovery.

3. Be open. Again tell your doctor everything. This is the wrong time to be modest and worry about how others will see you. Too many people underplay the severity of their illness and this can come with some costly consequences. Most people believe that if their doctors saw the true nature of their illness they will be thrown onto a psych ward but this is not the case. A psych ward situation only shows up for the most part when you appear to be a danger to yourself or others. My doctor and I talk about suicidal thoughts at every appointment as it is a normal part of my illness but it will not warrant another trip to the psych ward instead it is using as a measuring stick on the level of my depression. Remember the doctor is under legal obligation not to discuss your case with anyone as long as you are an adult and not a threat to yourself or others.

4. Question everything. If your doctor throws a theory at you that does not make sense then question her/him about it. Nothing is more frustrating then leaving the doctors office with the belief that this professional does not understand you or your situation. Remember the doctor works for you.

5. The doctor is human. He or she is just like you and me the only difference is they spent a real long time in school but that does not mean they are always right. There are a lot of different symptoms of mental illness that match up with multiple disorders so there is room for error. This is also why it is so critical to tell your doctor everything as the more information they have the better the chance of matching you up with the right diagnosis which opens the door to recovery.

I hope you have found the above information helpful and it will help you maximize the potential of this important relationship. If for whatever the reason you are unable to be open with your doctor then it is time to find a new health professional. Take care.

The Continuing Saga

For those of you keeping up a few days ago I had called my family doctor to get in to see him and the receptionist said she would try to get me in that day or the day after. Well they never called so when I called back on Thursday I found out the office was closed for the next week. So I decided I would just live with the sore tooth. Last night I kept repeatedly waking up as when the one tooth was hit the pain would jar me back awake. I found a walk in clinic and after a two hour wait saw the doctor on staff who after a brief examination declared the tooth was infected. Great another problem and yet another med to add to the list. On a positive note the walk in doctor was friendly and professional.

A steady traffic is coming in from Entrecard, nothing overly massive but enough to encourage me to keep dropping off more cards plus my subscription number has been steadily increasing which is always a bonus. The majority of my traffic is still from stumbleupon but that is really not a surprise.

Well I need to go back to bed but will try to come up with something for later on today. If anyone has questions or a comment just drop them off below and it could be the topic later on today. Oh please stumble me if you have enjoyed this blog as every thumbs up counts. Thanks. Take care

Not A Good Memory

I was twelve the first time my father died. Earlier that day we had the usual argument with me saying that I wish he was dead. On a good day the relationship with my Dad was a volatile one and heated discussions were common place. That night I went to bed thinking how my world would be a better place if my father was not in it.

I woke up to a noise a little after midnight. Carefully I crossed my room and cracked open the door to see what was going on. My parents bedroom light was on and there was a man pushing down on my fathers chest. My Mom woke up for some reason and realized my father was not only not snoring but he was not breathing so she quickly dialed 911. The ambulance arrived very quickly and I am guessing the noise I woke up to were the attendants rushing up the stairs. A miracle took place that night and my fathers heart was restarted.

I know now that my wish of him being dead then him dying was just a coincident but it haunted me for a very long time and probably did not help that my father blamed his poor health on "his kids who were trying to kill him". A couple of years later my Dads heart would stop twice on the operating table and there were numerous strokes through out my teenage years. I remember every time that an ambulance siren would sound off in the distance that my thoughts would immediately turn to fear that my father was in trouble and this sequence would happen until the day his heart stopped beating for good.

In the article that I wrote "Where my distrust of doctors comes from ... maybe" I am not overly nice to the medical profession but if I was really honest with myself I would realize if it was not for them I would have lost my father at twelve and not twenty eight. Sometimes its hard to see the forest because of the trees. take care.