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Letter from Psychiatric Social Worker -

Discussion in 'After Effects' started by GoldenPsych, Feb 17, 2008.

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  1. GoldenPsych

    GoldenPsych Well-Known Member

    Below is a letter that was sent to me as well as my Doctor. I obviously came across as though didn't need any more help...

    I assessed her on 23.01.08 following several presentations to ED with self harming behaviour. The last time was after an overdose of aprox 60 mixed pills and 2 bottles of wine. She explained to me that she had brought the pills ealier in the day when she had not consumed alcohol but was intoxicated at time of OD. She did leave a note but can not remember what she wrote on it.

    It was explained to me that at the time she wanted everything to end and had clear thoughts of dying. She did believe the pills would kill her.

    The first OD was taken in sept 07 but had began cutting before this. She also took an OD just before xmas 07 and one earlier in Jan 2008. She explained taht self harming behaviour due to chronic low mood which she has experienced since at least 2006.

    She expressed some regret following the OD but she said this was probably as it was not successful. She continues to have suicidal ideation and although has no clear plans can not guarentee will not happen again. (Obviously I didn;t tell her that if things got worse I would def do it again - and I did).

    She was well presented and seemed to be managing her self-care, was alert and able to establish good raport. Was emotionally reactive and speech was normal in tone and rate.

    Although there are symptoms of depressive low mood there are no indicators of significant mental illness - (so why the hell do I feel like I do when there are no reasons).
    I would identify the risk factors as ongoing self harm behaviour, excessive alcohol intake (which has now decreased a hell of a lot and still no change) and the fact she lives alone and may be experiencing some isolation - (I have no time to my self and I love living on my own - which I said as I like my space) and also chronic low mood with no triggers.

    I feel that she us high risk of further self harm but low risk of suicide (yeh well it was only 2 weeks later and I tried again).

    Well seems as though she got it wrong. Maybe when i go back to the doc I will tell him. it may be best that I print off what I have written on here so he can see how I feel. I can't go to him and tell him where as if he knows everything I can talk about it. It is 2 hard for me to turn round and say I am feeling like I wanna die 80% of the time and that there are occasions where I plan it and I research it on line like what I need to take and how much and what I can mix toegther, what I can do to make it look like an accident etc.

    So what the hell do I do now. I was waiting on this letter to get to the doc so that he would be able to suggest where to go from next. All she says is continue to see counsellor. Well obviously that isnt working as have been seeing counsellor since April and if anything things have gotton worse. The counsellor is good for getting things off my chest and just having a general chat with but I dont think I get anything out of it.
  2. HOW

    HOW Well-Known Member

    Assessing how someone feels inside is nearly impossible. If you don´t open up its impossible for them to make a realistic analysis of you. I´ve never seen a counsellor or anything similar and don´t plan on doing so, simply because I don´t believe they can help me. The only suggestion I can give is try to talk as much as possible with the counsellor and try to figure out why you are feeling so low.
  3. dazzle11215

    dazzle11215 Staff Alumni

    how awful to be talked about in the third person. yuck. it's exactly the kind of thing that would freak me out.

    do you need for someone else to say you want to die in order to make it real? you've been offered help at the hospital and bluffed your way out of it.... why not try something new... you are smart enough to "trick them" every time, playing the system, one against the other. i've been there myself. but you don't have to keep the act going anymore.

    i agree, bring the printouts, or even better, write out what you want to say. It may be that you are 80/20 somedays, and 99/1 others... fact is, unless you are honest about how you feel, with everyone, including your doc and counsellor as well as yourself all the letters in the world don't mean anything. if this counsellor isn't working get another. or, at your next meeting ask them if they think it's working, what with your 4 recent attempts i think they'd have to agree not.

    thing is, one of these days you might just succeed... the police won't come, you won't be in touch with a friend, you won't get to the hospital. and that would be a really, really sad day. really sad.

  4. eutxry

    eutxry Member

    Nobody can read your mind...you have unrealistic expectations for what she can know.
  5. Hatemylife88

    Hatemylife88 Well-Known Member

    Very true
  6. GoldenPsych

    GoldenPsych Well-Known Member

    I suppose, but when I did say to her it was something that I thought about a lot and that it was something that I could rely on. I dont know what I expected really. I dont know what else can be offered other than pills and counselling which I already get. As of that as I think I am getting what I can it makes me feel worse as I am not getting any better.
  7. dazzle11215

    dazzle11215 Staff Alumni


    sorry if it looks like we are ganging up on you...

    all i can say is that it seems like what you are doing now is not working. it's hard to ask for "more" or even know what "something different" might look like, but 4 attempts and all the other self-destructive behaviours are, to me, just a clear sign of how much you are suffering.

    can you start by saying to both your doc and your counsellor "you know, this isn't working. what are my other options? what else can i try?"

    just want to add that just because the professionals seem a bit clued out as to what's going on inside, and you havent' found the combo of things that will work for you, doesn't mean that you are unfixable or somehow not worthy of being well. it's a scary place to be. my combo of things is a psych nurse, some meds, making art, photographing, SF, meditation, exercise, and tackling my negative self-talk (and boy do i have loads of that). no counselling, as such, although i had addictions counselling in the past that is helping me keep mostly on track now. no psych except 10 minutes once a month, and i even hate that. so... what can help you heal will be unique to you.... just keep looking for it.

    there's nothing wrong with sticking around until you find that right combo of help and/or treatment. it doesn't mean you arent' trying hard enough, as someone who has survived suicide i know that even making it through the day without another attempt is a huge accomplishment, and some days, that's good enough. but there is more and with time you can begin to embrace life again.

    back to main point: can you say... "this isn't working for me... and here's why.... what else can we do?"

  8. Ignored

    Ignored Staff Alumni

    When I first started seeing psychiatrist/cpn, I really wanted them to 'get me' in order to offer the solution which would help me. I now realise that there is no solution, only the ones we can think of ourselves to get through, or hang on or whatever the fuck it is that we do. Psychiatry is a joke... unfortunately it's us that's the punchline.
  9. GoldenPsych

    GoldenPsych Well-Known Member

    So what do you suggest I do. I am at a dead end!
  10. dazzle11215

    dazzle11215 Staff Alumni

    no easy answers. and yes, it's a bit much for us to ask you to come up with the answers on your own, especially in the middle of this pain. that's why the professionals are there.... to help you figure out what combo of things work. i've mentioned before i have home visits and phone calls from a psych nurse i trust. we do the basics first. sleep, nutrition, exercise. that helps me feel well enough to start on some of the emotional problems underlying my despair. sounds funny, but she'll call up randomly and ask "hey, how was your food yesterday? did you cook dinner for yourself? how did you sleep?" sounds like a little thing given the depths of my sadness but first things first in fighting depression.

    anything wrong with saying "it ain't working.... i'm gonna need more help..."
    frankly, the fact that your counsellor is coasting along while you've made 4 or is it 5 recent attempts is appalling (sp??) to me. can they not see what's going on?

  11. Crue-K

    Crue-K Well-Known Member

    So true, mental health users in this country are treated as second class citizens and given no respect. I feel the majority of professionals lack any empathy and are just going through the motions to pick up their salaries.

  12. GoldenPsych

    GoldenPsych Well-Known Member

    So I have written a letter to my doc - not been sent yet but basically I have put the posts what I have written on here in to the letter - it is about 15pages long. Hope he has time to read it before next appointment which wil e next week. I am so sick of not being able to sleep. It is my day off tomorrow but I have to go in to work for a meeting - stupid thing!
  13. Crying All Time

    Crying All Time Well-Known Member

    my doc was also treated me bad, then i changed him and now my new doc is perfect
  14. GoldenPsych

    GoldenPsych Well-Known Member

    ... being as though I pretty much tell everything on here I have another letter that I will share... Ichave opened a new thread for it.
  15. downunder

    downunder Well-Known Member

    That was very interesting to read. I have to go before a psych and need to put on a good performance so that I can keep my job. Now at least I know what they are looking at. I once had the CAT team guy, tell my husband that I was not depressed, and was not at risk, and did not have a mental illness. 2 weeks later I made another attempt.
  16. GoldenPsych

    GoldenPsych Well-Known Member

    There is obviously a list of different things they ask you about. Maybe you do need help though so i is best to be honest.
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