I had a stay in a rehab facility for 3 months after having severe psychiatric issues, and there i met a bunch of borderliners who were also on rehabilitation there. They really don’t have it easy, but it was good to see how much they improved when getting adequate care. As you say, as with any severe psychiatric disorders, the patient has to want to get better, which includes even realizing that something is wrong.
These things are the largest barriers for successful treatment in many psychiatric conditions, e.g. paranoid schizophrenia which suffers from abysmal compliance rates, often leading to a cycle of “on meds -> feeling well, but the meds have side effects -> dropping the meds to get rid of the side effects -> back to the start, but with the idea that the doctors want to poison me”.
As you say, as with any severe psychiatric disorders, the patient has to want to get better, which includes even realizing that something is wrong.
To be clear, with many psychiatric disorders, the disorder itself can influence the patient to not want to get better. For example, a patient who is responding well to treatment but stops taking their meds because their condition makes them believe that the meds are the problem.
Yeah, after i read my comment again i edited it to reflect that - you are absolutely right. And from personal experience with psychiatric medication, i can fully understand it. One of the medications i was on when depressed to the point of being suicidal was Quetiapine, and you feel absolutely dead inside. It was preferrable to the state i was in before, but for someone who isn’t depressive as fuck this can be a negative thing.
And there is always the issue with psychiatrists thinking they always deal with people that are non-compliant when issues arise. I have been suffering from sleep disorder where i would be so tired during the day that things just fell out of my hands because i fell asleep for fractions of seconds during the day (so called somnolence), and abnormal nightmares/night terrors (normal nightmares you have nearly forgotten at the point of waking up. I was able to recite the complete plot incl. small details days after these, and they were horrific.) up to the point that i had a phase where i simply did not want to go to sleep anymore, resulting in a phase with recurring sleep paralysis.
I was complaining about this to my psychiatrists, who responded by prescribing me sleeping pills - but those only caused me to be disoriented when i woke from my nightmares, and being completely lethargic on the next day. During this time (a duration of around 8 years) I was on a pretty high dose of Duloxetine, also known as Cymbalta in the US as a mood stabilizer to prevent sliding back into depression. But what none of my psychiatrists informed me about was that Duloxetine has pretty common side effects on sleep, including somnolence and abnormal nightmares. A few months back I was reading up on my medication by random chance, and saw the list of common side effects.
I instantly started halving the dose i took, because my dose was the one cited with the highest incidence of sleep disorder. My nightmares became less and less during the next weeks, and for the first time in years i was able to get a satisfying amount of sleep. Afterwards i talked to another psychiatrist who i knew (but wasn’t the one who prescribed these meds), who - after a few sentences, i wasn’t even able to complete what i wanted to say - acknowledged that she already suspected that i might suffer from the side effects, but since i was the active patient of another psych, she did not want to interfere. (I do not blame her - messing with things that are not really your business is a bad idea in the medical field)
I made an appointment with my psych, and they confirmed that they knew for YEARS that my issues were because of the meds, and that they decided that informing me about this fact might cause me to simply dump the meds and opted for trying to suppress the side effects without success.
I have an avoidant personality disorder, making it very hard for me to trust anyone, but i am one of the few psychiatric patients who know that a statistic does not say anything about a specific patient. I would have tried to work with these meds even with the side effects. I would have tried other medication. But they took the easy way, which resulted in me having dropped the medication (slowly - you can’t just stop these things) and now looking for a Psychiatrist that respects my autonomy. For now, i feel fine because my life circumstances have changed a lot and many of the stressors in my life are gone (and i never was a problem for others, only for myself) outside of getting wet eyes when i watch series that tug on my heart tendons lol. But if i were someone prone to psychosis or paranoid schizophrenia, i would never take anything again. My trust has been violated and abused, just to make their job easier.
I won’t trust any psychiatrist blindly again. This wasn’t a single psych, this is an organisation paid for by the city of Vienna where i had 4 different psychs over the years, with an attached day center for people like me, with ergotherapy groups, movie groups, physiotherapy and so on. It hurts to leave all this infrastructure behind, but being in the center means i have to be a patient of their psychs. None of them considered the damage to my meager trust that i have to actively work for to sustain when they hid the truth from me.
I had a stay in a rehab facility for 3 months after having severe psychiatric issues, and there i met a bunch of borderliners who were also on rehabilitation there. They really don’t have it easy, but it was good to see how much they improved when getting adequate care. As you say, as with any severe psychiatric disorders, the patient has to want to get better, which includes even realizing that something is wrong.
These things are the largest barriers for successful treatment in many psychiatric conditions, e.g. paranoid schizophrenia which suffers from abysmal compliance rates, often leading to a cycle of “on meds -> feeling well, but the meds have side effects -> dropping the meds to get rid of the side effects -> back to the start, but with the idea that the doctors want to poison me”.
To be clear, with many psychiatric disorders, the disorder itself can influence the patient to not want to get better. For example, a patient who is responding well to treatment but stops taking their meds because their condition makes them believe that the meds are the problem.
Yeah, after i read my comment again i edited it to reflect that - you are absolutely right. And from personal experience with psychiatric medication, i can fully understand it. One of the medications i was on when depressed to the point of being suicidal was Quetiapine, and you feel absolutely dead inside. It was preferrable to the state i was in before, but for someone who isn’t depressive as fuck this can be a negative thing.
And there is always the issue with psychiatrists thinking they always deal with people that are non-compliant when issues arise. I have been suffering from sleep disorder where i would be so tired during the day that things just fell out of my hands because i fell asleep for fractions of seconds during the day (so called somnolence), and abnormal nightmares/night terrors (normal nightmares you have nearly forgotten at the point of waking up. I was able to recite the complete plot incl. small details days after these, and they were horrific.) up to the point that i had a phase where i simply did not want to go to sleep anymore, resulting in a phase with recurring sleep paralysis.
I was complaining about this to my psychiatrists, who responded by prescribing me sleeping pills - but those only caused me to be disoriented when i woke from my nightmares, and being completely lethargic on the next day. During this time (a duration of around 8 years) I was on a pretty high dose of Duloxetine, also known as Cymbalta in the US as a mood stabilizer to prevent sliding back into depression. But what none of my psychiatrists informed me about was that Duloxetine has pretty common side effects on sleep, including somnolence and abnormal nightmares. A few months back I was reading up on my medication by random chance, and saw the list of common side effects.
I instantly started halving the dose i took, because my dose was the one cited with the highest incidence of sleep disorder. My nightmares became less and less during the next weeks, and for the first time in years i was able to get a satisfying amount of sleep. Afterwards i talked to another psychiatrist who i knew (but wasn’t the one who prescribed these meds), who - after a few sentences, i wasn’t even able to complete what i wanted to say - acknowledged that she already suspected that i might suffer from the side effects, but since i was the active patient of another psych, she did not want to interfere. (I do not blame her - messing with things that are not really your business is a bad idea in the medical field)
I made an appointment with my psych, and they confirmed that they knew for YEARS that my issues were because of the meds, and that they decided that informing me about this fact might cause me to simply dump the meds and opted for trying to suppress the side effects without success.
I have an avoidant personality disorder, making it very hard for me to trust anyone, but i am one of the few psychiatric patients who know that a statistic does not say anything about a specific patient. I would have tried to work with these meds even with the side effects. I would have tried other medication. But they took the easy way, which resulted in me having dropped the medication (slowly - you can’t just stop these things) and now looking for a Psychiatrist that respects my autonomy. For now, i feel fine because my life circumstances have changed a lot and many of the stressors in my life are gone (and i never was a problem for others, only for myself) outside of getting wet eyes when i watch series that tug on my heart tendons lol. But if i were someone prone to psychosis or paranoid schizophrenia, i would never take anything again. My trust has been violated and abused, just to make their job easier.
I won’t trust any psychiatrist blindly again. This wasn’t a single psych, this is an organisation paid for by the city of Vienna where i had 4 different psychs over the years, with an attached day center for people like me, with ergotherapy groups, movie groups, physiotherapy and so on. It hurts to leave all this infrastructure behind, but being in the center means i have to be a patient of their psychs. None of them considered the damage to my meager trust that i have to actively work for to sustain when they hid the truth from me.