TW Si - Not wanting to keep going. Hope of improvement is gone

@Paperdaisy

Thanks for the nice words... Invalidating is exactly the word I was trying to come up with. Definitely the way I was feeling.

I'm lucky I have an amazing GP and my psych is good. He gets a little stuck with what to do with me sometimes.

Hope your day has been okay ☺️

Little update,

Saw my psychiatrist. We reduced my medication and we're leaving my other meds the same for now. I'll do another round of rTMS, and some group programs at the hospital.

GP was amazing as always... He was surprised when he heard what the psychologist said. He knows me well enough and understood why I was caught off guard.

Emailed the psychologist and she agreed that I made the right decision. I think she could tell I wasn't overly committed to the therapeutic process with her.

Thank everyone for listening and sharing your feedback. I'm feeling okay at the moment. Actually relieved that I decided to stop with my psych. Now just to decide what I want to do next.

Hey everyone, thought I'd provide an update from my old initial post because I am getting ever so close to not wanting to go on
FYI: I am safe despite my SI being very present.

This is part very lonnng post, part asking for any suggestions on who to engage with my very complex mental health. I'm in Brisbane.

This is part of my mental health journey for the last 1 year and 6 months:

• Diagnosed BPAD2, BPD, CPTSD, GAD, Depersonalisation/derealisation disorder (DDD).
• An inpatient private mental health stay with TMS being done and a slight medication change. Med change caused permanent extrapyramidal symptoms - restlessness, tics, muscle pain and stiffness, jerking movements that I can't control throughout my body. Now I clench my teeth so my front teeth keep chipping, lip biting and constant clenching of my jaw.
• Serotonin syndrome 3 times
• Basically can't change meds or I'm at a very high risk of dying.

Since my last post...

• Serotonin syndrome again making it 3 times now. The third time was triggered by a very small dose of an anti-migraine medication.
• I had another inpatient private mental health stay in Dec 2022 and did a further 20 TMS sessions. The effectiveness of the treatment didn't last very long.
• Engaged with a BPD/DBT specialist psychologist who was dismissive, pushy and invalidating. So I decided to not see her anymore.
• Have been engaged with a Nurse Navigator through the public system for quite a few months. She is helpful and I feel safe seeing her but she has run out of ideas/options to help me because of the complexity of my mental health.
• My private health had to be cancelled as I just couldn't afford it anymore.
• Can't see my psychiatrist from the private hospital as he won't bulk bill.
• The public mental health system won't actually accept me because I don't have the presentation or symptoms of being acutely unwell. They can't do anything with my medication and despite me being very suicidal they don't consider me as a high enough risk. No ongoing psychotherapy options or the ability to see a psychiatrist either. I have tried so many angles with them and it's a constant no.
• I've been referred to 4 different support agencies who have either closed off my referral because I'm "too complex" or have referred me to other supports who I've tried and haven't been accepted.
• When I have attempted to start engaging with supports there is this feeling of "judgement" because I am a very "I can't, I've tried doesn't work" type of person. This is seen as me being too difficult. But it's been identified through psychotherapy with my regular counsellor that I suffer from an intense Existential crisis & Nihilistic view of life and my future treatment options are meaningless and not worth the effort.
• I've started to see a new psychologist who is a specialist in EMDR. She is absolutely lovely and we have a great rapport. However, at the moment my mental health is so acutely unwell she doesn't think EMDR is suitable at this time.
• I need intensive regular psychotherapy. When I say regular it needs to be weekly or fortnightly. I have no support network for the 13 days between sessions. So it's just me and my mind which goes absolutely nonstop and driving me insane.
• I've run out of MHCP sessions and I might need to stop seeing my regular counsellor because of costs. I also will need to stop seeing my new psychologist because it just doesn't fit into my budget anymore despite having extras insurance.
• The next step is applying for the NDIS under psychosocial disability so that hopefully I have funding to increase my functional capacity. The thought of the application process just makes me cry and have panic attacks. I literally just stare at the paperwork and cry. Then there is the risk that it will get rejected. It's really nearly my last option to afford supports.
• At the moment I really need someone that is going to sit down and help me to navigate me moving forward in a patient, non-judgmental way.
• Unfortunately for me, I have a very strong ability to put on the mask and pretend I got this or everything is okay. I also have incredible insight into my mental health and mental health in general (I'm a trained broken counsellor), so everyone always asks me what I think is the solution or next steps. I need help from someone that can take that part of the job away from my brain.

I'm Christofuu (35) - Diagnosed in May 2022 with BPAD2, BPD, CPTSD, GAD, and Depersonalisation-derealisation disorder.

Had a private inpatient stay on 05/22. Apart from TMS, it wasn't an overly productive stay.

My counsellor for the last couple of years has been a MHSW. She's been amazing, which has been great to deal with situational crises that have needed to be dealt with (there's been a lot). The therapeutic relationship was established that way as I have very complex mental health challenges.

Where I'm currently sitting at the moment is I'm stuck in my derealisation state. I've tried so many things but I'm isolated from society & don't leave the house. I'm very depressed, also have suicidal ideations (no risk), and don't see a future so struggling to plan goals, I'm incredibly exhausted and have no willingness or capacity to practice any mindfulness, DBT skills, etc... I'm pretty much a shell at the moment with nothing inside.

I've started to see a new psychologist fortnightly at a cost of $250 with $120 out of pocket (she won't bulk bill) and I'm only on a disability pension.

After 7 sessions I feel no compatibility or connection. She's a specialist in BPD and DBT so she knows what she's doing but her approach is throwing me off and leading me to question whether to continue seeing her.

My support network is very limited but incredibly helpful. However, I need further frequent support but I don't know where or how to get more help.

My support network is:

• GP is fantastic and I see him regularly but I can't continue seeing him for MH struggles as we're not dealing with other health issues.
• The counsellor is still available to see but she's running at 6 - 8 weeks between sessions.
• New psychologist who I am reluctant to see.
• Psychiatrist who's good but not brilliant.
• Can go into private inpatient stay at any time.
• I have no family or friends that can help with support. I haven't spoken to my family for nearly 2 years.

My challenges to engage in further supports:

• Don't know where to go and what to do.
• I have a very high level of 'apparent competence'. This means I involuntarily show that I am coping better than I actually am. This is a very strong and ingrained behaviour from 35 years of trauma. My ability to wear the 'mask of everything is okay' is so strong it's an autonomous behaviour. I don't become vulnerable easily or communicate my needs effectively.
• Due to my 'apparent competence' and private health. Community mental health won't proceed with an intake. I've tried a few times.
• I have generalised hyperhidrosis and other health issues that have a substantial impact on my psychosocial disability. Link to hyperhidrosis mental health impact - https://sydneynorthneurology.com.au/living-with-hyperhidrosis/
• Due to the severity of my hyperhidrosis, I find it very difficult to want to engage in a group setting or even leave the house. I am constantly embarrassed and have social anxiety due to sweat-soaked clothing, wet palms, and uncontrollable sweat dripping from my face and whole body.
• My family don't have the capacity to help. I've been the one that has supported my whole family throughout my life.
• I don't have any friends. Not even one.
• I don't have anyone to regularly I can talk to when things aren't going okay.
• My medication changes are very complex as I am sensitive to any medication. I have developed serotonin syndrome twice and have permanent extrapyramidal symptoms (restlessness, tics, muscle pain and stiffness, slow & jerky movements that I can't control throughout my body) from a slight increase in my antipsychotic.
• I am only on a disability pension so I can't afford to pay for services. NDIS application is going to be done but even attempting to start is just too much.

So after the long post. If anyone has any suggestions on where I could go next?

I would like to engage with someone maybe weekly that can support me to engage in the supports I need for my MH and help me to just navigate life while I try to get myself better.

Hey @Christofuuu ,

I'm so so sorry that things have come to this. I hear there is such a huge need for ongoing psychotherapy for those presenting with BPD and associated symptoms.

There has been a huge push for people to sign a petition to increase the subsidised sessions for people with BPD from 10 sessions to 40 sessions because advocates realise that borderlines need more than 10 sessions.

Unfortunately, it seems that your experiences are not uncommon. Waitlists for BPD specific services are incredibly long. I read you are doing everything you can to stay on top of things, but cost is a huge contributor to what you can and can't access.

It seems so unfair that only those who can afford it can access therapy.

I think I've shared this with you before, but I was acutely unwell with CPTSD, BPD, GAD, and depression. I was rejected by NDIS when I applied. At least I gave it a shot. I ended up having mentalisation based therapy at Spectrum - a personality disorder specialist in Victoria. This therapy lasted a minimum 18months and consisted of both a group and individual session each week.

Clinicians were BPD specialists. They were so patient and understanding of my complex needs. You can read about the service here. https://www.spectrumbpd.com.au/

I just wish more people could access this service. It was one of the best things that happened to me because I could see the change. It was such a difficult process, but totally worth it.

Hang in there @Christofuuu . I was a complex case that didn't think I'd survive to see this day. So many services turned me away....until I found the one that didn't.

Please reach out to me by tagging me if you have any questions, BPD specific.

tyme

Thanks @tyme,
Sorry, I can be slow with replying. I try and limit my internet usage otherwise my brain gets overwhelmed.

I've sent an email to Spectrum to see if they know of any services that are in my area.

Just wondering did you do MBT rather than DBT? I'm a fan of DBT and was thinking of trying to give MBT a try.

Hey @Christofuuu !!! Great to hear from you!

I did the FULL MBT course. So twice weekly for about 18months - both individual and group.

Put it this way, if you can get into MBT, go for it. It is so rare in Australia at the moment, and hence you don't hear about it much.

DBT is more skills based. You learn a skill/s and then practice it, put it in your quiver, and use it when you need to.

MBT is not so much about learning skills. It is practicing, practicing, practicing the art of thinking in helpful ways.....

All the best finding the therapy that works for you. You deserve it.

I am so pleased that I am so well now. I never thought I'd be rid of those powerful negative thoughts... but here I am... a changed brain and a changed person.

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@tyme wrote:

MBT is not so much about learning skills. It is practicing, practicing, practicing the art of thinking in helpful ways.....

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@tyme

MBT sounds like it might fit into my toolkit. I find it frustrating sometimes doing group work and programs because my brain has the knowledge about what to do (being a counsellor) but my brain just doesn't do it. Practising, practising within a 'structured' environment would be a good way for me to give it a go. I know there was a psych/facilitator at the private hospital I used to go to that knows MBT so I think I might reach out to him and get his thoughts.

Thank you for the info. If I have any updates on finding MBT in my area I'll make sure I share it 🙂

That's great to hear @Christofuuu . I hope you find something.

Your post has strengthened my belief/hypothesis that people with BPD generally go into a career where they 'help' other people 🙂

I know countless people with BPD and ALL are in careers where they help people e.g. nurses, teachers, therapists etc. It's very interesting. For me, I think having BPD has helped me understand myself and others so much more. Without BPD, I think i'd be so dismissive of people with BPD (just like many others).