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Though it's almost impossible to engage in self-care activities when you're so low, do try. I would focus on diet and building your microbiome, focus on gut health.
You might want to look into getting a doc that focuses on integrative medecine, also functional medecine.
Medicine-wise - have you heard of ketamine? or tried it?
I would add that when I was in a very similar situation, I started listening to calming music and tones (7.83hz). YouTube has a great variety to search up.
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Nothing I've done has built my confidence for some reason. If I make it out to the store I come back and feel proud for a few minutes then I lose it all. I haven't felt the same since I dissociated in teens, 20's and no Dr. has ever wanted to discuss it including Doctors at Johns Hopkins. I didn't find enjoyment around my friends/family anymore, didn't find them funny, etc. and I couldn't relate to anyone anymore. (And I lost all of my friends in high school and college because I couldn't hold a conversation.) My childhood was excellent until I was 13.
What's integrative medicine?
I tried ketamine for 2 weeks and it made me suicidal for some reason, I don't know why (and not sure if it helped at all.) I think when I ran out I became very desperate and I craved it for some reason and called the Dr and told him I was suicidal and he never called me back. This particular Dr had worked at a prestigious hospital (Institute of PA, Philly - 1st Psych Hospital in the USA which is where I spent all my time in early 90's). The staff there ignored me every inpatient stay. This Dr. diagnosed me as bipolar because he said I have agitated depression (which is in the bipolar spectrum - and I've never been manic) and he put me on every mood stabilizer for 3 years and nothing helped. He didn't speak to me at all (all he did was push pills) and he got mad at me when I had horrific side effects on Depakote. I was on lithium for 15 yrs and didn't do a thing and I begged every Dr to stop it and no one would do it. Somehow I finally stopped it. I used to get very agitated and it came out of nowhere! and would last for hrs, days, weeks. I had to avoid everything because everything made me super irritable. I lived in 7 apartments and couldn't take the noise from neighbors and almost threatened a neighbor. This Dr listed "Psychotherapy" on his card but he never once mentioned therapy.
A psychologist gave me a test few yrs ago and summary (which was 6 pages long) said I have avoidant and schizoid personality disorders and no Dr has ever wanted to discuss it. She was very impersonal on the computer and the test questions were extremely vague. The questions were like "I spend most of my day angry - Yes or No?". I don't know how she reached her conclusions. The summary just listed my problems like "I ruin my attempts of getting better due to negative thoughts and self-doubt and don't want to be independent at all" and she didn't analyze what the cause of my problems were. Guess what? When you dissociate and have a mood disorder/anxiety when you're young you end up with negative thoughts and self-doubt! Surprise! I've done cognitive therapy and it doesn't help.
A lousy Resident at Hopkins in 2017 diagnosed me with Asberger's and didn't tell me how to get help and every Dr I've brought it up with ignores me (and a Dr at Sheppard Pratt yelled at me when I talked about it). The wards at Johns Hopkins are set up extremely poorly - either the residents do all the work and they don't know what they're doing or they give you an Associate Psychiatrist and change Drs on you EVERY 2 wks so you don't get any consistent care at all! On one ward you would see a disgruntled Senior Dr at 730AM every morning for 5 minutes and he would ask the same 4 questions every day: "How'd you sleep?", "How's your appetite?", "Do you think life is worth living?" and some other stupid question and he didn't want to know anything about my past diagnoses, medications, what brought you into the hospital, etc. Then he would say "Go get your breakfast". After 4 wks I told him "I can't stand it here!" and he said "Well, we'll discharge you" and he ended it with "It's going to take a lot for you to make it in this World...".
Sorry for all the complaining but I don't know what to do anymore!
Music has been the only thing I've enjoyed the last 45 years - I played electric/classical guitar. But my interest in it waxes and wanes the last 10 years. My anhedonia has been very bad.