[SarahSweden]

I´ve been a patient within our public mental health care for years without getting any proper help. As I can´t pay for therapy and we have no insurance based system I´m forced to attend a public clinic and to see a psychiatric nurse who just makes me feel worse.

I need a sick leave and to see a doctor who can extend that every six months or so. Because of that they demand I see a counsellor and they just pick one for me and for some months I´ve now seen this psychiatric nurse.


I could bear seeing her as long as I had my therapist in church as I´ve talked about in several other posts. But now I only see this nurse and there´s no chemistry, she´s only making me feel worse.

But the dilemma in all this is I can´t get another counsellor. This psychiatric nurse and my psychiatrist are meeting with a psychotherapy center in December to try to refer me to psychotherapy. The referall will most likely not be accepted but I can´t get another counsellor as my psychiatrist are working together with my psychiatric nurse on this referall.

There´s a big risk the referall won´t be accepted and then I´ve waited in vain and also become a lot more depressed. I can´t work so I need the sick leave and it´s too complicated to find another psychiatrist as I already feel very bad.


Does anyone have any thoughts on or consolation in this?

[downandlonely]

I'm sorry to hear that Sarah. I'm not familiar with your healthcare system, so I can't really offer any advice about a counselor.

I go to a free support group for people with mental illness, and I find it helpful. Is there anything like that where you live?

[SarahSweden]

Thanks. Yes, there are such groups but I need professional care. A support group could function as a complement to psychotherapy but I´m too ill and don´t have the energy to attend.

Originally Posted by downandlonely

I'm sorry to hear that Sarah. I'm not familiar with your healthcare system, so I can't really offer any advice about a counselor.

I go to a free support group for people with mental illness, and I find it helpful. Is there anything like that where you live?

[Ididitmyway]

I am also not familiar with your system. I don't know what it means "the referral will not be accepted". Who is not going to accept the referral? You? Or a therapist you'll be referred to? Can you explain?

[velcro003]

I thought Sweden had a good healthcare system. This sounds awful.

[SarahSweden]

Thanks. The clinic I´m at sometimes refers patients to a center for psychotherapy, also within public health care, but they only accept about 25% of those referalls due to lack of funding.


Here it´s not how the patient feels what matters, therapy is hardly restricted by lack of public funding and most patients don´t get the treatment they need. Only medicines are available to all but every kind of counselling or therapy is more or less impossible to get access to unless you can pay out of your own pocket.

Originally Posted by Ididitmyway

I am also not familiar with your system. I don't know what it means "the referral will not be accepted". Who is not going to accept the referral? You? Or a therapist you'll be referred to? Can you explain?

[SarahSweden]

Thanks. No, all kind of mental health care and psychotherapy suffers from lack of funding. Most people don´t get the help they need, about as much as 50% of all people applying for sick leave do that because of mental health care problems. Nothing is done about that.

Originally Posted by velcro003

I thought Sweden had a good healthcare system. This sounds awful.

[Ididitmyway]

Got it.

The system here is pretty crappy as well but in different ways. One option that low income people have though to get free and low cost counseling is if they do it at some professional colleges or universities that teach psychology. But there too they get a very limited number of sessions just like in that church that let you see a therapist for free. In my school, for example, we had a counseling center for students and interns to practice. Some clients of that center were required to sign an agreement for their sessions to be watched through a two way mirror if they wanted free therapy, and, again, it was also limited.

Are there such training places in Sweden where people can get low cost/free counseling if they agree to be seen by students?

[SarahSweden]

Thanks. As short-term therapies only hurts me and makes me feel worse in different ways I can´t join such therapies. I need a long-term therapy and students who offer therapy doesn´t stay long enough to provide good care. They take on more or less light cases, not someone who´s already within psychiatry.

Originally Posted by Ididitmyway

Got it.

The system here is pretty crappy as well but in different ways. One option that low income people have though to get free and low cost counseling is if they do it at some professional colleges or universities that teach psychology. But there too they get a very limited number of sessions just like in that church that let you see a therapist for free. In my school, for example, we had a counseling center for students and interns to practice. Some clients of that center were required to sign an agreement for their sessions to be watched through a two way mirror if they wanted free therapy, and, again, it was also limited.

Are there such training places in Sweden where people can get low cost/free counseling if they agree to be seen by students?

[here today]

As I think you know, I've tried for 55+ years to get helpful therapy, even paying out of my own pocket.

Didn't happen. Some may, but many psychotherapists don't know what they are doing, is my perspective.

Like your former therapist at the church.

Nevertheless, I hope the referral comes through. Maybe it will. Please let us know.

[cinnamon_roll]

Sarah,

I feel for you. Public healthcare has its benefits but also a lot of limitations as you point out in your posts. I know from my own experience that being inside such a system (and being dependent on it for sick leave or something else) can make you feel helpless and like you have no say or control in this situation.

As you cannot change the system, maybe a starting point could be to start thinking about different approaches to look at your situation?

I get a strong sense that for you it's you vs. 'the system'. Like running against a wall again and again. What could help you to get to a point where you can take the benefits from the system (like sick pay) without feeling you have to get into total submission to the system? More like a 'walking alongside the wall-thing' (instead of running against it)? And maybe to allow yourself to find out that there's a wall on one side, and it limits you, yes. But there might be another side that is more open and there might be space waiting to be explored and discovered. And it could be rather small things, like:

- a support group cannot replace proper treatment. But it can be helpful in giving you a sense of empowerment instead of feeling helpless (which again is a typical symptom for a deep depression...)

- a support group can help you to find new social contacts or even friends.

- start a new hobby. Learn to knit or learn to make little crochet animals, if you like being outside try to find a hiking group so you don't have to go alone. Being outside in nature gets your head free. Whenever I'm outside a lot of my problems aren't that dominant any longer. Nature helps me to stay in the present, the here and now.

- can you talk to your psychiatric nurse about your fears that your referral might be denied? That you are wondering what will happen then if you don't get the referral? That you feel that the 'system' is failing you as you don't get the help you feel you need? Sometimes for me being open about my frustrations and perceptions starts a shift as well. For me and for the other side. So the nurse might get the message, ok, if the referral doesn't go through, we need to think about alternatives instead of just 'dismissing' your case. Or she and the psychiatrist can make an extra point to make sure that you do get the referral. And: They are working for you, at least to some extent, no matter how you feel about it, because they are working on referring you to this other place. So maybe if you try to see them as allies - they are as much 'caught' in the system as you are, and they might be frustrated by the limitations as well.

- I think you said a while ago that you don't want to take anti-depressive medication. Have you ever tried it? I know for me, when I was in really dark places, medication did make a difference. It didn't make all the symptoms magically go away. But it helped to shift my perspective enough so I could start work on changing things, step by step. Without medication the depressive vicious circle would just stop me before I even started. Because everything felt so deeply hopeless. So maybe reconsidering your position on meds might also be a starting point for some change?

- This might sound a bit harsh, but I just really want for you to see some changes happen. You can wait for the system to rescue you. This obviously won't happen. Instead of waiting forever you could start changing some things that you do have influence on. And there are some things, no matter how you feel about it right now. This won't turn your life around over night, but it will make a difference in the long run. But you have to start somewhere, and no-one will do that for you.

I keep my fingers crossed that you do get the referral in the end. But instead of just waiting (do you have any idea when they will decide about it??) and worrying, start some action. Any action will do.

Sending you hope and much love,

c_r

[Anne2.0]

Originally Posted by cinnamon_roll

- This might sound a bit harsh, but I just really want for you to see some changes happen. You can wait for the system to rescue you. This obviously won't happen. Instead of waiting forever you could start changing some things that you do have influence on. And there are some things, no matter how you feel about it right now. This won't turn your life around over night, but it will make a difference in the long run. But you have to start somewhere, and no-one will do that for you.

I confess, and I've been reading your posts for a long time, including from the beginning when you had a long term therapist provided for you as part of the system, and when that ended you thought you wouldn't be given another one, but I think you were. And that was before the most recent "church" counselor, IIRC. I would really like to see some changes happen for you, but what I see in your postings is that you seem inflexible about making any changes yourself, so I'm not going to recommend anything other than to say that I second the suggestions made by CR here. Add to that, and I've made this suggestion before, volunteer work that would get you out of the house and connected with people in some way. If you can go to your appointment with a psychiatric nurse who makes you feel worse, I think you could go to a support group, or at least try it. I'm not sure I buy the "I'm too ill to do anything" line. It is a choice you are making, and it's fine to exercise your right to a choice, but it seems like a pretense to me to claim you have none.

Also, I don't buy that you are "forced" to see this nurse. Or that it's impossible to have a productive relationship with her. You want to receive public benefits because you are unable to work-- nothing wrong with that-- and, in exchange, this is something you have to do. I won't make any suggestions for how to approach this relationship differently, because I anticipate you will reject them. I wish you could approach your life with a greater sense of agency and willingness to change-- and I don't mean to say that you haven't made progress, because you have and that can be seen on this board-- that is my issue, not yours. I'm sorry I can't be more responsive and just empathize with your struggle, but I feel that you construct the possibilities for your life in limiting ways, when I think you have a lot to offer the world. I'd like to see you out there in the world and have an improved quality of life, but again, that's my issue. Clearly you don't want that and I should just accept that, because it's your life to live and on your own terms and not mine.

[Vossie50]

Hi Sarahsweden! It sounds like you're in a deep, dark, hopeless hole. I've been there. Many of us have and many are still there. You're not alone. I think Cinnamon Roll gave good advice. Since you can't change the system, change the things you can. All of the suggestions Cinnamon made are small things, but the small things add up. They can make a noticeable difference.

For many people, it's a combination of formal therapy, medication and self-help that help them get better. Exactly how much of each varies from person to person and even varies for the same person at different points in their life. I encourage you to keep trying to find that combination.

Now, to put my money where my mouth is...

[luvyrself]

Please don’t fall into the trap of thinking that wellness comes only from the perfect therapist and that that is the magic bullet. Those of us who have struggled with MI for many years know, as stated by the posters above, that improvement comes from many variables, most of which you control yrself. Getting yrself around people is absolutely vital. For me, vigorous exercise helps so much that it is almost like magic. There are workbooks online (amazon)that give a structured approach that really helps me, like examining what caused yr illness (triggers) . Do something, even clean out a closet. Maybe a pet would help. Cats are easy to take care of. Keep moving. You don’t feel like it, you have to anyway. No choice. Don’t let the disorder win. We’re with you.
I think you really must ask yrself why you won’t even try antidepressants. Do you have a definite diagnosis? An assessment and diagnosis comes first.
Finally, you live so far north w short summers that I think it is important to see if sadd (seasonal affective...)is affecting you.
Talk to someone, even in line for coffee, and get moving. Now. You’ll feel so empowered when these things start to work. And it will be gradual. Hugs!

I very much agree with cinnamon's and Anne's suggestions. This is, again, similar to what I said on one of your previous threads: you have this very ingrained pattern of focusing on all the negative, your inability, hopelessness etc. So attached to your own pain, depression and lack of perspective that you don't ever see silver linings, possibilities and the role of your own decisions in all this. I agree that going to support groups and volunteering is a good idea and that if you could go to therapy sessions and can see the nurse, you could also make those. It is really a choice; it would take some forcing yourself, but everything that could possibly create forward movement would be hard at first.

I personally really don't like to hear suggestions that pain should be left to last as long as it lasts - I think suggestions like that are usually made by people who refuse to see/acknowledge their self-sabotage, don't want to see things differently and justify it by their pain and, most importantly, don't act differently toward meeting their desires and goals. They just keep blaming and bashing the "system" for years, decades, forever... which can be fine and maybe helpful, but I doubt it would make a difference and make someone really better on its own. I did have a period like that as well regarding therapy and the "system" (being all negative and punitive about it) and am quite happy it's finally over, it really wasn't my nature to engage in that to that extent. It also just reinforced resentments that were counterproductive for me and clouded my vision from seeing my own role in it.

There is no other way to break a self-defeating, unproductive cycle but to start doing things differently. I asked you about medication before, for example - that would be possible professional treatment without your having to do much more than taking it, at minimum. If you are that ill and on disability, can't you see a doctor and discuss those options? It really seems like you could have many options to change things but you choose not to do them and rationalize it with being too unwell and hopeless. Those are symptoms of depression and it can be treated in so many ways!

[PabstBlueRibbon]

I feel for you Sarah, and I know how hard it is to navigate the Swedish mental healthcare system - since I'm from Sweden myself. If you want to talk, feel free to message me.

Edit: I just took a quick look at threads started by you and I see you seem to write about loneliness and people thinking you have autism. You seem to react very negatively to this, but I think you should consider doing an evaluation. I'm on the spectrum and it's really not that bad. =)

Kram

I did have a period like that as well...There is no other way to break a self-defeating, unproductive cycle but to start doing things differently.

If someone wrote a similar post to you when you were in that state, telling you to do thjngs differently, would their post have been the catalyst for you to change?

Everyone of us here did what we did....until we didn't...until we changed. Many of us have been stuck. What you said may be true, but I just wonder if a person has to be in a certain mindset to benefit from such challenging words or if they might lead someone to feel more hopeless?

[Ididitmyway]

Originally Posted by octoberful

If someone wrote a similar post to you when you were in that state, telling you to do thjngs differently, would their post have been the catalyst for you to change?

But people who know what's best for others are never in a vulnerable state (or, to be more accurate, they deny their vulnerabilities), or they'd tell you they hit the rock bottom many times, but that they were always able to pull their **** together, pick themselves up and dust themselves off because they are so self-sufficient, so mature and responsible, so awesome, so strong and independent. And, if you don't measure up to their standards you are just a whiny little baby who refuses to take responsibility for your own life and they always make sure that you know that.

I find it entertaining that such independent, "rational" and "strong" people have the need to hang out on forums like this one and seem to be so emotionally invested in convincing others to make personal choices that are consistent with their own views and attitudes and so agitated when people "don't listen" to them.

One thing is to have a debate on some psychology/psychotherapy topic, but telling someone how to handle their personal predicament and, not only that, but to pass a moral judgment on a person for handling it differently from how they would handle it is a completely different thing.

IMO, strong and independent people don't get so personally invested in other people's lives and don't get offended by the personal choices other people make, because they are actively engaged in their own lives and have a thousand of more important and exciting things to do than to keep convincing someone they don't even know to live their life differently.

When I see someone becoming so frustrated with the choices of the other person, especially when that person is someone they don't even know because they interact with them online only, I doubt that they are as strong and independent and rational as they are trying to present themselves to others. A rational person wouldn't waste time on someone who is clearly not interested in taking their advice. A rational person would ..well..get a life.

Clearly, the "strong" people here, who are "not victims" got triggered by the OPs stories. What got triggered in them, I suspect, is their own vulnerability they don't want to acknowledge and deal with.

I am not commenting on this issue any more. I needed to say what I've just said because I hate moralistic lecturing no matter how sugar coated it is and how much it is disguised as an intention to "help". I think, those who claim they want to " help" would benefit from some self-examination and from being honest with themselves about what REALLY makes them come to the OPs threads and comment.

I will not respond to any "rebuttals" to this.

I didnt take Xynesthesia's post like that.
I wanted to provide another perspective about when someone is in a vulnerable state and already feeling hopeless, like you said.

[Ididitmyway]

Originally Posted by octoberful

I didnt take Xynesthesia's post like that.
I wanted to provide another perspective about when someone is in a vulnerable state and already feeling hopeless, like you said.

That's fine. You take anyone's post however you take it and I take it how I take it. That's all there is to it.

Originally Posted by octoberful

If someone wrote a similar post to you when you were in that state, telling you to do thjngs differently, would their post have been the catalyst for you to change?

Everyone of us here did what we did....until we didn't...until we changed. Many of us have been stuck. What you said may be true, but I just wonder if a person has to be in a certain mindset to benefit from such challenging words or if they might lead someone to feel more hopeless?

To the bolded: yes, many times, for the bolded question. Not only me but I had seen quite a lot of people. Not so much on this one forum, but on another mental health-related one where I participated a lot before and many people were not any less vulnerable and stranded, myself included in certain periods. People challenging these states directly were often the most helpful for many of us. I also see this pretty often in person, in everyday life. Often it does not seem to be helpful immediately and people can react quite negatively to it in the moment (just like here now) but equally often enough it makes them think and re-evaluate in the longer run, exactly because it had a stronger effect initially so it lingers. This is why I do it - I tends to work for me best and have seen it work for enough others as well. Surely not everyone and maybe it's not a certain mental state one has to be in rather than a certain personality. But we don't really know each-other well on a forum like this to really know what truly works for whom and when. I don't talk in this way all the time, not even too often, I do when I have already tried a bunch of other things, the OP I talk to has been in that state for a long time and clearly suffers from it, and empathy/sympathy alone does not seem to be helping much to change it. Of course getting this kind of response alone would not help either, but on a message board like this, with a variety, I don't mind taking a role to do this as it'll be balanced by many other kinds of posts. I am happy to take criticism for it though and like this kind of direct one.

Ididitmyway, you have been reacting to my comments not targeted to you, for a while I think. I wonder why you do not talk to me directly though if you feel a need to defend others, or even yourself? This is probably most direct so at least I can say something to it. I am not sure where you get the notion that I am not vulnerable and am only "independent and rational". You must have read only a smaller proportion of my posts to assume that, or read them selectively, which is fine, but then the perception may not be accurate. I also posted many times that I do tend to have issues acknowledging vulnerabilities at times, so it is useful for me to be reminded. I also wonder why you make such strong statement(s) though and then finish saying you will not respond to a response - you do this often, not just this time and not only in response to one person or two. Do you think it is an effective way to challenge people or to get your opinions considered seriously and in the longer run, whether it critiques a condition, behavior, attitude, concept, or is meant to protect others? I do appreciate many of your posts about various topics (as I had told you before) but would appreciate more direct communication if you wanted to challenge me as in this way it cannot be true communication and it only/mostly sounds defensive, and not defensive of the OP. As I said the feedback is useful for me anyway and perhaps it is true it's best if I don't use this attitude on Sarah's threads.

[Anne2.0]

Originally Posted by Ididitmyway

But people who know what's best for others are never in a vulnerable state (or, to be more accurate, they deny their vulnerabilities), or they'd tell you they hit the rock bottom many times, but that they were always able to pull their **** together, pick themselves up and dust themselves off because they are so self-sufficient, so mature and responsible, so awesome, so strong and independent. And, if you don't measure up to their standards you are just a whiny little baby who refuses to take responsibility for your own life and they always make sure that you know that.

. . .

I will not respond to any "rebuttals" to this.

I think that your post is better suited as a self guide to examining its internally inconsistent content, because the only person that seems to have an agenda here, to condescend to tell others how to post here to invisible rules you have implemented and judged, is you. You don't have any better idea of what's supportive than anybody else, and I really don't think it's necessary to bully and denigrate others just because you disagree with their approach to saying what they think. Most of all, I don't think it is healthy to attempt to silence others and pretend it's for somebody else's good. I had a childhood full of that and I'm not doing it again.