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Samantics
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Trig Oct 07, 2020 at 09:07 PM
  #1
Hi there, I'm new here, and new to treatment/diagnosis. I've just recently started talk therapy to try to help treat PTSD (from repeated child sexual abuse) and related problems (severe depression, suicidal ideation, OCD, social anxiety, relationship/intimacy problems, concentration deficiency, all the classics!)

I'm not on any meds at the moment, but am working toward seeing a psychiatrist and talking about the possibility of a prescription. I am a former drug addict (opiates, valium, cocaine, MDMA), but don't use anything anymore (quit everything cold turkey, but still fantasize about buying again when things are darkest).

I was wondering what a psychiatrist might ask me or what they might assume or comment on if I tell them about my past drug issues. I'm getting less and less safe to myself as time goes on, and feel as if talk therapy might not be enough. I'm one of those obnoxious brainiacs who thinks that they're smarter than their therapist - not in a delusional way, just in a "I've read more books than you and am more eloquent" kind of way. I keep this completely to myself because I know it's not fair or rational, but it does hinder the effectiveness of the therapy.

Anyway, that was less a question and more a messy ramble. I hope someone can read this and maybe offer some advice? Anyone dealing with similar things? I'm new to this so don't go too hard on me! Just need some sense-making.

Thanks in advance!

Last edited by bluekoi; Oct 07, 2020 at 09:42 PM.. Reason: Add trigger icon.
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KBMK
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Default Oct 08, 2020 at 02:57 AM
  #2
Hi, I haven't been diagnosed, but think post traumatic stress is definitely the struggle. I am so sorry to hear what you have had to experience as a child. I can only imagine how horrifying it is to come to terms with that in sobriety. I really believe, because of what you have survived so far, you are an incredibly strong person, and you will find what you need.

I have quite recently stopped acting out badly and self medicating. For me, it's been massively helpful finding a psychotherapist that isn't patronising. He helps me laugh when I'm taking myself too seriously, and helps me get real when I'm minimizing the big issues.

Do you think it's possible that your therapist might be able to offer some insight if you were to bring up your concerns about their ability to help you?

Do you have faith that the therapy itself could help?

It could be worth trying, and if they're not so insightful, and it doesn't help, could it be worth seeking out a better fitting therapist?

I am thinking about prescription medication (I'm stuck, not being able to deal with some pressing issues that are badly triggering), and have many concerns about the effectiveness, side effects, habit formation...on and on. At the end of the day, I think we have to be willing to trust our own judgement (of the professional person), and to trust our knowledge of our own experience to get anywhere with this.

I'm sure a great psychiatrist would give you a well formed professional opinion, address your concerns, and help you make a well informed choice. Most psychiatrists, I expect, would do their best to help you. They could be a bit judgemental, or have their own concerns about prescribing, but I think it's likely they'd want to reduce your risk of harm from self medicating. They would very likely understand (medically) exactly why you have had to do that, too. It's probably worth trying by the sounds of it.

Thanks for your post (and good moving joining PC...it has been for me )

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Default Oct 08, 2020 at 11:07 PM
  #3
Hey @ Samantics: Its a tough question whether or not to disclose substance use. But in terms of mental health its almost imperative. I am an alcoholic in recovery and my mental health treatment included full disclosure. My psyche still prescribed me adderall for adhd. But I do not tell all doctors because I have experienced bias and poor treatment especially when some have found out I take a controlled substance. I do not have the addictions you have had but some psyche docs with prescribe benzos for anxiety and you do not want to find yourself subconsciously looking for valium. I am only saying that because of what you shared. Kudos to you for kicking it all.

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Samantics
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Default Oct 09, 2020 at 06:14 AM
  #4
Thank you all very much for the perspectives. Off to work now, but I will post more detailed response when I have time. Very helpful perspectives so far. Thanks again
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Default Oct 09, 2020 at 06:28 AM
  #5
I agree with the previous two replies. You should let them know about your worries of being too book smart and eloquent. I've had a therapist who would have been offended, but at least you set the tone of the sessions. I've also had one that would have appreciated the concern because they were thick skinned and able to handle it. Therapy should be a place to let it all out. Since your are so self-aware you should be able to let them know all your thoughts and feelings in a graceful way. While health professionals are human beings with feelings, too, they get paid to listen to our deepest thoughts since the average person can't handle them.

Also, revealing your history with drugs is imparative as they will be able to prescribe what's best for your case. Better to be thorough and honest for your own sake!

Sorry for your struggles! I know child abuse is a lifelong burden. You are strong for facing your demons!
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Samantics
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Default Oct 09, 2020 at 10:02 PM
  #6
Thanks everyone for the advice and experience. And thanks for being such nice people!

I've decided based on your collective input to be very upfront with the psychiatrist when the drug thing comes up. I'm desperate for them to provide the best care they can at this point and it sounds like your suggestions are well tested.

I'll also do my best to address the self-awareness/book learnin' issue in as open and non-confrontational a way as possible. I'll try to bring it up with my talk therapist as well. Hopefully he'll be able to adapt and innovate something to work around it... he is the expert after all!

I have one or two more things I'd like to ask, but maybe I'll save them for their own threads (if that's how things are done on this board?)

Thanks again folks. Hope you all have a healthy and otherwise awesome weekend.
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