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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 30. This is the beginning of the thread.
Posted by judy1 on March 15, 2001, at 10:30:42
My therp mentioned a hospital that specializes in this, 2 weeks inpatient. I freaked out. I just can't do hospitals. I was up all night with panic attacks and e-mailed my shrink this morning to make sure everyone understands. If you have any suggestions on how to protect myself, please help. thanks, judy
Posted by Chris A. on March 15, 2001, at 14:02:13
In reply to cutting not in control, posted by judy1 on March 15, 2001, at 10:30:42
Dear Judy,
Sorry to hear you're having such a rough time. Is there a reason hospitalization is so scary to you? I see them as being there to help in time of need. If they have tools in their box to help us deal with these devastating illnesses that is a plus. I develop an aversion to hospitalization when a staff member is less than sensitive or I perceive them to treat me with less than respect. My less than stellar experiences have been with techs, not with those with more professional training. Ask questions about the hospital's program. Phone and ask to speak with the program director to see what they have to offer. You are the consumer and should be in charge. Without satisfied customers they'd all be out of a job. My biggest frustration is that I haven't gotten well, despite the hospitalizations. Mine have been mostly to keep me safe, though.
Blessings,Chris A.
Posted by pat123 on March 15, 2001, at 14:59:09
In reply to cutting not in control, posted by judy1 on March 15, 2001, at 10:30:42
> My therp mentioned a hospital that specializes in this, 2 weeks inpatient. I freaked out. I just can't do hospitals.
From what I understand, cutting is a difficult behavior to get under control. Given that this hospital specalizes in this problem you may have to put aside your hospital phobia to get well. That is what you want, isn't it ? It may take a controled environment where you cannot do this while at the same time spend all your waking hours
working out why you do this and how to stop it.Do keep in mind that the psyc hospital is different from a regular hospital. No daily blood draws and other intrusive procedures. Could you visit this place to check it out ?
I remember from the archives that you have been working to stop this for some time. Cutting seems
to become a ingrained behavior over time so if you are not having sucess (stopping cutting) going inpaient for 2 week sounds like a good next move, to me. Otherwise the other option is to do nothing and continue cutting. Inpatient treatment
holds the possibility to stop this. This behavior
must be very troubling to you and drastically effects your quality of life. If it were me I would do anything to stop it.Maybe if you did some fact finding about this hospital program this would help calm your fears.
Pat
Posted by aDaMs on March 15, 2001, at 15:58:43
In reply to cutting not in control, posted by judy1 on March 15, 2001, at 10:30:42
I dont understand cutting, is it a addiction that you cannot stop? It is self mutilation, maybe you could try to explain why you are cutting yourself? If you want to. But I think that you must be in a lot of pain if you are cutting yourself, the question is why do you want to cause yourself more pain? It seems like you must be suffering and you need better treatment then what you are getting now, if a hospital can provide you with the treatment you need then you should go.
Posted by ShelliR on March 15, 2001, at 16:20:09
In reply to cutting not in control, posted by judy1 on March 15, 2001, at 10:30:42
Judy, before you said that you don't know when you're cutting--that you dissociate. Is that the case now also? If you have particular objects that you cut with, can you rid your house of them?
Incidently, I've had good experiences in the hospital, even though the first time I was pretrified to go in. Can you visit the hospital before you decide. I did--I went for a little tour and spoke to some of the staff on the unit and felt very reassured. shelli
Posted by judy1 on March 15, 2001, at 21:47:46
In reply to Re: cutting not in control » judy1, posted by ShelliR on March 15, 2001, at 16:20:09
My psychiatrist just said no hospitalization without his approval, that made me feel a lot better. Hospitals probably mean something very different to all of you than me; to me they mean restraints and isolation rooms and threats of ECT. These are 'good' hospitals- I guess none of you have been committed involuntarily? I don't want to cut, yes I dissociate, i try to follow all my therps directions it still happens. I am really depressed, this is how i deal with it. I know it's sick. thank you for all your replies- judy
Posted by Shar on March 16, 2001, at 3:46:24
In reply to Re: cutting not in control- to all, posted by judy1 on March 15, 2001, at 21:47:46
Judy,
I get so concerned about you! I know you will be ok, and I was happy to see you got right in touch with your doc and didn't wait in agony til things felt worse. That's a very healthy thing to do to take care of yourself--quick action on behalf of yourself.I suppose it would be really impossible for you to get rid of all of the sharp objects in your home. Does it get down to the purpose of cutting? What I heard was to be able to feel something, anything. Or, to feel in control. Does that fit for you?
The times I've harmed myself haven't been cutting, but the purpose was to express rage the way a helpless, powerless person could--against the self. But I think cutting may be different.
Anyhow, Judy, we're all sick, so that's sort of a given (in my head at least) and I don't worry about it. Maybe you could not worry about it.
You are a strong, courageous woman. Hang in there.
Shar
Posted by pat123 on March 16, 2001, at 10:36:52
In reply to Re: cutting not in control- to all, posted by judy1 on March 15, 2001, at 21:47:46
Hospitals probably mean something very different to all of you than me; to me they mean restraints and isolation rooms and threats of ECT. These are 'good' hospitals- I guess none of you have been committed involuntarily?
Provided you commit yourself voluntarily this cannot happen, you can leave anytime. All the more reason to deal with this now before you
really spin out of control and are committed involuntarily because you are a danger to yourself.Pat
Posted by judy1 on March 16, 2001, at 11:02:18
In reply to Re: cutting not in control- to all » judy1, posted by Shar on March 16, 2001, at 3:46:24
I think it's because of the childhood sexual abuse, no control i just left in my mind. It is my coping skill, i have to learn others. Hospitals make me feel like that, no control, i feel like they are out to hurt me. thank you for your kind words- judy
Posted by CarolynAnn on March 16, 2001, at 19:39:47
In reply to Re: cutting not in control- to all, posted by judy1 on March 15, 2001, at 21:47:46
> My psychiatrist just said no hospitalization without his approval, that made me feel a lot better. Hospitals probably mean something very different to all of you than me; to me they mean restraints and isolation rooms and threats of ECT. These are 'good' hospitals- I guess none of you have been committed involuntarily? I don't want to cut, yes I dissociate, i try to follow all my therps directions it still happens. I am really depressed, this is how i deal with it. I know it's sick. thank you for all your replies- judy
I don't know where you are, but I have been in the hospital three times, and, in my experience, the only time it means restraints and isolation is if you are threatening harm to others, or to seriously harm yourself. It can be very helpful, and at least a rest! I also had ECT and found it not to be bad at all. Of course I can't remember exactly how I felt about it at the time. I would have thought I'd be terrified at the idea, but my husband said no...I was more relieved that maybe it would help. And it did. So, my suggestion is that, if a doctor suggests that hospitalization may help, try to put aside your fears and realize that sometimes that what it takes to acheive better health in the end. Actually, I was really scared the first time I went in, but found it was just about as difficult to come back home! And I had many humorous experiences there and made some good friends. So you just never know!
Take care...
Carolyn
Posted by Craig on March 18, 2001, at 3:18:00
In reply to Re: cutting not in control- to all, posted by pat123 on March 16, 2001, at 10:36:52
My experience with voluntary hospitalization is that the theory is good, but the practice can be something different. Signing yourself into the hospital voluntarily does NOT always mean that you can leave whenever you want. If your doctor is present and he agrees that you're ready to leave the hospital, chances are that you'll be discharged without a problem. If he doesn't feel discharge is in your best interest, but you aren't a danger to yourself or others, you'll probably be allowed to leave AMA (against medical advice).
However, if your doctor isn't around and the ward staff drag their feet long enough or just plain won't bother to locate your doctor until it's too late in the day, you may as well forget about leaving then. You can tell me all you want about how that is against the law, but it happened to me. Other reasons why I wasn't allowed to leave when I requested to be discharged were it was a Saturday and requests had to be made Monday-Friday during the day. At other hospitals, after you'd made a written request to leave, you had to wait 5 business days before your request would be considered. This is the point at which I would be threatened by the doctor to either drop my request to be discharged or he would petition to have me involuntarily committed. I once had a strange doctor who told me if I dropped my request to leave, he would give me a weekend pass! I accepted his offer, went to my parent's house on pass, locked myself in the bathroom and refused to return to the hospital. (OK, it was childish, but it worked.) The doctor called and threatened to have the police come and pick me up, but I gambled and figured they had better things to do the week before Christmas than break down somebody's bathroom door to retrieve a "mental case." Maybe I got lucky because I was only a danger to myself.
I think I understand some of Judy's panic. My previous doctor once told me over the phone that I was to go to the Emergency Room right away. I know this sounds odd, but I remember telling him I couldn't because I was too sick to go to the hospital. It's a feeling of being overwhelmed and unable to defend yourself. For someone who doesn't trust well, going into the hospital is very hard to do.
P.S. to Judy: Like you, I am also familiar with restraints and isolation rooms. My history goes back to the days when injections of Thorazine were the ward staff's answer to seemingly everything. Some things you never forget.
**************************************************
> Provided you commit yourself voluntarily this cannot happen, you can leave anytime. All the more reason to deal with this now before you
> really spin out of control and are committed involuntarily because you are a danger to yourself.
>
> Pat
Posted by Shar on March 18, 2001, at 18:45:50
In reply to Voluntary Hospitalization, posted by Craig on March 18, 2001, at 3:18:00
Judy,
I've never been hospitalized, and it does not sound pretty, what you talked about and what Craig talked about sounds sort of scary. So, I understand why you might be worried about going in.On the other hand, I believe there must be safeguards you can take before you go in, to have someone check on you, or something like that. I don't have a good suggestion, but letting someone from the outside know you might be too scared in the hospital to benefit.
It isn't sensible to me to hospitalize someone who is terrified because then it seems you'd spend your time getting the terror under control. Maybe not.
I would like to see you get more help about your cutting. I really am concerned about you on that score. The hospital may not be the way to go, but maybe there is other therapy, or a group for folks who were sexually abused or dissociate.
Something to help you, Judy. Not to terrify. To keep you present, not dissociated. To keep you whole. I will pray for you for what it's worth.
Shar
Posted by judy1 on March 18, 2001, at 21:12:33
In reply to Voluntary Hospitalization, posted by Craig on March 18, 2001, at 3:18:00
Dear Craig,
Thank you for understanding; I think only someone who has been through this understands my terror. take care, judy (I have also had the week-end problem- no pdoc, no discharge)
Posted by judy1 on March 18, 2001, at 21:18:16
In reply to Re: Voluntary Hospitalization----Judy, posted by Shar on March 18, 2001, at 18:45:50
Shar,
Thank you for your prayers; I agree I will not benefit feeling the way I do. My pdoc mentioned something about intensive therapy- like seeing him daily for a week. That was really nice of him but insurance won't cover, he's far so I would have to stay in a hotel... I'm doing a little better with the dissociation today. thank you- judy
Posted by noa on March 18, 2001, at 21:29:18
In reply to Voluntary Hospitalization, posted by Craig on March 18, 2001, at 3:18:00
Judy, thinking of you.
Posted by judy1 on March 19, 2001, at 11:00:33
In reply to Re: Voluntary Hospitalization--Judy, posted by noa on March 18, 2001, at 21:29:18
thank you Noa, that means a lot to me. You have always been generous with your support and knowledge. take care, judy
Posted by Ted on March 19, 2001, at 23:32:15
In reply to Re: Voluntary Hospitalization » noa, posted by judy1 on March 19, 2001, at 11:00:33
Judy,
I too am thinking of you.
I voluntarily admitted myself to a local hospital about 2 years ago (night before mother's day, 1999). I consider it the single best thing I have ever done. But it is risky. You have to make sure you go to a good, private hospital, where there are good doctors & nurses, and where you will be treated well. My week at "El Camino Resort & Country Club" as I call it was 100% positive. I was lucky. I met other patients there who had been at other hospitals and weren't so lucky. And unfortunately you are not in a state of mind to go around evaluating hospitals.
DO take care of yourself. Try not to be alone. Remember, we all care.
Ted
Posted by judy1 on March 20, 2001, at 12:16:49
In reply to Re: Voluntary Hospitalization, posted by Ted on March 19, 2001, at 23:32:15
Ted,
Thank you for your kind words. You are right, I can't go and check out hospitals. Even going to the parking lot i start having panic attacks. The last time I was in a hospital (there have been many times) I was on a suicide watch and checked every 15 min? There was a little slot underneath a window that wouldn't open and i would put my hand in and try to turn my wrist in an attempt to cut it all the time counting out the time until the nurses would check on me again. when the dr came the next day i had long sleeves so noone could see the bruises. I truly would rather be dead than be in a hospital. My dr. knows that and I think Craig maybe understood. I am happy for all the people that have had good experiences, there have been places that did not hurt me but I still was certain they would. this is on me I will try to work hard with my pdoc. take care, judy
Posted by SLS on March 21, 2001, at 22:19:44
In reply to cutting not in control, posted by judy1 on March 15, 2001, at 10:30:42
> My therp mentioned a hospital that specializes in this, 2 weeks inpatient. I freaked out. I just can't do hospitals. I was up all night with panic attacks and e-mailed my shrink this morning to make sure everyone understands. If you have any suggestions on how to protect myself, please help. thanks, judy
I am sorry if someone else has already mentioned this (I lack the concentration to read the whole thread), but what about trying the drug naltrexone (Revia)? I know it is being studied for use in a variety of conditions displaying SIB (self-injurious behavior). It might be the quickest way to mitigate cutting without hospitalization. I don't know how well accepted this treatment is yet.I came across a few optimistic studies concluding that even a short course of treatment (acute) can produce improvements that last for some time beyond the end of treatment. Similarly, long-term treatment with naltrexone can have long-lasting effects once the drug has been discontinued. Improvements can be progressive over the course of time with continuing treatment. These are just the results of some of the very few investigations into the use of naltrexone in SIB, and probably best evaluated with caution.
Naltrexone doesn't seem to be particularly effective in cases of SIB associated with autism, and may even make it worse. Most of the studies of naltrexone involve mental retardation and pediatric developmental disorders.
There really ain't too much good work done on naltrexone treatment of SIB yet, but large-scale investigations have begun. There is a lot of anecdotal stuff, though. For now, perhaps the material involving borderline-personality disorder is the most relevant.
- Scott
Posted by judy1 on March 22, 2001, at 8:03:59
In reply to Re: cutting not in control » judy1, posted by SLS on March 21, 2001, at 22:19:44
Dear Scott,
That is an EXCELLENT suggestion, and if I can manage to stop the hydrocodone abuse, naltrexone is definitely the next step. (Actually if you are not a psychopharmacologist, you should be) I am working with 2 shrinks now, who have managed to put egos aside- no easy feat- and are trying to get this under control. This is based in chilhood trauma, it is a long standing coping mechanism for me. I think I read somewhere that things that happen in childhood actually cause changes in the brain. Is that true? When you get a chance can you please look at my question on agitation on the other board? I really value your input. I am doing better (drugged to the hilt) and hope you are well- judy
Posted by Noa on March 22, 2001, at 17:18:57
In reply to Re: cutting not in control » SLS, posted by judy1 on March 22, 2001, at 8:03:59
Would the naltrexone help with the hydrocondone abuse? Isn't it used to treat alcohol abuse?
Posted by judy1 on March 22, 2001, at 17:53:57
In reply to Re: cutting not in control, posted by Noa on March 22, 2001, at 17:18:57
Hi Noa,
Beacause it is an opiate agonist it would throw me into severe detox, not a pleasant thought. Take care, judy
Posted by judy1 on March 22, 2001, at 18:00:55
In reply to Re: cutting not in control » Noa, posted by judy1 on March 22, 2001, at 17:53:57
that would cause agony for people still on opiates.
Posted by SLS on March 22, 2001, at 21:18:34
In reply to Re: cutting not in control » SLS, posted by judy1 on March 22, 2001, at 8:03:59
Dear Judy,
> if I can manage to stop the hydrocodone abuse, naltrexone is definitely the next step.
Do you think you would experience significant withdrawal symptoms should you discontinue hydrocodone? I guess you already know that naltrexone can make it worse. Once you are detoxified, naltrexone will help prevent you from abusing hydrocodone again and treat the SIB.
Maybe cool: Clonidine can help you get through hydrocodone withdrawal, reduce anxiety, agitation and aggression, and treat akathisia.
For Noa - naltrexone seems to work well to help some alcohol abusers maintain abstinance. I don't know if it serves any role in treating someone who is still abusing.
> (Actually if you are not a psychopharmacologist, you should be)
Thanks, but the flattery is truly underserved. No false modesty here. I guess I have learned enough to know how much it is that I don't know. Yes, when I was in my twenties, it was my passionate goal to become a research clinical psychopharmacologist. I wanted to get lots of people well. Unfortunately, by age 32, I realized that the stresses and demands placed upon a medical school student and, perhaps worse, the terms of internship and residency, were prohibitive if I wanted to maintain any kind of remission from bipolar disorder. I would still consider going to school to pursue a Ph.D. in neuroscience. Gotta' win the lottery first, though.
> I think I read somewhere that things that happen in childhood actually cause changes in the brain. Is that true?
Yes. Definitely. Almost any kind of chronic stress or trauma can do this.
> When you get a chance can you please look at my question on agitation on the other board? I really value your input. I am doing better (drugged to the hilt) and hope you are well- judy
Thanks, Judy
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Posted by judy1 on March 23, 2001, at 13:37:55
In reply to Re: cutting not in control » judy1, posted by SLS on March 22, 2001, at 21:18:34
Dear Scott,
You ARE good. Actually, I have .2mg clonidine pills on hand for the last time I tried to get off hydrocodone. The problems are I have really mixed feelings about it. I find it helps my panic disorder a great deal (which is always worse when depressed) So on one hand a have an effective anti-panic (with maybe AD effects?) med versus a pretty bad increase in SI- which has everyone very worried. It's hard to think logically when down isn't it? Thank you so much again, I will let you know what happens- judy P.S. I read what you wrote to Chris A- all great advice. When I took cogentin for EPS, I had some heart problems and my doc made me stop. I think that's kind of rare though.
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