ask a psychotherapist

[bassment zombie]

Other folks have been so helpful with their areas of expertise, I figured I'd offer a bit of my own. I've got my tweed jacket on, tissue box nearby, and a fresh pad of notepaper. Feel free to post your behavioral health questions and curiosities here. :coffee:

[cdb]

Other folks have been so helpful with their areas of expertise, I figured I'd offer a bit of my own. I've got my tweed jacket on, tissue box nearby, and a fresh pad of notepaper. Feel free to post your behavioral health questions and curiosities here. :coffee:

why am I so nuts? I have chronic dysthymia, overly sarcastic and ill-tempered, and I drink like a fish. Whats up with that?

[bill]

why am I so nuts? I have chronic dysthymia, overly sarcastic and ill-tempered, and I drink like a fish. Whats up with that?

Might have to do with being an old hippie and what young hippies did before they got old..... but that is just a guess:dunno:

[cdb]

Might have to do with being an old hippie and what young hippies did before they got old..... but that is just a guess:dunno:

Hey! You stay outta this! I asked a shrink, not a dubiously appointed official from Minnesota!:mad:;)

[bill]

Hey! You stay outta this! I asked a shrink, not a dubiously appointed official from Minnesota!:mad:;)

:P

[thrash_jazz]

Does Chuck have issues, a subscription, or the whole library?

[bassment zombie]

why am I so nuts? I have chronic dysthymia, overly sarcastic and ill-tempered, and I drink like a fish. Whats up with that?
Ill tempered and 'chronic' is par for the course in those suffering from dysthymic disorder. You're not nuts at all. Unlucky is what I'd call it. :(

I wouldn't be surprised if you also had sleep difficulties, fatigue, impaired concentration and feelings of hopelessness...self-critical'ness...feelings of inadequacy...lost of interest in activities that were previously pleasurable...social withdrawal...guilt and ruminations about the past...anger...am I leaving anything out? Man, it's not a good place to be - I feel for you. That's an enormous burden :(

The really sad part about this disorder is that the diagnostic criteria entails that the chronically depressed mood persists more days than not for at least 2 years, and thus, many sufferers don't recognize that 'something is wrong' and instead feel these horrible symptoms are part of their personality or 'makeup,' so to speak. :angel:

Its also not surprising that you tend to drink a lot.

The good news is that evidence DOES show that sufferers have significantly better outcomes with treatment. You seem to have a great deal of knowledge about your condition already, so I assume you receive treatment. For mood disorders, I always recommend a bilateral treatment approach with both psychopharmacological and clinical therapy.

So yea, that was my long response. :smack:

My short response is - your experience sounds completely par for the course for those who suffer from Dysthymia. I hope you're receiving treatment and have a good support system in place. You seem like a great guy, you have a great sense of humor and are doing good things with yourself, and for that, you should be commended :wave: That said, Dysthymic Disorder is one nasty fucker. I wouldn't wish it upon my worst enemy. What'sup with that, you ask? There's definitely a strong genetic component among first degree blood relatives. So you can fully thank ma or pa for that genetic cocktail you were dealt. :angry:

If you have any additional questions or concerns regarding treatment, diagnostic details, or whatever, feel free to be in touch. :wave:

[Low Tone]

I've discussed this some on the forum before but I have an overwhelming fear of death. It actually keeps me awake at night thinking about it.

What happens if the Christians are right and I'm going to Hell?
Worse, what if the atheists are right and I cease to exist at all?
Might sound a bit Narsistic but ceasing to exist doesn't seem like any fun at all.
Of course, burning in eternal Hellfire wouldn't be any picnic either.

What are they going to do with my body afterwards? The idea of being stuffed in a box and burried 6 ft underground doesn't appeal to me at all. Creamation doesn't sound much better. Mausoleums are too expensive.

You wouldn't believe the nightmares this shit leads to.

I'm also scared of flying and tight spaces.
I won't go into spiders.

[bassment zombie]

I've discussed this some on the forum before but I have an overwhelming fear of death. It actually keeps me awake at night thinking about it.
That sounds rough.

I was about to respond to this portion of your post, but then I caught myself and realized that you didn't ask a question. Is there anything specific in your post you'd like me to address?

[Low Tone]

That sounds rough.

I was about to respond to this portion of your post, but then I caught myself and realized that you didn't ask a question. Is there anything specific in your post you'd like me to address?

Address as you see fit.
I'm interested in hearing people's analysis of me.

[DeathHands]

Dysthymia... Hmmm... I think I may have this. I've got a lot of the symptoms listed in the very trustworthy Wikipedia. I was diagnosed with blanket depression a little while back, but I don't see depression. I'm also very much obsessed with my own demise. And I'm sort of talking out of my ass. You can ask me things, and I can answer. :P

That's an awkward first-post.

[Low Tone]

That sounds rough.

I was about to respond to this portion of your post, but then I caught myself and realized that you didn't ask a question. Is there anything specific in your post you'd like me to address?

Address as you see fit.
I'm interested in hearing people's analysis of me.

Actually, I'd really like to know what to do about this.
There are times when the fear of dying actually leaves me almost paralyzed.
I'm rather obsessed about it at times. I know it's inevitable and that's the part that scares me most.

[bassment zombie]

Address as you see fit.
I'm interested in hearing people's analysis of me.
Psychoanalysis...that type of work is best and responsibly done with a professional under the protection of confidentiality and trust. It also takes an amazingly long amount of time to do properly. Years. And you'll go into all kinds of shit about yourself, your history, your memories and your makeup that you didn't even realize was there. It can be fascinating and rewarding work, but its not going to help you anytime soon. There are many other very effective therapeutic methods and approaches that are much less costly and much more timely. Psychoanalysis is great for people who have tons of money, a lot of time, and are ready and willing to engage in self-exploration over a long period of time.

In my opinion, it sounds like your biggest problem that you've shared is this:

I've discussed this some on the forum before but I have an overwhelming fear of death. It actually keeps me awake at night thinking about it.

Fears and anxieties are par for the course for the vast majority of us. However, what I think I hear you saying (correct me if I'm wrong) is that your daily functioning is negatively impacted - as evidenced by your disturbed sleep (or lack thereof), and perhaps other things you haven't identified. You didn't elaborate, so I cannot assume how much or how little it affects you and your life - your vocational functioning, your energy and presence with your family, your self-directiveness, etc...You can certainly keep on keeping on as you always have. But you know what...it doesn't have to be that way.

I would recommend that you go through your insurance carrier and find a therapist as soon as possible to help you with the above presenting problem - at the very least to begin with. If you've never done it before, I'd be happy to tell you all about the process to let you know what to expect. Most people bonk themselves upside the head and wonder what the hell took them so long to start receiving treatment and the resulting support, resources, coping mechanisms and growth it can provide.

Dysthymia... Hmmm... I think I may have this. I've got a lot of the symptoms listed in the very trustworthy Wikipedia. I was diagnosed with blanket depression a little while back, but I don't see depression. I'm also very much obsessed with my own demise. And I'm sort of talking out of my ass. You can ask me things, and I can answer. :P

That's an awkward first-post.
No worries! It's always useful to obtain as much information as possible. However, it's very difficult to self-diagnose. In many respects, diagnoses are quite fluid. That's not to say that they're "BS"...though they certainly can be guesstimates in some ways - which, by the way, is also the case in medical treatment, as well. We live in a deficit, pathology-based system. In order to provide treatment, a diagnosis must be given. That's right - I see a client one time, do a clinical interview, and I have to diagnose. That said, the diagnosis can and does change. Think of them as 'a moment in time' for a client. Some diagnoses are more fluid than others due to their very nature, of course. The diagnosis guides the treatment, etc. The treatment among various depressive disorders can appear remarkably similar - with minor variations to address the variances. Has your treatment been effective? Where has it fallen short (if at all)? The piece concerning your obsession is a separate matter that I don't want to force you to self-disclose.

Actually, I'd really like to know what to do about this.
There are times when the fear of dying actually leaves me almost paralyzed.
I'm rather obsessed about it at times. I know it's inevitable and that's the part that scares me most.
What happens to you when you become almost paralyzed? What is it like?
When does it happen?
How often does it happen?
On a scale of 1-10, how bad is it for you? (1 = not bad at all, 10 = couldn't be worse)
How does it affect your life? Your daily life? Your functioning (work, family, personal life, sleep, etc.)

As I mentioned before, I think you could really benefit from therapy.

[Low Tone]

As I mentioned before, I think you could really benefit from therapy.

People have told me that for years. :D

Seriously, this is a new one that just started a couple of years ago when I had problems with my neck. I'll try to elaborate more later but right now I have to run for work.

[DeathHands]

No worries! It's always useful to obtain as much information as possible. However, it's very difficult to self-diagnose. In many respects, diagnoses are quite fluid. That's not to say that they're "BS"...though they certainly can be guesstimates in some ways - which, by the way, is also the case in medical treatment, as well. We live in a deficit, pathology-based system. In order to provide treatment, a diagnosis must be given. That's right - I see a client one time, do a clinical interview, and I have to diagnose. That said, the diagnosis can and does change. Think of them as 'a moment in time' for a client. Some diagnoses are more fluid than others due to their very nature, of course. The diagnosis guides the treatment, etc. The treatment among various depressive disorders can appear remarkably similar - with minor variations to address the variances. Has your treatment been effective? Where has it fallen short (if at all)? The piece concerning your obsession is a separate matter that I don't want to force you to self-disclose.
I guess. I was on depakote for a while, but I disliked taking so much, so I've slowly weened myself from it. I don't get to see my pysche doc for another couple of weeks, and I got sick of having 1.25 grams of that in my system. It did nothing noticeable for me. I'm also on Zoloft. Again, no noticeable changes for myself.

I think that the two are totally related. I'm a very down and negative person. The obsession with my death and what happens afterwards has been around for as long as I can recall. A few months ago, I attempted suicide(which was due in part to other factors, but it was also there because I have that morbid curiousity), and I was hospitalized. The doctor that diagnosed me refused to accept the fact that I feel that I'm not depressed. Not in any traditional sense that I can use to define "depression". I'm not exactly jovial, but I'm far from an extreme example of anything, other than cyncism and other things that I read about in that wikiarticle.

It's very contradicting and absolutely difficult to try and put it down without a guideline. Haha.

[Low Tone]

What happens to you when you become almost paralyzed? What is it like?
When does it happen?
How often does it happen?
On a scale of 1-10, how bad is it for you? (1 = not bad at all, 10 = couldn't be worse)
How does it affect your life? Your daily life? Your functioning (work, family, personal life, sleep, etc.)

As I mentioned before, I think you could really benefit from therapy.

OK... A little more elaboration.

I would guess that "paralyzed" is probably the wrong way to put it.
Basically, I just have really vivid daydreams. Like to the point I can see myself lying locked inside a coffin. As I mentioned, I'm clausterphobic anyway so it's not a pleasant sensation. (I'd make a lousy vampire for that reason.) It's not really a fear of being "burried alive" but being dead and still being aware of my surroundings. I know that sounds weird but that's the best way I can describe it.

These daydreams can get vivid enough to the point where it almost seems real. I will forget whatever I am doing and just sort of lose myself in them. Fortunately, they don't occur whenever I'm driving or operating heavy equipment. It usually happens when I'm sitting idle and not thinking about anything else in particular. The worst is at night when I'm trying to go to sleep.

Aside from the coffin, I have also had daydreams where I've found myself in Hell or Purgatory. Either burning or just wandering around lost and cold. Usually I am alone but sometimes I can see other people in varying degrees of decay or just ghostly figures. (Tim Burton would love wandering around in my head.)

Less frequently, I see myself inside the chamber of a creamtion oven. Not exactly a fun thought either. None of the daydreams are pleasant. I don't ever get to go to heaven or just hang around in a higher state of conciousness. It's always something bad.

This actually all started about 3 years ago when I had the bone spurs in my neck. They tried to do a MRI scan on me and I had such a clausterphobic reaction that it sent me into full blown panic mode. I felt like I was going to get stuck inside the tube and get trapped there forever. Totally irrational but that was the one thought stuck in my head. I finally ended up getting an open MRI done but having that big plate hanging over me wasn't much better.

After that was done and they found the bone spurs, they signed me up for physical therapy but told me if that didn't work then I would have to have surgery. The thought of them doing surgery on my neck didn't help matters either. I kept having these thoughts about the doctor fucking something up and leaving me paralyzed or the scalpel slipping and killing me altogether. I won't even go into the "anesthesia awareness" fantasies. Fortunately, the physical therapy did the job and I recovered without them cutting up my neck.

However, I still keep having these messed up death fantasies. Compound that with my agnostic belief system and the whole concept of dying just really freaks me out.