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Old 08-25-2014, 03:21 PM
 
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I still disagree that what you have experienced is typical. I'm sorry you had a bad experience. I do hear that California in particular has a lot of problems, but that is not the way it is everywhere.

Most places with sliding scale fees slide all the way down to zero, based on income. If your income is low enough, you then qualify for Medicaid. The income limit for Medicaid is different according to state and region within a state, but if you are poor enough, you will get Medicaid. If we intake a person with no income or extremely income and they don't have Medicaid yet, we advise them to go apply, and in the mean time, they go on zero-fee.

I did work in a big city for over 12 years--Philadelphia. Anyone in Philly who wanted therapy could get it. There was always a waiting list to see a psychiatrist, but for just an intake for therapy it might be the same week or 3 weeks tops to get in. Summers are harder, with no interns, so that's when you'll typically see a waiting list. I also always tell people that September/October is the best time to start therapy at a clinic because that's when they have all the student interns who need a caseload.

Emergencies are different. If someone is suicidal, they get seen right away. And yes, depending on where you live, that might have to be in the ER where they have mental health professionals doing evaluation & screening. But suicidal people will be seen immediately. Every county in the nation has designated crisis centers, very often within ERs, but sometimes separate.

Most of the negatives you mention experiencing were related to seeing a doctor for your meds. Like I said, that's different. Psychiatrist time is premium, and a stable person might go 6 months in between med visits. When you have problems with a medication, yes, it is hard to get an appointment moved up. But you were saying earlier that the mental health system just wants people on meds and not therapy, and that's simply not true. We'd love to have a lower demand for meds and doctor time. I've intaked plenty of people for whom I recommended just therapy, and they didn't want to do the work that therapy takes, and insisted on a psych eval appointment so that they cold get on meds.

Psychiatrists get paid a lot more than Master's level therapists. So even if we totally book up a doctor's schedule, we usually lose money on doctor time. Therapists earn less, so a well-run clinic can hope to break even. Of course, the for-profit sector is different, but that's not the arena in which I work. Again, non-profit clinics have a lot more oversight, so you can have confidence that your therapist has someone keeping an eye on their work.

I'm not sure about California, but in most places "private" treatment doesn't mean "expensive." In many places you don't have to go to a government program to get services. I've always worked for private non-profits. We survive on a lot of public funds, namely from Medicaid and Medicare billing, but we are private entities.

Last edited by Tracysherm; 08-25-2014 at 03:26 PM.. Reason: \/\/\/ Why are those silly photos showing up under my post?\/\/\/
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Old 08-25-2014, 11:07 PM
 
Location: Cushing OK
14,545 posts, read 18,219,558 times
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Originally Posted by TracySam View Post
I still disagree that what you have experienced is typical. I'm sorry you had a bad experience. I do hear that California in particular has a lot of problems, but that is not the way it is everywhere.

Most places with sliding scale fees slide all the way down to zero, based on income. If your income is low enough, you then qualify for Medicaid. The income limit for Medicaid is different according to state and region within a state, but if you are poor enough, you will get Medicaid. If we intake a person with no income or extremely income and they don't have Medicaid yet, we advise them to go apply, and in the mean time, they go on zero-fee.

I did work in a big city for over 12 years--Philadelphia. Anyone in Philly who wanted therapy could get it. There was always a waiting list to see a psychiatrist, but for just an intake for therapy it might be the same week or 3 weeks tops to get in. Summers are harder, with no interns, so that's when you'll typically see a waiting list. I also always tell people that September/October is the best time to start therapy at a clinic because that's when they have all the student interns who need a caseload.

Emergencies are different. If someone is suicidal, they get seen right away. And yes, depending on where you live, that might have to be in the ER where they have mental health professionals doing evaluation & screening. But suicidal people will be seen immediately. Every county in the nation has designated crisis centers, very often within ERs, but sometimes separate.

Most of the negatives you mention experiencing were related to seeing a doctor for your meds. Like I said, that's different. Psychiatrist time is premium, and a stable person might go 6 months in between med visits. When you have problems with a medication, yes, it is hard to get an appointment moved up. But you were saying earlier that the mental health system just wants people on meds and not therapy, and that's simply not true. We'd love to have a lower demand for meds and doctor time. I've intaked plenty of people for whom I recommended just therapy, and they didn't want to do the work that therapy takes, and insisted on a psych eval appointment so that they cold get on meds.

Psychiatrists get paid a lot more than Master's level therapists. So even if we totally book up a doctor's schedule, we usually lose money on doctor time. Therapists earn less, so a well-run clinic can hope to break even. Of course, the for-profit sector is different, but that's not the arena in which I work. Again, non-profit clinics have a lot more oversight, so you can have confidence that your therapist has someone keeping an eye on their work.

I'm not sure about California, but in most places "private" treatment doesn't mean "expensive." In many places you don't have to go to a government program to get services. I've always worked for private non-profits. We survive on a lot of public funds, namely from Medicaid and Medicare billing, but we are private entities.
The thing is, they had to actually break the law to make appointments every three months. And I often to usually explained I was having side effects which were impacting physical health. These are things which MUST be dealt with and any psycologist/psychiratist should understand that. I even went into detail why. I'd even ask for therapy because I knew I needed to get these things out but they didn't have it and there wasn't any real low cost place. Anyone who has need of talk help and issues should be given info on organizations like the DBSA since its *those* people who helped me far more than anyone dealing with medical/county/psych concerns.

I hoped for some therapy when I moved, since there are fewer (actually much much fewer) people here. I told them I wouldn't do meds and ask if it would be worth my while and finding a ride to another town. She said no. So I just pulled myself fully away from the meds, and then in my own way dealt with the flood of emotion that let go. That is what helped make me feel so much better. I would say the mental health system out there is broken, and its not what it should be here.

I don't care how much money they make or what sort of degree they have, if a patients says look, I have this physical condition and I have to be careful and these pills are just making it worse, then they are duty bound to listen. And they were supposed to order yearly and in one case every three month blood tests to look for liver damage. Got none whatsoever. My regular doctor was working with me to see what was making me pass out, though I complaned to the pdoc. If you dispense something you *have* to listen when its a problem and screen when giving them out.

And I had medicade, and they were paying for the pills. Pills were the problem.

I'm just saying that the people like me who needed to be off meds long before I took myself off, and were discounted when I showed up with my own research on meds, and most of all had real and still effecting my life medical problems which got worse thanks to meds deserve to be heard and listened to.

The whole system is gadged at doing the cheapest you can, which if five minutes with a doctor and cheap pills. If people can't afford a therapist they should be steered to non cost support groups like the Dbsa. And patients who use the resources available at the click of your mouse should be respected as it being their choice when they look up meds and choose not to risk the side effects. One in particuar I said no to was red checked as a warning applying to me by the FDA approaval report which I found but the pdoc had never heard of it, which lost any respect for his skills and training I might have had.

At one point I was seeing a therapist, but when I got moved to medicade, no money for it.
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Old 09-01-2014, 01:01 AM
 
Location: Purgatory
6,322 posts, read 5,009,442 times
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Originally Posted by zugor View Post
I wonder if any research is being done on the long term effects of anti-depressant usage. I was one of the earliest users of Prozac and have taken it as well as several others for most of the past 25 years. I am glad not to experience those overwhelming bouts of being in the depths of depression and despair, barely able to function and in tears far too often but I hate the fact that there are times when I should be feeling terrible at some loss and I just can't even cry.

I think it makes others perceive me as cold hearted and not caring but that is not the case, I just don't "feel" deep sorrow on an emotional basis, I only know "intellectually" that the event is sad and that I should be feeling more.

My last experience of that sort of depth was when I lost my heart dog extraordinaire 8 years ago. Since then I have had to bid farewell to many senior dogs that I'd adopted and had with me for a few months or a few years, as well as a couple of dogs that had been with me for their whole lives but I just do not cry at all when it is time to let them go.
I wonder this as well. I would love to see some studies.

When i am "well", I'm also more apt to intellectualize my pain and not "feel it." When i am depressed, i can cry in bed for days over the smallest thing.

What bothers me more is I'm like the Seinfeld character who never laughs and just says "that's funny. " I have always been like this and always am- depressed or not. I'm so embarrassed and ashamed of this that I often fake laugh just to fit in.

I often wonder what effect antidepressants have had on my cognitive processes. I have been on them for nearly 20 years, moving through various ones to find one that works.

Zoloft was the most bizarre experience and I fear it actually gave me brain damage. Before Zoloft, i had an eidedic memory. But sin email I was brought up in a very abusive environment, intrusive thoughts of picture perfect abuse was common. Zoloft all but wiped out my long term memory. My thought process was not as quick in every area. I actually started getting secondary depression from not being able to "think good"! I felt drunk all the time and not in a good way.

When i came off it, i still felt like this. It took me years to return to a semi sober place. I still have the least memories of those years than any others and after that, i no longer had an eidedic memory. I guess this is good and bad....
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Old 09-01-2014, 02:44 AM
 
Location: Cushing OK
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Originally Posted by Utopian Slums View Post
I wonder this as well. I would love to see some studies.

When i am "well", I'm also more apt to intellectualize my pain and not "feel it." When i am depressed, i can cry in bed for days over the smallest thing.

What bothers me more is I'm like the Seinfeld character who never laughs and just says "that's funny. " I have always been like this and always am- depressed or not. I'm so embarrassed and ashamed of this that I often fake laugh just to fit in.

I often wonder what effect antidepressants have had on my cognitive processes. I have been on them for nearly 20 years, moving through various ones to find one that works.

Zoloft was the most bizarre experience and I fear it actually gave me brain damage. Before Zoloft, i had an eidedic memory. But sin email I was brought up in a very abusive environment, intrusive thoughts of picture perfect abuse was common. Zoloft all but wiped out my long term memory. My thought process was not as quick in every area. I actually started getting secondary depression from not being able to "think good"! I felt drunk all the time and not in a good way.

When i came off it, i still felt like this. It took me years to return to a semi sober place. I still have the least memories of those years than any others and after that, i no longer had an eidedic memory. I guess this is good and bad....
For my experience, I measure that in my writing. The stuff written before any meds is intensely emotional and while some of the characters are quite cold, the anger all around them is quite palatable. I got LOTS of feedback on how the stories drew you in and one person read the whole novel in a day. Yes, it was fanfiction but very much about real things, and without that feeling it would not have worked. That and a lot of research on people in long term captive/occupied circumstances.

Then the anger about my life I was using to write with surfaced and life got totally out of control. With triggers the biggest problem meds really didn't help. I'd crash from a trigger without or with the meds so they made them stronger. But I read that stuff, and some of its quite good, but its so... cold. It fits the setting but its like some completely different person wrote it.

I've been working on old projects again, and have not taken meds unless I *need* to for five years. It happens to be the aniverserary of moving, and last night I was feeling really down. I could feel a crash coming on over some old memory. I'd been writing and editing some scenes at the time.

I took a st john's wort, not real strong but it stopped things. It made me feel odd, like someone was in my head that wasn't me, since I usually stop them without medicinal help. I didn't like the feeling at all. But with the ad fairly strong, I tried to at least edit. But it was all words. The people and place behind it were flat and cardboard, and I could pick out the spelling and the missed words, but no idea if it really worked since I couldn't go there.

Today, no meds effect left but too hot to peak outside, I went back to editing. The bad down is gone but my mind is working again, and I notice places where a character wouldn't say that or react that way since I can draw on them. The drug just wiped it out.

One of the reasons I quit meds was I knew I had a sea of issues swimming around inside, and didn't deal with them since they didn't matter most of the time. When they mattered they did a lot and my mood dropped from the tower to the lobby suddenly. Meds were not ever going to fix it, ONLY dealing with the 'stuff', and so I let myself. I still don't 'feel' a lot, but sometimes its because survival mode kicks in and feeling is dangerous.

I'm sure that they have some effect over time, even more than they do at the time. Depression itself can have that effect, but then I did some great writing when I was depressed. Writing was my escape from it. But when I felt all 'blunted' I think the worse part was that I couldn't do the things I loved.

A few months ago I had to have my oldest cat put down. She wasn't that old, but she'd suddenly lost weight. I gave her more food, suppliments, and so forth, and it didn't help. I was going to take her to the vet when she suddenly got very weak and covered in fleas after. It was a weekend and I couldn't get her there til Monday. She just lay there and I chose to end her suffering out of love, but can't express any of any of it.

Someday I'd like to meet some person I could care for, maybe enjoy each other's company, but right now I feel sufficently emotionally stunted enough I don't know if I could do that now.
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Old 09-01-2014, 07:56 AM
 
Location: Not.here
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Originally Posted by CTGirlNoMore View Post
After having things happen to you, and feeling beaten down. Have you noticed whether you have no emotion, good or bad?

What I mean is - one of my mother's good friend's was just diagnosed with cancer and is going for chemo. My mother is devasted and was in tears. Me - I think it's terrible, but I can't show any emotion.

I've noticed over the past years, with all the bad stuff that has happened to me, I seem to have lost compassion. But only for humans - animals I can show emotion for (like seeing/hearing about an bused one). The news tells how a 15 y/o was stabbed to death and it doesn't bother me. Show an animal needing a home and it makes me sad.

Has this happened to anyone else?
Very good post CTGirlNoMore!

This is common for those that have been abused and hurt by others. Their sense of empathy towards others becomes more dull. We are always consciously or subconsciously comparing ourselves to others. Those that have experienced a deep hurt in the past place their suffering above the suffering of all others. That is the root cause. Then, whether aware of it or not, they basically rationalize why they should not show others more concern than for their own selves.

Animals (our pets) don't abuse us mentally. Some might be a little more rough than others in their behavior, but that is due to their nature. We don't compare ourselves to our pets in the way that we do to other people.

Last edited by nezlie; 09-01-2014 at 08:18 AM.. Reason: about animals
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Old 09-01-2014, 08:03 AM
 
Location: Not.here
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Originally Posted by TracySam View Post
There is a well-know phenomenon called "compassion fatigue" that comes up a lot with mental health and medical professionals, first responders, and other caretakers. It's different, and more specific, than the idea of "burnout," and many of us have gone to trainings on this, to be able to recognize it in ourselves and our collegaues. Think of it like muscle fatigue, but instead of your muscle getting tired, your compassion gets tired.
But people not working in these fields can experience compassion fatigue too--when they are continually encountering people with lots of traumas, needs, and bad things happening to them, especially when they are also going through their own traumas, needs, or bad things.

It doesn't make you a bad person, and it's a temporary state. You won't turn into some sort of sociopath who has no empathy for the rest of your life. We just get overloaded, and have only so much capacity for how much we can care and really feel it.

I tend to think it's a survival mechanism. We can only handle so much in the way of emotional demands, so we switch from feeling empathy to just thinking empathically. We can act sensitively toward a person, and think "that's really terrible what she's going through," but not really FEEL anything for her. And we can't get back any capacity to feel unless something lets up, or unless we let go of some of what we're carrying around.
This is a completely different thing than what the OP is talking about. Compassion fatigue is a deliberate repression of one's feelings in an environment like work so that you will not be overwhelmed at the end of the day. It is done deliberately so you can maintain some sort of an even emotional keel during the work day. You described it very well. On the street they say, "It's putting on your game face."
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Old 09-01-2014, 01:59 PM
 
Location: Cushing OK
14,545 posts, read 18,219,558 times
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Originally Posted by nezlie View Post
Very good post CTGirlNoMore!

This is common for those that have been abused and hurt by others. Their sense of empathy towards others becomes more dull. We are always consciously or subconsciously comparing ourselves to others. Those that have experienced a deep hurt in the past place their suffering above the suffering of all others. That is the root cause. Then, whether aware of it or not, they basically rationalize why they should not show others more concern than for their own selves.

Animals (our pets) don't abuse us mentally. Some might be a little more rough than others in their behavior, but that is due to their nature. We don't compare ourselves to our pets in the way that we do to other people.
I understand this in some cases. It can be traumatic to revisit in someone elses story the trauma which became part of yours. Some people use it to move on and some just want to forget. But then I do find that not everyone is so dulled. And rather than it just being a lack of empathy, in some cases its that a chance is there but its easier to be wounded. I find this is especially strong with oh poor me situations. I ended up after the marriage collapse disastor with pets, what I had in my car and stuff in storage I lost. I'm not rich now but sure feel like it. But I never really did the oh poor me bit. I was too busy figuring out how to survive.

When people list their bucket lists of reasons why nothing will help, why nobody will help them etc and its clear they are wallowing entirely in their own sorrow and don't want to climb out, I find it hard to have sympathy. Give them options, suggestions and so forth but I've learned that ultimately what we do is up to us and which bubble we choose to live in.

One friend was mid divorce and kept ranting about her husband accusing her of harrassing him. She called him sometimes twenty times a day. No amount of talking would convince her that she was doing just that, and if he wasn't going to answer the first or second call, he wasn't going to answer. She decided I too was against her. I felt very sad since she was taking comfort in swermov ice, but you do what you can. She moved and I don't know what happened, but she had convinced herself it was all his fault and so long as she believed that, nothing was going to help.

I think sometimes apathy towards others is mistaken as not caring, when it is in large part self knowledge that only you can choose to crawl out of your bunker and if you truely don't want to then you won't.
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Old 09-02-2014, 06:34 PM
 
9,237 posts, read 19,618,194 times
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Originally Posted by nezlie View Post
This is a completely different thing than what the OP is talking about. Compassion fatigue is a deliberate repression of one's feelings in an environment like work so that you will not be overwhelmed at the end of the day. It is done deliberately so you can maintain some sort of an even emotional keel during the work day. You described it very well. On the street they say, "It's putting on your game face."
No, actually, compassion fatigue is not voluntary and not simply "putting on one's game face."
It's actually more similar to the avoidance side of PTSD (PTSD has both "intrusion" and "avoidance" symptoms), and has even been described as a form of vicarious PTSD.
Yes, people in the helping professions do often have to keep their emotions in check, and maybe deliberately compartmentalize them. But compassion fatigue is not that. It's an involuntary numbing and disconnection from emotions many of us experience. It can affect our personal lives as well, and that is certainly not deliberate.
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Old 09-04-2014, 05:30 AM
 
Location: Tucson/Nogales
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One good reason we love animals so much is because they're devoid of ego's. It's the ego in humans that will always complicate relationships. And feel no guilt whatsoever, as one philosopher once stated: Man is inherently a misanthrope!
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Old 10-26-2014, 03:03 AM
 
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I loved someoone but lost that passion i would call love . She still loves me and has so much feelings for me but i dont i jus feel like am there. And it started off with her l but then i noticed it was towards lots of things like my life my career i jus didn't care anymore. I use ti be very open and now am jus shut off. I cant sleep am up till 3 in th morning mostly everynight i dont want to go out with my friends i find no reason too. I need help but i have no idea we're to go or where to start .
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