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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by Maxime on March 25, 2005, at 23:42:32
I don't have the right to complain about things I bring upon myself. But tonight was just too much I ended up cutting. Why???? Why do I do these stupid things????? It hurts and I think I need stitches.
But I won't go to get any. ER docs don't understand ...I want to fly away from here.
Maxime
Posted by alexandra_k on March 26, 2005, at 1:04:43
In reply to ouch ... my own stupidity, posted by Maxime on March 25, 2005, at 23:42:32
I replied over on social. Here is a link:
http://www.dr-bob.org/babble/social/20050316/msgs/475695.html
I probably should have left your post at the top so people could see what I was responding to... Sorry, not too good at the old redirects sometimes.
Posted by SLS on March 26, 2005, at 7:13:14
In reply to ouch ... my own stupidity, posted by Maxime on March 25, 2005, at 23:42:32
> I don't have the right to complain about things I bring upon myself. But tonight was just too much I ended up cutting.
> Why????
You know the reason why, so give yourself a break.
There is no shame in it.
> Why do I do these stupid things?????
Be merciful on yourself!
> I want to fly away from here.
I'll meet you. Where do you want to go?
:-)
- Scott
Posted by Phillipa on March 26, 2005, at 10:53:44
In reply to Re: ouch ... my own stupidity » Maxime, posted by SLS on March 26, 2005, at 7:13:14
If you need stitches you need to go now. There is a window of when they can stitch you or when it's too late. I won't be here all day, so good luck until I get back this evening. And don't beat yourself up as Scott says fly away with him! Fondly Phillipa
Posted by SLS on March 26, 2005, at 11:36:20
In reply to ouch ... my own stupidity, posted by Maxime on March 25, 2005, at 23:42:32
Two quick questions for you, Maxime.
Have you been diagnosed as having borderline personality disorder (BPD) or any other Axis II disorder?
To what degree is anxiety a problem?
I know other people who cut, and I think I can understand what it is that precipitates the behavior. Cutting feels good. It certainly feels better than the painful anxiety and tension that builds up over time with depression or any other mental illness. It is a release.
As a matter of fact, cutting really is a release. It provokes the release of endogenous opioids and an adrenaline rush. Opioids can be feel-good neurotransmitters. The endorphins are the most well-known of these opioids. Enkephalins might actually be more potent. Morphine and heroin are opioids, and you know how addictive these drugs can be. You are somewhat addicted to cutting. Of course, the adrenaline rush helps mask the problems that you are trying to escape. If the cutting gets out of hand, there are drugs used to help with it. They block the opioid receptors so that there is no reward in cutting and cravings to cut are reduced. Naltrexone is one of these drugs. I'm sure there are psychotherapeutic alternatives that might make sense to investigate first, particularly if BPD is an issue.
- Scott
Posted by maxime on March 26, 2005, at 12:50:12
In reply to Re: ouch ... my own stupidity » Maxime, posted by SLS on March 26, 2005, at 7:13:14
>
> > I want to fly away from here.
>
> I'll meet you. Where do you want to go?
>
Heaven.Maxime
Posted by maxime on March 26, 2005, at 13:04:56
In reply to Re: ouch ... my own stupidity » Maxime, posted by SLS on March 26, 2005, at 11:36:20
Hi Scott. No BPD. In fact, I was so upset once at my cutting that I asked two of my pdocs if they thought I was and they said I did not fit the criteria.
Despite that they said, I decided on my own to go through intensive DBT for 20 weeks based on Marsha Linehan's theories. Even though I didn't have the diagnosis I figured it would be helpful to have another tool set of coping skills.
Anorexia my is Axis II diagnosis.
I cut for different reasons. Sometimes I need to know to that I am alive. I need to see the blood. Other times it's to release emotions that I don't know what to do with. This is what the DBT was suppose to help me with and it did. And sometimes I will punish myself for eating and cut myself.
Maxime
> Two quick questions for you, Maxime.
>
> Have you been diagnosed as having borderline personality disorder (BPD) or any other Axis II disorder?
>
> To what degree is anxiety a problem?
>
> I know other people who cut, and I think I can understand what it is that precipitates the behavior. Cutting feels good. It certainly feels better than the painful anxiety and tension that builds up over time with depression or any other mental illness. It is a release.
>
> As a matter of fact, cutting really is a release. It provokes the release of endogenous opioids and an adrenaline rush. Opioids can be feel-good neurotransmitters. The endorphins are the most well-known of these opioids. Enkephalins might actually be more potent. Morphine and heroin are opioids, and you know how addictive these drugs can be. You are somewhat addicted to cutting. Of course, the adrenaline rush helps mask the problems that you are trying to escape. If the cutting gets out of hand, there are drugs used to help with it. They block the opioid receptors so that there is no reward in cutting and cravings to cut are reduced. Naltrexone is one of these drugs. I'm sure there are psychotherapeutic alternatives that might make sense to investigate first, particularly if BPD is an issue.
>
>
> - Scott
Posted by Racer on March 26, 2005, at 13:13:46
In reply to Re: ouch ... my own stupidity » SLS, posted by maxime on March 26, 2005, at 13:04:56
>
> Anorexia my is Axis II diagnosis.
>
> I cut for different reasons. Sometimes I need to know to that I am alive. I need to see the blood. Other times it's to release emotions that I don't know what to do with. This is what the DBT was suppose to help me with and it did. And sometimes I will punish myself for eating and cut myself.
>
> Maxime
Actually, Anorexia Nervosa is an Axis I diagnosis, not Axis II.Cutting reminds me of certain self-injurious behaviors seen in animals under stressful conditions. I'm sure that there's some biochemical or evolutionary reality there, and Scott's probably got some good information about how it works.
For that matter, some studies have shown purely biochemical rewards for AN...
You didn't answer Scott's question, by the way, about how much of an issue anxiety is for you. It's only in the last few months that I've really understood how much of an issue it is for me, and now that I "get it", I can see how much of a problem it always has been for me. Hard as hell for me to look at it, but I'm glad now that I did.
Posted by SLS on March 26, 2005, at 13:44:42
In reply to Re: ouch ... my own stupidity, posted by maxime on March 26, 2005, at 12:50:12
> > > I want to fly away from here.
> > I'll meet you. Where do you want to go?
> Heaven.
We'll meet there soon enough. In the meantime, let us continue to try to build our respective Heavens on Earth. I know how good it can be. It is worth the time, pain, and effort.Did I mention that I was a bit of an optimist?
:-)
We might not be in the same boat, you and me, but we are both bailing out the water as fast as we can just to keep up with the leaks.
Every now and then, it becomes too overwhelming and too fatiguing to fight the rising water. You have no more energy or desire to bail a single bucket. The boat never seems to sink to the bottom, though. It stays afloat despite being full of water. The boat itself is still buoyant. Better said, you are still buoyant. Your natural survival instincts and your true desire to live keep you afloat. When you regain the energy, you once again try to build a life for yourself.
I'll help you bail your boat if you help me bail mine. I bet our leaks are in different parts of the boat. Perhaps you know better than me how to fix mine.
- Scott
Posted by ed_uk on March 26, 2005, at 13:51:59
In reply to Re: ouch ... my own stupidity » maxime, posted by SLS on March 26, 2005, at 13:44:42
Hi Scott and Maxime!
I'll help you both bail!
Ed.
PS. To Maxime- I'm going send you a babblemail soon, probably later this evening :-)
Posted by Spriggy on March 26, 2005, at 14:05:08
In reply to ouch ... my own stupidity, posted by Maxime on March 25, 2005, at 23:42:32
Maxime,
I sent you a babblemail.
You are in my prayers DAILY!
I ache for your hurts and hope you know you are cared about and loved.
Posted by maxime on March 26, 2005, at 17:47:55
In reply to Re: ouch ... my own stupidity » maxime, posted by Racer on March 26, 2005, at 13:13:46
Scott I wrote that I don't anxious/anxiety. But I was thinking of GAD, SA, or depression related forms. But I just realised that I DO GET ANXIOUS and I only thought of it now. I get anxious about food. About how many calories I am consuming. If I have to eat out I comb the menu for something where I know the approximate amount of calories and even then my throat tightens as I try to swallow the food. When I had friends and we would go out for supper I would only join them for the coffee portion of the meal because I couldn't handle it.
So I stand corrected ... I have anxiety.
Maxime
>
> >
> > Anorexia my is Axis II diagnosis.
> >
> > I cut for different reasons. Sometimes I need to know to that I am alive. I need to see the blood. Other times it's to release emotions that I don't know what to do with. This is what the DBT was suppose to help me with and it did. And sometimes I will punish myself for eating and cut myself.
> >
> > Maxime
>
>
> Actually, Anorexia Nervosa is an Axis I diagnosis, not Axis II.
>
> Cutting reminds me of certain self-injurious behaviors seen in animals under stressful conditions. I'm sure that there's some biochemical or evolutionary reality there, and Scott's probably got some good information about how it works.
>
> For that matter, some studies have shown purely biochemical rewards for AN...
>
> You didn't answer Scott's question, by the way, about how much of an issue anxiety is for you. It's only in the last few months that I've really understood how much of an issue it is for me, and now that I "get it", I can see how much of a problem it always has been for me. Hard as hell for me to look at it, but I'm glad now that I did.
Posted by Phillipa on March 26, 2005, at 18:13:59
In reply to Scott Racer .... I do get anxious, posted by maxime on March 26, 2005, at 17:47:55
Wow! What a lot of good advise and support you've received today. Yes one thing I learned in psych is what my patients said over and over again. "When I cut I feel alive because I can see the blood". Not everyone can personally relate with having felt this way, but I did see most of the patients later say they were glad that their suicide attempt didn't work. Or if it was a cry for help, they were glad they were in the hospital where they felt safe. Fondly, Phillipa
Posted by maxime on March 26, 2005, at 20:33:58
In reply to Re: Scott Racer .... I do get anxious » maxime, posted by Phillipa on March 26, 2005, at 18:13:59
Yes, I am lucky to have people here who care. :)
Cutting isn't a suicide attempt though. It's not even (although it can be) a cry for help. I cut where no one can see the scars. I have a few faded ones on my arms but that's it. I cut elsewhere. I don't want people to see the scars or the cuts or the wads of gauze I have to use. It's a coping mechanism. A screwed up coping mechanism.
Maxime
> Wow! What a lot of good advise and support you've received today. Yes one thing I learned in psych is what my patients said over and over again. "When I cut I feel alive because I can see the blood". Not everyone can personally relate with having felt this way, but I did see most of the patients later say they were glad that their suicide attempt didn't work. Or if it was a cry for help, they were glad they were in the hospital where they felt safe. Fondly, Phillipa
Posted by maxime on March 26, 2005, at 20:57:14
In reply to Re: ouch ... my own stupidity » maxime, posted by SLS on March 26, 2005, at 13:44:42
You are very sweet Scott. Unfortunately I am a pessimist. :( Besides, look what happened to the Titanic!
Your analogy to a sinking boat is very accurate though. I think I've gone through the Bermuda Triangle and am lost forever.
I'm 36 years old and this is the worst I have felt since I was 13 and attempted suicide for the first time.
Maxime
> > > > I want to fly away from here.
>
> > > I'll meet you. Where do you want to go?
>
> > Heaven.
>
>
> We'll meet there soon enough. In the meantime, let us continue to try to build our respective Heavens on Earth. I know how good it can be. It is worth the time, pain, and effort.
>
> Did I mention that I was a bit of an optimist?
>
> :-)
>
> We might not be in the same boat, you and me, but we are both bailing out the water as fast as we can just to keep up with the leaks.
>
> Every now and then, it becomes too overwhelming and too fatiguing to fight the rising water. You have no more energy or desire to bail a single bucket. The boat never seems to sink to the bottom, though. It stays afloat despite being full of water. The boat itself is still buoyant. Better said, you are still buoyant. Your natural survival instincts and your true desire to live keep you afloat. When you regain the energy, you once again try to build a life for yourself.
>
> I'll help you bail your boat if you help me bail mine. I bet our leaks are in different parts of the boat. Perhaps you know better than me how to fix mine.
>
>
> - Scott
Posted by jasmineneroli on March 27, 2005, at 0:04:05
In reply to Re: ouch ... my own stupidity, posted by maxime on March 26, 2005, at 20:57:14
Maxime,
I've read your posts many times, but haven't been posting myself for a while, until just now.
You are so kind and helpful to others, even when you suffer so yourself. That is such a valuable asset, and I, for one, am thankful for your ability to step outside your own pain for other people.
Did you end up getting medical treatment for the cut? I understand that attention is not what you were looking for, but maybe the hospital could be a good place to be now?
Even though you are not making overt suicide attempts, you display some suicide ideation or "para-suicidal" thoughts, in several of your posts over the past 2 days. For e.g.: Wanting to go to "Heaven", as a vacation destination, taking a lot of pills for sleep "but not enough to OD", and now cutting deep enough to require stitches.Something's going on here.
You are worrying me.
Can you call your Pdoc? A close friend?
Please take care.
Warmest wishes,
Jas
Posted by maxime on March 27, 2005, at 0:05:56
In reply to Re: ouch ... my own stupidity, posted by maxime on March 26, 2005, at 20:57:14
Another reason I cut is part of PTSD. I normally have that under control, but even now that is creeping back into my life.
Everything is haunting me. Even myself.
Maxime
Posted by maxime on March 27, 2005, at 0:28:06
In reply to Re: ouch ... my own stupidity, posted by jasmineneroli on March 27, 2005, at 0:04:05
Dear Jas. I know things are getting bad. But if I go to the hospital I will just be turned away. I ended up using butterfly strips for my cut. It will still heal funny but it's better than nothing.
A few weeks ago I typed out journal for my pdoc every night for one week. I made explicit references to suicide. I was very honest in my daily updates. I would then fax them to him. I did this upon his request.
I feel like I have done everything possible to tell my doctor that I am going downhill. He also knows I have a history of serious attempts (not cries for help). So I feel like my feelings and thoughts have been ignored or negated somehow. In the past I have never been so open with a pdoc before. Now I am and he isn't listening. So I figure it means it doesn't matter. That I am not that sick. I even told him what I have been eating and he is not phased by it. So I see it as a green light to go ahead and continue eating 500 calories a day. I AM NOT EVEN LOSING ANY WEIGHT!
I have a close friend who live in another Province and her pdoc called the police on her. She was taken to the hospital and then sent home because she wasn't going to kill herself that night. The same thing happened to me when I was living there.
So then I am made to feel like I am wasting a bed. In fact, one time when I was living in that other province I had taken an OD. I wasn't trying to kill myself, I just wanted to escape. I lived on my own and I knew I would just wake up eventually. But someone phoned me and I instinctively picked up the phone. The person called the police and I was taken to the hospital. I overheard a nurse say that I was "using up a bed" and that there were people waiting in the ER waiting room who DESERVED it (that is the word she used) more than me. I got out of the bed and tore the IV out of my arm and said "I'm leaving, give it to someone who deserves it". By then my arm was dripping blood from where I had taken out the IV and two security guards pounced on me and dragged me to a psych room where I stayed locked up for 24 hours and then I was released.
I am not going to the hospital. They can't help me. They don't want me. The province I am living in is worse than where I was before so I am scared sh*tless to even try.
Thanks for caring though. I appreciate it. I truly do.
Maxime
> Maxime,
> I've read your posts many times, but haven't been posting myself for a while, until just now.
> You are so kind and helpful to others, even when you suffer so yourself. That is such a valuable asset, and I, for one, am thankful for your ability to step outside your own pain for other people.
> Did you end up getting medical treatment for the cut? I understand that attention is not what you were looking for, but maybe the hospital could be a good place to be now?
> Even though you are not making overt suicide attempts, you display some suicide ideation or "para-suicidal" thoughts, in several of your posts over the past 2 days. For e.g.: Wanting to go to "Heaven", as a vacation destination, taking a lot of pills for sleep "but not enough to OD", and now cutting deep enough to require stitches.
>
> Something's going on here.
>
> You are worrying me.
> Can you call your Pdoc? A close friend?
> Please take care.
> Warmest wishes,
> Jas
>
Posted by Racer on March 27, 2005, at 0:39:40
In reply to Re: Scott Racer .... I do get anxious » Phillipa, posted by maxime on March 26, 2005, at 20:33:58
Yeah, when my new pdoc told me that he was dxing me with anxiety, my whole world shifted on its axis. It isn't always apparent to us when we have problems with it. For what it's worth, everything I've read leads me to think of AN as an attempt to self-medicate anxiety -- even the fact that you're only aware of anxiety around food, when in all likelihood it's more widespread than that. (I don't get anxious about food -- I get anxious because I've become so very fat. Same difference, you know?)
And as for cutting, my guess is that it's related to basic animal functioning. In horses, we use something called a twitch to control them in certain situations. When they're too upset to deal with, they can be dangerous, so we get out the twitch for their protection and our own. A twitch is an implement that you use to grab a horse's upper lip, and squeeze it as tight as possible. It generally immobilizes most horses, and the amazing part is that you can see in their eyes when the endorphins start to flow. That effect only lasts about twenty minutes, but they are still calmer after the effect wears off. I'd guess that something similar happens for you when you cut. What's more, just as there are all those jokes about stamping on someone's foot to take their mind off a toothache, that's got to be involved, too, I'd think.
Of course, I've never done it, so I'm just throwing out guesses. You can judge whether they're helpful or not for you.
Have you tried any sort of anxiolytic in the course of your treatment? I'd bet that a medication that targets NE and an anxiolytic might be a good combo for you, with some effect on 5HT. I'm also curious about to what extent you would like to recover from or remit your AN? I know that it bothers you to some extent, but wonder if you're actually interested in recovery? (Hey -- I'm having a hard time right now with the motivation to keep working at it, so I know it's not easy. I'm asking that because there are some meds out there that might be helpful for you if you are wanting recovery.)
Here's another question for you: do you find yourself having problems with obsessive thoughts? That's a characteristic of AN for me, which is why I ask.
Lastly, depending on the current state of you AN, most antidepressants that target 5HT will be unlikely to be helpful. You gotta be eating enough carbohydrate to have enough tryptophan coming in for your body to make the dang stuff -- inhibiting the reuptake of something that ain't there in the first place ain't exactly useful. Walter Kaye did a study a while back showing premorbid abnormalities in the whole 5HT system of ANs, which leads me to believe that SSRIs are not the best first choice for anyone with AN, which is very unfortuntate since the cardiotoxicity of TCAs don't make them good choices, either...
Best luck to you, Maxime, and I do hope things improve for you soon.
Posted by Phillipa on March 27, 2005, at 0:42:44
In reply to Re: ouch ... my own stupidity, posted by maxime on March 27, 2005, at 0:28:06
Maxime, You have talked to the pdoc to make sure he is reading your faxed material. I find it hard to believe that Canada is like that. Here in the USA you would be admitted pronto! Now don't get mad as I know all the drugs you've tried but have you tried Luvox? It sounds like you are a little OCD. But I don't know. Just know I care. Fondly, Phillipa
Posted by maxime on March 27, 2005, at 0:52:14
In reply to Re: ouch ... my own stupidity » maxime, posted by Phillipa on March 27, 2005, at 0:42:44
Yes, he read them. We talked about them but in terms of how I was reacting to the meds. I was sitting right in front him. I am not lying Phillipa.
I don't have OCD although some people think that people with eating disorders are OCD. I was on Luvox and I had a seizure and my pdoc took me off it. This was back in 1997. Anyhow, SSRI make me manic.
Sigh. I am not lying about my doctor.
Maxime
> Maxime, You have talked to the pdoc to make sure he is reading your faxed material. I find it hard to believe that Canada is like that. Here in the USA you would be admitted pronto! Now don't get mad as I know all the drugs you've tried but have you tried Luvox? It sounds like you are a little OCD. But I don't know. Just know I care. Fondly, Phillipa
Posted by Phillipa on March 27, 2005, at 0:56:22
In reply to I am not lying, posted by maxime on March 27, 2005, at 0:52:14
Maxime, I believe you. I just don't know what to say at this point. But the fact that you are posting is still in my opinion good therapy for you. Fondly, Phillipa
Posted by maxime on March 27, 2005, at 0:59:34
In reply to Re: Scott Racer .... I do get anxious » maxime, posted by Racer on March 27, 2005, at 0:39:40
No Racer, I am not ready for recovery from my eating disorder. It's a coping mechanism and I need it right now. So many other things need to be addressed first.
I know for myself my ANA was or is not related to anxiety but to low self esteem. Not feeling worthy or deserving.
And no, I don't have OCD. I took Paxil and it triggered a manic OCD kind of behaviour with cleaning. After about a week my room mate called my doctor to let her know and I was taken off the med. Our appartment was spotless though.
Maxime - who is tired and going to bed to cacoon.
Posted by SLS on March 27, 2005, at 6:42:17
In reply to Re: Scott Racer .... I do get anxious » Phillipa, posted by maxime on March 26, 2005, at 20:33:58
Maxime, you might want to try from several classes of drugs things that will reduce your anxiety. It might make things MUCH more tolerable for you. It might even reduce your cutting.
I was thinking either Klonopin or Zyprexa. You know, of course, that Zyprexa might prompt you to eat more. I'm not really with it this morning, so it would be a good idea to have others help make you a list of candidates. If there's a bipolar thing going on there, maybe Trileptal is worth looking at. I don't remember what your diagnosis is.
- Scott
Posted by Maxime on March 27, 2005, at 10:31:40
In reply to Re: Scott Racer .... I do get anxious » maxime, posted by SLS on March 27, 2005, at 6:42:17
Hi Scott. I am starting to trust less people here. So I don't know ...
I take 4 mg of Klonopin at night as a mood stabiliser and I take Trileptal as well. I am BP Type 2. I was given Zyprexa in the hospital to make me gain weight which I think was a horrid thing to do because I started binging on everything but the fridge itself. I don't purge so it was hard to deal with. I had to stop it anyway because I started to lactate.
I'm sorry you are not doing so well this morning. What part of your boat needs water bailed out? I have a bucket ready and waiting. Or maybe I could use a shop vac. I am not very big (5 feet) but I can haul a heavy load. When I was living in D.C., my appartment flooded and I "shop-vacuumed (new verb) 300 gallons of water by myself.
Take it easy today Scott.
Maxime
> Maxime, you might want to try from several classes of drugs things that will reduce your anxiety. It might make things MUCH more tolerable for you. It might even reduce your cutting.
>
> I was thinking either Klonopin or Zyprexa. You know, of course, that Zyprexa might prompt you to eat more. I'm not really with it this morning, so it would be a good idea to have others help make you a list of candidates. If there's a bipolar thing going on there, maybe Trileptal is worth looking at. I don't remember what your diagnosis is.
>
>
> - Scott
>
>
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