The Mental Health Thread

[the_geneticist]

Trying to find words. Not having an easy time.

About a week ago another TA learned about my depression and suicidality. Became intensely emphatic that she wanted to help anyway she could and would never want to hear anything had happened to me. Shared her own previous struggles with depression in grad school, emphasizing the people who helped her get through it.

I generally don't follow up on such offers of help, because people often say such things automatically or with good intention but no idea how to follow through. I try to avoid putting someone in that awkward situation. But she was so insistent and spoke so passionately, when I was struggling to hold together last week, I texted her asking if sometime over the next few days she'd be free for a phone chat. Told her the isolation over weekends, when there are no scheduled school or lab-related meetings was hard to withstand when having a bad spell. She said absolutely and texted she would call me the next afternoon.

Didn't hear from her the next day or the day after that or the day after that. Didn't want to prod her because she had offered a favor, it wasn't an obligation. Felt sad and empty and a little scared something bad had happened to her.

Then got an email saying sorry she couldn't call but she was totally preoccupied with quals prep. Understandable. Just feeling...I don't know...insignificant. Would have felt ok if she had taken 10 seconds to send a message saying "Slammed with work; can we postpone our phone chat to another day?" Or something like that. Something to let me know she remembered I exist.

Same day I got that email my psychiatrist missed our appointment. He has a habit of not writing things down right away, and sometimes doesn't realize we had agreed to meet. Spent half an hour staring at a blank Zoom meeting window.

Spent a few hours last night deep breathing against a suffocating feeling in my chest.

Utterly ashamed at how poorly I am coping with minor disappointments. I don't think I've ever had the strength to manage on my own without comfort or validation from other people. I still don't feel like a proper adult, and I no longer feel like a real person. There is less distress thinking about dying than there is thinking about living.

Trying to focus on work as much as possible. End of term is in a couple of weeks. I told myself I would hold off thinking about anything else until then. It seemed a manageable goal. Don't know quite where to go from there. I can't endure feeling this way forever.

Smallcleanrat, please contact your psychiatrist to get another appointment. 
Also, there are 24/7 help resources.  https://www.imalive.org, https://afsp.org
Call 800-273-8255
Or text TALK to 741741
These are staffed by folks who are trained to offer assistance.  It's not a bother or a burden to contact them.  Really.  Try calling or texting today so you can save the contact in your phone.

[smallcleanrat]

Thanks for your reply, clean.

1) I had texted the day before. She said she would call me the next day. I didn't want to bug her because I guessed she was swamped with work. I just wish she had taken a moment to send a message cancelling that plan.

2) I did confirm the appointment that same morning. He repeated the time back to me and said, "See you then!" Calling the office always goes to voice mail and takes at least a day before getting a response. I emailed the doctor, which I'm the past has been the more likely way to get a response. We rescheduled to later this week. I'm just tired of being forgotten.

I've tried the crisis lines. They can help through the moment. But it's nothing like talking to someone who actually knows you.

I swear I've been trying, it just gets harder and harder to remember what for.

[smallcleanrat]

2.a. Many of my doctors offices phone the day before to confirm our appointments.  Perhaps you can act more proactively to do the same.  You can call the office a day or even 2 before to confirm that you have an appointment scheduled.  Especially if someone has a history that hu "doesnt realize we had agreed to meet".  (I learned this from Gomer Pyle, but I m sure it comes from somewhere else originally, "Fool me once shame on you.  Fool me twice shame on me!")

You are in more control of your life than you realize and personalizing too much, perhaps.  I have read many of your posts and I understand your general situation.  I appreciate that you are not coping well, but I think that by taking a few actions on your own behalf will save you from the spiral of gloom that follows a disappointment.  If you avoid putting yourself in the position to be disappointed, you will feel better.

I agree with the principle of being proactive. But in addition to that morning confirmation, he sent me the Zoom invite himself a few hours before the appointment. And that morning was the *second* confirmation I'd gotten from him since our last appointment. And I messaged him to find out what was up through what has historically been the most reliable means of getting a response.

I do whatever I can think of.

Recently my therapist (the one I combed through dozens of names within my network to connect with) said "I don't think I can do anything to help you." Followed by a long awkward pause as I waited for him to say more, thinking that couldn't be the entire message. Had to prod him asking whether he had ideas for where I should go next (once I got an explanation he was talking about his areas of expertise). Got numbers from him, asked for numbers from the TMS clinic, spoke to the grad student health center and got more contacts...have been emailing and calling and asking about schedules and insurance, etc...

I've compiled reading lists related to my chronic conditions and mental health issues, trying to synthesize the various streams of advice. Drew up a daily self care schedule that I've taped to my wall, making an effort to stick to healthy habits. Keep a journal to track which treatments seem  to help and which don't.

Being proactive is probably why I didn't fall completely to pieces years ago.

I'm sure there are other things I haven't thought of yet that might help, but...it's hard for me to swallow lack of trying as the reason I still hurt all the time. I could be completely wrong and may have been lying to myself, but I would need help to see it.

[clean]

It seems, then, that you are taking the right steps to start with.  The only other suggestion I have may not be helpful.  If you can not trust your professionals to be there when they say they will be and they dont provide a satisfactory explanation for missing the appointment (again!), then perhaps it is time to fire this one and find another! 


Otherwise, it does seem like you are taking the right steps!

Good luck! and Hang in there! 

[Puget]

Hang in there SCR! You are not responsible for other people's flakiness and their flakiness is about them, not you.

The psychiatrist is being very unprofessional to miss appointments-- is this the same psychiatrist who was not listening to you and your concerns before? If so (and maybe even if not), yes, fire him! (After finding someone new). He may have been helpful in some ways, but he really doesn't sound like he's doing a very good job. You deserve someone who is professional, competent and respectful of your time and your voice.

[Cheerful]

...another TA learned about my depression and suicidality. Became intensely emphatic that she wanted to help anyway she could and would never want to hear anything had happened to me. Shared her own previous struggles with depression in grad school, emphasizing the people who helped her get through it.

I generally don't follow up on such offers of help, because people often say such things automatically or with good intention but no idea how to follow through. I try to avoid putting someone in that awkward situation. But she was so insistent and spoke so passionately, when I was struggling to hold together last week, I texted her asking if sometime over the next few days she'd be free for a phone chat. Told her the isolation over weekends, when there are no scheduled school or lab-related meetings was hard to withstand when having a bad spell. She said absolutely and texted she would call me the next afternoon.

Didn't hear from her the next day or the day after that or the day after that. Didn't want to prod her because she had offered a favor, it wasn't an obligation. Felt sad and empty and a little scared something bad had happened to her.

Then got an email saying sorry she couldn't call but she was totally preoccupied with quals prep. Understandable....

That's really unfortunate. I wouldn't call it "understandable" or excusable.  Your disappointment and hurt are reasonable.  How kind that you were concerned that she was OK.  Maybe she had good intentions initially.  When it came to following through on her pledge, she showed that she is flaky, insensitive, and may be coping with personal problems.  You've now learned that this person is not reliable.

Same day I got that email my psychiatrist missed our appointment. He has a habit of not writing things down right away, and sometimes doesn't realize we had agreed to meet. Spent half an hour staring at a blank Zoom meeting window.

Unprofessional and unfortunate that he's apparently not able to manage his appointments better.  You aren't the first person to encounter a medical professional who is less than stellar in dealing with patients.  Decide whether his appointment issues are worth putting up with given the quality of treatment you're receiving and availability of other doctors.

Utterly ashamed at how poorly I am coping with minor disappointments.

These weren't minor disappointments.  Sounds like you're coping well.

Recently my therapist (the one I combed through dozens of names within my network to connect with) said "I don't think I can do anything to help you."...[snip] Got numbers from him, asked for numbers from the TMS clinic, spoke to the grad student health center and got more contacts...have been emailing and calling and asking about schedules and insurance, etc.

As you know, it can take several therapists to find the right fit.  This one isn't the right fit.  Keep persevering and taking these smart steps to find the therapist you deserve.  It's draining, but you're fighting on.

I've compiled reading lists related to my chronic conditions and mental health issues, trying to synthesize the various streams of advice. Drew up a daily self care schedule that I've taped to my wall, making an effort to stick to healthy habits. Keep a journal to track which treatments seem  to help and which don't.

Excellent!  All of these are huge accomplishments, give yourself huge credit.

[polly_mer]

smallcleanrat,

1) I would definitely fire that psychiatrist and get one who acts like a professional.  It is not OK to 'forget' appointments, especially ones confirmed within hours.

2) I would cross the TA off my support list. It's one thing to push a scheduled appointment on short notice because things are running late or something urgent came up; it's quite another to agree to be available and then just not.

You (smallcleanrat) matter and it's entirely reasonable to be unhappy with support folks who just fail.  That failure is on them, not you.

Keep reaching out!

[sprout]

smallcleanrat,

1) I would definitely fire that psychiatrist and get one who acts like a professional.  It is not OK to 'forget' appointments, especially ones confirmed within hours.

Wholeheartedly agree with this, and I find it particularly egregious in a mental health professional. They should know that this kind of thing can send someone already struggling with depression and anxiety into a tailspin.  If you have the spoons for it, you could make it clear exactly why you're not continuing with them.

[dr_codex]

smallcleanrat,

1) I would definitely fire that psychiatrist and get one who acts like a professional.  It is not OK to 'forget' appointments, especially ones confirmed within hours.

Wholeheartedly agree with this, and I find it particularly egregious in a mental health professional. They should know that this kind of thing can send someone already struggling with depression and anxiety into a tailspin.  If you have the spoons for it, you could make it clear exactly why you're not continuing with them.

Yup. I dumped a therapist for ghosting me at a time of extreme need. She had some nerve giving me grief about it.

[smallcleanrat]

Thanks for commenting, everybody.

The other TA had said in her email that she would "definitely" check in with me once her quals were finished. They were scheduled several days ago. I texted her recently saying "Hi. How did your quals go?" No response. I didn't get my hopes up for a response this time, so I'm not feeling too hurt by this. I do find it puzzling.

She seemed so concerned earlier; there was such urgency in her voice when she told me to let her know if there was anything she could do to help. And I had explicitly told her, I had treatment providers I could contact for crises/emergencies. What she could do to help was just have a friendly chat with me once in a while; some human interaction to cut through the isolation. She seemed relieved I had told her a way to help and eager to follow up.

Why ignore me then?

This is why can be so hard to interpret people when they say, "I care about you and I don't want anything to happen to you." Because it often seems I can disappear without many of the people who said such things even noticing, let alone feeling anything about it.

I'll probably look around for a new psychiatrist, but I'm reluctant to leave my current one as he has been one of the best doctors I've ever had for meds management. I'd rather have someone who forgets appointments at times but thinks carefully about my medical history and strategically about medication changes than someone who is always punctual but prescribes haphazardly.

I did make some headway with one of the therapy programs I contacted. Even with insurance, it will be quite expensive (about  1-1.5 months' worth of stipend), but reading about the groups and skills coaching they offer makes me think, just maybe, there's a chance this place might actually be able to help me. There's a strong emphasis on helping people learn to integrate the principles they learn in therapy into their real lives (where situations are more complex and nuanced than examples in a workbook). This is what I have been saying for years is what I need the most. I still need to clear an intake assessment to determine if I'm a good fit for the program.

It sounds intense: 3-5 days per week, 3hr per day minimum. But I can only be in lab part-time for the moment anyway; research labs are just starting to ramp up, but we have to work in shifts to keep personnel density low. So this might be the ideal time to go for it. Especially since I was feeling so ambivalent about whether I'd be able to continue living with this despair past the end of the Spring.

[apl68]

Thanks for commenting, everybody.

The other TA had said in her email that she would "definitely" check in with me once her quals were finished. They were scheduled several days ago. I texted her recently saying "Hi. How did your quals go?" No response. I didn't get my hopes up for a response this time, so I'm not feeling too hurt by this. I do find it puzzling.

She seemed so concerned earlier; there was such urgency in her voice when she told me to let her know if there was anything she could do to help. And I had explicitly told her, I had treatment providers I could contact for crises/emergencies. What she could do to help was just have a friendly chat with me once in a while; some human interaction to cut through the isolation. She seemed relieved I had told her a way to help and eager to follow up.

Why ignore me then?

During my own low periods I've had similar experiences of acquaintances offering to help and then failing to follow through.  It can be deeply upsetting.  It feels like you're being kicked when you're down.  I've learned in hindsight not to take it too personally.  Sometimes people honestly want to help, but then the rest of their lives just get in the way and keep them from following through.  When you feel yourself so desperately in need of help this can hurt a lot.  But you don't need to add to your burden of concern by wondering why she did this. 

Just try to forgive her and let it go, and continue treating her in a friendly manner.  It will help you in the long run.  Please trust me on this.  I've been there.  Been there in recent months, in fact.

[polly_mer]

I'll probably look around for a new psychiatrist, but I'm reluctant to leave my current one as he has been one of the best doctors I've ever had for meds management. I'd rather have someone who forgets appointments at times but thinks carefully about my medical history and strategically about medication changes than someone who is always punctual but prescribes haphazardly.

Ask for a referral.  It is entirely reasonable to want someone who does good meds management and manages to keep appointments.  These are not rare and unusual skills that are seldom found in combination.

[permanent imposter]

It sounds intense: 3-5 days per week, 3hr per day minimum. But I can only be in lab part-time for the moment anyway; research labs are just starting to ramp up, but we have to work in shifts to keep personnel density low.

I'm quite curious about this therapy program and I wonder what you'd be doing three hours a day. If you feel up to it, please share your experience!

I agree with what others said about the flaky friend. Put your energy into taking care of yourself; we might never know what other people are thinking or what's going on in their lives.

[mahagonny]

I believe I mentioned this before, but a reminder: when I was suicidal, my therapist not only kept our weekly appointments, but checked in with me by phone mid week. There are people who will go the extra mile.

[polly_mer]

I believe I mentioned this before, but a reminder: when I was suicidal, my therapist not only kept our weekly appointments, but checked in with me by phone mid week. There are people who will go the extra mile.

Yes, that's the kind of thing to look for in a therapist.  Missing appointments with fragile people is really, really not good.