Quite frankly I'm just at a loss at this point. Been on the therapy and meds journey for almost a year now, and did the whole exercise shebang consistently for like 2 years. I was doing cardio for an hour every 1-2 days.
I am getting quite disillusioned and don't understand what I'm even doing anymore. I'm getting so caught up in various things that I'm just confused as all hell. Every time I think I figure something out, I end up so wrong it's almost like it's not even funny.
I have intense reactions to rejection. I have extreme and intense negative emotions that persist for many hours and days after a trigger and they are very painful and difficult to deal with and can impair functioning. I have a lot of social anxiety, which I did not think contributed much to this. But now I'm wondering if I have a pattern of social anxiety --> extreme rejection sensitivity --> extreme emotional dysregulation.
I have been on escitalopram (Lexapro), then lamotrigine (Lamictal), and now quetiapine (Seroquel). I do not have ADHD. I do not have bipolar disorder. I don't even have persistent depression. I have periodic extreme episodes that cause a lot of distress and can cause functional impairment like how my work threatened to fire me. I also have intense shame and self-hatred, often babbling to my online friends nonsense about how I'm a "demon" when I get this way. I am also totally normal 90% of the time. It's only the remaining 10% that causes the struggle.
People always tell me to "go to therapy". I am. I have seen multiple therapists and have been consistent with this one since the fall. People tell me I don't put enough work. I am. People tell me I am not honest enough to my providers. I am. People tell me try a different therapist. I have tried many (I stick with my main one for continuity and so that I don't have to keep rehashing my backstory).
At this point I feel like I don't know what is down and what is up. I no longer understand what my problem is anymore. Every time I think I figure out what my issue is, every time I think I figure out a technique to help me, I'm wrong.
I'm starting to think that this is who I am. It is unchangeable. I experience a lot of pain and sensitivity where others don't. I wish that wasn't the case, but I think it can't be changed.
Idk where do I go from here, friends? Thank you to those who have read my entire rant lmao.
Funny you should mention borderline personality disorder. I've thought for a while now that I've met a ton of the traits. It's supposed to be responsive to therapy, particularly DBT, which is why I was interested in seeking it out. My current therapist only uses general DBT concepts which is frustrating but I have a comprehensive DBT skills book that I have been working through to supplement. While the skills seem to occasionally help with mild issues/triggers, unfortunately they don't seem to begin to touch the pain of larger ones.
Oh it also usually takes a year for full efficacy. It took me two. Hi I've got borderline and I've been working in psychiatry for almost 10 years now.
Wow!! It's really good to hear a success story! What things have helped you the most? Have any medications helped you at all? I know borderline is refractory to meds, but a lot of times I really just wish I had something that could even help tone things down slightly to be more productive with the therapy techniques.
My current major players are seroquel for sleep and strattera during the day. I decided to try lamictal a few years ago just to see if it was bipolar and idk that it really helped but even with the dose maxxed it has basically 0 side effects so I just never stopped. I would think I would have noticed either a feeling of increased calm or often I have patients who report that it makes them feel "depressed" just because it's been ages since they were actually euthymic and they're using mania as their definition of normal.
The biggest thing I'm trying lately is clonidine vs guanfacine to stop the weird apocalyptic nightmares. I might have to stop the seroquel sometime in the next year because after about a decade I'm starting to grind my teeth and I've been trying to think what I'll try for sleep instead. I'm not typically a fan of SSRIs due to the anorgasmia but ultimately sleep goals will take priority. If I was gonna switch that up though I'd probably have to take a week or two PTO to experiment, I'm pretty careful with my meds as it concerns work.
Like I said in my other comment, your med list is not long at all, I've been on more different drugs than that all at one time and most of them don't even start working until you've been on them for like a month, AT LEAST. It honestly just takes time and if you're not willing to take it slow and be open to input from providers you trust you're gonna have a bad time.
Idk why people on the internet like to accuse me of not doing what my providers are telling me lol. They are the ones dictating my meds, not me!
Lexapro I was on for several months before being discontinued. Lamictal I have been on since around August. My current dose of Lamictal I have been on since November. Like you, I notice literally zero effect, neither positive nor negative lol (besides itchiness when first titrating). She had me on a low dose of Luvox for only one month. It was sub therapeutic and I was actually optimistic for her to increase it.
But instead I guess because of an event I told her, she immediately discontinued that and switched to Seroquel. I kind of regret telling her, but people always tell me I have to be honest with my providers. I was disheartened, but I did agree to try it. I always agree to try these things.
My med list is longer, but I never bothered to list my PRN meds. I have never found them overly helpful because I can't always predict triggers and they take too long to kick in if I'm actively freaking out. Have tried hydroxyzine, propranolol, and now clonidine as needed. So far it seems like clonidine has been occasionally mildly useful, but otherwise that's about it. I don't have issues with sleep or nightmares, so they aren't given to me for that purpose.
I am trying to be patient, but it's hard because I feel like I have made zero progress despite being on this journey for so long.
People also always tell me to get a different provider. I do that too concurrently without dumping my current providers just to see if anyone else could possibly be more helpful. But I always maintain my old providers because they know me and my history and I also am trying to not just seem like I always start and stop and that I am never trying to get anywhere.
My psychiatric NP actually literally told me the other day that she feels bad that she and my therapist are struggling to help me. It's not that I am being difficult.
Anyway, sorry for the wall. I'm just endlessly frustrated but endlessly trying!
I'm not questioning your compliance I'm reframing your perspective. You're interpreting it as the former because rejecting it entirely is easier than shifting your perspective to one that's less pessimistic of both yourself and others. You're having difficulty hearing a perspective that puts work ahead of you instead of the ease of just deciding failure is inevitable and laying down to die where you are. The fundamental dialectic of DBT that you are utterly failing to grasp is that it will ALWAYS be true that you are both doing the best you can currently AND can do better in the future.
I don't understand why you think I'm not continuing to put the work in? I've just been so exhausted. I would just like some of this stuff to even remotely help me a little bit.