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DijonPepperberry897 karma

I work as a pediatric psychiatrist, and many of your medical diagnoses have strong psychological inputs and psychiatric illness (depression, conversion, anxiety) can even be at the core of some of the physical symptoms. I've seen that you are and have seen psychology/psychiatry but I just wanted to give you a lot of support and hope that you continue to do so! Many of my patients with POTS/FM/ME/unexplained seizure/seizure-like activity have experienced significant recovery when the focus moves away from the physical and more to the mental (coping, pacing, management, increasing activities, pushing tolerance, etc). As you're well aware, your medical conditions have very uninspiring treatments like "watch and wait".

For my question, because you've mentioned PTSD from a relationship, I'm wondering about PTSD from the accident. Do you find that your care by physicians and staff has been trauma informed (ie, considering the fact that you're already traumatized pre-injury, and some things they offer/do are harder to process/accept/cope with for people who have been traumatized)?

Edit: I am not asserting deception or faking. Stigmatizing disability because it is not visible is a horrible trait in humanity and invisible illnesses like ME/POTS/TBI are major causes of real disability.

DijonPepperberry109 karma

As a psychiatrist, I wanted to add to this reply - " Generally people know within a month if they are going to be of aid. " applies to one trial of antidepressant. The standard course of antidepressants is to switch within the SSRI class after a month, then try an antidepressant outside of the SSRI class for a month... so technically "you'll know within 3 months" whether or not they will be of aid.

If they are to be chosen as an avenue of treatment (appropriate for well-diagnosed depression), following guidelines of evidence-based antidepressant therapy is generally a 1-6 month process of establishing the right medication treatment.

Aborting all antidepressant medications after your first SSRI 4-week trial would be a significant departure from evidence-based treatment.

DijonPepperberry41 karma

Not OP, but a psychiatrist nonetheless. The use of most nootropics are not supported by any science of efficacy, and for those with clear effect (amphetamines, etc), the risks likely outweigh the benefits.

DijonPepperberry41 karma

As a child and adolescent psychiatrist who treats children in a hospital ward, and is the director of a child psychiatric emergency department, nothing about this AMA makes sense to me. In the Canadian system, I can certify people and hospitalize them against their will, but I must justify it and it is reviewable by an independent panel at the patient's request. Our ward is a bit "sterile" but not unpleasant and patients generally are an active part of treatment planning.

I just wanted to say this because it seems thay people are presenting very much one side of a story... it certainly can be harrowing to be hospitalized but for an emergency, it can also be a life saver.

There is so much poor psychoeducation in this thread I dont even know where to begin, so ill just suggest that people take a critical view of this thread, talk to your own health care provider if you are struggling, and reach out for help BEFORE it becomes an emergency and medical protection is necessary.

DijonPepperberry15 karma

Hi there! I'm a psychiatrist and a suicidologist, and I thought I'd take a go at this.

First, it's a complex answer, because we have to define "cure". To us in psychiatry science, "cure" means "remission" - symptoms that define depression leaving and not coming back. In that case, both psychotherapy and medications have remission rates (about 40 to 60% of first attempts to treat). Now, not all of this is due to treatment, but some of it is, so the treatments are recommended.

If you define "cure" as "always treat anyone with these problems", then we are likely a far ways away, because some people do not respond to treatment. It's very likely that depression/other MH disorder are causes by MANY pathways and causes. So one treatment is unlikely to "pin them all down."

Like all sciences, we will continue to learn more over time and science will further define things we don't know and refine things we do.

In terms of how to follow the research, it's difficult because I see things through an expert lens. I have Google scholar delivering me content directly into my brain everyday. But societies like the one above and public/parent/community groups exist all over.