Occupational Therapy/Physiatrist vs Psychologist

[ineverlearn]

My doctor has convinced my to talk to a social worker who in turn will work with a occupational therapist and a psychiatrist that I'm to talk to also. I've talked to a counsellor for 2 months then been talking to a psychologist for the last 5 months , I've been open and honest. The psychologist hasn't told me anything that I haven't worked out myself, in fact, he didn't say much. Next week I'm going to bring this up with him.

What will an occupational therapist and psychiatrist bring to the table? I'm going through the motions of getting help. But I couldn't care less to "heal" or "get better". It really just feels like they're all just trying to get me functional enough to keep working and not kill myself. With my experience so far, it doesn't seem that me feeling happiness is really anyone's goal. Rather just to hear that "I'm fine" and that I don't I'll myself. Hell, my psychologist doesn't even know that I'm suicidal, has never asked and I've never told.

What has occupational therapy or a psychiatrist done for you? Is it anything more than just getting you out of your bed and superficially functioning? Or has it actually helped you?

 

[BitterlyAlive_]

I've only seen a few psychiatrists, so I'll comment on that. The first two sucked and didn't care. The one I'm seeing now seems alright. He seems to care for my wellbeing, keeps communication open, and offered a surprising med combo. I'm on a stimulant with my antidepressant; he thinks it's a better way to get me functioning versus another antipsychotic (both boost dopamine). Antipsychotics tend to have undesirable side effects - I suffered from akathisia on Abilify and that was enough lol. Plus, they tend to cause/worsen anhedonia...a stimulant may help with that as well as mood.

I don't really feel any different. But at least I have a psychiatrist who gives a fuck this time. I hope you're able to find a good fit as well.

I'm going through the motions of getting help. But I couldn't care less to "heal" or "get better".

Also this is incredibly relatable.

 

[ineverlearn]

@BitterlyAlive_
Thank you for sharing your experience. I think my psychologist does care. I just feel like he doesn't understand the understanding I've gotten on my own, with the work I've put into figuring out what plagues me. But he doesn't really guide or lead me anywhere. He listens though.

I'm very adverse to medication, it's the reason, partially, why I am where I am already. There isn't a thing that gives me any pleasure already, don't think I cope with anything that worsens my anhedonia. If it's even possible.

I wish you well on your progress. I hope you get to feel different and happy eventually.

 

[BitterlyAlive_]

@BitterlyAlive_
Thank you for sharing your experience. I think my psychologist does care. I just feel like he doesn't understand the understanding I've gotten on my own, with the work I've put into figuring out what plagues me. But he doesn't really guide or lead me anywhere. He listens though.

I'm very adverse to medication, it's the reason, partially, why I am where I am already. There isn't a thing that gives me any pleasure already, don't think I cope with anything that worsens my anhedonia. If it's even possible.

I wish you well on your progress. I hope you get to feel different and happy eventually.

It's good that your psychologist seems to care, and that he listens. Have you tried explaining what you already know, the work you've done with your own research? You may have to be blunt about it. I'm a bit surprised he doesn't really guide you - the role of a therapist is to facilitate change, and that includes guidance.

I'm sorry by the way, I guess I forgot that you literally had said all of those things in your initial post. I literally forget things right after I read it sometimes, I get too focused on one point (in this case my psychiatrist).

Yes, meds....agh, they can be tricky, to put it lightly. I have anhedonia as well, which you know is definitely a struggle on its own. Add in the side effects and possible emotional blunting from meds and oof. I don't blame you for having an aversion too. Some meds, assuming we're talking about antidepressants, are a bit more...stimulating. Wellbutrin is one, I think it affects norepinephrine and dopamine? Seems less likely to worsen anhedonia and, if I remember right, has helped some people with it? Hm. I guess I'm writing this in case someone mentions you trying it. But you may already know about the different meds and their general effects from your research.

Thank you for the last part. :) I hope this stuff made sense, think I'm kind of rambling.

 

[ineverlearn]

It's good that your psychologist seems to care, and that he listens. Have you tried explaining what you already know, the work you've done with your own research? You may have to be blunt about it. I'm a bit surprised he doesn't really guide you - the role of a therapist is to facilitate change, and that includes guidance.

I'm sorry by the way, I guess I forgot that you literally had said all of those things in your initial post. I literally forget things right after I read it sometimes, I get too focused on one point (in this case my psychiatrist).

Yes, meds....agh, they can be tricky, to put it lightly. I have anhedonia as well, which you know is definitely a struggle on its own. Add in the side effects and possible emotional blunting from meds and oof. I don't blame you for having an aversion too. Some meds, assuming we're talking about antidepressants, are a bit more...stimulating. Wellbutrin is one, I think it affects norepinephrine and dopamine? Seems less likely to worsen anhedonia and, if I remember right, has helped some people with it? Hm. I guess I'm writing this in case someone mentions you trying it. But you may already know about the different meds and their general effects from your research.

Thank you for the last part. :) I hope this stuff made sense, think I'm kind of rambling.

Don't be sorry, I really appreciate you taking the time to share your experience and thoughts. I can barely express my thoughts and you're understanding what I feel still. That means a lot.

I'm giving my psychologist the benefit of the doubt, he may think that I just need someone to listen to me. Like you say, I think I need to be more blunt with how I feel be isn't really helping. But I find myself thinking about how I might hurt his feelings...

So far I'm pushing back on the idea of taking medication, fortunately so far I'm getting the response that it's my choice. I'm willing to explore non-medication treatment, so I guess they're okay with my push back for now.

And you definitely made sense :) thank you for your support

 

[BitterlyAlive_]

Don't be sorry, I really appreciate you taking the time to share your experience and thoughts. I can barely express my thoughts and you're understanding what I feel still. That means a lot.

I'm giving my psychologist the benefit of the doubt, he may think that I just need someone to listen to me. Like you say, I think I need to be more blunt with how I feel be isn't really helping. But I find myself thinking about how I might hurt his feelings...

So far I'm pushing back on the idea of taking medication, fortunately so far I'm getting the response that it's my choice. I'm willing to explore non-medication treatment, so I guess they're okay with my push back for now.

And you definitely made sense :) thank you for your support

Yup, your psychologist would ideally be on the same page as you. It's perfectly alright to be a bit blunt, it's different from being abrasive. His feelings won't be hurt if he's good at his job.

Medication should be your choice, so it's good that the professionals are respecting your autonomy. This may be where the occupational therapist comes in? I'm not certain because I've only really skimmed this info, but I think occupational therapists step in to help someone with mental illness function. I believe they help with activities of daily living? ADLs. I could be wrong, but someone has mentioned occupational therapy for my depression and I think that's what I found.

Glad I can help. We're here to support one another. :)

 

[ineverlearn]

it's different from being abrasive

Sometimes when I play out the conversations in my head I'm an asshole. But in reality that doesn't happen. I guess when I tell him next week, I'll have a clearer idea of he's good at his job or not.

I think you're right, it seems the occupational therapist is really there for ADLs. I just can't see how they get me to care enough about anything to actually get me motivated to do anything. Or to feel any pleasure.

Is there a reason you never saw an OT? Since it was mentioned to you.

Glad I can help. We're here to support one another. :)

Hopefully I can be of some help for someone at some point too.

 

[BitterlyAlive_]

Sometimes when I play out the conversations in my head I'm an asshole. But in reality that doesn't happen. I guess when I tell him next week, I'll have a clearer idea of he's good at his job or not.

I think you're right, it seems the occupational therapist is really there for ADLs. I just can't see how they get me to care enough about anything to actually get me motivated to do anything. Or to feel any pleasure.

Is there a reason you never saw an OT? Since it was mentioned to you.


Hopefully I can be of some help for someone at some point too.

That's a good way to look at your next appointment. Don't get me wrong though - it's really good that you're concerned about his feelings. The second paragraph you wrote...it's the great struggle of anhedonia. This year I got fed up and began testing the professionals I've seen by seeing if they even understand the concept of anhedonia. Because it really reduces one's quality of life, motivation, etc. They should understand that anhedonia is a huge barrier to treatment and that it makes the often suggested advice for depression useless. But I'm rambling. It's 3am and I'm tired, sorry for all of that.

I never expressed an interest in seeing an OT, I just let the person mention it and never brought it up because...eh. The depression is really bad and severely impacts my ability (and desire) to take care of myself, but I don't want help with ADLs if I'm struggling. I'd rather suffer the consequences, personally.

Spend enough time here, chat enough, and I'm sure you'll help somebody. Oftentimes, simply knowing we aren't alone in our struggles and experiences helps.

 

[moonchild]

I saw an occupational therapist briefly earlier this year. We pretty much only talked about how I could create structure and routine in my everyday life, and she gave me some tips on how I could make it easier to also follow through with it. So yes, it was basically to get me out of bed and make/keep me superficially functional. Very straight-forward and focused on practical aspects. I didn't find it very helpful, but I wasn't seeing my psychologist at that time and I think I could've maybe found it more helpful if I had both aspects from the start. My main issue isn't with planning and creating structure, it's that I don't even want to do that because everything's pointless and I'd rather be dead. So the psychologist could've maybe balanced it out a bit.

It was still kind of nice to just discuss my own planning with someone else and get some feedback, so it wasn't completely useless. But that probably depends a lot on how you get a long with your OT.

 

[ineverlearn]

That's a good way to look at your next appointment. Don't get me wrong though - it's really good that you're concerned about his feelings. The second paragraph you wrote...it's the great struggle of anhedonia. This year I got fed up and began testing the professionals I've seen by seeing if they even understand the concept of anhedonia. Because it really reduces one's quality of life, motivation, etc. They should understand that anhedonia is a huge barrier to treatment and that it makes the often suggested advice for depression useless. But I'm rambling. It's 3am and I'm tired, sorry for all of that.

I never expressed an interest in seeing an OT, I just let the person mention it and never brought it up because...eh. The depression is really bad and severely impacts my ability (and desire) to take care of myself, but I don't want help with ADLs if I'm struggling. I'd rather suffer the consequences, personally.

Spend enough time here, chat enough, and I'm sure you'll help somebody. Oftentimes, simply knowing we aren't alone in our struggles and experiences helps.

I guess we're in the same time zone :p

I don't find that your rambling at all, quite the contrary.

Any talk of any treatment feels useless. Like you seem to describe, I would rather just lay here in bed and never move. Which I do most of the time already. The consequences of my inactions are compounding. Don't even care.

I've definitely found comfort in being able to talk openly here and read other people's words that I can resonate with.

I saw an occupational therapist briefly earlier this year. We pretty much only talked about how I could create structure and routine in my everyday life, and she gave me some tips on how I could make it easier to also follow through with it. So yes, it was basically to get me out of bed and make/keep me superficially functional. Very straight-forward and focused on practical aspects. I didn't find it very helpful, but I wasn't seeing my psychologist at that time and I think I could've maybe found it more helpful if I had both aspects from the start. My main issue isn't with planning and creating structure, it's that I don't even want to do that because everything's pointless and I'd rather be dead. So the psychologist could've maybe balanced it out a bit.

It was still kind of nice to just discuss my own planning with someone else and get some feedback, so it wasn't completely useless. But that probably depends a lot on how you get a long with your OT.

If it ends up like your experience, I won't care to stick with it. Going through motions just for the for sake of it serves me no purpose. "Everything's pointless" - ain't that the truth?

Maybe since the OT will be working in tandem with a social worker and psychiatrist, I might get something out of it... I doubt it though...

And you make a good point. I'm going to have to make a connection with all these people.

 

[moonchild]

If it ends up like your experience, I won't care to stick with it. Going through motions just for the for sake of it serves me no purpose. "Everything's pointless" - ain't that the truth?

Maybe since the OT will be working in tandem with a social worker and psychiatrist, I might get something out of it... I doubt it though...

And you make a good point. I'm going to have to make a connection with all these people.

Yeah, I feel like it would only really be helpful for people who just need a little push, but maybe someone else will come along and give a different perspective.

 

[Sherri]

Both just tell me to hit the gym and eat healthy and depression will go away. I just laugh inside every time I hear that.

 

[Nexuno]

But I couldn't care less to "heal" or "get better".

I've wasted my entire life talking with psychologists and psychiatrists, and I never ever understood what their work is all about. The only thing I can say is that I didn't care at all to heal or get better too; My advice to you is to talk about THIS (the fact that you don't care) with them and just evaluate their reply and see if this leads to "something". I think this is the best way for you to be really active (vs being totally passive with the psych being in auto-pilot mode) in the conversation with your psychs. Just talk to them about your doubts just like you did in your post.

 

[ineverlearn]

Yeah, I feel like it would only really be helpful for people who just need a little push, but maybe someone else will come along and give a different perspective.

That's what I'm hoping for I suppose, a different perspective.

Both just tell me to hit the gym and eat healthy and depression will go away. I just laugh inside every time I hear that.

Yeah... Telling me what I "should" be doing is not going to help me want to do it. Let alone the quick fixes.

I've wasted my entire life talking with psychologists and psychiatrists, and I never ever understood what their work is all about. The only thing I can say is that I didn't care at all to heal or get better too; My advice to you is to talk about THIS (the fact that you don't care) with them and just evaluate their reply and see if this leads to "something". I think this is the best way for you to be really active (vs being totally passive with the psych being in auto-pilot mode) in the conversation with your psychs. Just talk to them about your doubts just like you did in your post.

I have been talking to my psychologist about the not caring. He hasn't really respond in any helpful way. I'm going to bring this up next time. He's nice but maybe not the right one for me.

 

[Nexuno]

He hasn't really respond in any helpful way. I'm going to bring this up next time. He's nice but maybe not the right one for me.

Well this is very significative, IMO. It could mean a lot of things, but I think it's a crucial aspect of the whole thing and you should insist on it. I think the psych. have to reply to specific requests, like this one in this particular case, and not simply ignore them or being evasive. Always remember to trust your psych but, at the same time, remember that you can make your choices and yes, maybe he's not the right one for you! ;)

 

[ineverlearn]

Always remember to trust your psych but, at the same time, remember that you can make your choices

I've been so low and deemed him trustworthy, that I've been giving him a pass week after week, thinking that he has a plan or knows what he's doing. I guess how he responds well be very telling.

But I don't want to go through the process of getting another psychologist, spending months again laying the groundwork for my issues before starting to hopefully work on things, the cost, etc etc etc. Just thinking about that makes me want to retreat into a corner and not talk to anyone.

 

[Nexuno]

I've been so low and deemed him trustworthy, that I've been giving him a pass week after week, thinking that he has a plan or knows what he's doing. I guess how he responds well be very telling.

But I don't want to go through the process of getting another psychologist, spending months again laying the groundwork for my issues before starting to hopefully work on things, the cost, etc etc etc. Just thinking about that makes me want to retreat into a corner and not talk to anyone.

Yes, I know this is a huge problem! Having too much trust and fearing to start again the process with another psych it's what made me waste lots of time, though :( Has been like being stuck in an infinite loop, waiting with no avail for "something" to happen. The key here is being sincerely communicative with him (something that I neglected to do). I perfectly understand when you say it makes you feel like you don't want to talk anymore: well, don't do it! :D

 

[ineverlearn]

Yes, I know this is a huge problem! Having too much trust and fearing to start again the process with another psych it's what made me waste lots of time, though :( Has been like being stuck in an infinite loop, waiting with no avail for "something" to happen. The key here is being sincerely communicative with him (something that I neglected to do). I perfectly understand when you say it makes you feel like you don't want to talk anymore: well, don't do it! :D

Funny thing is, I'm honest about everything - except if I think it might hurt his feelings for not doing a good job. Which is stupid...

Stuck in loop... That's everything now and has been for a very long time. And that "something" in all aspects never happens...

I know a part of me wants to keep suffering for the pain I've caused. I don't feel like I deserve to be happy or even just okay.

 

[Nexuno]

Funny thing is, I'm honest about everything - except if I think it might hurt his feelings for not doing a good job. Which is stupid...

Hahaha, it was exactly like this for me too

Stuck in loop... That's everything now and has been for a very long time. And that "something" in all aspects never happens...
I know a part of me wants to keep suffering for the pain I've caused. I don't feel like I deserve to be happy or even just okay.

I think this is a part of the mental process, the "easy" way to deal with the problem. On the other hand you are talking with a psych though and this, potentially, is the other way to deal with your issue(s). It's ok that you recognize that a part of you wants to be exactly where it is; but just try to look and recognize that a part of you (maybe, just maybe) wants to go in the other direction. The fact that you don't deserve to be happy it's a lie; you even care to don't hurt the feelings of your psychologist, lol... This means you must have positive qualities that most of the people don't have for sure. Just remember the good things of you every time you think to not deserve something!

 

[ineverlearn]

Hahaha, it was exactly like this for me too



I think this is a part of the mental process, the "easy" way to deal with the problem. On the other hand you are talking with a psych though and this, potentially, is the other way to deal with your issue(s). It's ok that you recognize that a part of you wants to be exactly where it is; but just try to look and recognize that a part of you (maybe, just maybe) wants to go in the other direction. The fact that you don't deserve to be happy it's a lie; you even care to don't hurt the feelings of your psychologist, lol... This means you must have positive qualities that most of the people don't have for sure. Just remember the good things of you every time you think to not deserve something!

The pain I've caused supercedes any good things about myself. I can't forgive myself for the hurt I've caused which in turn caused my life to fall apart. The thing that keeps me going is the false hope I have that I can get an opportunity to try to repair that pain and hurt I've caused. But everything points to that it's never going to be possible. I'm lying to myself that there is an infinitely small chance - otherwise I will stop trying with anything and just pick a date, make it all stop for good.

 

[Nexuno]

I'm lying to myself that there is an infinitely small chance - otherwise I will stop trying with anything and just pick a date, make it all stop for good.

Well that "small chance" it could really be a lot. In any case always remember that there is something good in you: you are suffering, yet you are struggling for "repair". Either you decide or not to end your pain by choosing a date don't be unnecessarily cruel with yourself <3

 

[ineverlearn]

Well that "small chance" it could really be a lot. In any case always remember that there is something good in you: you are suffering, yet you are struggling for "repair". Either you decide or not to end your pain by choosing a date don't be unnecessarily cruel with yourself <3

Thank you for your kind words. I will try to remember them. I hope you too find your way.

 

[Nexuno]

I hope you too find your way.

Thank you!

 

[Gnip]

Both just tell me to hit the gym and eat healthy and depression will go away. I just laugh inside every time I hear that.

Concerning nutrition, the only psychiatrist I could ever take seriously on the subject of eating for counteracting depression is Priscilla Slagle, because I actually read her book, "The Way Up from Down" back in the 1990's. (I was never able to attempt her regimen, but her story is that she was always depressed and became a psychiatrist in a desperate bid to overcome her own severe lifelong depression.) The chief problem with her nutritional regimen is that the foods and supplements she recommended cost around $100 a month 25 years ago. Nobody should even contemplate buying anything available through her website without first obtaining a copy of and reading "The Way Up from Down," first, something I cannot stress enough.:

https://www.thewayup.com/

After all these years, it may be possible that Slagle's work has inspired other psychiatrists to follow in her footsteps.


99.99999% of all psychologists are about as useful as a pimple on an ass. There might be a few biofeedback therapists and clinical hypnotists who happen to have psychology degrees, but anybody who's been to college knows that psych majors are among the most completely stupid of all university attendees, only there so they can spend their party years fucking, drinking and doing drugs. Psychology has no right to exist as a profession. Nobody anywhere should be able to make a living as a paid counselor in 2020.



Psychiatrists are a different matter, as psychiatrists are prescribers. You want somebody who is authorized to prescribe medications and referrals for treatments like ECT, rTMS and DBS, along with green lighting euthanasia and physician assisted suicide. School psychologists made me suicidal. My depression is now formally documented in my medical records as iatrogenic in origin. Psychiatrists actually treated my multiple conditions, and although what successes there were turned out to be temporary, I did briefly experience what it was like to be able to focus, not be depressed and relieved of my clinical anxiety and chronic sleep disturbance. Psychiatric care also got me fully qualified for psychiatrist administered euthanasia wherever that relief protocol is practiced.