Had a psychiatrist appointment to find out more about dissociation etc.

Discussion in 'The Watercooler' started by SuZir, Apr 23, 2013.

  1. SuZir

    SuZir Well-Known Member

    After feeling rather freaked out of reality of difficult child's dissociative, depersonalization and derealization symptoms I booked myself an appointment with psychiatrist specialised trauma issues (not same psychiatrist who treats difficult child.) Good thing was that I managed to get difficult child's permission to tell about his symptoms to husband and take him with me. I think that was most helpful in this.

    As I expected it was very difficult to get anything but absolute basics out of the psychiatrist, luckily I did had my question list. Without that I don't think we would had gain much. Now it was at least very informative to husband who is more of a practical kind of guy and takes better in auditory information and was never into academics that much (very possibly would never had obtain his master's degree if I wouldn't had helped/done work for him, to be honest. He just isn't academic minded.) We also got some unofficial recommendations of professionals to seek for and what and even who, to avoid, in some cities difficult child may end up next. That was very helpful.

    According to her what we told about difficult child's care it seems he is treated with best and most recommended practises right now. That is good. She did stress that substance abuse and developing other disabling conditions like severe depression or social anxieties are the greatest threat. And if any way possible to avoid regular or frequent benzo medication because of high abuse risk (especially with younger and male patients.) Therapy is the most important thing and tends to have highly positive outcomes, medications are just to make therapy possible. She also said that him being young and male, gaming can be a real threat. He should be very cautious how much and what type of console games he is playing. Keep time used very moderate and not play much or any the most hooking games like WoW or CoD and preferably play mostly with friends, not alone, not more than hour or two at the time and during a day and not night. Apparently she has many trauma patients who have developed addiction issues with these games that are very similar to substance abuse and very adverse to their recovery.

    She also recommended we take difficult child's lead on how to deal with his dissociative symptoms and stay very matter of fact and undramatic. According to her many dissociative patients do mystify their symptoms because other wise making sense to them is too difficult and that it is very good sign, difficult child is not doing that but is able to see his symptoms as symptoms not some paranormal experiences. And apparently difficult child's symptoms, while seeming dramatic enough for me, are still more in the milder side of moderate. Especially his easy ability to tell what is real and what is in his head makes them much less serious than they easily seem. Apparently severe symptoms are much more dramatic and that ability to tell they are not real is almost gone and they may seem a lot like severe acute psychosis. Difference is that AP's don't help much and the patient can be talked to believe the hallucinations are not real, there with psychosis AP's are highly effective and patient can't be talked out of believing their hallucinations.

    When it comes to prognosis, she of course couldn't tell much. Most people with PTSD do recover. With 30 % it gets chronic. With specialised therapy outcomes are good, 80 % get significantly better and difficult child being able to engage the therapy hints that he will be one of those who greatly benefit. But other than gender, current high functioning, not having current substance abuse issues and having support network things seem to be piling against difficult child. And her 'best guess' was that in some level this may be life long issue with difficult child but he is likely to improve significantly with therapy. But he will always be very prone to dissociative symptoms, will likely have them flare up time after time when life-stressors come along and he will be vulnerable to being re-traumatised. So learning to live and deal with symptoms will be paramount. However him being as functional as he is now may be a very good sign and even if this issues never totally go away she told us that we have every reason to be hopeful he can live with them and be functional.

    By the way, apparently difficult child's childhood imaginary friends, very vivid imagination and his proneness to alternate reality/hyper focused/self hypnotised/flow-experiences are sign that he has in-born vulnerability to dissociation. And there are even some perks that come with that, so we should just think it is something that is just part of who he is and he has to learn to live with having that type of way to react to situations.

    What we can do isn't much. Make sure he has access to resources he needs, try to make sure he keeps his day to day routine, doesn't let himself isolated and if needed in most difficult times to offer him safe place to be and make sure he keeps those routines (sleeps at night, is up at day time, eats regularly, does all kinds of low-stress activities etc.), be vigilant with substance abuse and gaming and offer him a possibility to call any time to talk mundane things to help him feel grounded if he is having tough time with his symptoms. Especially during the night time (having this kid really is very adverse to me sleeping. ;) He has been almost sole reason for me not having a good night sleep for twenty years and counting. Would like to see that midwife who told me almost exactly 20 years ago (when difficult child was kicking my ribs like crazy all nights through) I should get used to not sleeping, because in worst case baby would keep me sleeping badly for two years. We are 18 years over that worst case scenario and my baby is still keeping me awake.)
  2. TerryJ2

    TerryJ2 Well-Known Member

    That's great info. I am so glad you had a list! I hate it when you have to pry info from a dr. Interesting that having invisible childhood friends can be a flag for later dissociation. I'm wondering if, since he's good at separating what is real and what is not, if he would ever be interested in being a writer, a fiction writer? May as well take a negative and make it into a positive. Just a thought.
  3. SuZir

    SuZir Well-Known Member

    Terry: If I understood correctly dissociation is not only a spectrum, but to be able to dissociate you have to have some kind of ability to that. Most people have, very few don't have it at all (can't for example be hypnotised) and some have high ability. And then if person has traumatic experience, those with high ability to dissociation just tend to use that as a coping mechanism. And in some ways it can be very useful and can prevent self-destruction. But when it gets chronic, it is bothersome. Imaginary friends in childhood are one of the signs that person likely has high dissociative ability. Or something like that.

    When younger, difficult child did make some rather cool comics. He seems to have inherited some artistic ability from my dad (who is professional artist and good enough that he has managed to keep himself in booze and bedmates for well over forty years by now. Especially the first one is not a small achievement.) difficult child's artistic talents are more in the visual side of things, but also the story lines in those comics were wild and interesting ones. Now difficult child is a good drawer but mostly his eye for things comes out in photos he takes. But he is not passionate enough with any of it to make anything out of it. My easy child is the one who has ability to write, but he too lacks the passion for it. You can see his talent from just his school works, but without passion he of course will never make anything more out of it (or at most maybe career in advertising or something like that.) Both of them have firmly decided to be stupid, uncultured jocks instead of delving into their artistic gifts ;)

    Trying to get info out from doctors is always frustrating. In some ways I do get it. They know that often people take anything they say too seriously and if they can't give definite answers, they would rather not give any. But we for example made it very clear that we do understand that this psychiatrist can not say anything sure about our son she has never even met, but we would like to hear a little bit about what we should be prepared for, what are likely scenarios and what are less likely. After quite a lot of prying we did get useful info out of her so it was money well spent. Inside info of possible service providers is well worth it to us and especially husband is much less freaked about it after an appointment. For him knowing that difficult child is not likely to become 'permanently crazy' is a big thing.