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I feel trapped.

by MoreyPiya

I feel trapped.

 

I am a doctor working in the NHS.

I have been in and out of mental health services as a patient.

My mental health is starting to deteriorate once again.

I want help but I don’t know where to get it.

 

I am terrified of being found out. I am terrified of my work colleagues finding out about my mental health issues. I am terrified of being seen as weak, as manipulative, as not up to the job, as second-class, as inferior.

 

When I was in medical school I was briefly admitted to hospital and told to stop attention seeking and manipulating staff for attention.

 

When I was in medical school I was assessed by a psychiatrist and deemed to have traits of narcissistic personality disorder and not suitable to be a doctor.

 

When I was working as a junior doctor I was also seeing a psychiatrist when one of my work colleagues came across my medical records; he is now aware of my mental health problems and some of my deepest and darkest secrets. I am terrified of the day I will next bump into him; at a conference, at work, as a member of my team, at a professional social gathering.

 

When I was working as a (more senior) junior doctor I was told by a friend & work colleague about some ‘gossip’ – a medical student who had just joined his team had been in hospital a few years ago with a psychotic episode. How did he know this? The students old consultant psychiatrist was also my friends supervisor and they had ‘gossiped’ about it.

‘You wouldn’t have guessed it would you!’ he said.

So much for fucking confidentiality. God knows what my old psychiatrist ‘gossips’ about me these days.

 

I now work as a doctor in psychiatry and things are worse. Everyday I see young women come in with issues around self-harm and thoughts of suicide, with difficulty controlling their emotions and issues around self-esteem and self-confidence.

Everyday I hear the same fucking thing from the staff who are supposed to be treating them.

 

‘Oh, she’s just saying that to get attention.’

‘She just wants to get benefits.’

‘It’s all behavioural, there’s no mental illness.’

‘She has a personality disorder, there’s nothing we can do about it.’

 

Where the fuck am I supposed to go for help?

 

If I seek help from mental health services I will be treated by people who I will later be working with. Not only will these people know I have a mental health problem but they will know some of the most personal things about me. I will be expected to share painful, embarrassing thoughts and emotions while being expected to act ‘normal’ when I work with them as a doctor and not as a patient.

 

If I go privately I will probably (again) be deemed to have a personality disorder, to be narcissistic and manipulative and – heaven-forbid, attention-seeking (!) – and have my personal story discussed in multi-disciplinary meetings with teams who I will work with as a doctor in the future.

 

What am I supposed to do?

Where am I supposed to go?

 

How do I access treatment as a patient and not as a doctor?

How can I guarantee my confidentiality?

How can I seek help as a patient when I have seen my problems being dealt with so callously when it comes to others like me?

 

Where the fuck do I go to be listened to, to get some fucking empathy, to be treated as a human being?

 

Or do I just wait until this problem gets worse once again, and when the suicidal thoughts get too much, when the drinking becomes too heavy, when the darkness starts to overwhelm me, that I decide to just give in it one last time and cease to be?

Maybe that’s the ‘better’ option.

Maybe that’s the only option.

At least no one (else) will know I have a problem.

At least I will be fucking normal to everyone else.

6 comments
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6 comments

thehusk 2/26/2020 - 3:22 pm

Medicine seems like an unnecessarily stressful and competitive field.

Have you thought about seeking more low level help – counselors and therapists rather than psychiatrists or psychologists? Listening and empathy is their primary function (if they’re good at it), and they’re unlikely to diagnose you. They’re also duty bound to maintain confidentiality, and I’m sure there are plenty who are never involved with NHS work. You could talk through all your concerns around confidentiality with them before sharing anything embarrassing.

Obviously they wouldn’t be able to prescribe anything for you, if that’s what you’re after. But if what you want is to be really listened to and empathized with by a professional, then I’d look for a good counselor or therapist who you get on with (particularly a person-centered one) . They do exist (though some are quacks.)

muspelhem 2/26/2020 - 4:16 pm

I can understand your practical considerations around confidentiality and not wanting to work with people who know the most intimate details of your inner life.

Can’t you seek help at another hospital than the one you work in?

Apart from that you seem to have some shame about your mental health struggles, and about how it reflects on you given your profession.

This I find entirely unwarranted. Doctors are human beings too. Mental illness does not discriminate. It is laudible that you have chosen a profession which is about helping others. Furthermore, that profession (hopefully) means you are somewhat comfortable financially, which is at least something when dealing with mental illness.

I really think you should seek the help you need, try to get as much privacy around it as you can, and otherwise disregard what others might think of you based on your mental health. Again: You are a human being. You have chosen a pro-social line of work, which should be commended. And you are no doubt doing your best to hold it together. Give yourself a pat on the back.

LifesBeenGoodToMe 2/26/2020 - 4:43 pm

You must go to yourself for help. And by that, I suppose I mean *google* or whatever search engine you use. In my case, after my divorce I tripped over some really brilliant advice in the form of the first three bullet points of a religion: Buddhism. They have these tenants and I really didn’t need to read past the first three, to be honest. I’ve never gone to a Buddhist temple or called myself a Buddhist. I sort of just used those to heal myself. I fixed me by just reading those and understanding what they meant.

mountaingoat 2/27/2020 - 11:48 am

You’re a doctor. Should have enough money to seek help somewhere far away from your peers, no?

That’s quite a situation you are in. Your peers can’t find out the truth! That’s enough to drive me bonkers in itself.

I dunno doc, maybe you should try psychedelic drugs.

DRx 2/28/2020 - 2:41 pm

[ I don’t have time to visit sites like this very often, so I will try to address all of your questions & concerns in one post. ]

a) I speak to them about their fears, their worries and their hopes. I give them a hand to hold as they go through the most horrific moments of their life. As their life shatters all around them, I make sure I am there to give them a hug. To let them know everything will be okay.

b) I am not human. I am more of a mutant. I am not worthy of friendship. I deserve to be alone, for I am not worthy of anyone else’s company.

Both of these statements cannot be true. If you have genuine empathy for others, there is something of value.

> When I was in medical school I was assessed by a psychiatrist and deemed to have traits of narcissistic personality disorder and not suitable to be a doctor.

I have listened extensively to the victims of malevolent narcissists, and even worked for someone who met the diagnostic criteria, but have never encountered a case where a narcissist would admit there is something wrong with them and seek professional treatment. That is why your posts interest me (and why I suspect the accuracy or completeness of this diagnosis.) The most significant characteristics of NPD are lack of empathy and general disrespect for others. Narcissists are egotistical and conceited. They are not really interested in what others have to say, or what they think and feel. Narcissists typically do not present as clinically depressed:

“Patients with NPD are reportedly happier than others in society. Being highly materialistic, self-enhancing, entitled and impulsive, they may not learn from mistakes, and have a tendency to get into even greater trouble, notably legal and disciplinary.”

https://www.theravive.com/therapedia/narcissistic-personality-disorder-dsm–5-301.81-(f60.81)

> When I was in medical school I was briefly admitted to hospital and told to stop attention seeking and manipulating staff for attention.

Narcissistic manipulation is not just done for attention – it often involves defrauding, belittling or humiliating others. So I would say that proper diagnosis hinges on the FORM of attention seeking and manipulation, which you did not specify. Do others regard your behavior as abusive, or is it merely annoying?

“People with NPD often spend much time thinking about achieving power and success, or their appearance. Typically, they also take advantage of the people around them.”

https://en.wikipedia.org/wiki/Narcissistic_personality_disorder
http://narcopath.info/about-npd/overview/dsm-5/

> Have those staff members then sat behind hidden doors, lying upon their armchairs and chuckling about your pleas for attention?

I doubt it… you are just another line on their schedule, and any time which they have to spare would not be spent sitting and chuckling. I don’t know anyone who thinks that NPD is entertaining.

> What do you do when you’ve been diagnosed with narcissistic personality disorder?

Get a second opinion? –Unless you are not being totally honest, this sounds like an incomplete diagnosis. While narcissists do seek to be the center of attention, not every person who craves attention has NPD. It depends on the KIND of attention seeking.

Malevolent narcissists are not in the habit of exposing their weaknesses, faults, or vulnerabilities. And they are typically not suicidal: they live to abuse & humiliate others. When they manipulate people, the purpose is to cheat, belittle, or degrade them – it’s not a form of seeking help or emotional affect. Furthermore, there are no two cases which match the same exact diagnostic criteria. These labels only represent a best effort to characterize and communicate personality disorders. That is the best we can do at this time.

? Psychiatric Diagnoses Are ‘Scientifically Meaningless’ In Treating Mental Health
https://www.studyfinds.org/study-psychiatric-diagnoses-are-scientifically-meaningless/

A person with some “narcissistic tendencies” is not necessarily a malevolent narcissist, and may not qualify as NPD. Proper diagnosis and treatment of personality disorders can take a lot of time. It requires considerable intelligence, patience, knowledge, experience, and intuition. These are things which many doctors lack. They often want to pigeonhole people as quickly as possible, write a prescription, and send them on their way. When the state is footing the bill, the pressure to dispose of cases quickly can be tremendous, since doctors are judged by efficiency metrics, not by patient progress.

> When I was working as a (more senior) junior doctor I was told by a friend & work colleague about some ‘gossip’ – a medical student who had just joined his team had been in hospital a few years ago with a psychotic episode. How did he know this? The students old consultant psychiatrist was also my friends supervisor and they had ‘gossiped’ about it.

I dont know the regulations in your facility or jurisdiction – but you might want to consult a lawyer who specializes in medical malpractice cases.

> God knows what my old psychiatrist ‘gossips’ about me these days.

I think this speaks to the diagnosis: the narcissists which I have encountered were not particularly concerned about gossip — they just burn one person after another and keep moving on. When their friends disappear, they go out and socialize, turn on the charm, and recruit some more.

> The anger you felt when your friend turned up fifteen minutes late. Was that because of a deep insecurity about your own importance in the world?

Narcissists often do become enraged at the slightest perceived offense. But this is not sufficient for a diagnosis of NPD, and may be a form of projection (where the things that anger you are things which you subconsciously dislike about yourself.) While you may have some “narcissistic tendencies”, you could also be somewhat bipolar or manic depressive. In any case, I would like to suggest that you try Lithium Orotate to control these manic episodes… it’s far less dangerous than synthetic anti-depressants, which can make you suicidal. (It can also be equally dangerous to stop taking them all at once if you have become dependent.) As with anything else, it’s your responsibility to research contraindications – especially when other medications are involved. And here is something else to consider:

? This study gives rise to the growing belief among scientists that depression and anxiety has less to do with the “serotonin hypothesis” and possibly more to do with the “neurogenic theory of depression and anxiety.”

https://themindunleashed.com/2019/10/lions-mane-mushroom-reduce-anxiety-depression.html

> I now work as a doctor in psychiatry and things are worse. Everyday I see young women come in with issues around self-harm and thoughts of suicide, with difficulty controlling their emotions and issues around self-esteem and self-confidence. Everyday I hear the same fucking thing from the staff who are supposed to be treating them. Oh, she’s just saying that to get attention.’

This is absolutely appalling – and in a respectable private practice, they would probably be fired for mocking the patients. If a patient comes into the office expecting that they will have to discuss embarrassing personal issues in order to obtain anti-depressants, common sense dictates that they are in fact clinically depressed. (Even if that is not the best mode of treatment.)

To some extent I think this phenomenon is symptomatic of government institutions (which do not attract the most qualified and caring people.) It’s a job that many people don’t take very seriously, since you really have to screw up bad before you get fired by the state. As they used to say in the USSR, “we pretend to work and they pretend to pay us.” The quality of care tends to decline in a regime of this sort, where there is no meaningful competition. And the same holds true for public education. Many of the most talented, intelligent and creative people cannot stand working in a poorly-managed bureaucracy like the NHS, so you tend to get the kind of people who cannot compete in a free market. If you don’t engage in such gossip, then you are a better human being than them, and I don’t think you are really a narcissist …at least not the malicious sort.

> Where the fuck am I supposed to go for help? How do I access treatment as a patient and not as a doctor?

1. If you dont know the cause of your depression, consider consulting a psychic counselor who might be able to see things you cant and steer you in the right direction. (And I don’t mean the tarot readers on TV!) They aren’t all fakes, and some of them are amazing. For example, Edgar Cayce was one of the greatest physicians the world has ever seen: it’s a thoroughly documented and witnessed fact that he correctly diagnosed and cured many patients which doctors did not know how to treat. There are also many police agencies that secretly employ psychics to crack unsolvable cases.

? What a Shaman Sees in A Mental Hospital
https://themindunleashed.com/2014/08/shaman-sees-mental-hospital.html

2. There is some serious scientific research which indicates that clinical treatment with psychedelics can produce fast results – and treat substance addictions as well. Perhaps you could find some trials going on at a research university or something like that. In particular, Ayahuasca or Psilocybin might be worth looking into, especially when administered by a professional with experience in this mode of treatment. (Yes, I know they are few and far-between.)

Johns Hopkins University Opens First Ever Psychedelic Research Center
https://themindunleashed.com/2019/09/johns-hopkins-opens-psychedelic-research-center.html

3. Brain chemistry is important, and randomly trying synthetic anti-depressants is a crap shoot, with all of the long-term side effects that they tend to produce. Have a look at this, please:

“I consider Daniel Amen to be the most innovative psychiatrist in America. His dietary and lifestyle strategies to maintain brain health are based on the world’s most comprehensive library of brain imaging technology that allows one to observe the impact of his recommendations.”

“What makes his work distinct is his study of sophisticated SPECT brain scans, which demonstrate how the brain is malfunctioning in many common states of mind – anxiety states, depression, OCD, ADHD etc. The data make vividly clear the brain state basis of these common problems – and, most importantly, outline helpful ways to counter these and facilitate optimum brain function.”

https://www.amazon.com/Change-Your-Brain-Revised-Expanded/dp/110190464X

> If I seek help from mental health services I will be treated by people who I will later be working with. If I go privately I will have my personal story discussed in multi-disciplinary meetings with teams who I will work with as a doctor in the future. What am I supposed to do? Where am I supposed to go?

Are surnames disclosed in those multi-disciplinary meetings, or is the data anonymized? Could you use a pseudonym? Could you go on disability and take a paid sabbatical while seeking treatment, then find work in another province, or a different theater of operations? Do you have sufficient medical training to work for the World Health Organization or some other kind of international relief agency? Could you obtain funding or sponsorship for a research project that involves alternative treatments? Are your patients generally pleased with the quality of service – and could you start a private practice? Broaden your horizons; there are many possibilities.

Cause of Death: Suicide 2/29/2020 - 2:40 pm

Just a thought – I would assume that the depth of your narcissistic, attention-seeking diagnosis comes indeed from the fact that you are a doctor, which is one of the only best jobs there are out there… which only is suitable for the best and brightest people – What with peoples lives and wellbeing being put into your hands – of course you’d have to have a bit of a big head if you are a doctor, because the career alone, is one that brings a very strong feeling of pride. I presume you are viewed as narcissistic because you have that accomplishment and perhaps you are viewed to flaunt it. Although – I do not see how narcissism can fit in here, because the exact role of a ‘good’ doctor is one that is not self-absorbed at all and is concerned more about the all of humanity. Maybe you have a different personality out of the clinic than in the clinic.

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