That’s my goal anyway….but I’m feeling intense anxiety just thinking about it . I’m just worried she’s going to be weirded or think I was stalkery. Like this feels like the most shameful part of who I am.
Anyone talk to their therapist about it? Were you better for it ?
How do you suddenly get to middle age,no trouble with alcohol even with family history of alcoholism and suddenly you are addicted??
I mean you’re fine with it for 43 fucking years. Then year 44 hits and you are in over your head.
I mean— I poured out the last shot but I’m hammered so it’s not that impressive
I’ve been through a gallon of tequila this year. A gallon. Good god.
Any motivational thoughts are welcome. I’ll take any stern lectures to.whatever it takes
So I’m just not sure how to process this. I’ve missed my last two therapy sessions (every other week). First one she postponed a week for something, I don’t know what. Then yesterday she canceled because her daughter’s fiance died quite suddenly — so very understandable cancellation.
So next appointment is in 1-2 weeks. It will have been a month for slightly more since my last appointment and I just don’t know how to proceed. 1) I feel like any momentum I was starting to build in therapy has ground to a halt and 2) my problems feel petty and stupid compared to what her family just went through. It just seems like it’s going to be uncomfortable and it just feels like I’ll be whining about my life .
So I’m just not sure how to process this. I’ve missed my last two therapy sessions (every other week). First one she postponed a week for something, I don’t know what. Then yesterday she canceled because her daughter’s fiance died quite suddenly — so very understandable cancellation.
So next appointment is in 1-2 weeks. It will have been a month for slightly more since my last appointment and I just don’t know how to proceed. 1) I feel like any momentum I was starting to build in therapy has ground to a halt and 2) my problems feel petty and stupid compared to what her family just went through. It just seems like it’s going to be uncomfortable and it just feels like I’ll be whining about my life .
I always like to turn to his works when life is getting dark. It doesn’t make things easier but it helps get me to the next day and just forget for awhile.
He got me through my husband’s Covid pneumonia hospitalization back in 2020 with Carpe Jugulum. right now im going through a fairly rough depression. I’m coping with the illustrated Last Hero and the audiobook of Maskerade. I love opera so I am particularly loving that.
Not in the sense that I’m on a medication with bad side effects or anything.
Just…it’s like you coast with the anxiety and just deal with it for awhile. But the “do I or don’t I see a doctor” itself kind of makes you ruminate on the anxiety, then you are anxious about actually seein the doctor then the treatment plan.
Anyone know what I mean?
I’ve seen a few people ok this combo in this forum but all the posts are a few years old. Are any of you on this combination ?
My doctor is adding it on to get a little more mood boost for me plus to address some anxiety. Hopefully I’ll not need too much since I have thr 300 Wellbutrin on board.
As it says. Anyone? Doc, PA, nurse, EMT etc. does the medical work contribute to your depression
Physician assistant here.
My son is in 10th grade, marching band, and they performed at the high school graduation. I saw they actually had purple cords on the gowns of the students who were blood donors. I thought that was awesome!!
I’m almost embarassed to admit it. But so far I think I like the Earl greys with bergamot flavoring more than those with bergamot oil.
Please tell me I’m not the only one.
(Yes. I like bagged Twinnings Earl Grey. It was my first. Shame shame!)
For my fellow heathens what other brands with bergamot flavor rather than oil do you like?
I work in palliative and home-based primary care for the elderly and chronically ill and I’m wondering if my psychiatry friends can find a new angle on this case for me. Because I am coming up empty.
I have a patient with progressive Multiple sclerosis, very severe, pretty much couch bound. She is so ill it’s affecting food intake and basic needs. She has a primary caregiver who is over 80 and can barely care for her anymore.
She seems very mentally intact except for one very important thing. She is in complete denial that she has MS. She’s convinced she has a copper deficiency and is self treating with copper and supplements. I even read her reports very clearly to her—-she kind of seemed to accept it then next visit fixated back on the copper.
What the heck do I do? This truly seems to me like a delusion. Adult protective services have offered some in home services but not enough. They ignored my AND her neurologist’s letter that we deemed she wasn’t capable of making medical decisions but she passed cognitive testing so they don’t care. Her partner is contacting a lawyer to get her declare incompetent but that takes time . Time that I don’t think she has . I put in a welfare check just now but don’t know what will come of it. Is there an angle I have not explored? Home care medicine is new territory for me so this case just blows my mind. Again, her neuro and I are convinced this must be a delusion
I work in palliative and home-based primary care for the elderly and chronically ill and I’m wondering if my psychiatry friends can find a new angle on this case for me. Because I am coming up empty.
I have a patient with progressive Multiple sclerosis, very severe, pretty much couch bound. She is so ill it’s affecting food intake and basic needs. She has a primary caregiver who is over 80 and can barely care for her anymore.
She seems very mentally intact except for one very important thing. She is in complete denial that she has MS. She’s convinced she has a copper deficiency and is self treating with copper and supplements. I even read her reports very clearly to her—-she kind of seemed to accept it then next visit fixated back on the copper.
What the heck do I do? This truly seems to me like a delusion. Adult protective services have offered some in home services but not enough. They ignored my AND her neurologist’s letter that we deemed she wasn’t capable of making medical decisions but she passed cognitive testing so they don’t care. Her partner is contacting a lawyer to get her declare incompetent but that takes time . Time that I don’t think she has . I put in a welfare check just now but don’t know what will come of it. Is there an angle I have not explored? Home care medicine is new territory for me so this case just blows my mind. Again, her neuro and I are convinced this must be a delusion
Three sessions in with a therapist. Primarily being seen for occupational stress—(medicine) with multiple job losses.
That’s kind of my main reason for being in, but the crux of the matter is I have fairly low self worth snd have for a long time. And of course losing multiple jobs kind of reinforces that.
So I’ve been going back and digging into all that childhood stuff that got me into that mindset in the first place. Alcoholic father bullying . You know the garden variety usual.
So now I’m kind of feeling even worse because not only am I dealing with the current occupational stress (in a new job fortunately but it’s not going great) I’m now dealing with unhappy childhood memories.
Feeling fine in the sessions themselves but it’s kind of when I am journaling ahead in preparation for the next session .
I know in the long run I probably just need to push through and process in order to work on improving my self worth. But any thoughts ?
I thought it might be nice to have a support thread for anyone who needs it, and to commiserate. I’ve been having a tough time lately and wondered who else was.
Our field can be brutal in a number of ways. Residencies *tips hat to the physicians* trying to navigate our broken medical system to help a patient and sometimes coming up empty. The pressure to avoid making mistakes. The bean counters caring more about the numbers rather than the quality of medicine we provide. Even worse now with the lack of respect of the medical field.
I dreamed of having a stable family medicine job for decades. Treating generations from the same family. It hasn’t worked out that way. I’ve lost my job more than once due to restructuring and downsizing . It’s very demoralizing. I’m by no means perfect, but my supervising physicians always knew I practiced quality medicine. Never has a medical colleague doubted my abilities. And yet more than once management has decided I’m not worth keeping . Gets to a point where you doubt your own worth . You get to thinking maybe they must be right? I’ve landed a new job, but I don’t know if it’s a good fit and now I’m struggling with self doubt. I’m so mentally drained and I have half my career ahead of me .
This isn’t just about me. I want to hear from all of you . Unburden your stresses to the fellow medical practitioners in the trenches with you.
This is something of a follow-up or companion post to when I talked about low self worth awhile back. So I started counseling at the beginning of the month. I started counseling for WORK stress after multiple job losses in my career and the pressures of working in medicine. The whole making what I do too much a part of who I am. I wanted to focus on Regaining confidence in my skills. I told myself I wouldn’t survive losing a job again, but I did. I got laid off. Again. So guess what ; I have to survive after all.
I didn’t want to rehash childhood stuff . I haven’t lived with an alcoholic in 24 years. I’ve made my peace with my father’s alcoholism and the damage it did to my relationship with my sister growing up. It’s a wrap. It’s fine. He only has two drinks a day now anyway. I’ve DONE my therapy for family-of-origin wounds a decade ago.
But….since the core of the issue is rebuilding my nonexistent self worth. Guess what? We have to go back to what caused that in the FIRST place. It’s like the job losses confirmed all my worst fears that I’m not enough. And I have to work again to heal that initial wound in order to move forward to the stuff that I ACTUALLY intended to pay a therapist for.
This post is half tongue in cheek and half serious. I get why it has to be this way but damn is it annoying.
Know what i mean?
So, just an off hand thought but I wanted to share. Currently my limerence is very mild. Kind of like I think of them as a sort of habit more than being actively limerent if that makes sense. But it’s on my mind because I’m in counseling and kind of focusing on my tremendous self doubt and shame. And I’ve just never talked to a professional about it and felt it might be enlightening. So here is something I journaled today and it felt very powerful.
“I find mentors, and then turn those mentors into heroes. This leads to me blaming myself for being unable to reach the pedestals I put them on”
I’m just going to sit with this one for a bit…
Just wondering if anyone else can relate. Adult daughter of a functional alcoholic. My father. I definitely was in the road of as a people pleaser in the family, the peacekeeper.
My life has had its share of ups and downs. Overall it’s been a pretty good one. I was really successful in high school and college and in one sense have a good career. I am a physician assistant. In many ways it’s turned out to be a disappointing career for a few reasons
Through my life, there’s always been the undercurrent of not being good enough. Imposter syndrome is not uncommon in medicine certainly but this goes beyond that.
I realize I’ll just never never feel “good enough” it’s just this undercurrent through my whole life and I don’t think it will ever go away.
Anyone else? How do you handle it?
So I started a new job in-home primary care and palliative care and wow. Didn’t know what I was in for. I got some really tough cases right off the bat.
First patient a male in his 50s, severe food related OCD which essentially led to ARFID. Became obsessed with the idea that he swallowed some soap a few years ago. Feels like every time he eats it irritates the soap in his stomach. He’s eaten so little that he is now too weak to drive to get more food. I got him connected with Meals on Wheels but that’s not adequate. He’s so anxious he is cripplingly overwhelmed about making any decisions. Won’t agree to anxiety meds or psychotherapy. Won’t go to the hospital. Won’t accept bus passes to go get groceries. Won’t take a cognitive assessment to determine mental incapacity. And adult protective services refuses to do anything more for him.
Second, woman in her 50s with multiple sclerosis. In complete denial. Convinced she has copper or B12 deficiency. She doesn’t. She’s taking vitamins thinking she’s going to get better. She’s lost about thirty pounds in about two months and is literally wasting away. Her caregiver is a man in his 80s at his wits end. Called 911 because she was in such bad shape. But because she’s alert and oriented X 4 and refuses. They can’t force her to go. Her neurologist and I are trying like hell to —again, get APS involved helping her but because her cognitive assessment is normal, they won’t do anything more.
I feel so helpless. I’m basically showing up at their homes every week just watching them both slowly killing themselves and there’s not a damn thing I can do
Has anyone been on 450 mg before? So I’ve been on Wellbutrin a couple times before and it actually kicked in pretty quickly for me. Mood boost within a few days, and improved motivation above my baseline within a couple weeks.
This time it’s just not doing much. To be fair given more time it might ramp up just fine. I’ve been on it a couple weeks. With this difference I’m just concerned it won’t give me the same bang for my buck as before.
My doctor would like me to give it a couple more weeks but is open to bumping me to 450. Pretty sizeable dose. Have any of you been up to 450? What was your experience ?
I just wanted to share because I know good news is few and far between on this forum.
I am one of the early long-haulers, having gotten such in November 2020. My brand of long COVID has been gastrointestinal. Loss of appetite, vomiting, weight loss. My clinical picture was nearly identical to post viral gastroparesis except for negative testing (of course because COVID right?
My GI doctor felt that if I would recovered , I would do so in five years, if not I would be expected to deal with some level of symptoms for the rest of my life.
With my worst flare ever in January-April of 2025 I had given up the notion of recovery.
But once I was able to break out of that particular flare, something surprising happened. I started feeling much better than I ever did since I was sick. I had prior “remissions” of 2 weeks to 2 months but symptoms would always return. And “remissions” had me at about 80% better. This time, I felt about 99% better. I would occasionally feel nausea but there would be a clearly defined cause in each circumstance. I regained my lost weight. I’ve only vomited once in six months.
I learned not to get my hopes up too high in the past during remissions. But….I honestly think I’m better this time. I think I’ve healed.
How did it happen? I’m not sure. All my meds were symptomatic meds, nothing that would help me actually recover. I did acupuncture which helped individual flares but was never a permanent solution
It was one of two possibilities :
I did take Lactoferrin for about a month after my last flare. I read about one very small study about Lactoferrin being used for Covid GI issues. It might have actually worked !!
Or….i just healed. It was right around the end of the timeframe that my doctor had suggested.
Am I 100% certain I’m better? No. Like I said I’ve had remissions before. But this is the longest one I’ve ever had and like I said I feel even better than I did in those situations