lgbtq friends

[sky]

Hey again.

I’m just stopping in to say that, I made friends in the community online. They added me into a group chat with like 25 of us and I didn’t even talk that much in it because I’ve just been having a hard time with life and when I did talk they didn’t really say anything and then I was just deleted from the group lol. I’m thankful I was deleted because after like 2 days I wanted to get out and they said no so I stayed, even tho I didn’t fit in with them. I don’t fit in anywhere really.

But, I have an appointment to see a therapist on Friday and I don’t know if I am going to go because like, It’s so hard and she’s extremely welcoming to the gnc community and the lgbtq community and she specializes in suicidal ideation and stuff. But, I kinda wanna ask a few questions about it since I don’t have friends to ask anymore. Should I tell her about my active suicidal thoughts on the first appointment or should I just not bring up how bad it is for me right now. I have almost many times since we last interacted on her and my depression is extremely bad.

I am not going to do it hence why I haven’t actually tried. But like, I don’t have insurance and I can’t get it through work or state and I can’t afford meds out of pocket so why should I even bother bringing it up if I can’t be hospitalized or see a psychiatrist. I definitely could get the meds I think but the appointment to see the doc every month would be so expensive, that’s what I meant by can’t afford meds.

I know I said I wouldn’t come back. I kinda just want some input from people who know from personal experience or know from talking to as many people as they do. I’m sorry to have come back. I hope you’re all doing good.

[Heather]

Hey there, sky.

I am glad you started trying to make friends in the community. The good (but also sometimes intimidating) news is that because one group of queer/GNC friends wasn't a fit, that doesn't mean none will be. Making friends, and finding community, is a lot like dating: we will most often have to do a lot of finding out who is and who isn't a good fit for us before we start having ongoing friendships and growing community that's right for us. I hope this first try doesn't get you discouraged. All of our people are out there, I promise, even for the weirdest of us.

I'm also glad to hear you have an appointment with someone. By all means, I think you -- as anyone should -- should be very honest with this person. Mental healthcare providers need us to be honest with them in order for them to do their job: if we diminish or otherwise misrepresent our stuff, we really can't be part of effective therapy. And if and when you are screening someone new, it's vital to give them a real sense of your needs so they (and you) can be sure they can serve you well. Long story short, if you're seeking out therapy because you actually want help and you actually want therapy to be effective, you have to go all-in on your side of things.

You also can ask any therapist to help you get connected with any social services you might need to help you pay for therapy and/or medication. If your insurance doesn't cover it, there may still be ways for you to get it covered. Don't write off your ability to get therapy or medication before you even get started: that's sabotaging those things from the start, which is a waste of everyone's time and energy, yours most of all. Ask for help with these things first and see what your options actually are from people who know how to work these systems.

[sky]

Thank you! I think I’m just gonna go once to get everyone off my back and then I won’t go again, unless I really like her and feel comfortable. I’m really nervous to go. I’m already so so fragile and having to open up about things is really making me scared. But I can’t keep running because it’s gotten me here and here isn’t a good place to be

[Heather]

You know, I personally am not a fan of the idea of only going to see a therapist to get people telling you to see a therapist off your back.

If that really is the only reason you're going -- it's hard for me to sort that out, because you also seem to be saying you want to find out if you like this person and, I assume, might then want to see them again if you do -- I'd reconsider. Often mental health services are in high demand, and so when we take an appointment with someone, someone else doesn't get one. Too, we take the time and energy, then, of that professional, which isn't such a cool thing to do if we don't have any real inclination to let them do their job.

If people in your life are "on your back" for you to get therapy and you want them to stop, I doubt one visit will do that. I also don't think that's a sound approach to that conflict: to address that, you need to talk with those people about this.

I do, as I have said before, personally think that you could benefit tremendously from actively taking part in ongoing therapy with an queer-friendly therapist. You can even go and talk to them about the idea that you need to see them to get people off your back: if that's honest, I think that's as good a start as any to see if someone is a good fit for you or not.

But that bit about actively taking part is the key bit: just showing up to an appointment so you can say you went isn't that. If you don't intend to try and really participate, or aren't looking to screen a therapist for yourself -- not because of other people -- because you are ready to go, and are trying to find someone to see, I'd suggest you rethink this. Get what I mean?

[sky]

I do get you heather. I just honestly am really scared. I’m scared of my head after these appointments. I want to go to therapy to try and get help for these thoughts but there’s so so much to it that’s unknown. It’s like, the suicidal ideation is so bad that I want help but I’m scared to get help because what if it makes it worse

[Heather]

One thing to know is that qualified help just usually doesn't do that. In screening visits, too, you're not usually going to be sharing anything super-duper deep like you're thinking, because that's just not usually how first visits go. If and when it is, and you need help and support because of how you're feeling, you tell the therapist that and they will absolutely make sure you're okay to leave their office, and have whatever you need to get safe if you do have issues. But on the whole, suicidality is something that tends to thrive far more in isolation and by hiding out in it, not by putting light on it with a trained professional.

As you know, we -- and especially I -- need to limit how much we talk about suicidality here, though, but this is one thing to absolutely talk to a therapist about, even if that we're the case. We can't speak for one therapist we don't even know.

When you go to screen a therapist, it's a good idea to bring a list of questions for them, period. Sounds like your list should have one it something to ask like, "I'm really worried that opening up will put me in danger of self-harm. Can we talk about that?"

This article has more information on that and more about therapy: https://www.scarleteen.com/article/disa ... of_therapy . I think it'd be a good one for you to read if you're in earnest about looking into or starting therapy.

[sky]

Thank you. Last time I had an intake I didn’t even open much up but I came home and cried for like 3 hours and then slept for like 6. I don’t really know why, but I’m just scared now. I will say that. I am going to go. Thank you again for easing my mind some

[Heather]

You know, having that kind of response doesn't mean things have gotten worse.

It's healthy and it's normal to have a big emotional response when we share big emotional things, and doing things after that help us resolve our stress cycle and process those feelings some more -- like crying, and then resting after -- is part of how we cope and get to the other side. I get that if you are someone who bottles up your feelings, then letting them out like that might feel "worse," but it's actually where you'll need to get in the long run in order to better manage things like depression and suicidality.

[sky]

Hey heather, it went really well. She’s super nice and we really connected I feel. She wants to see me weekly and she wants me to get on medication because if I am bipolar I shouldn’t be unmediated. But, I finally did go. I figured I would let you know since I’ve been a pain in the ass and caused a cluster fuck around here.

[Amanda F]

Hey Sky,

I'm so glad you went to see her! That's awesome. Will you see her again this week?

[sky]

No, unfortunately she just broke up with me! She told me to seek other care because it’s not appropriate for me to see her monthly and that she couldn’t help with everything in going through. I didn’t even tell her anything except about my childhood and I mentioned self harm and I mentioned a briefly that I’m often suicidal. So idk where she got that from so I’m just ignoring her resources and told her I’ve been handling it on my own and I will continue to.

[Heather]

I'd suggest no one think of a therapist you are screening deciding they can't give you the help you need as :"breaking up with" them. The deal with screenings is for both therapist and potential patient to try and sort out if they're a good fit for each other, and a therapist who doesn't think they'll be a good fit for you, for any reason, certainly wouldn't be doing you any favors by taking you on as a patient!

I do also think that you probably will find most therapists will want to see patients weekly, especially when they're new. It would be pretty hard to make any kind of timely progress with someone who could only come in once a month. It also wouldn't likely be a good use of your money and time that way because you'd probably spend the whole of that session each month just getting a therapist caught up, rather than having the time to really start working on things. I'm just letting you know that so you can figure that will likely come up often, and it's valid from a provider-side.

Why ignore her resources or suggestions for referrals?

[sky]

Hey Heather,

I was joking about the terming breaking up with me. I understand what you mean but it just kinda sucks and makes me upset that I told her like the bare minimum and she can’t help? It’s kinda a crummy feeling because I’m pretty sure I’m healed of all that trauma expect my dad leaving me but that’s something that I’m gonna struggle with my whole life.

It’s so hard to open up about childhood trauma and other things in the intake process and I’m just not currently ready for that process again. I am doing okay. I honestly just need medication, but I’m not sure if I can put my body through the trial and error again. Not knowing if I’m bipolar or if it’s just the ptsd affecting my moods is extremely hard to determine and my body and brain just freak out a lot when I’m on medication. I think I would rather just handle it on my own. I haven’t killed myself and I stopped cutting and stopped wanting to do self harming behaviors that we’ve talked about in here as well. So I must be doing something right. I really am trying my best to be better on my own. I do realize that’s not always the case with it’s a chemical thing not a me changing it thing. Hopefully all of that makes sense.

[Heather]

I understand that it can feel bad.

But finding a mental healthcare provider is ultimately like finding a specialist if you have a physical health issue for something that isn't that common: not just anyone will be able to treat you, and you really would be done a disservice by someone who said they could if they either knew or thought they weren't the right provider for you. That'd leave you out money and time and energy and emotional investment without a likely good return for that. (But like I said, I also would guess most therapists will not feel able to help you much only seeing you once a month as a new patient: that honestly is just a really big and pretty unrealistic ask for any mental healthcare provider, particularly given all that you're dealing with. It may well be that that alone formed the basis for her decision here.)

I do want to caution you against thinking -- or thinking you have to say -- that you have healed from all your trauma. I honestly doubt that at the age you are you have healed in full from ANY major trauma, just because a) there really isn't such a thing no matter what, because that's just not really how trauma and healing work, and b) it takes a good deal of time, and usually a lot of focus on doing all the emotional work involved, to heal from trauma. And often ongoing processes with that. That's not about that *you* likely couldn't, it's that that just isn't how any of this works for anyone. Too, while I'm not a mental healthcare professional, as someone very educated about trauma, having engaged with you, I would also say that it seems pretty clear to me you have a good deal of trauma you are very much still in process with, as well as some things that might not be connected to trauma, but that you have very much been struggling with.

I hope that you know that it is okay that those of us with trauma are not "healed," or all the way over it, and that how it usually works is that we are all in an ongoing process of processing trauma and then learning, usually over a great deal of time, how to manage it. None of us have to be completed works (again, as if that were even possible, which, so long as we're still living, it really isn't) to be okay or to be acceptable or to have the right not to choose certain kinds of healthcare: there's nothing wrong with all of us being works in process. That we -- that you -- survived and continue to survive trauma is already pretty darn major.

I know that the intake process can be really exhausting, and I'm sorry that you didn't hit a home run with this first at-bat this time around. Even though that's actually pretty unusual -- more often we all have to shop around a little more than that -- it still would obviously have been ideal that you did. If you want or need a break before you dive in again, or you want to try managing your mental health on your own and without medication, that's absolutely your right.

That said, I hope that whatever choice you make with this you do centering your own best interest, and not out of reactivity or frustration with the process, if you catch my drift.

[sky]

Hey heather, thanks for being so nice to me. I’m sorry that you understand the process and feelings that I’m talking about but I’m really glad that you do because it’s helping me a lot. I emailed her back after she said I’m a good person who deserves help. I told her that what she said made me upset for some reason and I said i didn’t need help over pure irritation. I said that I was sorry and that I probably will go to her recommendation because I’m drowning and I thought I finally had someone on my side when I saw her but that’s not the case.

She responded with a long thing and in it she said what you said about the whole they screen me thing. She said something that really fucking hurts a lot, she said “I know that you are going to need constant therapy and medication because of your traumas and everything you’re going through right now” which I don’t really get, I’m dealing with sexual harassment at work and religious guilt over being gay and emotional abuse from family that’s playing a big toll on me, big woop. I don’t get why she felt the need to say that to me. I’m really not that messed up. She mentioned schizophrenia to me too and I was like no no. I know that medication and therapy doesn’t make you weak and that it’s nothing to be ashamed of and I’m not ashamed in the slightest I just don’t want to do it all again.

I did though. I saw the email last night ended with she high encourages me to reach out to them. The office was closed and I knew I wouldn’t call today and so I let contact info on their site and they will call me. Yesterday I had a very bad outburst of my anger and I got screamed at by my store manager because of it and then I went to apologize later and my anxiety was high and I asked if I was going to get fired and she said no but she’s done with it. So I need to get my anger and emotions under control. I hate that I need a pill and therapy for it all.

[Sam W]

Hi sky,

It sounds like that last exchange with your therapist left you feeling pretty frustrated and defeated. I'm not entirely sure why she phrased that recommendation the way she did, because it was a clunky way of expressing something sound: you're dealing with multiple, difficult things, including trauma, and if a therapist knows they, or their schedule, are not equipped to address that properly, the ethical thing to do is refer a client elsewhere.

I'm glad you're in the process of reaching out to a new resource, one that will hopefully be a better fit for your needs. I do want to say that those feelings about medication and therapy (knowing they don't make you weak but being angry that you need them) are actually something to raise with your therapist. They're common feelings for people dealing with trauma and other mental health issues, and a therapist who's a good match for you will help you work through those feelings to make sure they're less of a barrier to you accessing care.

[sky]

I did what she said. I do need help. Hopefully they can get me in soon!

[sky]

I know this isn’t the place for mental health matters. I just wanted to tell you heather that you’ve been pretty much right about everything. I was not well so I got money together and made an appointment and she told me that I have bipolar with psychosis and that my ptsd is very severe. I’m Upset? About it?

[Sam W]

Hi Sky,

Those can be very intense diagnoses to get, especially given that there's still stigma around bipolar disorder. If you haven't already, I would definitely raise your feelings about that diagnosis with your therapist the next time you see her, so the two of you can begin processing what it means and how you feel about it.

[sky]

Hey, I don’t think I’m breaking anything here (I’m trying my best to respect boundaries). Today I was told that I more then likely have borderline personality disorder. Which is, something that’s been said to me before but it still is pretty shitty to hear. So yay! Another thing on the board it’s kinda nice to have something that helps me understand why I feel the way I do. Also, today I just found out that people aren’t suicidal everyday. I thought it was a normal thing, I’ve been so used to it since I was like 8. Didn’t know others didn’t feel this way. Definitely is, an interesting feeling, all of today. Wanted to give an update

[Sam W]

It can definitely be tough when you first get a diagnosis, or when you're going through the sort of trial and error period of figuring out what diagnosis might be the most accurate and what approaches are going to be the most helpful. If you haven't already done so, you might want to ask your therapist if they have tools or support groups they recommend for people dealing with borderline, since it's a mental illness that has a lot of misinformation floating around it. Too, it sounds like you've raised your recurring thoughts of self-harm with your therapist, but just in case you haven't, that's something to bring up immediately.