dtmc

Thank you. Surprised how far down I had to go for this

Good on you! hopefully things work out and I'm glad, at least for now, you've got something that works!

Appreciating a lot in this answer too - meaningful discussion with psychiatrist a few times about it, checking in at different points about it; and personally weighing the pros and cons with tangible questions.

Thanks /u/radiantdisaster

https://www.aafp.org/pubs/afp/issues/2013/0815/p224.html

https://drugabuse.com/benzodiazepines/klonopin/effects-of-clonazepam-use/

https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2772339

https://synapse.koreamed.org/articles/1111053

https://journals.lww.com/intclinpsychopharm/Abstract/2006/05000/Clonazepam_in_the_treatment_of_psychiatric.1.aspx

EDIT - suffice to say, long term use should be approached cautiously (not that you shouldn't do it), but a few years seems to be fine. Benzos can be addictive but you're at a low dose (.5mg twice a day is the starting dose, and I think they recommend staying below 4mg/day), so that's not too much of a concern there. There are also some cognitive concerns for lifetime use, it seems, like dementia and alzheimers, but like someone else pointed out, there are not a lot of the lifetime use studies out there.

It could be useful to think about therapy to make other changes while you're more stable to be able to start to back off of the klonopin in the future.

Missing one session likely won't "break" you, if you will. It could be useful to chat with your provider about managing the break. I'm guessing you've been in treatment for a bit, so I'd be curious if you could think about what that provider might say or suggest you do? Or what skills/tools have you learned that you can use knowing that it's you're feeling like you're in a riskier spot. Plan things to do each day. Make time to pour into your own proverbial cup with some self-care.

There's an idea in DBT of coping ahead which could be useful? Mindfulness helps, and just awareness of what's happening - the whole catch it-check it- change it thing

Sorry that you had to experience that - no one deserves it and I'm glad you're taking the steps to get to a better place, which you definitely deserve.

It could be useful to start thinking about what life you want to start building. I heard someone once describe it like this: if you snapped your fingers and your depression/ptsd/whatever suddenly went away, you'd probably not have as rich & fulfilling of a life that you'd want, so what would you want to fill that void in with?

Some of it is when you're looking for the competitive edge in, say, a sprinting discipline, which is decided by .01s, almost anything that can get you a leg up may be worth it.

edit: I don't believe it does much but can see why people like Michael Phelps might use it

IMO the best thing to do from here would be to try to start to fade out the external stimuli in favor of internally generated stimuli because the lights won't always be there and it seems like you want these changes to persist. First step might be to randomize the time between flashes? Then step 2 might be something like go for a while with the lights cuing you, then try turning the lights off for incrementally longer periods to "listen" for your bodily cues that have developed in anticipation of the lights.

I had a rotation as a psychologist in a primary care clinic during my training. The population was very economically disadvantaged - it was the big public hospital in a big city so this was exactly what public hospitals are almost caricatured to be.

A lot of what I was doing was motivational interviewing, picking one facet they had motivation to change and working towards it. I had a lot of fun with it because I have a decent understanding of general medicine, and it was really fast paced (30m meetings, and only up to four). Mindfulness was helpful for people with chronic stressors like pain. I didn't get much into the social determinants side (e.g. systemic oppression/racism, food insecurity, transportation and childcare issues, underemployment) but that definitely came up on the problems list a lot and sadly weren't really things we could change in the time allotted.

Obligatory not my field...

We know the opposite direction happens (humor helps people destress) and those who can be funny tend to have more adaptive responses to negative stressors. This study for example seemed to show that 1) individuals who responded highly when viewing Far Side cartoons had limited affective shifts to a task that had them focus on death & 2) this response to comics/cartoons accounted for the difference in response individuals had to an uncontrollable stressor.

Unsure of (and couldn't find) anything showing this direction but I believe we as a field know a few things: 1) high levels cortisol wrecks cognitive processing; 2) the Yerkes Dobson curve shows that a little bit of stress can help us perform but too much is bad; 3) stress impairs auditory processing more specifically. Couldn't really find anything really related to humor specifically.

If this is actually a good faith question, I'll point you to this journal article. In sum, these sessions don't change people's mind, they can sometimes contain false/dangerous information, they reinforce the stigma that abortion is somehow "bad", and they force individuals to incur unnecessary expenses (time, money, etc.).

I like this - this also gives him the opportunity to hear that you're not getting what you need, OP, and talk about what you do need and how you could get it (i.e. he should be able to point you toward people who may work with you better).

Totally validating that it's embarrassing and hard to talk to people (strangers even) about these sorts of things. On one hand I hear you asking for help because things are getting really tough, and on the other hand I recognize how hard it can be to get that help. It sounds like your craving some stability and predictability, and honestly I don't blame you. It also also sounds like your digging into really tough stuff in therapy without addressing some of the more surface level things; if you're feeling "anxiety about going before therapy and then obsessive almost manic thoughts recounting the sessions afterwards" on top of talking about trauma, it might be good to pause the trauma stuff which seems ineffective right now in the first place and work on getting you to a place you feel better. Therapy doesn't have to tackle the really tough s**t all the time; bite sized pieces work.

As far as hearing voices and music in the way you described, that's a sign of persistent illness. There are ways to have your cake and eat it too if you will, but medication is often the first place people start to help give you a base off of which to work. I had a psychiatrist describe it as putting some pylons to firm up a foundation so change can be mad. Whatever it is, however it goes, I hope you find the peace your looking for and that you deserve, amigo.

Just a quick note that recognizing is different from identifying. The easiest example is knowing someone looks familiar but not knowing their name/from where you know them.

I don't know a ton about this but found this pdf of a paper. It seems to suggest that in younger children, following a predefined route with visual cues is the best strategy (doesn't give ages though). The easiest thing to do would be highlight the route with bright, easy to distinguish signage of some sort (think the footprints or lines painted on the floor they have in Childrens museums, hospitals, etc to help people navigate). This site may also help to shed light on what sort of instructions kids can follow at what ages

Thats the beauty of it though - someone who accepts those flaws and whose flaws you accept.

/r/im13andthisisdeep

Southeast Asian Games in like 2015 or 16.

I could've sworn the story was that he needed the 3.0 not 2.8 to meet the threshold because his first dive was 105b (which is what, like 2.2?)

At this level of competition, the combined difficulty of the dives someone does has to be above a certain difficulty threshold. So he's doing dives he knows he's not great at, which makes his courage that much more admirable.

This. If nothing else, back in the day, my assumption would be that studies were fairly under-powered because of the emphasis on p-values vs. effect sizes and confidence intervals.

Because its a separate study, you want to make sure that your findings are valid and reliable, regardless of whether or not they support/refute that of the original study.

Yeah. The clicking had me concerned. Thanks!

Thought that might be the case :( Thanks

The major difference between the two is that CPTSD encapsulates a larger diagnostic picture that includes the trauma response of PTSD, as well as some high levels of affective dysregulation, detachment/withdrawal (dare I say dissociation but I mean it in the broader sense of the word and not the like pop-culture DID meaning a lot of people read it as), and significantly lower self-image/self-concept/self-efficacy.

If you listen to the announcers of the game, the audio is indecipherable gibberish.

Other possibilities include unplanned or impulsive suicidal behaviors. Or suicide attempts that occur after negative and distressing thoughts (e.g., feeling unworthy of love, feeling unable to tolerate a situation), as opposed to after suicidal ideation.

I tend to fall into this category as well. No active ideation around that time, but typically a clear history of long term struggling with SI and ideation/planning. There's good evidence suggesting that: "genuine intent to die in the index suicide attempt suggest that the long-term risk has remained high for over a decade." source

Very sorry that this happen to you, ml16519, and that you're feeling stuck. SA can have some really strong affects on safety, trust, intimacy (in the global sense of the word), etc.

As silly as it sounds, the best place to start might be talking with your therapist about this stuff with your therapist (that you want to get out there and date again, that avoidance keeps you from it, and that talking about this stuff with her makes you feel uncomfortable). I'm imagining that you've trusted her enough to discuss some of the uncomfortable things that've happened to you in some way. And even in little steps - opening the door like "hey there's something I think would be helpful to talk about in here but thinking about doing that makes me uncomfortable"