Adolescent Psychiatrist | Child & Adolescent Psychiatry Questions Psychiatrist

Understanding individuals' conditions?

I have been seeing a psychiatrist and therapist for half a year and was in therapy a few years ago as well. I have had depression (I guess) with suicidal thoughts and self-harm tendencies for a few years although I'm not sure why it seems to be hard to get professionals to understand where I'm coming from. My two therapists have identified small personality traits of mine that would cause anxiety, but nothing to help me with controlling the urge to self-harm/end my life (which is what I have told my therapist I am in therapy for).

My psychiatrist, along with a doctor I saw at an inpatient hospital, thinks I have borderline personality disorder, which my family and I are certain I don't have (my aunt has BPD, so we are all very familiar with the disorder). I am getting a new therapist and psychiatrist since neither of them has been helping (because none of the many meds I have taken have done anything either), but I am worried that I won't be able to find someone who will understand my situation and therefore be able to help me.

I have looked online for the specific symptoms/urges/thoughts I have and have found nothing that resembles someone in a similar situation. I know that I'm not the only one out there who is affected by whatever it is like I am, but it is honestly disheartening to know that none of the professionals I have talked to know how to help me. The nurses and other professionals at the inpatient hospital simply told me I have to figure it out for myself since no one else can do that for me (even though I was hospitalized because I had no idea how to keep myself from ending my life anymore and I'm certain if I wasn't restrained from doing so, I would be dead right now).

It may help to note that it has been explained to me that having a higher IQ could be a slight obstacle in others understanding me since I have found myself able to analyze myself and figure out how to help myself to a degree. I just don't know what to do or how to get a professional who is trying to help me to understand my situation so the treatment for whatever the root issue is is actually effective. To put it bluntly, I'm losing hope for making this better and am starting to become less resistant to the idea of allowing myself to just end my life. I guess what I'm asking is what can I do in this situation?

Thank you ahead of time for reading this long and ridiculous question and I appreciate any help.

16 years old
Complaint duration: About 3 months

4 Answers

First of all, find a MH team composed of a psychologist and psychiatrist who work as a team or can work together interdisciplinary-wise. There are professionals out there who can help you - persevere! It looks like you may require IOP therapy coming out of IP. Your reaching out tells me you care a lot. Get a strong support system in place and use it to stay safe until you gain confidence in the help you get to resolve your MH issue. If you and your mom/dad can afford it, check out Amen Clinic and see if you can get a Brain SPECT done by Dr. Amen's group.
Hello,

You are 16? You have the capabilities many adults never attain. Of course good help exists, but where you live perhaps not. However, this is the era of Zoom, so assuming you have sufficient tech access, you can work with a therapist remotely. I assure you, havIng spent all of the last COVID year working on Zoom, it is a very successful modality for therapy. Preferable, even, for some people who have well-developed intellects and want to understand themselves.

So, where to find and "meet" such a person? Believe it or not, if you don’t have a good local referral person (could be a teacher, or other adult you trust), try Find A Top Doc - that is a good start. Other sites also have therapist-written bios, some with videos. Make sure the person is legit - a licensed psychologist or social worker - and then assess their ability to understand you and their experience and interest in doing so. Perhaps show them this letter you wrote.

I have had many clients in their 40’s-80’s who had histories like yours, who found good help on their own at your age. They all did really well in their later lives - good careers, part era, interests, some with children and some not. You can do it too.


Peace,

Dr. Marian Shapiro
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Thanks for sharing and asking an important and hard question. Sometimes it is good to switch treatment providers. I have had patients whom did not work well with me, due to style, approaches, and differences. I would suggest asking lots of questions. I would also suggest being open to feedback particularly as you progress through treatment and diagnosis may shift. Some schools of thought in psych say most depression and anxiety is driven by personality issues. Be mindful that diagnosis can differ in terms of severity as your aunt may have more pronounced systems and you may not. Ask about DBT, dialect behavior therapy, as it is a gold standard for personality issues as well as suicidal tendencies.

It is unfortunate that neither your therapist nor your psychiatrist were able to understand you in ways that proved helpful. It's good that you are setting a new psychiatrist. I would suggest that you ask your psychiatrist to see you for hour-long therapy visits, and if you do not believe that those sessions are helpful, find a new psychiatrist.