Throwaway05
19d ago
It's also worth keeping mind that mental illness almost always impairs insight - your ability to understand and read your mental state may be hampered (not that the average person is truly good at this, but it can be more important in someone who struggles).
Many borderline patients hear the diagnosis and its description and go "thank god, that's me! it all makes sense now." Many go "no that's bullshit I AM TOTALLY FINE LALLAALAL................."
Throwaway05
14hr ago
I wouldn't call it "don't allow." VBAC's can be very dangerous, they can also be safe, the relevant care team will likely try to assess the risks and summarize for the patient. OB is pretty notorious for being a bit more heavy handed with consent than some specialties, but that's ultimately not that unreasonable when many women are interested in fucking off and having a "natural" birth at home even when it's high risk to the baby and mom (and notoriously, will see the doctor even when it's a consequence of their own shitty decision).
This over focus on outcomes and liability potential is also why you shouldn't trust those stories from mothers. Yes it probably happens at times, and certainly used to be more common back in the days when OB was >85% male instead of >85% female, but OBs are way too worried about getting sued and making sure the baby is okay to do that for the most part.*
And hospitals are very likely to have a dedicated laborist these days anyway.
*"Force" mom to have a C-Section and something goes wrong because you wanted to go play golf? That's a multi-million dollar liability judgement. Everyone knows that isn't worth it.
Throwaway05
20d ago
Dawg I haven't changed my goal posts at all you just jumped down my throat reaallllll harrrrrdddd.
Throwaway05
21d ago
I am supportive of hypnosis as a modality but it has limited utility and that utility is further hampered by susceptibility to hypnosis seemingly being more of an innate trait. Some people it works for and they want it to work for and you can do some great things with it but for the majority it is useless.
However overstating its value in the way you seem to do patterns matches to ....a lack of scientific rigor, and I'm saying this as someone who came into the conversation correction someone to let them know hypnosis is actually a thing.
Throwaway05
21d ago
Since you are asking this question I'm sure there is a paper from 50 years ago with terrible research methods that suggests this is a thing, but that doesn't make it not absolute nonsense.
To more directly answer your question, I predict the literature that is the body of scientific knowledge suggests that this is not a thing and does not take it credibly. The existence of crank papers to the contrary does not mitigate this.
Especially since it is now known that many strange papers at the time represented intelligence work.
Throwaway05
21d ago
I mean it's entirely possible it's more potent than described by medical literature. It's also entirely possible that people who buy into it are more likely to have out of character or excessive manifestations.
Throwaway05
22d ago
This is a common side effect of that class of medications, you should discuss this with your primary care doctor and psychiatrist, they may recommend medication changes, dietary counseling, ancillary medications like statins etc.
Throwaway05
23d ago
Some of that was deleted (or I otherwise can't see). Missed the previous discussion in the weird psychopathology thread line.
I invite you to read the wikipedia page, which links to some actually studies on the matter (ex: https://onlinelibrary.wiley.com/doi/10.1111/apt.13706)
Basically the most evidence based approach to hypnosis concludes that it seems to function similar to mindfulness meditation, biofeedback, and other similar modalities where someone hacks their cognitive state and level of arousal, which is often easier to do with assistance from an external resource then by a person on their own.
Obviously this implies a limited level of clinical utility but it can help with psychosomatic adjacent pathology and any time "mind over matter" is more directly relevant.
I was fortunate enough to experience some training in this during my medical education and while I personally was not hypnotized I witnessed some of my colleagues experiencing it....and it was ultimately very unexciting and contrary to media portrayal (which is as this usually goes).
It seems most reputable people who do this emphasize the limitations and the fact that it can't really make you do stuff you don't want to do already.
Throwaway05
12d ago
I am sure that some people exist who feel this way, but all of the therapists I know (which is bounded by these people being mostly physicians, or PHD/PsyD psychologists), think that shit is nuts (and have much displeasure with the popular presentation of therapy, mental illness and so on).
Throwaway05
20d ago
Yeah don't date one, but you gotta keep in mind that if you are seeing them (at this phase in your training) it's either so bad they are on an inpatient psych unit or in the ED, or they are in the hospital for other reasons and they are such a pain in the ass that the diagnosis makes itself clear.
In training you'll get the skills to pick up more mild cases in the community, and presumably also see more mild cases in therapy clinic.
This also is true for things like depression and anxiety (early in training you'll only see total shit shows, but more mild cases exist they just don't need you).
This is also, also true for things like hypertensive emergency vs. generally outpatient family medicine seeing mostly controlled shit.
Throwaway05
20d ago
Borderline is better conceptualized as more like depression or anxiety than schizophrenia when it comes to severity. Many people with depression or depressive thought process never present for care, nor do they need it. Some of these people kill themselves.
The same is true with Borderline. At state hospitals in the U.S. you often see a mix of psychosis and severe borderlines who won't stop hurting themselves. It can be very bad. You also have borderlines where the symptoms are so rare or mild that you'd have to have a long relationship with a therapist to catch it.
Don't underestimate how "harmless" it can be.
When it comes to treatment it is treatable. Certain kinds of therapy work (chiefly DBT). Patients accumulate coping skills and calm down just by aging. Medications don't work great but can be helpful for symptomatic management.
Throwaway05
21d ago
Lots of weird shit causes orgasms, and IIRC people have used hypnosis as a replacement for anesthesia. Dissociation is powerful.
If you are saying hypnosis can make your boobs grow then I'm going to call you a crank unless you have some damn good evidence.
Throwaway05
23d ago
Hypnosis is actually not fake, it just doesn't work the way people think it does. It's used in modern (Western) medicine it just doesn't really work well and the real version isn't mega useful so you don't hear about it a lot.
Throwaway05
13d ago
To conclude, is therapy helpful when administered by someone who knows what the fuck they're doing? Yes.
This point is the whole thing. I notice here that a lot of people seem to have complaints about "endless therapy" and "never getting better," but reputable, well trained therapy involves a constant progression towards "being done" (well typically anyway).
I suspect this is equal parts misunderstanding and a surplus of shitty therapists, which makes sense since it's far harder to regulate, train, and assess than "traditional" medicine.
Small amounts of therapy that anyone with diligence and training can do (like motivational interviewing) can radical improve care for any specialty.
Shit is good when done well. And even more fluffy and "less evidence based" therapy modalities like psychodynamic therapy work great when done by someone who cares and knows what they are doing (and are shocking similar to CBT anyway).
Throwaway05
21d ago
Funnily enough, no AVM found on multiple kinds of imaging, including an MR angiogram. No kidney disease either. As far as anyone could tell, it was just bad luck.
Fuck.
Also OB/GYN is traumagenic. Complicates the psychiatric formulation.
On a more serious note it's worth thinking about the way autism has become a catch all for poor socialization, that isn't to say that these people don't have some form of autism spectrum, just that it's worth being a bit more cautious with it since it's becoming an over diagnosed thing (at least in the U.S., thanks TikTok!).
Throwaway05
20d ago
Mild symptoms complicate both diagnosis and treatment - much of what DBT is designed to help is for moderate functioning people (can be great) and low functioning people (where it isn't likely to).
Your diagnosis could be wrong, but I'd guess what's happening is that you are well enough, and the underlying biological reality of a borderline brain gets in the way sometimes.
However also possible you are what you are and don't meet criteria for anything.
Throwaway05
21d ago
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Never, ever, EVER, sleep with someone you can diagnose with BPD easily. You're welcome. cries
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Excuse me what the fuck with that head bleed.
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Social media autism.
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All these people are probably borderline.
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Once you have training to look for mental illness you'll see it everywhere, especially on the apps.
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Tell them Tylenol is the absolutely worst way to die and to use Melatonin instead.
If you are willing to explore changing medications (may not be safe depending on your situation) some of the medications in that class are more weight neutral than others.
Additionally depending on the pathology an alternate medication class might be available, especially if you haven't really revisited it in the years since you started (some things will require that type of med though).
Medicaid may cover a dietician which is better than nothing.
Your primary care may have some routine health suggestions (again a statin, some preventative care etc) or maybe even something like Ozempic.
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