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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by josiejo on June 30, 2001, at 18:25:43
Hi,
I haven't been here in a really long time... I've been self-medicating, and basically trying to get everything in my life back in order.
Now, I'm not writing about myself. I'm writing about an employee of mine, who is also a good, close friend. I'm posting here today as her friend, not her boss.
She was diagnosed as bi-polar about 2 years ago and has had her ups and downs. She has been in and out of hospitals, and in and out of work. About 3 or 4 months ago, during one of her 'out of work times', she called me and told me that she wanted to be honest. That she had been cutting.
Having read things, and having another friend who is a cutter (and has not hurt herself in over a year!!) I knew what she was talking about.
I didn't know how bad it was until just a few weeks ago when she came back to work for one day, and that night, she admitted herself to another hospital. After about 2 weeks in the hospital, she didn't feel like doing what they told her anymore, and she left. She came back to work. She came to talk to me and I could see after just a few seconds that she was 'not right'. First thing I asked her was if she was ok. It took her a minute or 2 to answer "uh huh". I knew she wasn't. I suggested that we go outside, have a smoke and just talk. While we were smoking, I had to ask about the obvious scars all over her arm. She was making light of it, saying that in the hospital, they had plastic knives with the meals and she used them to cut herself instead of the food. She had 15 or 20 very obvious cut marks that weren't very old on her arm. Because of her light attitude, I downplayed the whole thing too.
When we went back inside, she pulled out her daily pills and took her morning dosage. While she had her pill container out, I asked... she was taking a lot different meds including prozac, dilantin and ambien. Most of the dosages were incredibly high.
I had to play 2 parts now... her boss and her friend. As her boss, I had to tell her I couldn't allow her to come back to work now, and as her friend, I asked her to please keep me updated and call me, that I cared.I guess what I'm asking here is if anyone has had any experience with cutters or with cutting themselves. I'm not sure what to say or how to act...
Can anyone help?Thanks,
Josie
Posted by judy1 on June 30, 2001, at 22:03:28
In reply to cutting, posted by josiejo on June 30, 2001, at 18:25:43
You might want to do a search on self-injury here; I posted a while ago about my own problems and I remember we had quite a thread going with a lot of references that were helpful to me. SI (and cutting is the most common) is a coping mechanism used by people who haven't developed more effective ones. It usually isn't life threatening unless dissociation is involved (and in cases like that it can get fairly serious). It is not easy to give up, I have been in therapy for quite a while to deal with it- you just really have to want to stop and have alternative strategies in place. It just takes a lot of work with a therapist who is experienced with SI. Hope some of this helps- judy
Posted by Autumn Despotis on July 1, 2001, at 2:37:18
In reply to cutting, posted by josiejo on June 30, 2001, at 18:25:43
> Hi,
>
> I haven't been here in a really long time... I've been self-medicating,I hope this doesn't offend you, but I was wondering about your self medication. I've been trying to find more information on this topic, I've been doing it off and on since I was in college. If you don't mind, could you tell me a bit more about your experience with this?
Thank you so much. . .
Posted by geekUK on July 1, 2001, at 4:46:26
In reply to cutting, posted by josiejo on June 30, 2001, at 18:25:43
I was going to start with 'once apon a time', but that will take to long. hell its about me. I may not be a typical self harmer as well as am male, (in 'about' 1 1/2 year cutting remition ).
coping mechanism yes, I think of it like crying. I dont think there is any reson to regard it any different. Think the lows of depression and pain, then think adrenaline and endorphins. its a little more complex than that, all cutters have there own tack. but during the act you cant focus on anything but the act- so no raceing bad thoughts. you see damage/ blood- you look a bit closer to how you feel, afterward there is an endorphin effect- a state of relaxation and freedom for 20ish seconds, tipcaly the time when i tryed to sleep. I never show anyone the scars I where long sleeves all year even in summer, have done so for 6 odd years, nobody noticed!
summary
a method of transfering mental pain to physical pain.
You should look beyond the self harm in your freind, its very confusing to read anything about how things are underneath from quantity or depth of cuts, just look at the other symptoms and monitor for increases in s.h. behaviour-tied to mood changes
Posted by josiejo on July 1, 2001, at 10:15:49
In reply to Re: cutting » josiejo, posted by judy1 on June 30, 2001, at 22:03:28
judy and geek,
thank you both so much... this really helps. I do know some about cutting and self-injurious behavior, but it makes me feel better to hear about it from someone who's been there.
Posted by josiejo on July 1, 2001, at 10:23:28
In reply to Re: cutting » josiejo, posted by Autumn Despotis on July 1, 2001, at 2:37:18
It doesn't offend me... not much does.
Self medicating.. hm... well, I won't go in to huge details regarding my own versions... I'm the first to say that it's not always right. Especially for me because I don't always do it in healthy ways. I've about given up on trying to talk to my doctor about it because it doesn't seem to matter what I have to say, she believes that everything that is wrong with me is because I smoke. She's gotten pretty nasty about it the last few times I've gone to see her.For myself, self medicating includes changing the dosage of my meds, drinking, work, and sleeping. Usually I can make myself forget I have a problem with depression. For awhile anyway.
I don't condone it, but until I kick myself in the ass again and start taking meds and seeing a therapist, I'll probably keep doing it.
Sorry if that wasn't the answer you were looking for.> I hope this doesn't offend you, but I was wondering about your self medication. I've been trying to find more information on this topic, I've been doing it off and on since I was in college. If you don't mind, could you tell me a bit more about your experience with this?
> Thank you so much. . .
Posted by rmshed on July 1, 2001, at 12:01:14
In reply to Re: cutting, posted by josiejo on July 1, 2001, at 10:15:49
> judy and geek,
> thank you both so much... this really helps. I do know some about cutting and self-injurious behavior, but it makes me feel better to hear about it from someone who's been there.I am too a self injurer. It is never easy to allow others to know this, it is not understood very well. Last year about this time, I injured myself, it was the worst ever. I had to go to the hospital and get first aid for the 50+ cuts. I hadn't cut in a couple of years. I wish there was some medication to help with this.
Posted by judy1 on July 2, 2001, at 10:32:35
In reply to Re: cutting, posted by rmshed on July 1, 2001, at 12:01:14
One med that was suggested to me was naltrexone, an opiate antagonist. The theory being that cutting releases endogenous opiates and if that doesn't occur then the cutter won't get the relief he is seeking. All well and good, but I feel cutting or SI is a great deal more complex, and probably can only be dealt with using psychotherapy (with someone very experienced) and hard work on the client's part. I'm very happy to hear you haven't cut in 2 years- have you developed other coping mechanisms? Take care, judy
Posted by kid_A on July 2, 2001, at 10:54:25
In reply to cutting, posted by josiejo on June 30, 2001, at 18:25:43
Since I was younger, (am 30 now) I had turned to cutting as some form of release from feelings of intense despair. I have just started on meds not too long ago and actually had an instance of cutting just prior to seeing the pdoc.As for myself, I never looked at cutting as anything more than catharsis... It usually happened for me at some point when I was *extremely* upset and the only outlet for me was to perform this act... Now that I'm on meds I'll hopefully get away from being self-injurous and use a more effective method of treatment for the problems I have...
I've carved the words yes (scar still very readable), no, diagonal, horizontal, vertical slashes... glass, razor blades... etc... Before I saw my pdoc for the first time I smashed my head into my bathroom mirror and shatered it... later I used the glass to cut my right arm...
In the end I dont think that this is an acceptable mechanism for self-medication, even though it usually marks the end (for me at least) of any one particulary nasty bout of intensely bad feelings. I dont think this act is uncommon, nor is it as troublesome as it may seem, but it would be good to push the person involved in cutting toward a direction of meds/psych...
Posted by geekUK on July 3, 2001, at 18:28:30
In reply to Re: cutting » josiejo, posted by judy1 on June 30, 2001, at 22:03:28
I dont think cutting is about not having more effective methods of copeing. Its about that critical point when pain reaches a point when it is one of the only outlets. probably due to underdeveloped coping before the event, but at the time it is an effective release when talking and other things all fail. the times when the serpents writhe in your belly and hot coals bounce round your head. the times when you cant eat/sleep/talk/think and can only feel pain. the sad thing is since I stopped i have been transfering this little strategy to drinking and drugs and have become a much more violent person inside (though never hit anyone in anger yet).
MC
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