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Norman M.
Norman M., Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA
Category: Mental Health
Satisfied Customers: 2543
Experience:  ADHP(NC), DEHP(NC), ECP, UKCP Registered.
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Please only EXPERT in General Adaptation Syndrome model

Resolved Question:

Please, only respond if you are REALLY good and REALLY experienced in getting people out of the exhaustion phase of the General Adaptation Syndrome model, that has already resulted in conversion disorder and multiple physiological conditions.

Let me try to explain my psychological state.

If a lion walks into the room, many things happen, including your stress and anxiety increase, and your digestion and ability to feel happy decrease. But in this case, they cause is clear, there is a lion in the room; or for some people it is a bad marriage, financial troubles, a death in the family, etc. In my case, there is no external cause or reason for this chronic feeling of being tense, rushed, anxious, and having a muted ability for enthusiasm/joy. So I believe there must be an internal disease, reaction, or allergy, etc. that is causing an imbalance of neurotransmitters, thus chemically imprisoning me in this very undesirable state of emotion. And since the mind and body are not capable of functioning in this state for long periods of time, I’m also suffering from a number of physical symptoms. Immune suppression is a well-known consequence, as well as depression, thinking/memory impairment (hippocampus damage), skin conditions such as psoriasis and dermatographism, inflammatory bowel disease, sleep problems, restless limbs, trichotillomania, adrenal fatigue, rheumatoid arthritis, blindness, etc. I have all these!

I’ve been treated with all kinds of medications (the list is huge) and taken all kinds of supplements (my house looks like a GNC). I’ve seen many traditional Doctors and alternative ones. Nothing seems to help at all with any of my conditions. I read that as long as there is mental/emotional sickness, and things like Conversion Disorder are happening, none of these things are going to do much; so maybe that explains it. I’ve seen many psychologists over the past few years via weekly sessions, but they either listen silently without giving any helpful response, or they say something stupid, like that I should just accept that I’m a looser, or they try to say the solution is for me to start going to the same church they do, or they say they can’t think of how to help me because they don’t have much experience in this area, etc etc. PLEASE, I need Help!!
Submitted: 2 years ago.
Category: Mental Health
Expert:  Camille-Mod replied 2 years ago.

Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find a Professional to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Customer: replied 2 years ago.
Yes, still waiting. (Again, you do not need to keep asking if I am waiting. If I was no longer waiting/needing an answer, I would post that fact.)
Customer: replied 2 years ago.
Willing to pay large bonus to Expert who resolves this for me. Still waiting on Expert.

[[ Mod: please open this up to mental health experts. ]]
Expert:  Norman M. replied 2 years ago.
Before I can provide you with an answer, can you give me the following information:

What medication are you currently taking, and for how long?

What kind of treatment have you had apart from medication?

What, in your view was the stressor or series of stressors that initiated this process?

When was conversion disorder diagnosed, and by whom?
Customer: replied 2 years ago.
Sure, below are the answers to your questions:

1. For past few years, I sometimes take 1mg Lorazepam when the seizures are keeping me up at night, and usually it helps enough so I can get to sleep. I use it sparingly to avoid the chance of building a dependency/tolerance.


2. Not sure what you mean beyond what I mentioned, I've seen 10 or more different psychologists and a couple psychiatrists.


3. There is not an apparent stressor at this time, but if I searched for past life aspects that may have been my first steps on this path of unhealthy mental state, they may include:

I started feelings of being an outcast and low self-worth starting in Jr. High.
Not able to get a girlfriend my whole life.
To divert myself from these things I dove very intensely into my startup businesses.
(but don't know if these are the cause of my chemical imbalance, or the result.)


4. I was diagnosed by me in early 2011, based on my own logic and observation of all these physical ailments that nobody seemed to know the cause, nor solution. (All the mental professionals I'd seen over the years didn't seem to know much about their field, and never mentioned such a concept, so I can't say if they even know it exists) About a month ago I saw an eye specialist in NYC, and his conclusion, without me mentioning it, was that my vision problems were the result of Psychogenic Movement Disorder... essentially conversion disorder.

--

The following is a timeline of when my current conditions began. My hope is this data will shed light on which conditions may be the result of others; and more importantly, what may be common cause(s) between them. The goal being to find and resolve the underlying source creating the observed symptoms.

 

1990 – Acne on face, neck, scalp, chest, back. Continues today despite aggressive topical and systemic treatments.

 

1993 – The start of depression, low self-worth, loneliness, etc. In general, this has escalated each year up to present.

 

1997 – First of 4 surgeries to remove nasal polyps, yet they return each time.

 

2001 – First major depressive episode, including thoughts of not wanting to continue living.

 

2002 – Dermagraphism, which has escalated in recent years. Anti-histamines don’t help much and also don’t address the cause of the mast cell fragility.

 

2005 – Chronic state of stress, tension, rushed, agitated, out-of-time; like being locked in fight-flight mode.

 

2008 – Psoriasis on the face and scalp.

 

2008 – Start of vision difficulties due to over-convergence and over-accommodation. It has progressively gotten worse and is now so severe I’m almost blind unless I strain very hard, resulting in bad headache. I’ve seen many eye specialists in USA and their conclusion was it’s not an eye problem but Conversion Disorder / Psychogenic Movement Disorder.

 

2008 - Started having symptom of uncontrolled movement of legs, arms, head (Restless Limbs). This happens mostly when lying in bed at night, but sometimes during the day, and often keeps me awake for many hours or until morning. Like this, but not yet this severe: http://www.youtube.com/watch?v=uJXxcGdJh8M

 

2009 – Trichotillomania. I’m aware, but can't stop myself.

 

2009 - First major panic attack with full body perspiration. It has re-occurred on several occasions.

 

2010 – First major Crohn’s flair and diagnosis via scope. Before this, my body mass was low at 160lb., but by end of that year weight dropped to only 102lb. (currently 118). I required several infusions because of much blood loss every day. April 2011 full colectomy and ileostomy. July 2011 symptoms started in rectum. July 2011 Ileorectal anastomosis. Rectum continued to get worse until frequency was 40+ per day, so November 2011 had a diverting loop ileostomy. Until present, rectum is still bleeding on some days, so I cannot get the diverting loop closed despite how much I disdain the ostomy bag.

 

2012 - I get episodes of stinging in both hands or hands and feet. It happens more often when I am startled or when I’m about to begin physical activity. (The feeling is like many needles or as if I placed my hands into glycolic acid).


MEDECATION HISTORY

Crohn’s:

Infliximab

Tacrolimus

Prednisone

Mesalamine

Rifaximin and other antibiotics

Low-Dose Naltrexone

Phosphatidylcholine

Blueberry extract

Food eliminations based on IgG testing

Many types of diets and supplements

 

Depression:

Sertraline

Doxepin

Bupropion

Amitriptyline

 

Anxiety:

Lorazepam

clonazepam

Vision:

Atropine

Dermagraphism:

Zyrtec

Loratadine

Claritin

 

Restless Limbs:

Pramipexole

Hydrocodone

 

Acne:

BENZOYL PEROXIDE

SALICYLIC ACID

GLYCOLIC ACID

HYDROGEN PEROXIDE

APPLY CIDER VINEGAR

TRETINOIN (RETIN-A)

ADAPALENE (DIFFERIN)

TAZOROTENE (TAZORAC)

CLINDAMYCIN

ERYTHROMYCIN

TETRACYCLINE

OXYTETRACYCLINE

MINOCYCLINE

DOXYCYCLINE

ERYTHROMYCIN & BENZOYL PEROXIDE (BENZAMYCIN)

CLINDAMYCIN & BENZOYL PEROXIDE (DUAC)

ERYTHROMYCIN & ZINC (ZINERYT)

ISOTRETINOIN (ACCUTANE/ROACCUTANE) many courses 20-60mg spread over a 20 year period


MEDECATIONS I THINK COULD BE HELPFUL AT THIS TIME

ALPRAZOLAM (for anxiety, night-time seizures, trichotillomania, and maybe vision and skin issues)

Expert:  Norman M. replied 2 years ago.

In my view, there are several issue here that need to be tackled - some conjointly, and some separately.

First of all is the question of neuro-transmitter imbalance and depression and its sequelae.


No-one really knows why neuro-transmitter imbalance happens, but the results are clear when it does. There is no adequate or meaningful way of testing in any particular individual, but from all that you have said, iat appears to me that getting back into balance is your first step.

Now, there is an old saying that a Doctor who treats himself (ir diagnoses himself, for that matter) has a fool for a patient. You are clearly a very knowledgeable toung man, but please do not put your faith in self diagnosis and self prescribing.

You said that there are no current stressors, but I suspect that that is not the case. Your medical condition in itself must be a considerable stress producer, and indeed, you say that your feelings of lonlieness, depression and low self worth have worsened year on year. You are, clearly in a worsening cycle of stress and negative thinking.

So, what to do? Get back to square one and get the neurotransmitter issue sorted, whether by sustained anti-depressant use or otherwise.


If conventional anti-depressants do not work for you, ask your Doctor about Trans Cranial Magnetic Stimulation, a recently developed non-invasive treatment that has produced good results where traditional anti-depressants have failed.

Secondly, you need to deal with the stress that your current negative thinking is producing, and to do that I’m going to suggest that you would benefit from some Cognitive Behavioral Therapy.


CBT is based on the fact that what we think in any given situation generates beliefs about, and reactions to that situation, and also causes the behaviour and feelings which flow from those beliefs and reactions.

These ‘automatic thoughts’ are so fast that generally, we are unaware that we have even had them. We call them ANTS (automatic negative thoughts) for short.

If the pattern of thinking we use, or our beliefs about our situation are even slightly distorted, the resulting emotions and actions that flow from them can be extremely negative and unhelpful. The object of CBT is to identify these ‘automatic thoughts’ then to re-adjust our thoughts and beliefs so that they are entirely realistic and correspond to the realities of our lives, and that therefore, the resulting emotions, feelings and actions we have will be more useful and helpful.

Cognitive therapists do not usually interpret or seek for unconscious motivations but bring cognitions and beliefs into the current focus of attention and through guided discovery encourage clients to gently re-evaluate their thinking.

Therapy is not seen as something “done to” the client. CBT is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates. Through collaboration, questioning and re-evaluating their views, clients come to see for themselves that there are alternatives and that they can change.

Clients try things out in between therapy sessions, putting what has been learned into practice, learning how therapy translates into real life improvement.

Please visit this website for much more detailed information on CBT:

http://www.rcpsych.ac.uk/mentalhealthinfoforall/treatments/cbt.aspx

If you cannot afford to see a therapist, there are good free CBT based self-help resources here:

http://www.getselfhelp.co.uk/cbtstep1.htm

Also, there is a book called ”Feeling good - the new mood therapy” by Dr. David Burns. It has a hand book which gives you practical exercises to work through and further instructions on how to better use CBT. I really do recommend it.

Cognitive Behavioural Therapy Workbook for Dummies By Rhena Branch, Rob Willson is also pretty good.


The combination of getting your neurotransmitters into balance and CBT will greatly enhance your feelings of confidence and self worth, and help you to see your situation from different angle, reducing the stress levels that you experience.

That is the essential part an moving forward from here.

Finally, you would also benefit from treatment from a well trained hypnotherapist to deal directly with your trichotillomania and restless limb syndrome. As your stress levels reduce, and your confidence increases, there is a good chance that your psoriasis will improve, especially if you continue aggressive medication therapy. The combination of CBT and hypnotherapy will also help with your panic and anxiety issues.

I hope you find this useful.

Norman M., Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA
Category: Mental Health
Satisfied Customers: 2543
Experience: ADHP(NC), DEHP(NC), ECP, UKCP Registered.
Norman M. and 2 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you for your response.
I understand your point regarding self-diagnosis, with its various pitfalls, but is was a last resort option, because all attempts thus far by medical "professionals" had been failures.

On the physical side, none of the many treatments from specialists helped my diseases, and in fact some of them made the conditions worse. Yet some treatments I came up with on my own actually have provided some benefit where the Drs. have failed, such as low-dose naltrexone, and IgG food sensitivity testing, etc.

On the psychological side, all mental "professionals" I've seen thus far have either not cared about helping me, or been lazy, or incompetent. If I told you some of the stories you would be appalled and embarrassed for your profession. None of them mentioned CBT, but I discovered it on my own and so brought several books on the subject to learn it on my own, including ”Feeling good - the new mood therapy” by Dr. David Burns, which I read twice. CBT has helped me to recognize those types of thoughts, give them a label, and know they are distorted, but I haven't had any success yet at preventing my mind from being in that state and having those types of thoughts in the first place, which is the real goal here.

(I really think there is a chemical issue at work here, or at least the two feed off each other, because I'll very occasionally have a 20 minute or so period where my mind flips like a switch for no reason, and I will feel normal, optimistic, happy, excited, positive, enthusiastic, then it just goes away and won't resurface for a month or more. And on rare occasions, I'll have the same phenomenon, but in the opposite direction, for a half hour or so, the world will change into a desolate void and I'll feel like the planet is the size of a house, no one else exists on it but me, there is no events or things in the future that will ever happen or to look forward to, nothing has any meaning or shape, so there is no reason for me to continue existing... then it passes and I go back up to the level of my regular depressed and lonely state.)

Regarding getting the neuro-transmitters into imbalance, that sounds like something I want, but all the meds seem to have no effect, so I'm not sure what clue that fact sheds on the cause.

Of the many offices I've called, none deal with conversion disorder. I've also looked aggressively in Charlotte, but have found no hypnotherapists for this type of endeavor, only things like quitting smoking and loosing weight, which doesn't sound like the level of therapist I would have confidence in anyway. (You may sense that I've been burnt too many times by rip-off artists).

I'm just so lost!! As you said, it's hard to treat oneself, I should get help from someone who has experience with this stuff, yet no one has helped me.
Expert:  Norman M. replied 2 years ago.
I think it would be well worth your while following up on the Trans Cranial Magnetic Stimulation process, and finding a CBT therapist to work with - it is very hard to get the full benefit of the therapy by working on your own.

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