<p>I’ve noticed that on CC. there’s always a tendency to suggest that people seek counseling/therapy/medication to deal with possible psychological disorders and subclinical psychological issues. While I agree that there are some problems when therapy and/or medication (anoxeria, depression, bipolar, psychotic disorders, etc.) is necessary, can’t a lot of psychological disorders/issues be self-treated by means of will power–trying to get better and work through the issue?</p>
<p>Discuss.</p>
<p>“Discuss.”? What is this, a final exam essay question?</p>
<p>In general, if someone is asking for help with a problem on CC, the self-treatment will-power what-ever route has been tried and failed. If someone is asking for advice on a public forum, professional counseling is an obvious recommendation.</p>
<p>I would say that posters are too quick to recommend medication, without doubt, and too quick to armchair diagnose.</p>
<p>Suggesting that a troubled student find someone to talk to, to help sort out the issues, is good common sense though.</p>
<p>I think recommending counseling is a good idea on a forum like this, simply because the people posting here cannot really know what is going on in a situation-- they are only able to judge by whatever one-sided version of the problem is posted. Encouraging the person to talk with a professional is a good way of ensuring that their problem is PROPERLY evaluated, and then treated if necessary. </p>
<p>I don’t think a true psychological disorder should be self-treated. There may be certain ISSUES that can be self-treated-- issues like “I’m very sad because I got a rejection letter from Prestige U on the same day my grandma died.” In that case, the person will likely heal with time. A true psychological disorder, though, is a different story.</p>
<p>This is a message board. Mostly lay people are “dispensing advice” and being supportive and sharing, etc. When someone presents a “problem”, others can give opinions and advice and there are many knowledgeable and thoughtful CCers who do that. The person seeking advice can weigh the collective wisdom of so many people’s input and decide what actions to take next. Not every “problem” or issue someone presents here is a psychological disorder. Further, not every problem requires counseling. Sometimes just talking it over with someone and making some changes or taking action is enough. But nobody here can fully know the extent of someone’s issue, but only what they choose to present on an anonymous forum. So, when readers read a post where they feel there may be a serious issue, they often recommend counseling which is not the same as “treatment” necessarily. They are recommending the person seek further advice, and professional (not lay people who are anonymous on a message board)'s advice. Talking to a counselor doesn’t mean that treatment must follow. It may not be a “disorder”. It may just be something that needs support and sorting out. And if it is a psychological disorder, professional help can be a positive thing, as it is not so easy to treat on one’s own.</p>
<p>Most medical problems are also benign and resolve on their own.</p>
<p>However, if someone comes to a message board and just posts symptoms, it is prudent to just tell them to see an MD, since you don’t know them or their history. It’s entirely different if you’re speaking to a friend or relative that you know.</p>
<p>Agree with all of the above. Also, while one can sometimes “tough out” a problem such as depression and it passes, the amount of misery that a person can suffer in doing this may not be necessary. Psychological problems can also affect everyone who cares about the person who is suffering.</p>
<p>And sometimes, problems can’t be “toughed out” on one’s own, no matter how much effort a person makes. I believe any problem can be coped with, as long as the person reaches out for help. Some things can’t be handled alone.</p>
<p>I’m of the mindset who believes that everyone can benefit from some sort of therapy/counseling/self-reflection/etc. Self-awareness can only propel you closer to your full potential. I don’t place a stigma on mental/spiritual health exercises or endeavors if it’s genuinely done to realize one’s full potential. I’m probably in the minority about this, but I think if the stigma were erased, more people who really need it for pathological mental illness would seek it out.</p>
<p>I agree, teriwtt,</p>
<p>No one would be stigmatized for taking insulin for diabetes. Clinical depression is a physical illness that is often best treated with a combination of meds and counseling–as is diabetes. We humans deal with a lot of stress and we need help from each other to handle it–whether it is peer support or professional support. Why try to do it alone when others would love to help? I’m only using depression as an example. The same could be said for all “mental illnesses”. A combination of medication (if needed–it isn’t always) and social/ professional support is usually most effective. In fact, things like eating right and getting enough sleep and exercise can sometimes reduce/eliminate the need for meds. But not always.</p>
<p>I had a really horrible time with an assistant who refused to acknowledge that she had clinical depression. She tried to tough it out and was doing a real mess of things. I had to threaten to fire her–a real possibility since she was falling down on the job so badly it affected my own effectiveness. She took a medical leave and stayed off the job for a whole year during which time I had to make do with a temp. But she came back, cured and as efficient as she had been before her illness.</p>
<p>I agree that online diagnosis and prescription is not a great idea, but posters do solicit advice. We can suggest counseling, we can also suggest that a particular problem is not “all in your mind, grin and bear it and it will go away” so that true sufferers do not feel stigmatized. If only my assistant had not spent months resisting my suggestions, she (and I) would have been better off that much sooner!</p>
<p>Leaving aside the issue of armchair diagnosing (bad but kind of fun on TWoP), I was wondering this because I was reading something about bulimia, and it occured to me that disorders like OCD and bulimia, where recovery is linked to stopping certain behavoirs, might be good candidates for self-recovery without professional intervention because the person primarily needs to just get themselves to STOP what they’re doing. Am I totally off-base on this?</p>
<p>Well. I have worked with people who have stopped their OCD behavior and it has worked. I also have seen PET scans of the brain where people have taken meds or forced themselves to stop an OCD behavior and the brain changes are the same. I would say, though, that I would rather be with a client to help him or her through this kind of change whether I got paid or not. I’ll say again, dear wolfpiper, I think you might love to study this whole field. The body, the brain, nutrition, etc. It’s all connected. It’s where I’d go in psychology if I were starting out now (and it’s not so different from a spiritual approach). I think you could be heading toward a very interesting career path. Don’t be afraid to get professional help on the way–I certainly have. The wounded healer is the best equipped to help others.</p>
<p>On the topic of self-treatment of OCD, the following link might be of interest:</p>
<p><a href=“http://www.ocduk.org/2/foursteps.htm[/url]”>http://www.ocduk.org/2/foursteps.htm</a></p>
<p>I have a family member with an eating disorder and I do not believe that bulimia or anorexia can be self treated with any long term success. The eating part is a symptom of other issues. There are a host of mental processes which need treatment if the symptoms are to abate on any long term basis.
I have no direct experience with OCD so I will not comment on that.</p>
<p>I guess what I would question if someone were trying to self-recover is, have you substituted another unhealthy behavior for the one you’ve ‘recovered’ from. This is true of ‘dry drunks’, people who give up physically drinking alcohol (and perceive it as self recovery), but substitute it with gambling, sex, etc. Having a professional is crucial in helping people remain accountable - making sure there isn’t another underlying problem, other than just the behavior that one wants to self-recover from. You’d have to have an awfully dedicated and aware support system in place that won’t enable you if you choose to do it without professional help.</p>
<p>teriwtt, you said it right there “having a professional is crucial…making sure there isn’t another underlying problem…”
THERE IS. Bulimia and anorexia are not the problem, they are a symptom. Having a professional is crucial, IMHO.</p>
<p>My sister was diagnosed with bulimia during college. (My stepmother, bless her, found her supply of Ex-Lax, among other things, and led her gently but firmly to counselling.) She’s now 36, a mother of three great kids. She says there is <em>no way</em> she could have self-treated for this - she would not be the healthy person she is today if she had not been treated by trained professionals, including a therapist and a nutritionist.</p>
<p>She likens bulimia to alcoholism. You’re never “cured”; it’s something that is always there. She sees her therapist on occasion (last time was about three years ago, after she had her second kid) when she feels she needs a “tune-up” so she won’t slide back into bulimia.</p>
<p>It’s my understanding that the longer an eating disorder goes untreated, the harder it is to get and stay well in the long run.</p>
<p>W,
If one read all the self help books on OCD and EDs, could internalize and then think and act diferently, she/he could make significant steps towards recovery. If one has OCD as a child, and then develops an ED, the combination is resistant to self-help. Even in a residential setting, this combo is difficult.</p>
<p>When traditional outpatient treatment is not enough, there are more specialized programs for each of these disorders. So much depends on the degree of impairment, the support system, and past history.</p>
<p>The reason people on CC suggest that someone speak to a professional is to make an accurate diagnosis and share info on resources.</p>
<p>On a slightly tangential note, I always find it a bit odd that people always group anoxeria and bulimia toghther, as they seem very different. While a good number of recovering anoxerics do seem to develop bulimia afterwaRDS (recovering>binging>freaking out out about gaining weight>purging), most bulimics seem to start by purging the occasional meal to figuring that since they’re going to purge anyway, they might as well binge, and it then becomes an addictive cycle. I guess some do start out binging, gaining weight, and then discovering purging, but it seems less common. Bulimics are generallyolder, less weight obessed than anoxerics (though not always), and better at hiding it. While some do envy anoxerics, a lot of them seemed really annoyed by anoxerics who freak out over eating 500 kcal while they’re like “Shut up. I just ate six cakes and a gallon of ice cream here!” Also, bulimics have more insight than anoxerics; bulimics will often profuse to hating bulimia whereas that’s very rare among anoxerics. Thus, you’ll find a lot of pro-ana stuff where as people who come looking for bulimic “tips” will often by greated with “This is horrible. Don’t start! This is not a good weight loss tool.” On this end, most bulimics are not skinny; most are “normal” weight and some are overweight. Also, some gain weight while binge/purging, some lose, and most maintain. Bulimics, like people with OCD, are also great at faking normal, hiding their disorders and generally functioning well. One bulimic who is a recovering (for years) drug addict says that, though she hates bulimia, she would always chose it over addiction, because at least she can function as bulimic (this is not to endorse bulimia in any way… see above). Also, bulimia, like OCD, has a “bad boyfriend” mentality (promising the person the world if they obey, screwing them up with they do, making them feel horrible if they resist). Both can become well-ingrained “habits,” and longtime bulimics will often remark that they just often binge/purge just out of routine, as opposed to with a “trigger” (though that does happen, too). </p>
<p>Finally, going back to anoxeria for a moment, many bulimics will restrict but for different reasons than anoxerics–thy simply cannot eat normally without binging. Bulimics tend to restrict for shorter peroids of time than anoxerics and are generally less “hardcore” about it. They also tend to have better grammar for some strange reason…</p>
<p>Bulimics seem to have typically bad responses to outpatient therapy treatment but can have good responses to medication and Inpatient/outpatient programs (among a totally unscientific sample, mind you). They report little value in psychoanalysis but decent value in CBT.</p>
<p>Anoxerics tend to have the best responses to family-based refeeding (Maudsley method), the theory being that many of the comordibities associated with anoxeria (personality disorders, anxiety, depression, complusive behavoirs) are actually a result of malnutrition, not a CAUSE of the disorder (see the famous Minnesota Starvation Study).</p>
<p>Ultimately, though, bulimics and OCDites (just made up a word) both have to face they’re triggers daily, which is why I would imagine self-treatment would be good, though not easy (common things to be said include “recovery sucks,” “recovery is harder than the disorder,” and, my personal favorite, “I’m pro-recovery for everone except me” because, yeah, that pretty much seems to sum it up… They want to get better; they just don’t want to have to go through Hell to get there! That “abusive boyfriend” can apparently be a really PITA to leave). At the end of the day, it’s still the bulimic and the food, finger/chopstick/abdominal muscles/toothbrush/spoon, and the toliet/shower/bag/bin/sink/water bottle, and the OCDite and the soap/lock/table. Bulimics have said that their parents have sent them to treatment and then sent them home with 5000 calories worth of cookies or taken them to an all-you-can-eat buffet. OCDites will find gallons of soap, and commercials encouraging their maladaptive behavoir. They will find norovirus outbreaks; bulimics will find after-Christmas cake sales and CC’s pizza restaurants, so wouldn’t it be better for most of them to recover by themselves in the triggered-filled “Real World” with that sweet-talking “boyfriend” behind every corner?</p>
<p>Finally, both disorders produce a lot of shame. Bulimics don’t want to admit they eat food out of the bins and then puke it up. They don’t want to admit they can’t pay their rent because they spent so much money on bingefood. They don’t want people to find their puke bowl, notice the spot on the sink that has been eaten away by stomache acid, have the lady at cafeteria wonder way they’re being five cakes for the second time in one day, or wonder whatever happen to all the groceries they just bought. OCDites don’t want to admit that they’ve spent the last hour watching their hands, that they haven’t eaten out in months for fear of other people breathing on their food, that they won’t eat foods they have to touch for fear of contiminating them, that they were late to conference because they had to check their lock fifty times… They (both theys) feel horrible, weak, and hopeless… all the worse to have to go someone and admit that, no? Wouldn’t self-recovery be better in that it might get rid of the shame, i.e., being strong enough to kick out the “abusive boyfried” themselves. Anoxerics don’t have to (and rarely do) “want” recovery (though it helps) because they get betteras they’re refeed and return from malnutritiobn (a dedicated refeeder has to be commented to go through emotional hell and keep vigil, though, which is by no means easy), but both bulimics and OCDites do because how oh how sweet does that boyfriend sound to them?</p>
<p>This is not say that professionals can’t help either group (in fact, see above), but that there’s a lot that supports self-recovery as well
[/end today’s lecture courtesy of livejournal and college psychology classes]</p>
<p>(Sorry about all the typos… I thought I proofread but apparently didn’t. Also, sorry for spelling “anorexia” incorrectly; I’m selectively dyslexic with that word!)</p>