this post was submitted on 28 Feb 2024
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Bipolar Disorder

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The VA has approved me for community care! Instead of a revolving door of unprofessional incompetent clowns who specialize in PTSD, I can select one of the incompetent unprofessional clowns from my community who specialize in BPD!

How should I look for a psychologist? There's like, a lot to choose from here. Most everyone mentions "specialties" like bipolar on their site, in among a bunch of stuff like ptsd and depression and lgbtq issues- Which makes me think they aren't actually specialists, which gives me the impression they'll say just about anything to get me in the door. It's all a bit overwhelming and I basically only have one shot. Once I engage with someone, if they aren't a good fit (my history suggests it will take several sessions before I know if they'll be a good fit, so...) I have to go through the several months approval process for community care again before I can make another selection, assuming I'm approved. How do you weed out assholes, idiots, and the incompetent before you see them?

What treatments have you found to be effective in your therapy?

Also, I'm much better on Lithium than I ever have been, but I'm already coming close to the maximum safe dose- if there is such a thing. The psychiatrist mentioned depakote, but I've tried that before and had severe gastrointestinal problems. Are there any other medications I should be looking out for or asking about here?

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[–] protist@mander.xyz 2 points 8 months ago* (last edited 8 months ago)

Definitely sounds like you're looking for psychotherapy rather than further med management. For psychotherapy, you're going to be looking for someone with the credentials PhD, PsyD, LCSW, or LPC (these titles vary a bit by state). Finding a new therapist can be daunting...did the VA give you a set to choose from, or can you choose anyone?

If you're in a place to be able to talk about the really hard stuff and not spiral into depression or out of control, you could find someone who specializes in a process-type non-traums therapy, like psychodynamic therapy, where you'll explore how your experiences in childhood may be affecting your relational patterns and self-perception today.

CPT is geared more toward the type of trauma that's a single, short-duration event, and may not be indicated for the complex trauma you're describing.

If you would rather focus on "building a life worth living," you might try dialectical behavior therapy (DBT), where you'll focus on recognizing and interrupting unhelpful patterns of thinking, as well as skills related to emotional regulation, distress tolerance, and interpersonal communication.

There are lots of other options too. It can all be overwhelming, honestly