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Psychiatry & Psychology--General/Mental disorder and self medicating

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I have anger, towards my loved ones and myself, always irritable and seem to not care about anything. Not kind, self-hating and lacking empathy. This is on a normal day without medication.
I've noticed that once I medicate, it's as if I suddenly an out of that daze. My thoughts are reminiscent. I think to myself " what is wrong with you, why are you so mean to everyone, why don't you love yourself, why did you do what you did"... (for example: I self medicated and found myself crying in the shower about my behavior the past month of me not using. I suddenly remember my mood swings and behavior and can actually see the wrong in my actions. I cried to myself and had to, in a way, advice myself to stop hurting my lovednones and to care about thwbones that do so much for me and love me) but why is it that without using, I can't seem to grasp that? When using, My attitude changes, I am pleasant,  patient, caring and reflective. I listen, I laugh more, my spirits are lifted, i am more positive, more relaxed, open and even have a sex drive. What disorder is there that would vause me to lack my positive traits/ outlook if I do not use my medication? It is like without it, i just float theough days with no memory, cares or emotions. I feel like I cannot function or am not myself without medication. For the record, my self medicating is with marijuana. I have read about personality disorders and other things but by simply googling symptoms, i have every disorder under the sun. I hope you can make sense of my inquiry and can offer some insight as to why I seem to lack 'sense' ( for lack of better words) and become moody and depressed without medicine. Pls excuse any typos, I am on a mobile phone. Thank you

Answer
Hello,

I am sorry for the delay but I have been without internet. I am going to rephrase the issue to make sure I have this correct:

It seems as if you are suffering from some psychological issue that then triggers animosity towards yourself and also loved ones. This behavior obviously bothers you so you "self-medicate" with marijuana. It seems the self-medication works but you are worried that there are issues that lie underneath the surface that are causing this negative behavior to begin with, and you are curious as to what might be the root cause.

First of all…you are right to be curious about why you feel towards yourself the way you do. If you were my patient, we would explore your childhood, your early relationships, and any traumatic experiences you might have had as a young person. We would examine the behaviors, if there are any triggers that provoke you and what ways you deal with those provocations. Then we would talk about marijuana use, how you use it and at what frequency to maintain some degree of control over your impulses and over your moods.

I have had patients that will use marijuana to elevate their moods but it becomes a question of how best to moderate the moods vs. the side effects. Marijuana does cause psychological addiction which is just as worrisome and troublesome as physical addiction. Some say the psychological addiction is tougher to beat. However, it is evident you do need something to help you as you work through your problems. Which moves us into the next idea…

I believe the best way to help you would be a combination of careful medication AND psychotherapy. I say careful medication management because you do not want all your feelings to be numbed. Feelings and emotions are actually messengers of truths. They inform people about their pasts, how they were made to feel about themselves and others, what to expect from relationships and life, etc. So you do not want everything numbed out. Sometimes it is easier to do this with prescription medications, starting out on the lowest dose and working up until you get some relief. However, most important to all this is getting simultaneous talk therapy. With therapy, you will eventually learn how you developed these behaviors and why. You are not crazy, you were not born this way…these behaviors were developed out of some effort to defend yourself against something and these defenses are usually developed in childhood. So you are also correct when you said you were seeking some insight into why you are moody and depressed without medication.

You asked what might have contributed to this problem. I do not know exactly but from my professional experience, any number of childhood difficulties or traumas could result in your having no compassion or love for yourself which would then cause a distrust of others and a tendency to lash out when you cannot soothe yourself. I would ask you to carefully reflect on your early relationships with mother, father, siblings, and see if you might identify instances where you were made to feel unlovable or if you were hurt in a way that would have affected your trust in others. These kinds of relational traumas often become observable in adulthood in just the way you describe your own troubles.

So…I believe psychotherapy is the way to uncover all that I have spoken of. While I totally understand that the marijuana can be so helpful to you, it is more difficult to moderate and it may be more difficult to taper off, once the talk therapy has become helpful to you. The goal is to alleviate your suffering just enough to allow the talk therapy to do some good. Then eventually you might be able to taper off the medication totally. Sometimes you may need a small dose but it can be better titrated to meet your needs…something that yo would have greater difficulty doing with marijuana use.

I hope this has been helpful to you. Please let me know through this site if you have any further questions.

Psychiatry & Psychology--General

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Jacquelynn Cunliffe

Expertise

I would like to answer under the category of Psychiatry and Psychology. However, I would like to see a separate category for Psychotherapy/Psychoanalysis. I do not answer questions about medications as I do not prescribe. My expertise is in psychotherapeutic treatment.

Experience

I am a psychotherapist and psychoanalyst who specializes in the treatment of mental health issues caused by childhood trauma, domestic abuse, eating disorders, relationship difficulties, and a wide variety of psychological disorders. The kind of therapy I do is often referred to as deep therapy, talk therapy, or psychoanalytic therapy. Please note that I am not against medications and when managed well, medication can be an adjunct to psychotherapy intervention. I think it is important for the public to realize that psychodynamic or psychoanalytic psychotherapy DOESmake changes not only in people's minds but those changes can also be detected in their brain structure. Psychotherapy and psychoanalysis are powerful interventions to help people change their lives from the inside out.

Organizations
American Psychoanalytic Association American Psychiatric Nurse Association Member of Psychoanalytic Center of Philadelphia Member of National Eating Disorder Association

Education/Credentials
Ph.D.-University of Pennsylvania, Psychology and Education, Division of Human Development M.S.N. and R.N.-B.C. Board Certified Nurse in Psychiatric and Mental Health Nursing. 2-Year Adult Psychotherapy Program graduate 2-Year Child Psychotherapy Graduate Current: Candidate in Psychoanalytic Training at the Psychoanalytic Center of Philadelphia

Past/Present Clients
I have worked with clients who have experienced significant childhood traumas. These patients come with a variety of mental health issues, including anxiety, depression, suicidal ideations, relationship difficulties and diagnoses such as Personality Disorders, Adjustment Disorders, and, though rarely, Dissociative Identity Disorder (formerly multiple Personality Disorder)

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