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Body dysmorphia: Another crash

Permanent Linkby margharris on Tue Jun 23, 2015 12:54 am

Well he came home after a day and a half of keeping up the pretense that all was well. He crashed spectacularly. Decided he needed the booze. Supposedly drank in the back bedroom. I smelt it later in the day. I took his car to his sisters so he wouldn't drink drive. He in the meantime decided a night walk to the pub was appropriate because he thought I was gone for the night. He was paralytic at 10.30pm. Fell over a low fence and scraped his face. I called the cops this time as I don't think he is taking this seriously. He has an intervention order for drinking at home already. Obviously he is doing too much and not handling the anxiety. It might be the BDD or more GAD. I just cant be taking responsibility for all of this. It has become a pattern. He crashes after a night with the new girlfriend.
There is just no problem solving. He is creating more problems as his orientation is to avoid anything that seems at all hard. Distraction is all he wants to do. Play mode keeps him in that childhood space. While I spend all my day doing the admin that keeps us all managing.
I suppose we are either a problem fixer or a creator. When you don't face your fears, they grow. You avoid and postpone and never get anything accomplished. There is nothing more completely consuming than a mental illness to fog your brain. Add alcohol and you can't even see where the problem is. They call it blind drunk.
Maybe there are three types of people. Those you can rely on to help and be there to fix and listen. Those who tell you they are too busy and move away from you and those who can even hurt you through criticism when you feel down. They can blame you for your mental illness making you feel worse still. Being type one, I am starting to worry that I am enabling but I don't like the sound of those other options. My son's mental illness seems to have trapped him in teenager mode, acting on impulse without any sound judgement.
I am so tired and feel gutted. I thought we had turned a corner but the high was only the brow of the hill on the road that hid the steep descent down. He has to be able to solve life problems well to be well. Two weeks from cutting as he tells it. First day sober again. Marg

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Body dysmorphia: It makes you unsafe.

Permanent Linkby margharris on Sun Jun 14, 2015 11:44 pm

Body dysmorphic: Unsafe in your own skin.
I see my son so tormented by his own reasoning that something is wrong and needs to be fixed. His hand constantly touches somewhere on his body to feel his own hair.
Going on a date seems to aggravate the whole thing. Talking about BDD or me even posting on the forum can take his thinking back to his concern. He then starts to ask for reassurance. He feels unsafe.
There seems to be no ability to resist this thinking once it has started. As his recovery continues he is able to occupy himself with more normal pursuits around the computer. He has downloaded stuff, reconnected with friends on Facebook and rekindled his interest in music. Plaid is now his recent favourite. This, his real life, needs to be his safe haven.
Doing urges is not the safe option to relieve his inner distressing thoughts. Going to the mirror or getting the hat is not safe. He has to constantly remind himself not of how much relief he can get from“ doing a check” but what he becomes when he needs to check.
It is the same for all his safety, rescue, avoidance maneuvers. He can give in to the urge to drink alcohol but he can’t escape what he becomes when he is drunk. He can use bed as a rescue but creating a den of doom is no life. He can avoid social contact but he only becomes more depressed.
So the safety, avoidance urges are only instant gratification. What he becomes after giving in, he never really likes. He never likes himself more after he has cut his hair off. So he has to learn to control the urges and think long term of what he wants to become. That goal is a long term integration with himself and his own destiny. Then he will be able to manage life better. It will still be tough at times but he will know giving into a urge will not ever lead to safety. At best it will only be temporary. He doesn’t want to become someone who always needs to check. He doesn’t like that person who thinks looks are so important or at least his are. He doesn't want to fear what he sees.

The alcoholism must be handled the same way. Yet another compulsion. But what does he become when drunk? I think he needs to write that story out and keep it on him so he doesn’t forget. But will he see it as important to do? Saving himself from ever drinking again and what the consequences can look like if he doesn’t take this seriously….
So what do you become when you do urges????? Down the road to regret.

Prozac 60mg is his current dose. I read up on the Katherine Phillips research. Her dosages for Prozac working were 67mg +or- 24mg as an average with results appearing in 8 to 12 weeks. So we are sitting on that now.
I tried to find her talk from the recent conference but wasn’t able to find it there yet. Wish us all well. Marg

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Body dysmorphia: 3 month update

Permanent Linkby margharris on Fri Jun 12, 2015 12:14 am

Well, the meds have worked to contain the worst of his BDD. The high dose Prozac with Lyrica to dampen side effects has turned things around.
He was functioning for almost a week until this last weekend when he had a stumble. He just did too much trying to pretend that all was well.
He opted for his usual coping strategies alcohol and BDD rituals. This has set him back all week. But I suppose we know that he is still very much unwell and there is no cover up of that.
The bed rescue is in full swing. Not much movement from the room all yesterday. He had reduced the dose of Prozac back to 50mg as he thought the anxiety he felt was partially due to the med high dose.
Well he got his first panic attack again this morning and has opted for more meds again. Back we go to 60mg. He is in there now, using line app to talk to the new girlfriend. He knows he is so needy for affirmation and love from someone but we all know this is far too soon. He knows but tries to justify what he is doing. He tells me she is so literate and he is using his brain concentrating on the texts.
I see it as a distraction again from dealing with the chores of life. It has to be fun for him to do something. Maybe there is some fundamental reward system not working in BDD so you focus on the reward from looking good. Your external appearance is something you see as tangible. Doing work well requires your inner world to be integrated and in service to your higher long term goals. There is no instant gratification that a sudden text from a love interest can excite when you sort out the rubbish for recycling.
We have another round in the MRI machine today. Keen that he can't live in bed today. The MRI gives functional pictures as there is a screen inside that displays images that he has to respond to during the scan. This next session has been labeled cognitive testing. Hope he comes out more balanced than last time.
This morning I spoke to him about this latest setback. Why he used alcohol and cut? He doesn't even seem to know. Just that he felt so much anxiety that he thought alcohol would allow him to escape it. Once drunk his inhibitions were reduced so he attacked his hair. He explained that he just doesn't like it. So no prior agreement can stand up to an alcoholic binge haze. There is remorse but definitely not enough for me to feel we aligned in this recovery together. He is still too unwell to see how much he is contributing to it.
The texting continues. I think there is something quite addictive about it.
So from our experience, Katherine Phillip's advice has been supported. Her studies can be found on Pubmed. I credit all the recent changes to the meds. He is too unwell for anything else. I have reasoned with him for almost years and it made very little difference.
Hope you gain something form this journey. Marg

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Body dysmorphia:Managing snakes and ladders of life.

Permanent Linkby margharris on Tue Jun 09, 2015 11:32 pm

The meds worked but life still Oh so trying. He can't live well.

We attended the MRI on Friday. His brain is free from any obvious nasties. A good thing to know. He was most likely given oxytocin and then filmed in the machine. Some other facial recognition tests were also given. Further cognitive tests are due. Then another scan. One of the scans was oxytocin and one was not.
The scans will now be examined for possible sites for TMS.

This was not pain free in the end.
He felt like he was high like he had had a few drinks. I spoke to him about me leaving the next morning to be with his sister. He would be being left in charge of his father and I would be back on Monday. He had a doc appointment on the Monday but he seemed fine to go alone…..
What could go wrong with that?
All of it…apparently. He never recalled the conversation at all. Hedonism might have played its part. He decided on the girl instead. Spent his time worrying what she wanted from him. Meanwhile she is planning his entire life totally unaware of his illness and his level of impairment. Over the weekend he became grossly overanxious. He went on a number of dates even with his own friend along. That friend used the word assertive to describe this new love interest. Of all the adjectives available, assertive doesn’t conjure up anything hopeful with me. It is s step away from critical and that only a step removed from contempt.
I suppose after months of isolation the feel of someone interested in you, even when you are lying all the time still feelings good. But it is a sham.
Real life was about how he coped with his own home and purpose there.
I don’t know really when the drinking started. So six month sobriety got a serious hiding. He could have landed a criminal charge if caught. He gave in to the urge to cut as well. The scissors were on the bench. He didn’t even seem aware. The docs appointment was missed. We have no support now for over a month. I was gone only two and a half days.
It feels like an emotional bashing. I have coined the phrase domestic terrorist. Maybe this is just out of control teenager. I had hope on Friday but now I don’t know what to feel. I am just hurt by having to face it all alone again. Feeling betrayed with nowhere to turn.
He really should have an interlock placed on his car. If he hurt someone I would be left feeling like I enabled it to happen.
So I suppose this happened because underneath this illness is someone without purpose and that higher moral code. He has broken it so many times in the past it no longer has much meaning for him. Just another time with no consequences for him to feel. No responsibility or accountability for his actions. He can bomb out and get away with it. But I know I am enabling it to happen. I am doing all the work to make the family survive this.
Can we blame it on the illness? Can we blame it on the oxytocin that might have tampered with his hormones on Friday? He doesn’t even recall our conversations. He only remembers agreeing to stuff without really listening.
When did that become OK? It is hard to not feel so cheated by his lack of care. It is 9.30am and he is not up yet. He doesn’t have to be as he hasn’t anything or anyone to be responsible for. I really can’t understand why he doesn’t care or feel some conscientiousness towards his own recovery. He just doesn’t seem to have any focus on it.
He probably thinks it is still his hair that is the problem. And after doing all this, it will be his hair that he doesn’t like….He can’t focus on recovery when his focus doesn’t understand his own problem. And that is the problem for all of you. The worry impairs your perception and judgement.
So we fell back down the snakes back and are 4 squares from the start. Desperate for some ladders but there is no easy escape from BDD. The meds were a great ladder but not the whole answer. He has to manage the stress of life with a higher moral code. That requires truth. You can’t build a life without...

[ Continued ]

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Body dysmorphia: Meds working. Didn't come home from date yet?

Permanent Linkby margharris on Tue Jun 02, 2015 10:24 pm

He is up and functioning. He is almost normal in his presentation. The anxiety is much less. We can actually talk about his BDD without too much distress. The touching still bothers me and him. He shaved his body hair off in the shower to try and reduce the compulsive urge to touch. It was an awfully long shower so I suspected something was up.
We still have all the mirrors down in the house and I am just not ready myself to introduce them.
He has gone out without a hat on a couple of occasions but I think there is some toppik going on. The camouflage is still playing into the need to avoid being seen.
I did mention in the last blog some of the meds we have tried during this exacerbation. But didn’t mention we did a lot of vitamin and amino acid regimes too. High dose fish oils, Vitamin Bs, Vitamin D, Magnesium, NAC and Lecithin and assorted protein supplements, green foods, acai and maca. I suppose they didn’t really do much other than give him really good blood work.
The doc claimed he has never seen anyone improve on NAC so I suppose don’t waste your money finding this online. There are clinical trials for it here but he must know already that it doesn’t work well enough.
I failed to mention that we did try almost everything available during the first exacerbation ten years earlier. At the time, we did Aropax, Zoloft, Effexor, Clomipramine, Mirtazepine, Seroquel, Risperdal, and Zyprexa. We settled on Luvox at that time. But my son ended up self- medicating the side effects with alcohol and Viagra.
From the sound of it, he became an alcoholic to handle the increased anxiety he experienced.
We have tried, Cogentin, Propranolol, Pindolol, Epilum and Valium for the side effect issues in the past.
So even though you may have tried medication, you can get so sick that you just have to give anything a go. You can’t give up and say you have tried it. There are so many. I just remembered another we gave a shot. Valdoxan. So the lesson here is to keep trying.
The doc is a vital ingredient in this success. We have seen two local doctors, two other psychiatrists, numerous community health workers and two clinical psychologists during this exacerbation. Really they just didn’t know what they were doing. You have got to find the specialist unit that treats hundreds of BDDers when you are this unwell. We are at the professor level and a specialist in the field. I did include his credentials but the mods thought better of it and deleted them in a prior post. This guy is at the Katherine Phillips or David Veale level. These two are luminaries in the field.
My son is off on another date. So using a dating site even without a profile pic works. It is a great distraction and gives your confidence a good boost. Someone is interested in you. He is going to get his life back. Actually he hasn’t come home?
Getting back to work and having the resilience to handle setbacks without BDD flaring is probably a way off. But we wouldn’t have expected this a week ago.
So the Prozac works. But there is the side effect issue. He can go a long time without eating. Big change from Mirtazepine head in the fridge. Insomnia last night was bad. The Fitbit showed almost no sleep at all. I didn’t notice the shaking leg so far today but it seems to come and go. No idea what really triggers it.
So the signs are encouraging. Meds do seem to make a big difference. So don’t tell yourself they don’t work. They are not all the same. I get it that one hates to be medically framed but when you get a life back it is so much better than being sick.
Wish you all a better future. Marg

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