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How to get help when little is available?

by Kristina Randle, Ph.D., LCSW

Q. I was born the middle child, and only female, in a very dysfunctional family where I was eventually raised by my divorced mother of 3. I was subjected to a great deal of anger and abuse (sexual, emotional and physical) during my childhood. By the age of 15 I began suicide attempts. To this day I am uncertain if I really wanted to die or if I was just looking for some help. I have self-harmed by cutting (minimal – wrists twice),drinking, drugging, sleeping with men and the worst – constantly being on the run. I have 3 children (25, 21 and 17) from 3 different fathers. I have been diagnosed with chronic depression, which was later re-diagnosed as acute depression and then later changed to Post Traumatic Stress Disorder complicated by depression. I am also hypothyroid. The medications I take are synthroid 0.15 mg and Effexor 225 mg. Last year (2006) I attended the Homewood Health Centre’s Post Traumatic Recovery Program in Guelph, Ontario for 8 weeks. Just prior to entering Homewood my mother was diagnosed with terminal bone cancer and given just a few months to live. I attended and fully participated in the Post Traumatic Recovery Program and then flew to Edmonton to stay with my dying mother. While there I was hit with many family problems and, as the only girl, was the one to stay nights with my mother at the hospital and provide hands-on care. Two months into my stay in Edmonton (and 2 weeks before my mother’s passing)I completely broke down and was immediately removed from Edmonton and flown back home to Whitehorse, Yukon by my social worker. I have a lot of guilt for not being able to stay with my mom until the end. Since my mom’s passing (which is the first death I’ve had to deal with that affected me personally) I am tired, scared, withdrawn, unsure of myself and a bit paranoid. I have always displayed these traits, of course, but somehow was always able to cope. I have worked hard, gone to night school, completed college while raising 3 children and rarely used the Social Service system while the children were young. However, in 2004 I broke down completely and went from being an Employment Officer with Yukon College to having not worked since. I hide from knocks, ringing phones, and people in general. I trust almost nobody and feel so full of anger yet am unsure if my anger is justified or not. Whitehorse, Yukon where I live is in the most northwestern part of Canada just a few hours from the Alaska border. We have just one psychiatrist for the entire territory – he has had my file for 1.5 years yet I have never met him or spoken with him. Help is not easy to find here and I do not have the resources to go outside or to pay for my own treatments. I need some help. I am unsure of the Effexor I take. At times I am happy and glad to see the few friends I have and other times I cannot face any person, place or thing. I go from extreme cleaning to extreme messiness – with my apartment and my own body. I go from eating nothing to eating way too much yet my weight seems to be pretty stable. I am approximately 15 pounds overweight and have been this way for the past 2 years, before this I had lost a lot of weight and was about 20 pounds underweight. At that point I was drinking almost daily and smoking marijuana and cigarettes. Now I still smoke cigs. but that is all other than the occassional drink with a girlfriend. My actual question is ‘What do I do?’ I fought the Yukon government to make them pay for my treatment at Homewood Health Centre and it is not likely they will pay again for the treatment. While at Homewood and involved in all therapy groups provided, I suffered from extreme dizzyness with ringing in the ears. I was given a C.T. Scan and after nothing out of the ordinary was found the attacks of dizzyness were diagnosed as extreme panic attacks. I have not since encountered the dizzyness to the extent I did then but still am dealing with it on and off along with the ringing in the ears. Sometimes I feel I am getting better only to wake the next day convinced I am getting worse. I do not read as often as I used to as my concentration is terrible. I fluctuate between needing the T.V. on all the time for the background noise (I sleep on the couch during these times) and needing absolute extreme quiet. I am trying very hard to help myself because I know the help for me is not readily available. But, when my family doctor tells me to get out of the house when I feel down, I feel she does not understand what is happening to me at all. When I’m good I can meet new people, take on chores and small responsibilities, truly laugh and feel pleasure and feel almost strong. When I’m not good I cannot even see the people I love. Can you offer any advice? I realize I am in a different country (Canada) with a different health care system but I am hoping for some proper advice.

Thank you for your detailed letter. I am sorry that you are having a rough time remaining emotionally stable and finding help. Since you have little access to care, you are limited in how you can be helped by those systems but I would encourage you to do what you can. I have a few suggestions. First, try to attend treatment again at the Homewood Health Centre, even if you have to fight with the government to get that treatment paid for. Fight for that help; what else do you have to lose? The fight, win or lose, would certainly be worth your time and effort. Secondly, you can also try speaking to your family doctor about a different medication. It is possible that switching off Effexor and on to another medication may help you gain better emotional stability. The third possibility to consider is that you might have to search for extra work to help you pay for a mental health professional. It seems that there is little doubt that you are suffering and that getting your panic attacks and PTSD under control would surely improve your life–probably tenfold. I know taking on extra work to pay the mental health bills is not ideal but it may be necessary for you to find some relief. Finding a qualified, skilled therapist to help you resolve your long running problems could improve your life significantly and would be well worth taking on an extra job. You have to do what you can to get help, and, as you alluded to in your letter, when you are not well the people around you are not either. I hope this helps. Take care.

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