I saw a new psychiatrist today. She was so incredibly educated and knowledgeable on trauma and dissociation that it was startling. She’s literally been doing this work longer than I have been alive. She actually noticed our switching/dissociation right in session and pointed it out on the spot. It was impressive, but scary because people don’t usually notice such subtle shifts and we felt very exposed to have her pick up on it so quickly.
She’s also a psychotherapist and she offered to do both medication management and therapy, but I don’t think that’s going to happen. At least not right now. I cannot handle doing intense DID work every single week for one thing. And for another, her fee is very high. When we have insurance coverage again, I would consider seeing her more frequently, but maybe every other week or so while also seeing a “regular” weekly therapist. I know several people with DID that have this arrangement and it makes a lot of sense to me. But we shall see.
She had a lot of great ideas for medication options. We didn’t change anything today, but she did add a short-acting beta blocker to help with anxiety. She said that if I tolerate it well, she can prescribe the long-acting version and that should help me wean off the benzodiazepine (which would be great because I hate being on anything sedating).
She pointed out that the benzo has a hypnotic effect that encourages dissociation, so although it lowers my anxiety, it’s also probably lowering my threshold for dissociation and that could be causing all of the late evening/night switching.
She also mentioned something about adding an amphetamine during the day to help reduce switching when I’m at school or work. I’m not sure how I feel about that, but I’m willing to do more research. It would admittedly be nice to feel more confident that we won’t unexpectedly switch at important professional moments.
She gave me a lot to think about. My brain feels very saturated right now. But I am definitely going to keep her on as my shrink for now.
Welcome to the team, Dr. Bird (her internet pseudonym).