ok so, this isn't actually about me, it's about a friend of mine, and i wanted to get some feedback from all of you because a lot of you seem really smart about therapy and brainstuffs. she's dealing with some pretty severe depression and BPD, and currently it's pretty much totally untreated, because mental illness is really stigmatized in her country and it's reeeeeaaally really difficult to find therapy or someone competent enough to prescribe meds. i know she did see someone to get her BPD diagnosis, but that was a one or two time visit. also that the visit was an intensely high-anxiety experience and that she scratched her arm raw during it. i'm not sure what to recommend to her for trying to get meds, but for therapy i've seen supposedly professional therapy offered online. i don't know if it's a legit or helpful thing, though, or worth looking into for her? but her mental healty is deteriorating at a scary rate and we're both pretty aware that i can't provide adequate help. also online therapy might reduce her anxiety a little if she's not stuck in a room with someone...? ugghhhhh i'm just really worried for her and i'm interested in hearing whether online therapy is a fakey-fake scam or a legit thing, or if there's any other alternative any of you know of.
better than not having it, but not as good as in-person, for me. if being in the same office as someone was that anxiety-inducing though it's probably a good place to start. i'd advise looking up the company - the online counselling i got was offered through my parents' insurance provider, so i knew it was legit. i would be really, really dubious about anyone willing to prescribe medication over the internet, but maybe if the therapist is familiar with the area they could recommend a good local psych.
Can you diagnose bpd for a one or two time thing? I thought you had to rule out a lot of other stuff like depression and anxiety disorders, and also establish a long term pattern of behavior? Im skeptical about this providers competence, esp if they let her sit there and self harm in their presence. That said, about your actual question: ive seen online kind of things where you can chat with someone but its more of a crisis intervention thing than longterm working your shit out kind of therapy. Might be good for if shes feeling like hurting herself, or having meltdowns. They tend to be kinda bewildered by the kind of extreme splitting bpd meltdowns tend to though, jsyk. Its usually volunteers and not trained professionals. Theres also a thing called moodgym, which is like an online cognitive behavior therapy workbook, that ive used a lot in the past and have found very useful for like, learning better ways to think about things and noticing when im using moon logic and working on changing my self-talk. Its free and you dont have to talk to anyone, i strongly recommend it.
@Lissiel I don't think any of the psychs in my psych rotation this summer (4 weeks) would have diagnosed someone as having BPD on the basis of two visits. They might have kept it in the back of their mind, or one of the psychs-in-training said to me that a woman we had seen together (who she knew better than just that one time) probably had some BPD traits, but two visits is nothing. Especially not for getting a good feeling for someone's personality. I did 1,5 hour intakes with psych patients, and personality was one of the things I found hardest to describe.
yeah, she's familiar with the volunteer-based places and (i get where she's coming from on this one) they're generally kind of frustrating because they basically just parrot stuff back, like "it sounds like you're feeling upset." yeah, no shit, sherlock, i know i'm upset, i just have absolutely no idea how to deal with it. i can talk her through a lot of crisis moments, but her overall health is deteriorating at an honestly concerning rate and i'm definitely not able to make any significant difference in that by myself. i'm not sure if maybe there was something more involved in getting that diagnosis that i'm forgetting or that she didn't mention, or if that's just a testament to how shitty mental health care is where she's at. according to google there are only four mental health places in literally her entire country, so. yeah. she seems like she displays a lot of symptoms of BPD, so it doesn't seem totally unlikely. my hope is that if she can find someone online who's competent enough to give her a few resources and just help her cope a little better, she can look for someone local who can help her medication-wise, and also maybe be in a situation that's a little less anxiety-inducing while she's just trying to get started on the therapy thing (side note: i wouldn't really WANT anyone to be prescribing meds over the internet, that sounds euughh.) but yeah, therapy is pretty intimidating for her because of all the stigma surrounding brain stuff where she lives, and also because opening up to people is a hard thing for her to do. it'd be a start, anyways, even if it's only talking to someone who's better qualified than i am to help her out. so i'm just trying to figure out i guess if people who do online therapy are really that different from 'trained volunteers' on those chat websites, and if there's any way to tell a good one apart from a scam and fjsdfjkj i don't know hardly anything about therapy and i have zero experience with online therapists, all i know is that her resources are pretty limited and she needs to find some help because things are getting worse scary fast. i guess i'm gonna run a google search and see what i can find, see if anything looks promising.
ok, i linked her to the moodgym thing, and her instant reaction was 'cringe'. the colorful cheerful layout and 'let us help you!' kind of attitude felt...kind of condescending to her, i guess? i get where she's coming from tbh, i've had weird experiences with sites like that before. but i don't know anything about the actual content therein to give her any idea of whether it's worth a try or not, can you clue me in a bit on what exactly it is besides a free self-help thing?
Its a cognitive behavior therapy workbook designed by...im blanking on which one rn but basicaly its a big university and the country australia working together to provide real therapy online since so much of their population doesn't have access to mental health care. It had to be useful to people of a wide variety of ages/education levels, and also drs arent great at being cool. Im sorry its a little cheesy. Cognitive behavior therapy and its cousin dialectical behavior therapy are one of the few styles of therapy shown to actually be effective in treating bpd. Traditional talk "tell me about your mother" can help with things like clinical (short term) depression that are just straight up pain, but since bpd is specifically about having learned flawed ways of thinking and dealing with the world traditional therapy doesn't help much in the long run. It makes you feel better in the short term maybe but doesn't help you learn how to function like healthy people. Cbt isnt "self help"; its a legit therepy style usually done at great expense with professionals. Moodgym gives you a rundown of the basic tennets, a bunch of exercises, and an easy way to track your mood/thoughts, for free. Because they didnt want people who couldnt get health care to just fucking die.
A friend of mine has had success with betterhelp.com. It has a free trial, I think, and then various levels of paid subscription. All the people she has talked to have been friendly and professional, and there is no pressure to stick with someone who doesn't fit you. I know money may be an obstacle, but it might be worth looking at?
about diagnosis, i do not have bpd so i might not know anything, but, i have been in the mental health system for years and every doctor i have ever spoken to has said, 'if someone comes in with bpd, you know right away' so it might be possible to get diagnosed very early?
ok, i'll look into the betterhelp thing and see if she'd be willing to give that a try. i don't think money's as much of an issue as just the fact that mental health stuff is so damn inaccessible where she lives? i've gotten the impression that her family wants to help her, but there aren't many places they can really take her to see someone on a regular basis. yeah, i'm getting really conflicting info on exactly how the diagnosis thing works? but BPD doesn't seem like an unlikely thing for her (not that i should...probably be saying that, because i probably don't know what i'm talking about.)
