TW: mentions of self harm
For context, I am an autistic and ADHD female. I have been seeing a psych for ADHD medication and last month asked him for a mood stabilizer to combate pmdd. In the 2 weeks before my period I have mood swings where I get very angry or depressed suddenly. I argue constantly with my husband, shout at my 4 year old, cry uncontrollably for long periods of time, etc. I am also much more likely to experience an autistic meltdown.
Because I described mood swings, my psych said that maybe I have bipolar (which I’m 100% sure I don’t as these extreme mood swings only dip to negative, never elated/manic, and ONLY occur after ovulation and before menstruation). I don’t really care because I am just hoping the mood stabilizer helps with the pmdd and my Japanese isn’t good enough to argue with him.
We are titrating the mood stabilizer, 25mg for 2 weeks and then 50mg, eventually going up to 100mg over two months. While I was on 25mg AND during my pmdd window, I had a very bad autistic meltdown and ended up hurting myself. I’m now conflicted whether to mention this to my psych when I see him next.
I worry about things like being forcibly hospitalized or my kids being taken away if I mention self harm or suicidal ideation, even though these things only occur when I have an extreme autistic meltdown and never involve hurting my children or putting them in danger. When I feel a meltdown coming on I get as far away from my kids as I can (obviously not leaving them alone at home or something but I’ll throw the tv on and run to another room). I am also confident in the medication my psych prescribed because when I went up to 50mg during the second week of my pmdd I actually felt stable, generally happy, and didn’t have any explosions of anger like I do when I’m experiencing pmdd. I’m hopeful that as we increase the medication my mood will stabilize further and help me keep myself safe.
But since I don’t know about the attitude of psychiatrists in Japan when it comes to mental health I’m not sure if mentioning the incident would be safe.
I apologize for the long post! Any advice would be appreciated. Thank you!
16 comments
Dont know much about this in japan so will refrain from giving advice. But i hope you can find the help you need both here on reddit but most importantly in real life. 🤍
If your episodes are that severe, it is important to address with a professional you trust. It is not fair to you, your kids, or your husband to not acknowledge the severity of your issues and the impact it has on you/them and your relationship. If you don’t address it you may lose it all even if they aren’t taken from you/ you from them.
I have bipolar and I’ve self injured in Japan while I was pregnant. My psychiatrist upped my mood stabilizers and prescribed emergency medication for when I was panicking. I wanted to be hospitalized, but my psychiatrist didn’t think it was a good idea.
You should tell your psychiatrist about your self injury. They won’t take your children away from you. Hospitalization may be an option, but it depends on the doctor and their opinion.
My mum had unmedicated PMDD and bipolar when I was young. They do overlap, so it’s possible you have both disorders.
Definitely tell your psychiatrist what’s going on. Your meds may need tweaking.
Why go to the doctor if you’re not honest about how you feel? Don’t you think this will affect your treatment? Your family?
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The answer is hard as yes you always should tell the full true to your doctor as it might affect your treatment and recovery.
I understand you’re afraid for your family and I will suggest to look up for free anonymous consultations in Japan.
I’m not sure if they exist or are easy to find but a quick google search gave me this :
” If you feel you are currently in crisis and would like to talk to someone, please contact the Tokyo English Lifeline through their call center (03-5774-0992, 9 AM to 11 PM every day) or chat service ([https://telljp.com/lifeline/tell-chat/ ](https://telljp.com/lifeline/tell-chat/), 10:30 PM to 2 AM Friday, Saturday, and Sunday).
We understand that the experience of living with and managing mental illness is highly variable and know that many of these resources are not applicable to everybody. However, we hope to share as much information as possible with you in the hope that, if necessary, you can find the support you need.”
It might be a good start.
I wish you well and remember they are always people ready to help.
I think if you feel relatively stable, you should start looking for a new doctor who has some English. Or at least who feels more trustworthy. I started with my regular doctor. It just so happened that his wife is a psychiatrist, and she worked with a guy who studied in the UK. We mostly talk for five minutes every month in Japanese, but it’s reassuring to know I can bust out an English phrase and he won’t freak out.
It could be a bad reaction to the medication if its a new one? That’s what happened to me out here. Was fine (actually, best ever) on the 50mg mood stabilizer for a month, then self harmed and became suicidal. Went off the meds and am fine being alive.
quite a load to be carrying on your own.
and quite brave to open up here.
you definitely need to talk to someone. That someone is most likely the person helping you medicate your way through this. Your meds may need tweaking.
Have you discussed birth control to possibly lessen the PMDD? (That might be another doctor)
Not sure which area in Japan you are in but is a second opinion an option?
What is your nearby support network? Good luck and keep talking communicating.
To be honest you just sound like you’re immature and don’t take personal responsibility for your own actions. It’s shocking that you have a husband and child already. You clearly don’t seem emotionally developed enough. How about take control over your own behaviour and attitude and your negative effect on others before seeking validation for your own shitty personally on Reddit? It also very much sounds like you are seeking excuses and an easy way out by looking to emotionally dump on people and seeking medication. Self harm is almost always a self centered and attention seeking behaviour. Again. The fact that you have children and STILL have this attitude sounds so abhorrent to me. By your own admission you haven’t even tried even the smallest of modifications of your own behaviour to address your issues. Just burden others and seek approval for it on the internet (because absolutely no rational person in real life would approve of what you are self reporting to do) grow up. Threatening self harm is the most weak and immature selfish act. Get over yourself. Having a child does not give you permission anymore to be so self involved. By your own admission you are behaving poorly. So do something about it. WORK ON BETTERING YOURSELF WITHOUT RELYING ON OTHERS. Everyone else in society can do it, you can too. Think of your child for god’s sake. Their wellbeing is too important to allow for you not to try to improve on your own behaviour and mentality. My honest advice is that you need to seek out cognitive behavioural therapy, and a psychologist that specialises in it.
Why would you lie at your last line of defense?
Feel free to ignore people who are being ignorant on here.
If you are sure you have PMDD and your doctor is poo poo ing you, I suggest you get another doctor. But I will advise you that once when I tried to go to a psychiatrist here they wouldn’t see me without getting a reference from my last psychiatrist, so that can be a thing here. I already have to see the gyno periodically due to ovarian endo (possibly the source of my PMDD as it seems any imbalance anywhere can cause it but who knows) so I just gave up on psychiatrists after that.
I think the suggestion that the mood stabilizer could be causing the self harm thoughts is likely. I don’t know why many psychs immediately jump to big guns here – a google search brings up that SSRis are commonly prescribed in the west for bipolar AND they are often prescribed for pmdd too. I think suggesting that might be a good option. If you really have pmdd it is likely that the ssri even at a small dose will help immediately, as it is known now at least in the west that what is happening in the brain with pmdd and ssris is different than with depression. You can also only take it during your luteal phase because of this (suggested by western docs now) but I’m not sure jp docs really know this.
Yaz is formulated for PMDD but if something doesn’t work for you (it gives me functional cysts a lot which hurt), don’t be afraid to try another birth control. Doctors act like Yaz is the only birth control that works for PMDD which is BS because all women react very individually to every birth control.
Good luck to you.
Where in Japan are you? I can DM you details for a psychiatrist if you want/need an alternative in the Tokyo area. She is an English-speaking female who specializes in ADHD and PMDD. I was upfront with her about the self-harm that I committed on my first week of a mood stabilizer (my initial diagnosis was bipolar); she immediately halted the medication and re-evaluated my situation (the lack of impulse control while on a mood stabilizer and other things brought us to ADHD).
In general, yes you should. WRT. Kids you’re thinking US or UK, it’s much saner here… though checking with a lawyer (or a very precise Google search in Japanese) may be a good idea.
I know just how you feel with the self injuries. Did you have these problems before coming to Japan? It’s a huge mental burden to be speaking a foreign language all day and having to anticipate the needs of people around you who grew up unconsciously mastering cultural subtleties that you have to expend mental energy to deal with; it wears you down and very few people will acknowledge this.
You should tell the psychiatrist, but don’t tell your employer. You don’t want them knowing about this kind of thing.
The normal, didn’t read the whole text, answer? Yes.
The conscientious answer: probably not. But you need to tell someone (maybe even plural) who you can trust to have your and your family’s best interests.
The whole point of medication is to get your system to a manageable status, but by itself, it does not auto-manage you. You still need to be equipped with proper coping methods that are functional, productive, and helpful to you. If you are relying on medication to “fix” you, then you’re doing it wrong. If your doctor expects medicine alone to help you, they are wrong too.
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Right now, medication is important so that whatever imbalance there is in your system gets sorted out so your brain can function normally. But at the same time, you need to know what the imbalance is and how to correct that normally -so that you are not reliant on medication alone.
Second, the imbalance is only “what makes it hard to solve problems”, it is not the problem in itself. Have you been able to analyze your emotional triggers, hormone cycles, attachment style, environmental stressors, etc? There’s a lot more to it than just being on the spectrum and having ADHD. How you deal with stress and anxiety is affected by a lot of factors. Knowing about these will help you a lot in terms of actually fixing things (ergo, once fixed, it becomes okay and is no longer a problem -as opposed to putting a band aid on everything and then replacing each band aid when the adhesive starts loosening).
> my Japanese isn’t good enough to argue with him.
Find someone you can communicate properly with. Your emotional and mental health is worth it. I’m sure you love your family and they love you too. So you owe it to yourself and them to address your problems correctly.