Seeking Help: Navigating Mental Health Challenges in Taiwan - Psychiatry

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I am a gay person from a violent family background.
I was very normal in elementary school, but in sixth grade, I experienced physical abuse from my father.
In middle school, I was filled with resentment and had thoughts of death and killing.
During high school, violent tendencies emerged, and I needed to kick and hit things to release my emotions, often damaging bathroom doors.
In my second year of high school, I met my first girlfriend and learned to relieve stress by cutting my arms, as my violent behavior scared her.
A month after graduating high school, I broke up with my girlfriend and spent an entire week without eating or drinking, only consuming alcohol.
I recklessly rode my motorcycle, resulting in multiple accidents.
Doctors at Keelung Municipal Hospital diagnosed me with severe bipolar disorder with depression.
I struggled to take medication and relied on self-discipline to recover.
A year later, all my resentment disappeared, leaving only sadness.
Two years after high school, I met my second girlfriend while studying in central Taiwan, and my personality changed significantly over the year.

At one point, I felt a dark space about three meters wide behind me, where two versions of myself existed—one crying and one laughing.
I often experienced seven different versions of myself at various times, each dressed differently and of different heights.
I discussed this with a psychiatrist at Taichung Hospital, as I could distinguish between the voices of these versions and the real world, although I could not see them—only feel their presence.
Therefore, I was diagnosed as not having schizophrenia and chose not to take medication, seeking help from a psychologist instead.
Are there psychologists in Taiwan? Does health insurance cover it? I gave up.

Once again, I forced my thoughts through self-discipline, and after three days, all the versions of myself left.
In a dream, I reported that I had built a village elsewhere, populated entirely by versions of myself, varying in age and number, working together in peace and happiness.
Seven days later, I received news in the dream that the village had been destroyed, and all its inhabitants had perished, leaving me unsure of who delivered the message, which I thought was a form of relief.
Within half a month, the laughing and crying versions returned, standing closely behind me and causing a disturbance.
Sometimes, due to my mood or arguments with my girlfriend, the volume of the laughing and crying voices would increase, each vying for dominance.
One day, the laughing version began to beat the crying version, and during that time, I was feeling low, unable to suppress simultaneous laughter and tears.
The beating lasted about two days, after which the laughing version fell silent, and the crying version died.
The laughing version then started digging a grave, and for three days, the sound of the shovel digging was incessant, which was quite frightening, as I feared the crying version's body would change.

After some days, my relationship with my girlfriend improved significantly, and the laughing version dug up the crying version's body to perform CPR.
The two versions returned to stand behind me.
Today, more than six months later, their presence is not as clear as it once was.
Two days ago, I violently assaulted my girlfriend over a trivial matter, marking the fifth instance of violence in our two-year relationship, leading to our breakup.
My violent tendencies are what I truly want to change, but I am unsure whether to seek help from a psychiatrist or a psychologist.
I feel very insecure yet also arrogant, believing I am exceptionally talented and charming, yet feeling worthless.
I oscillate between the emotions of being grateful for life and wanting to die to apologize.
I love the world yet hate it, fear loneliness, and despise crowds, sometimes having urges to harm everyone on the street.
Additionally, I have a fear of the dark and avoid enclosed spaces like elevators.
I want to win her back; I need her, yet I feel unworthy and think I should die to apologize.
Friends say I am just overthinking, with opinions divided between those who support seeking medical help and those who do not.
It’s frustrating to be trapped in these dreams and illusions.
I wonder if there are doctors in Taichung who can help.
I don’t know how I am still alive; I thought I would die, yet here I am, an unfortunate reality.

Xiao Bai, 20~29 year old female. Ask Date: 2003/12/21

Dr. Lin Yanhong reply Psychiatry


If it's convenient for you, please come to the outpatient clinic for a detailed discussion.
Thank you!

Reply Date: 2003/12/21

More Info


It sounds like you are going through an incredibly challenging time, and I want to acknowledge the courage it takes to share your experiences. Your history of trauma, emotional turmoil, and the complex feelings you are experiencing are significant and deserve attention and care.
In Taiwan, there are indeed mental health resources available, including both psychiatrists and psychologists, who can provide the support you need. Given your background of trauma and the symptoms you describe, it would be beneficial to seek help from both a psychiatrist and a psychologist. A psychiatrist can evaluate your mental health condition and may prescribe medication if necessary, while a psychologist can provide therapy to help you process your experiences and develop healthier coping mechanisms.

In terms of healthcare coverage, Taiwan's National Health Insurance (NHI) does cover mental health services, including visits to psychiatrists and psychologists. This means that you can access these services at a lower cost, which is a significant advantage. Many hospitals and clinics in cities like Taichung have mental health departments where you can find qualified professionals. You might consider visiting a local hospital or clinic to inquire about mental health services.
Given your history of violence and emotional instability, it is crucial to address these issues with a professional. Therapy can help you explore the underlying causes of your feelings and behaviors, and develop strategies to manage them. Cognitive Behavioral Therapy (CBT) is one effective approach that can help you reframe negative thoughts and reduce anxiety and depressive symptoms. Additionally, Dialectical Behavior Therapy (DBT) is particularly useful for individuals who struggle with intense emotions and interpersonal relationships.

It’s also important to create a support network. While it may feel isolating, reaching out to friends or support groups can provide a sense of community and understanding. There are LGBTQ+ support groups in Taiwan that can offer a safe space to share your experiences and connect with others who may have similar backgrounds.

You mentioned feelings of self-doubt and self-criticism, which can be debilitating. It’s essential to practice self-compassion and recognize that seeking help is a sign of strength, not weakness. You are not alone in feeling overwhelmed, and many people have found relief and healing through therapy and medication.

As for your concerns about your relationship and feelings of worthlessness, it’s understandable to feel conflicted. Relationships can be complicated, especially when emotions run high. Therapy can help you navigate these feelings and develop healthier ways to communicate and express your emotions without resorting to violence.

In summary, I strongly encourage you to seek professional help. Start by finding a mental health provider in Taichung who can assist you. Utilize the resources available through Taiwan's healthcare system, and don’t hesitate to reach out to support groups. Remember, healing is a journey, and taking the first step towards seeking help is a significant move towards a healthier and more fulfilling life. You deserve support and care as you navigate these challenges.

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