Thursday, 3 September 2015

Latest Psychiatrist appointment

I had my follow up psychiatrist appointment on Tuesday, and it went a lot better than expected! I'd used all the relaxing techniques I could think of & kept telling myself that if it was as bad as the last time, I didn't need to go back.

I usually find the place quite triggering; especially when my Depression's bad. It's probably because (most of) the times I've been there, I've felt as if the staff weren't taking me seriously. I'd had psych assessments there with the Crisis Team a couple of times, & it'd only made me feel worse. No matter what I said, how honest I was etc, the response was always along the lines of "We can't help you. Keep taking your meds, keep doing CBT". It takes a lot for me to ask for immediate help, and you can guarantee I've tried everything else (in terms of self help, self care etc) so to get that response makes everything feel pointless.

If you read my post I'm trying. I'm really trying you'll know that my first psychiatrist appointment wasn't exactly brilliant. I was expecting to see the same person this time, and I suppose I presumed he wouldn't listen this time either. My main aim was to get my words out and at least talk about how the Sertraline was working for me.

My neighbour was giving me a lift to my appointment, but she had to take me there 30 minutes early because of an appointment she had to get to at the same time. This sudden change of plans, although small, made me so panicky & even angry. I managed to pretend everything was fine. I hated myself for the way I'd reacted though. When going anywhere, I have to have a specific plan in my head as to what I'll do, in what order etc. It's supposed to be so I have as little stress as possible, but a change to a plan can have the opposite effect. The psychiatrist's waiting room is quite small, & the chairs face each other (which is really anxiety-inducing when it's busy!) but thankfully the main waiting area in reception is a lot more relaxed; with chairs quite far apart and a toilet that was easy to get to. I worked out the plan that I would wait in reception for 15 mins, I would then give myself 5 mins to use the toilet, and then I could slowly walk round to the psychiatrist waiting area and be there just in time. That way, (if he wasn't running late) it would only be a very short wait. I wore a necklace my best friend gave me, which I used as a sort of "lucky charm". I also brought a bottle of water & my anti-sickness tablets (I tend to get very nauseous when I'm nervous). It turned out that the psychiatrist's waiting room was very quiet, and there was no one in the seats opposite mine. I only had to wait a couple of minutes before I was seen.

The psychiatrist who saw me was a different one to last time (to my relief!). She was friendly, welcoming, and patient with me. It was clear that she had read my notes too, so I didn't feel as if I had to tell her my life story. She asked a few questions about how I'd been finding the medication, what therapy I'd been referred for, how my mental health had been etc. She gave me time to open up about other things (including the self harm) too.

I managed to say a lot more this time! I spoke about how the Sertraline took a bit of the edge off the anxiety and suicidal thoughts, but I felt that the effects wore off very quickly. I also spoke about how I have Diazepam to take as needed. She was happy for me to stay on both meds, and decided to up my Sertraline dose from 100mg to 150mg.

I then spoke about how I'd been finding CBT. It had helped very slightly with some things, but I'd been through my third round and didn't think it fit with my problems. The main thing was that CBT is very much focused on the present, and the past is barely touched upon. The different types of Anxiety I have, the OCD, the paranoia, and I suppose the Depression too tend to go right back to when I was at school. Two major triggering events were the bullying I experienced, and the traumatic abortion that I had, and I needed a type of therapy that would address these things so maybe I could get to a point where I can deal with them better.

The psychiatrist agreed that CBT wasn't really working for me, and she asked if I'd had any other form of therapy. I told her how I'd been told that (with my diagnoses), CBT was the only therapy available to me on the NHS. My therapist would be training in EMDR, so that was something I might be able to have in the future, but I'd not been offered anything else. She seemed surprised about this, and said that she believed I should have Psychodynamic therapy.

We spoke about the self harm in depth, as well as the OCD. She asked me some questions about rituals, and agreed with the diagnosis that I'd been given.

After discussing everything, the plan was that I'd be prescribed 150mg Sertraline and I'd keep taking the Diazepam as needed. She told me that she would write a letter to my GP, and that she'd also get in contact with my therapist to see about other types of therapy (preferably Psychodynamic). She also wants to see me in 3 months time, to see how I'm getting on.

Overall, this was a really good appointment! This psychiatrist made me feel at ease. She was understanding, compassionate, non-judgmental, and I really felt listened to. I have no idea how long the wait will be for more therapy, but to know that I may not be completely limited to CBT is a great feeling!

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