Why I’m anxious about seeing a Doctor

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I’ve been putting off seeing my doctor for ages.

Why?

I’m afraid. Afraid that they won’t be able to help me. That they’ll fob me off with a ‘just keep doing what you’re doing’ response. Anxious that they’ll want to change my medication. Again.

I’ve had a difficult year with medical professionals. Long story short, I was discharged whilst feeling suicidal. I made an official complaint to the hospital, and they investigated. The outcome; the psychiatrist denied his behaviour and that I agreed and was willing to be discharged. So he lied, to save himself. I was left without support from mental health services and had to fend for myself. I carried myself through that bout of depression and I’m still here. But that’s not the point. I felt let down, isolated, alone, and incredibly fearful for the future.

This year has been tough on my mental health. I decided to go full time as a freelance writer, giving up the security of a regular wage. Mental illness has kicked my arse. A few months ago I was depressed, and suffering from tactile hallucinations for the first time. I was scared, terrified of these crawling sensations on my skin. It meant I couldn’t sleep. Insomnia is painful. It seeps through your very being and leaves you hollow. I was sleeping maybe 2 -3 hours a night. For months. I tried everything I could think of before heading to the doctors. With the help of medication, I could sleep again. The hallucinations dissipated and the relief washed over me. I felt like I could breathe again.

Despite all this, I can’t bring myself to talk about mental illness with a doctor.

I didn’t mention the hallucinations to my GP (general practitioner). I knew they would refer me to mental health services. The idea of this fills me with anxiety. The number one thought that goes through my head is,

“What if I end up with my last psychiatrist?” The same one I made an official complaint against. Surely there would be some form of animosity from them. I’d be on edge and be distrustful of their competency. So then I’d have to explain this whole story to my GP, before they referred me. I might have to wait even longer than usual to see a different psychiatrist. What if they are the only one available? What would I do? I can’t afford to go private. There are so many questions going through my head, and the process just makes my head ache, and fills me with anxiety.

I know I need to see a doctor. I’m experiencing some weird symptoms that I think might be connected to one of my medications. I don’t want to have to change meds. On the whole, they’re doing a good job. As long as I keep stress in check, they work and keep me stable. It took years to find the right combination and I’m so afraid of losing this balance I’ve achieved.

Again, I need to see a doctor. There’s no way I want insomnia to come back. I’m scared of psychosis and how it could manifest. I need to work through these feelings and book an appointment when I feel brave enough.

I Gave Up Alcohol For My Mental Health

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My last psychiatry appointment was a tough one – I was told with certainty that I should, no, needed to give up alcohol. My response was a hopeful one, surely half a bottle of wine on a Saturday night was alright? The answer was a definitive no, even that amount of alcohol was far too much. We agreed that I should go sober, and I agreed reticently. I left feeling dejected, grumpy and silently cursing my psychiatrist. Although I felt fed up, I had known before my appointment that this change needed to happen.

Why go sober? 

My psychiatrist explained that alcohol reduces the effectiveness of many medications. Alcohol is a depressant, and pretty much cancels out the work my mental health medication does. In other words, I might as well not bother taking my medication every time I drink. If I have three days in a row of drinking, then that’s three days without medication. For me that can cause the beginning of withdrawal symptoms, that feel like having the flu. Or, more seriously, it can cause a bipolar episode of severe depression or mania.

The mental and physical effects

After a heavy weekend, or a number of days in a row of a ‘few’ drinks in the evening to help me unwind and relax I start feeling the negative effects of alcohol. I’ve noticed a correlation between heavy drinking and heart palpitations, that often leads to a full blown panic attack. Panic attacks are a debilitating and exhausting experience, and I’ll feel drained for days afterwards. Another experience I’ve had after drinking is psychosis. Earlier this year I drank heavily over my birthday weekend and at the end of it began to hear voices. I wrote about the experience in this post, My Hearing Voices Journal Alcohol free, I wouldn’t have gone through these experiences, and would have stayed mentally well and stable.

How I did it

I literally just stopped! Seriously though, it’s been tough, especially on nights out and at family celebrations. I’ve been drinking since I was fourteen, so to just suddenly go completely sober was a massive challenge. I was open about it with everyone, and my partner, family and friends have all been extremely supportive. I reached out to the twitter community and was given heaps of advice and tips on non alcoholic drinks so I wouldn’t feel like I was missing out on nights out. Soda and lime cordial has been my saviour when I’m out at a bar, along with flavoured sparkling water when I’m having a night in. It’s taken a terrific amount of self determination and will power, but I knew it was something I had to do for my mental health.

How I’m feeling now

Two months later and I feel fantastic! I’m clear headed, have more energy and haven’t had any palpitations or panic attacks. I’ve been stable and haven’t experienced psychosis or any depressive or manic episodes. I feel physically healthier and I’ve lost weight. I know my medications are working as they should be now, and that’s given me the impetus to stay sober.

I may have left my psychiatric appointment with a feeling of dread and wondering how the hell I was going to go sober, but I’m so glad I stuck with my decision.

Where I Am Now, A Mental Health Update

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I haven’t written about the state of my mental health for awhile, as I’ve been focusing more on thought pieces on the blog. I’ve spoken about my journey in this post My Journey so Far, Living with Bipolar Disorder  Today I’d like to focus on where I find myself now and the recent state of my mental health.

You’ll all be happy to know it’s almost all positive! I seem to have finally found the right combination of medication. It’s been a long road (I was diagnosed in December 2012 with Bipolar) to find the right mix for me. Many of the number of medications I’ve tried I’ve struggled with intense side effects that have altered and decreased my quality of life. Now I find myself on a combination that’s only side effect is to make me feel drowsy. This isn’t a problem as I take them just before I go to bed. I am currently taking Lamotrigine, that stabilises my mood, Aripiprazole, which is an antipsychotic and Sertraline, an anti depressant. These have by far kept me the most stable I have been in years. Since May of this year, my mood has been stable without any major depressive or manic episodes. Three months of stability may not register as meaningful to some, but for me it’s huge. My life has been so constantly controlled by my fluctuating moods since I was a teenager, that these past three months have been like living in paradise. I can’t quantify in words how much it means to me.

The only blip I have had is struggling with back pain. It’s totally unrelated to my mental health but has impacted on my sleep. A lack of sleep for me is a trigger for a manic episode that then ultimately leads to depression. I spoke to my doctor and I was given pills to help me sleep until my back improves. Being honest with my GP and being aware of triggers and warning signs has prevented me from becoming ill. It’s taken years to specifically identify when an episode is on the horizon and what circumstances can alter my mood. I’m still learning about the disorder and how it effects me. I look at this process as becoming an expert on my own mental health. Expertise in any subject takes years of study and that is precisely what I have to do when it comes to my mental health.

I’m currently thinking about returning to some form of part time work. It would give me more of a concrete routine and bring in regular money. At the moment I’m freelance writing when I feel I’m well enough to do so. It means I can turn down work if I need to and take a day or even a week off from writing. Money is tight, but being stable doesn’t have a price and is more valuable to me than any possession. I’m lucky enough to be in a position where I have a partner that works full time, which provides me with some security. I’ve had to apply for PIP (personal independence payments) as my DLA (disability living allowance) has ended. I’m nervous that I will be turned down as they have become much stricter regarding mental health conditions since I applied for DLA four years ago. If I’m turned down, I’ll appeal immediately!

I’m hoping to have some form of therapy to help me manage Bipolar and continue to live with stability. Again the last three months have been incredible. The relief I have felt has given me more clarity, but at the same time has been a surreal experience. It isn’t the norm for me to be stable, and it feels strange and alien to me, like someone experiencing depression or full blown mania for the first time. I’m getting used to the stability and realising this is how life should be. It should be calmer and softer, more even and tranquil. Of course there are ups and downs, but they shouldn’t be as harsh, with sharp edges ready to cut me. I have relaxed for the first time in years, I feel safe in my own mind, rather than being terrified of it turning on me when I least expect it. All I can hope for is that it lasts, but if it doesn’t I feel prepared and ready to deal with it.

 

 

 

A Response to BBC Panorama – A Prescription For Murder

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The reporting of anti depressants was shameful in this programme. This show was only about scaremongering and hysteria surrounding medication and mental illness. It’s harmful towards people with mental health problems. The programme will increase the stigma of mental illness and taking medications, which is already a problem for so many sufferers. The damage caused could be irreparable to audiences views on anti depressants and their views of mental health sufferers.

I think it’s important to acknowledge people with mental illness are far more likely to be a harm to themselves than to anyone else. According to Time to Change, “90 per cent of people who die through suicide in the UK are experiencing mental distress.” and statistics show that “Only 1 per cent of victims believed that the violent incident happened because the offender had a mental illness.” That means 99 per cent of violent crimes were committed by people who were not suffering from a mental illness. People with mental health problems are also far more likely to be the victims of crime than the perpetrators. The Royal College of Psychiatrists report that people with a severe mental health problem are five times more likely to be the victims of assault, with women being particularly vulnerable. Substance misuse is a far bigger problem and has much more of a tangible link to violent crime than mental illness.

The title in itself is damaging, “A Prescription for Murder” and seems to be there to increase ratings. I’m not exaggerating when I say this programme is dangerous that could lead to people not seeking help who are in desperate need. Imagine you’re a young person or someone that has never taken anti depressants. After seeing this programme would you be put off taking SSRI’s? I think so. Even if you are extremely unwell this show could deter someone from seeking help, with consequences that could be serious to that individual. Its’ title is misleading in its’ insinuation that the prescription will cause people to commit murder, when they are focusing on a tiny proportion of the global population.

I am also offended by the online twitter team. The tweets completely missed the point as to why so many people were angry. Tweeting to “see your doctor if you’re concerned about side effects” is an example of this. People are upset about this show because it is stigmatising and harmful, not because of a lack of information of what to do if you’re concerned about medication you’re taking. There was also a link to a BBC article about support for mental health. The image of someone clutching their head used in the article is stigmatising. Both Mind and Time for Change have guidelines for reporting on mental health, and images that should be used. Here is a link to Time for Change’s Responsible Reporting section. The programme and the image used in the article show that these guidelines were blatantly ignored in favour of ratings.

As someone with Bipolar, I take a mixture of mood stabilisers, anti psychotics and anti depressants. I have written about how Psychiatric Drugs Saved My Life It’s true that if I was taking anti depressants they would alter my mood and I have become manic because of them. What’s also true is at these times I was only ever a danger to myself. I was misdiagnosed with depression and with the proper treatment I am now much more stable. Although the connection between SSRI’s and violence is played up, what is downplayed is the connection between misdiagnosis and how anti depressants alone can be harmful for people with severe mental illnesses such as Bipolar. This isn’t a new revelation.

What also upsets me is the rhetoric that medication for physical health is seen as a positive and very much needed. However, as soon as the media start talking about mental health medication it’s only seen as negative, and dangerous at that. This is more harmful to the majority of people with mental health problems than any medication could ever be.

The BBC has a duty to be impartial and fair. They have a duty to report respectfully and without bias. I don’t believe this has happened with this programme. The media needs to be held accountable for how they portray people with mental illness and it’s our duty to make sure they are. If you wish to make a complaint about this programme the link is here

Missing Medication: Withdrawal and Side Effects

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It’s been around four months now that my psychiatrist has been telling my GP that I don’t need to see her every time I need a new prescription. It’s a situation that has been causing me a great deal of stress as it is nigh on impossible to see my doctor before I run out of medication. The first time I mentioned this to my psych he told me he had met with the doctors at a couple of GP surgeries to discuss this exact problem. My doctor has appeared to ignore this suggestion. The last time I went to see my psych he demanded in the update letter about my appointment that I should be given a repeat prescription, and that my GP and I should instead schedule regular ‘check ups’ to discuss how I was feeling and to discuss blood test results, if needed. It appears this information has not sunk in and my frustration with my doctor has manifested into full blown anger.

So inevitably, I ran out before I had a chance to see my doctor – any doctor – at the surgery. In the end I missed four days of aripiprazole and two days of lamotrigine. I must admit that missing so many days was partly my fault; at one point I simply gave up. Withdrawal is dreadful. I started experiencing tremors that became increasingly obvious. The tremors I could handle, I’ve had them before and I’ve only ever seen them as a mild irritation. I became utterly exhausted, with every task seemingly impossible. It felt like a bout of flu, actually worse than the flu. I somehow, as I often do in these situations, manage to carry on, much to the detriment to my overall health. There were times where I could barely keep my eyes open, and even now my eyes and head are pulsing with a haze of tiredness that refuses to dissipate. Then it gets a tad confusing. I’ve started taking the meds again and now I can’t distinguish what were just withdrawal symptoms and which are side effects; they seem to have overlapped. Now I still feel exhausted, but also nauseous, that has lead to bouts of vomiting. I can barely eat and I’m feeling constantly worn out with a large dollop of sickness to top it all off. And I can’t sleep, what has left me feeling so desperate I was shouting at myself at 3 in the morning. I just want to sleep and wake up feeling refreshed; not feeling that I’m going to throw up. So let me explain how this all came about.

A huge annoyance is how difficult it is to arrange an appointment to begin with. I’m fed up with tiresome phone calls to an engaged line, that then rings endlessly once I’ve got through. The problem is the surgery I’m registered with is ridiculously over subscribed, to the point where they are no longer taking on new patients. If I don’t ring at exactly 8 on a Monday morning I won’t get an appointment. There have been times when I’ve been sat waiting for the engaged tone to finally end, only to speak to a receptionist who informs me all appointments have now been booked for that day. I have to ring back on a Wednesday, or a Friday, or even the next week, where I might, just might, manage to see a doctor. It feels like I’ve entered a lottery each time I make the dreaded phone call.

Last time I managed to see my GP I told her about the problems I’d been having booking in. She was very sympathetic and to my surprise, was able to arrange an appointment to see her in four weeks time, there and then. However this meant I would receive my medication a few days before I ran out. I didn’t think anything of it at the time, I was just so pleased I wouldn’t have to deal with the stress of arranging to see her. She cancelled the appointment. I was furious. Marching up to the receptionist, trying to keep my cool, I demanded to see a doctor the next day, this was an emergency I said. I was told in explicit terms that it was not an emergency, or even a priority and I would have to ring them tomorrow. The next day, no appointments available. Christmas was looming and I was becoming increasingly desperate. The doctor I eventually saw was fantastic, and I intend to ask to see this GP instead of the one I’m registered with. What really upsets me is how dangerous this practice is. What if my mood (that has recently been more on the manic side) had made me decide that I just wouldn’t bother taking the meds anymore. What if this had caused an intense mania, a psychotic episode or a bout of severe depression?

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