Adventures in Psychiatry : Dealing with a bad appointment

As you may or may not know, today I was due to meet my new psychiatrist. I'm very used to this process now, but it's still nerve-wracking! I wasn't told anything about this doctor, and it escaped my mind to try to look up the surname on the GMC website. 

Anyway. I'm going to try and be helpful here, but this may just turn into a rant. I will preface this by saying that I have had good experiences with psychiatrists, not just bad, and that this area of medicine is subject to a lot of opinion. You could repeat the same history to three different psychiatrists and get three different diagnoses and treatment suggestions. 

My appointment was scheduled for 12.30pm, just 30 minutes after art group finished which worked out great. I decided to just wait in the kitchen to try and save some energy. I was already fighting to stay awake following a very busy day yesterday! The time came, and went. Late. Amazing. Then people started coming into the kitchen and it got too noisy for me to tolerate so I went into the garden. These people followed. AAAGH. It wasn't noisy anymore but I didn't like being around these people I didn't know, that were smoking. I finally got called in at 12.50pm and went upstairs to finally meet this mystery doctor. 

I was actually stunned to see an English woman holding her hand out to greet me! In terms of anxiety management and feeling able to speak openly, this was nothing short of a miracle. It takes me a long time to trust male doctors. 

Her first question was about what brought me to the day hospital, so I explained that I was seeing and hearing things which were causing me a great deal of distress. She seemed surprised to learn that I'd been living with this since the age of 7 but it's not unheard of. We discussed the way I had chosen to explain what I was experiencing and the nature of hallucinations and psychotic disorders. I'm very aware that other people can't see and hear what I can now... with age comes experience and learning and all that. 

So far we're doing great. Her examination of my mental health file - which, by the way, is ridiculously big now - led her to feel confident I'm not schizophrenic or manic depressive. Always nice to hear, but I'm always cautious about new doctors commenting on my moods on our first meeting. That file only tells half the story. She was fairly confident I don't have a psychotic disorder and the hallucinations stem from a psychological issue; PTSD. 

At the time, this felt almost absurd but by the time I got home it did make sense. The brain is a very strange and unknown organ and can do the most amazing things to protect us from distress. By far, the most incredible protection the brain can provide has become known as Dissociative Identity Disorder, aka Multiple Personality Disorder. It is very rare!

I had never heard of hallucinations being part of PTSD and I have yet to really look into it further, so this is just my initial 'idea' as it were. One of my hallucinations is a giant 'monk' who traps me in rooms and terrifies me. Why would my mind create this? The only memory I have to go on is being trapped in rooms by my father; who must have seemed like a giant when I was much younger, and used to always remind us that he was "higher than God". Why that translated into a 13th century monk, I don't know, but that's all I've got to go on right now.

Then we moved onto what I'd like to work on during my time at the day hospital. I hate this question. I settled on anxiety management around people being the biggest hurdle, especially with university on the horizon. She kept calling it college, which really started to get on my nerves. She appreciated that art therapy was good for me but I wasn't making any progress, which I did have to disagree with. I was doing a task for the majority of an hour! This got almost laughed off.

This is where we started to run into problems....

She asked about the mention of fatigue on my medical record, so I gave a painfully brief explanation of  my symptoms and that my GP had come to the conclusion of chronic fatigue syndrome after a year without any progress. She had already made up her mind that what I was describing was depression and was inadvertently calling me lazy because I said exercise made me worse. Yes, even a 10 minute walk. If I had any brain power left I would have argued until I was blue in the face why I know that this isn't depression and there is something very wrong with the way my body operates now. What did catch me off guard was that when I mentioned the level of pain I experience after actual physical exercise - swimming or zumba for example - she said "oh well that's not chronic fatigue syndrome..". I wish I'd pushed her on that but I was spent and needed to get out of the room.

I. Was. ANGRY.

We agreed to up my dose of venlafaxine to the maximum dose of 225mg and giving that a few weeks to see if it helped before we start adding anti-psychotics into the mix. Fair enough. I am very concerned that it will kick my anxiety into overdrive but medicine is an evidence-based thing so needs must! Plus I do enjoy it when I'm right about a medication making something worse.

She'll see me again in about 6 weeks. I'm going to start the 'least intense' group when it starts in a couple of weeks. Unfortunate timing as I'll be away... Haha. I think she said it's a stress management type group and looks at triggers, so it should be useful. You get out what you put in to things like this. I'm there to work my butt off. That's why I'm sober. That's why I'm yet to self-harm despite really freaking needing to. I haven't been purging. I'm living like a god damn saint!

When I left the hospital it was 1.45pm and I had absolutely no strength left and just wanted to curl up into a ball and cry. Looking back now it wasn't a disaster of an appointment. I've endured FAR worse! All I could hear in my head was her comment about chronic fatigue and that she was basically calling me a lazy faker. Oh and she made me feel freaking awful when I told her what level of Disability Living Allowance I'd been awarded. I don't think it occurred to her that these payments are 'rare' because they vet them so harshly and only those that truly NEED that money get it. Ugh.

I had to see my hairdresser after that appointment which gave me some time to calm down and have a bit of a vent and chat about more fun and normal things! A friend also reminded me that psychiatrists are useless when it comes to physical illness - very, very true! Nevertheless, I went to M&S and decided to eat my feelings; it's still a reflex from bulimia being in my brain. I am really struggling with urges to self-harm but thankfully I am finally realising that while the immediate release does the job nicely, the scars will be with me for the rest of my life. If I'm going to be lucky enough to enjoy more holidays, I don't want to have any more horrible keloid scars to be ashamed of.

I just have to sit with this feeling, and get through it. Tonight, that's by talking to you lovely people and going to bed very soon!

If I wasn't in a body that crumbles under any sort of strain, it'd be a lot harder to keep calm. I remember it all to well. If you have a crappy appointment with your doctor, talk to someone. Vent it out on your blog. Someone might be able to offer a different perspective or be able to relate all too well. Sadly, there are too many psychiatrists around with their heads up their backsides and no empathy.

If you need to cry, let it out. It's normal and actually healthy! Then stick a DVD on that's going to make you laugh. If you just want to punch something, get a pillow and have at it. If you just want your head to empty, go for a nice walk or a swim. It's supposedly spring now, so there's always an excuse for ice cream... Whatever you're feeling, it's alright. If it's an intense one, just remember there is always a peak and it never lasts long. It will stop. One of my favourite things to do is write a letter to the person that's made me feel that way. You don't send it, but just getting it out is so cathartic.

So. If you've had a rough ride with your doctor, I'm sorry. The best way to deal with it? Do something nice for yourself! I got my hair re-coloured :)

I hope that this has been somewhat helpful. Thank you so much to my new followers, I can't tell you how much it means to me! I'm off to make a hot chocolate and give Lily more cuddles.

Please message me either in the comments, tweet me or send an email if you have any questions or anything. I'm here to help as best as I can!

Until next time <3
Samantha Nicholls. Powered by Blogger.

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