Adventures in Psychiatry : The Return of The Day Hospital

It's bitter-sweet. I feel lucky to be able to access such support and so quickly, but it feels like I am constantly here. By here, I mean I have quite intensive out-patient support.

I am officially under the care of the day hospital. I have a CPN - community psychiatric nurse - for the first time, and I will be starting groups once there is a space for me. The approach is very, very different to the day hospital I spent many years under which makes little sense to me as they are part of the same PCT - primary care trust. But, I was able to see why there was no money back where I used to live; it was being poured into Brighton. The hospital is vastly better furnished and well equipped for their patients.

The day hospital sits on the first floor. The inpatient wards are on the ground floor. This makes for a slightly uncomfortable feeling. When I walked into the main entrance I was met with a flashbulb memory of being escorted into the inpatient ward, the layout was practically identical and it really stressed me out.

I met my CPN and spoke to her for an hour. She explained how the day hospital works, what their groups hope to achieve and the crisis services. We both felt that I would benefit from being there, so I'm now on the waiting list for the groups and I will be meeting with my CPN every fortnight, with the option for weekly meetings if I'm struggling, to talk about my symptoms and how to manage them in a CBT format. 

There is absolutely no point talking about past trauma. It's done. It happened. It wasn't my fault. I'm moving on with my life. Absolutely no good will come of analyzing what those people did and why. The brain represses these things for a reason. 

What I need support with is managing the 'aftermath' aka PTSD. I do have really messed up thoughts and beliefs which impact on my relationship and bond with my boyfriend. I need to learn how to manage my anxiety better and be in social situations, to practice talking. I would like to learn how to manage my moods and control my impulsive and compulsive behaviours. Being in a safe space to do that is a real blessing. I want to understand my condition. It is very frustrating not knowing what this incredibly debilitating illness is called. It's not about the 'label' and having it as part of my identity or anything like that, it's just, to understand. To know what the monster is called and then we know how to deal with it.

It's a daunting prospect, but I am going to make the most of this opportunity. 

In terms of my current medication: I am officially no longer taking quetiapine. I am also not taking propranolol but that is really not working for me, so I am going to re-start that at a slightly lower dose of 120mg, instead of the whacking great 160mg which was having such a crushing effect on my cardiovascular system. The doses will be split into 40mg in the morning and 80mg slow release at night. 

I am still on 150mg venlafaxine and the rebound effect is kicking in hard. My GP told me it takes a few weeks for the effect of a lower dose to become apparent, and my god how true that is. My anxiety has absolutely exploded and my moods are very erratic. I'm not engaging in excessive spending and I don't think I'm hallucinating, but compulsive checking is becoming a problem. I have a prescription waiting for 75mg and 37.5mg tablets to continue the taper down, but I need to be very careful now. 

The day hospital needs to know what I'm doing and I need to be prepared to hear that it might take me a very long time to be clear of venlafaxine.

I have also been allowed another prescription of buspirone which I am incredibly thankful to my GP for. I only ran out yesterday after having the prescription since October, so they definitely know I am not abusing them. I don't know where they see the addictive properties in this medication but there we are. They definitely don't press that button in my brain so we're cool. 

The university has expressed concern about my attendance which makes me incredibly nervous, but I know I am covered by the DSA and if I were to be summoned to a hearing or anything I would have the student union on my side. Even so, my worst fear is being kicked out and my brain is the master of catastrophising everything.

On a different note: next Tuesday I have a medical with ATOS. 

 God help me.

1 comment

  1. how did the medical go? Sorry to hear you're back at a day hospital, but at least you're getting support .


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