Today I had my quarterly psychiatrist review to see how I am getting on and if anything can be changed with medication etc. Normally my care co-ordinator is there as well but she couldn’t make it today so it was just me and my psychiatrist. I actually get on quite well with her, I think she is fair and I know that she backs the high risk management plan my care co-ordinator uses with me and without her, I’d be in a very different place right now.
Each appointment basically takes the same brief outline with questions such as:
How are you?
Do you think you are better or worse than last time you were here?
How do you think your meds are working?
How is work?
How do you see your future?
I generally struggle with these appointments because it feels like you have to bare your soul and then just be able to switch off all emotions once you’ve done that. It was all going ok until she asked about work and I told her about recent issues with my main client and with a smaller one which has left me with little income (I’m self-employed). In response my psychiatrist said she doesn’t think I’m fit for work and I should think about stopping it altogether at the moment.
I can see where she is coming from but I also think work has given me the incentive to get up at times and taken my mind off things. It has helped with my self esteem as I’ve known whilst working, my clients see some worth in continuing with my service and therefore that I am good at something.
We also spoke about suicidal thoughts and my recent overdose. I explained that I’m currently struggling daily with thoughts but they have just been thoughts. I told her that I have the means and a plan but that’s all and the last time I seriously thought about it was this morning but my plan needed darkness so I didn’t do anything. I guess this shows me how precariously on the edge I am – if it was dark and I had those feelings would I have gone through with it? I can’t answer that right now!
My psychiatrist then told me that on Friday, her, my cc and a psychologist were going to be meeting to discuss the way forward in terms of therapy. Is this not something they think I should be involved in? I only hope they are meeting to discuss options and not to make a decision as I honestly believe I need to be part of that final choice.
The next thing we spoke about was my medication and how I was finding it. I said I felt the promazine (for night anxiety) wasn’t as effective anymore and that I’m not sure the fluoxetine (anti-depressant) has ever been much use. She explained to me that she didn’t believe I had a major depression and so didn’t think upping my anti-depressant would help. Instead she believes because I have been victim of severe abuse, this is just the reaction to that abuse.
To be honest, that has completely thrown me. When I had depression as a diagnosis, I could tell myself, it’s ok, your brain isn’t working properly and that’s ok. But now I feel like this is my fault, that it’s about my ‘reaction’ and therefore I’m in the wrong.
I always remember an equation someone taught me; e+r=o (event + response = outcome). They said that the only thing you can control in that equation is your response to change the outcome. Now all of a sudden I am being told its my response to the event that is leaving me feeling this way, and that I have full control of that response (as opposed to only some and depression the other), I feel like a complete failure.
So basically the outcome of today was that