Preparing to see the new GP

March 26, 2007 at 7:51 am 4 comments

Well, with all the mouse-based excitement going on here, I seem to have forgotten to do the one thing I really meant to: Work out what I’m going to say to the new GP.

Depending on how various bits of the discussion go, I may not get around to other bits. I obviously need to start out with why I’m there.

“I’m currently under the care of a psychiatrist and have been signed off work since just after Christmas with anxiety/depression/sleep problems. I saw my psychitrist, seven weeks ago and was referred for an assessment by a psychologist with regard to CBT and to another psychiatrist for the sleep problems. I’m currently receiving no treatment at all. I’ve just changed to this surgery because my previous GP didn’t seem to be able to offer the information or support I’m looking for and was hoping that I’d be able to find a GP who is more informed about mental health issues and would be able to address my concerns with the treatment I’m receiving.”

Then depending on the GP’s answer to this, I’ll need to go briefly into my recent history, then progress to what I want now.

“There’s a couple of things I’m looking for now. I have a few reservations about the way the psychiatrist is dealing with me, which I hope you can help me with, and I’d also like to discuss what we can do while I’m waiting for the referrals.”

So, point 1 – the way the psychiatrist is dealing with me.

“The first psychiatrist I saw was a locum and prescribed me an anti-depressant called Sertaline. I had some severe side-effects and came off it after a week, on his advice. My current psychiatrist didn’t want to prescribe me anything and gave me the impression that because I had a bad reaction to one drug, I wouldn’t be able to take any others. I’m not convinced this is entirely true. Instead, she has referred me for CBT, which I don’t believe will work for me. My previous GP just told me to think positively, which wasn’t very helpful. I’m willing to try it and hope it will work, but I’ve looked into it and have taken an online CBT course that my psychiatrist suggested and found that it was completely unhelpful, since I don’t seem to have the distorted thinking it’s supposed to help with. I don’t really know what to do about this, especially since it’s taking a long time for the referral to come though and, if it doesn’t work, it’s a lot of wasted time.”

And point 2 – What we can do while I sit here waiting.

“As I said, I’ve been left without any treatment or support for the last seven weeks. I’ve been told that I can expect to wait for at least another two to four weeks before I even get dates for my two referrals. I understand that these things can take time, but in the meantime, I’m continuing to have regular phases of suicidal urges (to the point where I have a specific plan and have checked its practicality), self-harm and anxiety. My previous GP prescribed me a small amount of temazepam to help with some of the anxiety before I was seen by anyone, but didn’t seem willing to discuss possible medications. I didn’t find the temazepam very helpful anyway. I was wondering if something else might help?”

And what medication might that be?

“Obviously I’m not a doctor, so I’d value your opinion on this. I’ve heard that Seroquel, which is one of the newer atypical antipsychotics, is often used for anxiety and has mood-stabilising effects. I don’t know if it’ll be helpful, but at the moment I’d be willing to give almost anything that could possibly help a try. I’d prefer to stay away from the benzodiazepines if possible, though I recognise that diazepam would also be an option for short term treatment when the anxiety is particularly acute.”

I’ll be surprised if I get that far. I’ll be even more surprised if the GP actually prescribes me anything. And absolutely amazed if he has some positive suggestions on how to affect my treatment. So I’m going to go there hoping for the best, but prepared to be written off once again.

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Mouse: Part III New GP: New Meds

4 Comments Add your own

  • 1. ian  |  March 26, 2007 at 8:23 am

    good luck with your appointment EC, i hope it goes better then the last few hey?
    i’ve had to try in total four doctors before i found the one at my practice/surgery that would help…

    and you are right, unless you had major reactions to the AD mentioned previously (and if you did then it is incumbant upon the doctors to find out why), then you ARE of course entitled to further medication. But, it does take a while to find the right medication for you, as you probably know.

    i was first cycled through the antipsych’s – rsiperidal (horrible) and zyprexa (better, but still horrible) before, six months later tried on Prozac/fluoxetine (not good for me), Effexor (very good drug, but some bad side effects) and finally to cipralex.

    I’m no expert but i believe that there are ‘families’ of SSRI which the doctor may try you out on?? If you react badly to one in that family they may decide that group won’t work for you?? There is the citalopram/escitalopram family, setraline/seroxat?? family. I’m not sure (Sisyphus is the one for this conversation!!)

    You are entitled to treatment, and if you have to keep on battering down there door, explaining about SH tendancies or get advocates from Mind to speak for you, you SHOULD get that treatment that you may need.

    but i know how frustrating it all can be,
    much support,

  • 2. Maggie  |  March 26, 2007 at 1:57 pm

    Hope your new GP is more helpful than your last. Let us know when the appointment is, and I’m sure we’ll all be sending you “positve vibes” at the crucial time. Sorry to sound so hippy-ish, but I have really found it helpful when going through a stressful situation (eg when we had to meet with my father’s consultant at the hospital) to know that I have internet friends who care enough to spare me a thought at the time. I knew that one in particular was lighting a candle and thinking of us all.

    With best wishes from sunny Liverpool

  • 3. experimental chimp  |  March 26, 2007 at 2:00 pm

    ian – I don’t really want to try other antidepressants without a mood stabiliser of some sort, or very close monitoring, since I’d class part of my reaction to sertraline as dysphoric hypomania. If the doctor is really supportive he may try that, but since the psychiatrist seems to have decided I’m not bipolar (and probably borderline) I don’t know if the GP will be willing to go with that idea. It’s something I may mention if things go incredibly well.

    If they don’t, then my final question will probably be: Are there any GPs at this surgery who have a particular interest in mental health problems?

  • 4. Alex  |  April 25, 2007 at 2:17 pm

    Thank You

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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