I summoned up the courage to phone my parents.  When I said I was having suicidal thoughts, my Mum straight away said I should get an emergency appointment with the doctor tomorrow and see if I can get referred back to the psychiatrist or have my medication changed (although my experience of doctors on the NHS in the UK is that they tend to leave medication to the psychiatrist if possible). I should be able to get an appointment with the doctor tomorrow, even though there’s normally a huge waiting list, as when I was suicidal last winter, my doctor put a note on my file saying that I’m a priority and have to be given an appointment that day if I say it’s an emergency (young men living on their own are a massive suicide risk anyway, plus I have a long history of suicidal ideation).  I’ll have to phone my boss first thing in the morning to explain the situation, including mentioning the suicidal thoughts, otherwise it won’t seem bad enough for me to justify missing a day of work (or possibly a half-day if I can get  seen earlier).  I am dreading this.  I have just sent an email to explain the situation so that my phone call won’t be totally out of the blue, because I know I can get panicky and not completely coherent on the phone (not sure if that’s social anxiety or Asperger’s) and I don’t want it to sound as if I’m skiving.

I’m having self-critical thoughts saying I shouldn’t have gone from three days to four a week at work or even that I shouldn’t have left my old job, but I guess I did have to try to push myself and I was doing OK in the spring.  I made decisions based on the information available to me and although I knew there was a possibility of relapse, I didn’t know it would be this bad.  In some respects, I’m just glad it didn’t hit me until the winter break, after my sister’s wedding, as it would have been awful to miss that.  I just hope I can find a way to stick with this job.

I don’t know if there are still medication options.  There might be older tricyclic antidepressants I could try.  There’s MAOI antidepressants, which are a pain because of dietary restrictions, but they might help.  And there’s ECT although in my experience you have to be more or less totally non-functional before psychiatrists will prescribe that.  Still, my thinking – and my therapist agrees with me – is that medication can only keep me stable at best.  Beyond that, I need talking therapy and I need to somehow shift things in my life so I feel better about myself.  It’s hard to see where that could come from when I twist everything to fuel my self-loathing and where my efforts to deal with social anxiety and low self-esteem seem to continually hit the wall of depression and borderline Asperger’s symptoms.

So, I will try to remain positive and hope my appointment tomorrow is helpful.  I will just take some notes based on my previous blog post so that I’m not incoherent when I see the doctor and then get ready for bed.

4 thoughts on “Appointments

  1. Not sure what you’ve tried before, nut I’m sure there are other med options that could still be tried. Whether it’s another antidepressant (perhaps moclobemide, which is a reversible MAOI so doesn’t have the dietary restrictions), an antidepressant combo (mirtazapine and venlafaxine have a synergistic effect) or adding something like lithium or an atypical antipsychotic on top of an antidepressant, there’s a lot of different things to try. The important thing is that you’re going to see the doctor, which is great.


  2. I haven’t tried moclobemide. I have tried LOTS of combinations. I’m currently on clomipramine, lithium and olanzapine, which isn’t doing much except making me put on weight. Part of the problem is there doesn’t seem to be a full record of exactly what I’ve been on over the last fifteen years.


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