I’m just back from the psychiatrist.  It was not great.

The doctor had a thick Eastern European accent and I couldn’t always understand her.  She couldn’t always understand me either and I worried what might get lost in translation (she certainly misheard ‘autism’ as ‘OCD’ at one point).  She said I should stay on clomipramine even though it’s not doing much and the pharmacy is finding it hard to get hold of, as she thinks my OCD will get worse if I come off it (clomipramine helps OCD as well as depression).  She said she will write to my GP and tell him what to prescribe if they can’t get any more.  I think she said sertraline or venlafaxine, neither of which, to my lay knowledge, are like clomipramine (they’re new generation drugs, SSRIs; clomipramine is an older tricyclic) and both of which I think I’ve been on before (I’ve been on so many antidepressants I can’t remember which ones I’ve had.  My notes should say, but my experience is that my notes are incomplete, if not outright wrong, (“We love the NHS!”)).  The psychiatrist said that medication won’t help me much anyway (a previous psychiatrist said much the same) and encouraged me to get some CBT.  She did at least tell me how I could have that on the NHS with a relatively short waiting time.

I did ask about alternative diagnoses.  She said that if the Maudsley Hospital assessed me and said I’m not on the autistic spectrum, there isn’t a lot else that can be done, as they are the experts.  I was rather afraid of that.  I did ask if there is anything else that I might have to explain my condition, but she was pretty insistent on it just being treatment-resistant depression.  I feel that the psychiatrists must have missed something.  I guess I feel like I have psychiatric man flu.  I feel like ‘mere’ depression shouldn’t go on this long, or be this painful.  Maybe I just have as many prejudices about depression (and myself) as non-sufferers.

That was that, really.  She said she could discharge me or see me again in three months.  I opted for the latter, as I’m worried my condition will worsen when my contract ends in two weeks time and I remembered how hard it was to get into the system to get this appointment.  I reasoned that cancelling an existing appointment if a miracle happens and I feel a lot better will be much easier than getting a new appointment if I feel worse.  The receptionist who I was supposed to tell about the appointment hadn’t got a 2019 diary yet (don’t ask why they’re still using hardcopy diaries.  “We love the NHS!”) and wrote my name in the back of the 2018 diary.  My Mum, mindful of the problems I had getting this appointment (the phone calls and missing letters), was worried that I would get forgotten.  Unfortunately, the receptionist became angry and the confrontation became heated, making me feel uncomfortable (OK, making me wish the ground would swallow me up).  I think my Mum might write to complain.  I’m not a libertarian, but if I was the whole incident would seem to confirm a view of the NHS as an inefficient, under-equipped, unhelpful and bureaucratic organisation.  We love the NHS!

My Mum reminded me that I’m apparently supposed to have a meeting at The Network on 5 December.  So far as I can tell, this is a slightly Orwellian-named service for occupational therapy and support with work or other community-based activity for those with mental health issues.  It is perhaps worth pursuing, if they ever send me a letter telling me about my appointment.

I was so upset by the everything that happened that it didn’t occur to me for another hour afterwards that the appointment had finished early enough that I could have gone back to work for an hour or two.  I’m paid per hour, so it doesn’t make much difference to my employer, but the money might have been useful to me.  Now it’s too late to go back, which is probably just as well, as I still feel tense.  Tea has been consumed (if chicken soup is Jewish penicillin, then tea is English prozac), but retail therapy will probably be required after the stresses of yesterday and today (regarding yesterday’s events, my boss emailed me back from honeymoon saying I should just leave the data as it is.  I still think that she must regret hiring me, but my Mum told me not to mind-read).  I plan on buying cheap second-hand box sets of some of Sherlock and Jonathan Creek and possibly a volume of The Complete Peanuts as I fancy crime dramas to alternate with the Doctor Who episodes I’m watching for the book I’m writing (one could probably make the argument that Jonathan Creek is closer to the spirit of the prose Sherlock Holmes stories than Sherlock).  Other than that, I should use my free afternoon to try to self-refer for CBT and to catch up with emails, as much clearing out my inbox than actually writing to anyone.  I hope to get to shiur (Torah class) tonight too.

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6 thoughts on “NHS Woes

    1. Basically! I always feel somehow disloyal when I criticise the NHS in front of a non-UK audience (and I do think it’s better than no state healthcare at all, as in the USA), but certainly my experience of NHS mental health treatment over the decades has not been positive. I suppose I should point out that people who have had to use other parts of the NHS (e.g. accident and emergency or cancer treatment) are often more positive, but my experience has been variable and often negative.

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  1. Sorry things didn’t go as well as you wanted. If you do have autism, I read that SSRIs are usually prescribed, so maybe going an SSRI might be a good thing.

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  2. Oh, I’m so disappointed for you. What a frustrating experience. How a doctor/psychiatrist can be employed when communication with their clients is so difficult, I don’t know!
    All the autism info I’ve read has described the difficulty in getting a diagnosis, often taking years of dr hopping. Just as you are experiencing (if it is indeed Aspergers).
    I can understand your need of a clear correct diagnosis; to have explanations for the past and present and a direction for the future with coping etc.
    Don’t give up on getting answers, hopefully you’ll find a specialist in the area who has a good understanding and compassion for your situation.

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