17:08 – So the appointment was a complete disaster

5 Jun

I know I only wrote three hours ago but I’ve been back home from the appointment for quite a while and I’m an anxious mess all over again and can’t seem to calm things down. So the hope is that I write it all down and maybe I calm down…

Everything was a disaster. I was almost 15 minutes late in getting there because when I tried to leave my flat I started feeling all dizzy walking down the stairs so I turned round and ran back inside. I then stood inside my front door trying to breathe properly and calm myself down a bit. My appointment was for 2.30pm and it was 2.35 by the time I finally left. Needless to say when I finally got there at 2.45 I was panicking again because I was so late.

I stood outside the room I knew he was in and tried to discreetly listen through the door to see if I could hear any voices. I was hoping he was running late so that he wouldn’t realise how late I was but no such luck. I couldn’t hear any voices at the door so took a deep breath and knocked on it. He opened the door and I apologised for being late muttered something about anxiety and took a seat. He looked at his watch a couple of times obviously trying to work out how long he could see me for which clearly wasn’t very long as I think I was in there for all of 15-20 minutes. So yes, I took a seat and he introduced himself to me telling me his name and that he would be my new psychiatrist. I asked him if he was temporary or permanent and he replied “hopefully permanent!” with a smile. The smile made me a little tiny bit calmer and I thought he seemed OK.

He asked how I was doing and how my moods were at the moment. I told him things were OK and I felt things were quite well at the moment. Something about his watch checking made me think he had only allocated me a 30 minute appointment space and that he had someone else to see at 3pm so I didn’t see the point in getting into a ramble about all the crazy shit in my head. Telling him things were OK was the easier option to take.

And then it all started to go wrong.

He said he just wanted to check he had the correct details for the medications I’m taking and the doses of each. He read out the little list “Quetiapine 750mg?” I nodded. “Mirtazapine 30mg?” I nod again. “Diazepam 16mg?” I nod again. He made an unimpressed ‘hmm’ sound then asked me how long I’d been on daily Diazepam for and I tell him at least two years. He immediately replies telling me that Diazepam is a “very very bad drug” and that I must come off of it. Cue another massive wave of anxiety. I feel myself start to shake a little and my stomach starting to go into knots. I tell him that things have only just started to settle down over the past few weeks and that I really didn’t want to take the risk of everything getting seriously bad again by playing around with my medications. He responded to this by telling me I’d only need to reduce by 2mg a fortnight and that I wouldn’t even notice because I’m on 750mg of Quetiapine. I butt in and say that the Quetiapine is to try and shut the voices up and the Diazepam is to help with the agoraphobic symptoms – it isn’t even to do with the Bipolar really. By this point I am becoming noticeably anxious and can’t sit still in my chair. He goes on to tell me that Diazepam is an addictive drug and that after being on it so long I will now be dependent on it and it’s because I’m dependent on it that I’m reacting that way at the thought of it being taken away.

So I sit and stare at the floor while he runs through other questions about mood states and asks how my physical health is, if I’m attending my appointments with CPN#2, if I’m getting out of the house and seeing people all of which I continue to stare at the floor and without looking at him making small nods or shakes of the head to answer his questions. He finished off by asking me if I had any questions for him and I looked up briefly to shake my head then started getting up to leave. He said that I looked like I was unhappy and asked if it was because of the Diazepam. I knew then I had two choices – I could continue staring at the floor and achieve nothing or I could tell him what I felt about it. I decided to speak.

“I understand that I can’t stay on Diazepam forever and I understand that at some point it’s going to have to be reduced and stopped, but I found it really hard dropping down from 20mg a day to 18 and then to 16mg. Right now things are bearable, although I’m not really seeing anyone I am managing to get out of the house. I’m scared that messing with my medications is going to knock me off balance again when they have only just settled a bit. I can’t help but feel like if something isn’t broken then why fix it? Can’t we just leave things how they are for the moment please?” I rambled…

He then went on to say that I am only scared to stop it because I’m dependent on it even if I don’t think I am, after all if I wasn’t “addicted to it” then I wouldn’t be scared about not taking it. I wanted to say that wasn’t true, maybe I am dependent on it to some degree but it helps defuse some of my anxiety which in turn enables me to get out and do more things rather than lock myself away 24/7 in turn benefiting my moods. It can also help sometimes with stopping a self harm episode or at least reducing the severity of it. Also it can be helpful with sleeping from time to time. The next thought that came into my mind was that for all the things I use Diazepam for I don’t have any alternative coping mechanisms learned, surely I need to learn other ways of controlling my anxiety and self harming rather than just whipping the safety net away and leaving me to crack on with things. I so wanted to tell him all of this in a calm manner but I was back to shaking on the chair and staring at the floor with no words coming out my mouth. He said he would be willing do compromise with me and make it be reduced by 2mg every four weeks instead of every two weeks to start off with and asked me what I thought about that. Before I could answer he carried on saying that 750mg of Quetiapine was also quite a high dose in his opinion and over time he’d be looking to reduce it down as well to see how I would manage with a lower dose… With hearing that I cleared the frog from my throat and my voice suddenly appeared back in my mouth.

“Look, I want to be honest with you” I said to him (knowing another ramble was about to spill out). “I really didn’t want to come to this appointment, I have spent the full morning having horrible anxiety about it and I sat thinking to myself earlier about what the worst thing that could possibly happen by coming here today would be. The thing that scared me the most was the idea that I’d come to this appointment and the new doctor I’d only just met deciding that they were going to change things about. I find it really hard to deal with things when I feel like someone is taking control away from me and I can’t do anything about it. And that exact scenario that was up there with ‘the worst things that could happen at my appointment’ has now just happened. You don’t know anything about me other than some bits you’ve read about me that another doctor wrote and you are telling me you are going to change my medications around when things are only just starting to calm down? Please can you just leave things how they are?!”

He looks at his watch again and agrees to leave things alone for now then said I had to reduce by 2mg but then says when I see him again on the 1st of August that I will be reducing the Diazepam by 2mg and I “have to understand that it is going to happen that way” whether I like it or not because the Diazepam “is a very very bad drug” for me to take. So I’m not actually too sure if I’m supposed to be reducing from now or from the 1st of August.

I decide then that there is no point in saying anything else, and that whether I like it or not he is going to take my safety blanket away from me regardless of how I feel about it.

It was a horrible 20 minutes and now I just wish I had listened to the anxiety earlier on and not bothered attending it but it doesn’t matter now anyway does it? He isn’t going to change his mind and I have to get used to the idea that he is the one in control of my medications, not me. So in case you couldn’t guess the appointment was horrible, I have taken an instant dislike to new psychiatrist as I’m sure he himself guessed when I stood up and left at the end without even saying bye. I’m not so much angry as scared that I might be more dependent on the Diazepam than I think and that I might have to face some horrible withdrawal symptoms – the main worry I have is going through rebound anxiety. I have a slight amount of anger that someone who has only met me for a matter of minutes and who knows nothing about me really can come along and just decide what I can and what I can’t take without taking into account how those changes in medication might destabilise my mood.

Well I guess I’ve rambled on long enough but I had to get all of that out while it was still fresh in my head to try and make sense of it all. Despite the appointment only lasting 20 minutes there was a lot to take in in that time. Maybe now it’s all out the anxiety will step down a notch or two. Well I can but hope.

7 Responses to “17:08 – So the appointment was a complete disaster”

  1. crazyaboutbipolar June 5, 2013 at 19:21 #

    First of all, I don’t think a new doctor has any business making a medication change for you after having only spent 10 minutes with you. A responsible psychiatrist would have first spent time getting to know you, your symptoms, your anxieties and inhibitions. He would have made a professional decision and diagnosis only after learning how you work. As you and I both know, mental illnesses don’t fit into neat little categories that are the same for everyone. We all experience anxiety and depression and mania differently, and many of us are co-morbid so we have more than just bipolar to deal with. Shame on him for not taking the time to learn about you and your various symptoms before making a medication assessment. I am very proud of you for being honest with him, because so many times I’ve lied or withheld the truth just to make the appointment go by more quickly. But your honest can only work in your favor. Perhaps he is not the right match for you? And making you wait until August to see you again isn’t going to help you very much. Maybe you need to find someone who can see you every couple of weeks until he or she learns more about your disease, your personality, your fears and your symptoms. This guy doesn’t seem a very good judge of character or disease.

    Good luck, my dear. I think you should keep shopping.

    • mycrazybipolarlife June 8, 2013 at 14:58 #

      Hi sweetie, thanks for commenting and for making some very valid points.

      Unfortunately I don’t really have a choice over what psychiatrist I see as I live in a pretty rural area and he is only NHS psychiatrist available to me. However I am still really upset/annoyed/angry/disappointed and after having a few days to mull things over I’ve decided that the best thing to do is to write a letter to him. Not so much a complaint letter, more a letter to explain things that I didn’t have the chance to say at the time.

      I’m not sure what the reaction to sending him a letter will be and I am slightly scared about doing so but… I don’t know… I just feel like it’s something that I have to do or else I will end up regretting not doing so. Also, it’s a lot easier to put things in writing than trying to think of the words and the explanations when in a face to face environment.

      Hope you are keeping well,
      MCBL xx

  2. Bankalt June 9, 2013 at 15:24 #

    I’ve been reading your blog for ages but I’ve never commented before. I feel for you having to deal with a new psychiatrist. I would have been really upset to have him want to make such huge changes after only knowing me for 20 minutes. It is like they think they know you once they’ve read your notes or spoken to your CPN. I know that when you first went in to the psychiatrist’s room you only told him things were going okay because you were so anxious but maybe he took you at your word and thought things really were going okay? Even if he did, it’s still ridiculous that he launched straight into making such huge changes.

    I think it is the standard now that diazepam and the other benzodiazepines are only used short-term. That’s definitely what I’ve found myself and with friends I’ve made from the hospital over that last fifteen years I’ve been a patient. I trust the MIND and Rethink websites and they have the same idea. MIND’s page is also saying that benzodiazepines become much less effective or stop working after about four months. The other thing is that I’ve known people who say they can make depression and anxiety worse (there are links about that in diazepam’s wikipedia page if you can face wading through it). It’s called the ‘paradoxical effect’. I know about it because I get a paradoxical effect to caffeine sometimes – strong coffee makes me incredibly sleepy! Anyway, the reason I’m actually writing you this essay is that I was thinking that getting off the diazepam might work out well for you in the end. You might have gradually got side-effects from the diazepam that built up so slowly that they’re not noticeable but once they are gone, it will be a great relief. That’s happened to me several times now with drugs I had been taking for long periods of time. I’d be freaking the fuck out at the thought of having to do the diazepam withdrawal but if it’s done properly and slowly enough then you definitely shouldn’t be getting extra symptoms. Your GP would know a lot about that and perhaps you’d trust her to give you the correct information and have your best interests at heart? I think you can only get so much information from the internet. There is just too much shite there too.

    It was incredibly brave of you to stand up to the psychiatrist and say you didn’t want to change both the diazepam and the quetiapine at the same time. I’ve just shut up so many times because I don’t want to make a fuss or wanted to get away. A letter sounds like a great idea too since it lets you say all the things you need to but also give you time to think it over and adjust it before the psychiatrist actually sees it. I hope things work out well for you and that your next appointment goes a lot, lot better.

    • mycrazybipolarlife June 9, 2013 at 15:57 #

      Hi there, thank you so much for taking the time to comment and for the helpful links. You pretty much hit the nail on the head – deep down I know that I can’t take Diazepam forever, and I also know that it is much less effective in smaller doses now because my body is so used to it. But it all goes back to the fear of the unknown I guess and the fear that when I don’t take it any more I am going to end up with such crippling anxiety again that I simply cannot go out the door.

      Like you said at the beginning of your comment it was the way the psychiatrist decided to tell me he was going to make changes to my medication before spending any time in getting to know me or asking how I would feel about some changes being made. That’s what has upset me the most – the fact someone who is a complete stranger to me can just decide what I will and won’t take without asking me first how I feel about that decision.

      But you did mention something which I didn’t take into account. Maybe because I did say I was doing ok (hoping that would get me in and out of the appointment asap) maybe that did make him think I was in an ok place for medication changes to take place. I just wish he had asked my opinion or gently introduced the idea that some changes were going to happen rather than just dropped it all on me with no warning. I don’t cope with changes that well so the whole thing just threw me into a spiral of panic.

      So whilst I know that I cannot change the fact that I will need to start withdrawing in the very near future I do feel that sending a letter to explain my fears and anxieties surrounding it all would be a good idea. I guess more than anything it was the psychiatrist just dumping his decision on me without giving me time to voice my concerns properly that has upset me the most.

      Sorry for the essay length reply… I could go on and on as I’ve got so many thoughts, questions, complaints and other things associated with the withdrawal that I’m panicking about but what you said about hopefully not noticing the effects too much by doing it slowly has helped calm me down a little.

      Thanks again for commenting and for helping me look at things from a slightly different/calmer viewpoint. I hope you are doing ok just now xx

  3. The Sunshine Diary June 10, 2013 at 21:50 #

    I’m sorry he was so unhelpful. I think writing a letter outlining your concerns and true feelings is a good idea though, so try that. Take care sweetie xx

Trackbacks/Pingbacks

  1. 17:29 – Letter sent to new psychiatrist and my week’s worth of rambles | My Crazy Bipolar Life - June 22, 2013

    […] my first appointment with the new psychiatrist on the 5th of June and as you may remember it was a disaster. I thought about writing a letter to him pretty much as soon as the appointment was over but […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 3,826 other followers

%d bloggers like this: