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.