Tag Archives: diazepam withdrawal

17:10 – Pregabalin (Lyrica) for anxiety… anyone?

1 Aug

Sorry I haven’t posted for a couple of weeks, to be honest my head has been all over the place and I’ve been spending almost all my time self isolating recently. I still haven’t seen CPN#2 but I finally found some courage and phoned to request another appointment. I was only on the phone to her for about three minutes and all she talked about was how it would be beneficial if I could at least read the first chapter of the Compassionate Mind/Compassion Focused Therapy workbook thingy before I see her again. She said this is to prepare me for doing structured work with the psychologist but I have to admit I just sat here rolling my eyes thinking “what a load of bull” as she spoke. Anyway I said I would try and read some of it and the first appointment she could offer me won’t be until the 9th of August, so next Friday.

She didn’t ask why I haven’t been in touch with her for the best part of ten weeks; I did try to apologise but she just said “that’s your decision whether or not you want help” which kinda left me feeling like she thinks I’m not arsed about getting help from them. Of course there are some days when I’m not arsed, equally there are other days where I know that whether I like it or not I have to try this therapy stuff and just see what happens with it. The one thing that did confuse me though was the way she said I was working with her to prepare me for working with the psychologist – does this mean that when the psychologist finally starts working with me again that I’ll no longer have a CPN? I don’t know. It kinda sounded that way though. To be honest I obviously don’t feel much benefit from seeing her or I wouldn’t have let the past couple of months pass without getting in contact with her. So maybe that question answers itself.

Moving along to today and it was my second appointment with the new psychiatrist. I haven’t been sleeping great lately and looked like shit (felt like shit too with the combination of extreme tiredness and a bucket load of anxiety). My support worker came along to it with me which was a massive help because I felt more confident in talking about the points I raised with him in the letter I sent after meeting him for the first time. I told him about my concerns over stopping taking the daily Diazepam and how I understood that I cannot stay on it long term but at the moment it is doing something to help me and if he takes that away then there is nothing in it’s place to help me cope with the agoraphobic related anxiety and to a degree, social anxiety. I told him I’d also spoken to my GP about this whole coming off of the Diazepam stuff and how she agreed with me that it made much more sense for me to start the Compassionate Mind stuff and at least start learning the basics before withdrawing what is essentially my safety blanket. He didn’t say anything, in fact he barely looked at me. He scribbled some notes down and made the same comment as last time “you are only scared to withdraw from it because you are addicted” – well if I am addicted it’s the fucking fault of my old psychiatrist for leaving me on them for almost three years!!!

He asked about my social life (what social life??) and I told him I had been self isolating a lot lately and I told him I missed a few days of medication (twice) in the past couple of weeks and how disappointed it made me to realise that the voices were still there underneath the elastoplast band aid also known as Quetiapine.

I didn’t like my old psychiatrist much, I admit that, but at least he gave appointments that lasted around an hour not fifteen minutes. He would ask me about the voices, what they were saying, how they made me feel, how they affected me, what I thought they wanted, etc. But this new guy? He didn’t ask a single question.  He skimmed over my medications again then said he would agree to leave my Diazepam dose at the current level of 16mg a day for three more months before I have to start withdrawing and leave my Quetiapine at 750mg a day but he then said that he thought I was experiencing low moods and wanted to increase something to help me (Quetiapine is already maxed out) so he asked me if I’d like to move up from 30mg Mirtazapine a day to 45mg a day. I said I’d give it a go.

Then he said something which surprised me a little – he asked if I wanted something for the anxiety that I could take on a longer basis than any benzodiazapine? I asked him what he had in mind and the medication he recommended was Pregabalin. I told him I’d never heard of it before and he simply said just to try it and if I didn’t like it then I didn’t need to take it. This was another thing that annoyed me – the old psychiatrist would have taken five or ten minutes to explain what type of drug it was, what possible side effects there could be and answer any questions I had about it. This new psychiatrist, however, offered no information at all and simply told me to go to my GP next week and get a prescription for it, as well as for the extra dose of mirtazapine.

Of course as soon as I got home the first thing I did was consult Dr. Google about what the fuck Pregabalin actually is. It seems that it’s primarily a medicine for epilepsy, an anti-convulsant, which is also used for neuropathic pain (conditions like Fibromyalgia) but the more I read the more articles I came across for it also being an effective treatment for anxiety. I’m not sure what dose he is starting me on, I’m pretty sure he said 75mg but from all the reading I’ve done this afternoon it seems like most people need at least one if not two or three increases as a lot of people say it seems to lose effect after a while.

I’m apprehensive about trying it but if they are determined to wean me off the Diazepam starting October/November time then at least it gives a good period of time for the Pregabalin to build up in my system. I think the withdrawal off the Diazepam is going to take several months and I can’t lie, of course I would much rather stay on it, but I know I can’t, so if the Pregabalin works then that would be super.

I’m still experiencing bursts of laughter, uncontrollable giggles, and silly childish remarks off and on from little Berry but the voice of Sasha has well and truly gone. However I am still struggling a lot with urges to self harm. I’m on top of it at the moment but things do feel a lot like they are sliding backwards a lot of the time. Oh, that reminds me, I actually asked the new psychiatrist if he thought the voice hearing had come back almost like a rebound psychosis because I suddenly stopped taking my medications for a few days and he didn’t even answer me! I actually found him to be a little bit rude because I was talking about something personal and instead of listening to me he started writing me out another appointment card. At the moment I rate his communication skills as poor, his ability to display empathy or understanding as non-existent, and his 15 minute appointment sessions are just a joke. I know GP’s are limited to about 10 minute appointments but the ones with the psychiatrist are supposed to be anywhere from 30-60 minutes. Grrr.

I thought that by writing him a letter and explaining everything it would be beneficial to both him and me but now it sort of feels like a waste of time. Even though he wrote a short letter back thanking me and saying he understands my mental health better now. I don’t even think he remembered the letter until I mentioned it and even then I saw him flicking through my notes and speedily reading through it. Unfortunately I live in such a rural area that he is the ONLY psychiatrist I can see. I am very thankful that we have the NHS in the UK and receive free healthcare treatment but sometimes it’s extremely frustrating when you have to work with people who you feel no benefit from seeing but you carry on going to the appointments anyway because you know that if you don’t then you just won’t have a CPN/Psychiatrist/CMHT.

I think I have rambled on enough now but it would be great to hear from anyone who has tried Pregabalin for anxiety purposes (I believe it’s called Lyrica for my friends across the pond) and what you’re experiences of it have been – good or bad!

For now, I suppose I had better try and face the outside world and go buy some dinner for me and the doggies. Hope you’re all well xx

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17:29 – Letter sent to new psychiatrist and my week’s worth of rambles

22 Jun

So a few days have now passed since finding out I have the all clear, although it’s been weird, even after getting the results back on Tuesday the anxiety surrounding it all still took another day or two to settle down.

On Wednesday I spent a few hours with best friend and the kids and then got my hair cut and highlighted. It was getting really long again, a good six inches or so below my shoulders. Now it’s in a kinda choppy medium length bob, just sitting at my shoulders and the blond highlights all the way through are really nice. It’s strange though, best friend was like ‘look now you can tell CPN#2 when you next see her that you did something compassionate for yourself’… whereas in my head there was nothing compassionate about it… I wasn’t sitting there thinking ‘ohh I deserve this’ or ‘ohh my hair looks really nice’… all I could think was ‘my hair looks a mess, it’s far too long, I can’t be arsed to spend an hour or more straightening it, it’s time to get some chopped off’. The only reason I got the highlights was because there was a special offer on and whilst they look nice I still have that negative sort of view that the money could have been better spent on something else.

Anyways… moving along…

On Thursday I went to my appointment with my rape crisis support worker and we spent the session putting together a letter to send to new psychiatrist. I had 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 decided to give it a week or so just in case I was overreacting and thought I would maybe calm down about it all. But whilst I have calmed down, I still strongly felt like there were things that needed to be said to him before I next see him on August 1st.

I’m not going to copy and paste the full letter here mainly because of the length of it but also because it contains a lot of personal/confidential information but I’ll cut and paste the main points I raised:

  • As soon as I entered the appointment the first thing you did was check you had the correct medication information for me. As soon as I confirmed it was correct you automatically said that you want me to begin reducing my Diazepam (which I have been taking daily since Nov 2010) with your reasoning being that it can be an addictive medication.
  • You did not ask me how I would feel about reducing my dosage, there was no conversation about it nor did you ask me which of my symptoms that I feel the Diazepam helps with. You didn’t ask how my mood states had been recently, or if I was still self-harming, etc. In fact it seemed to me that you had already made the decision that changes should be made to my medication before I even entered the room and before meeting me.
  • You said to me that because I am on a high dose of Quetiapine that I wouldn’t notice not taking Diazepam. I don’t understand this because it is my understanding that the two medications are used to treat two completely different conditions. The Quetiapine helps control intrusive voices, paranoid thoughts and beliefs and delusional thinking. It does not help with anxiety. I am also concerned that you mentioned lowering my Quetiapine dosage slightly as well, when I have only very recently began to feel a little more stable. This concerns me as I worry if the Quetiapine is reduced as well then I may start to have symptoms of psychosis again or destabilising my mood to the extent where I end up back in hospital.
  • My main concern of all is, at the moment, I do not have any other coping techniques for my anxiety and agoraphobia and self-harming. I am currently on the waiting list to see the psychologist, however have not had an appointment to see her as yet. I hope that in time I will learn tools to enable me to cope with my anxiety, agoraphobic symptoms and distressing self-harm episodes, all in a way that does not require medications like Diazepam. I want to be able to deal with these situations in a healthier way, but the fact remains that right now I do not have any non-medicated coping strategies in place to help me cope with the debilitating levels of anxiety that I experience. It just seems that it would make a lot more sense to: wait until I begin seeing the psychologist; start learning and putting into practice non-medicated coping skills; and then start to lower the diazepam medication.
  • I would also like to make clear that I do not object to the idea of lowering the dosage of the Diazepam slowly and safely and I would also like to make clear that I fully understand it is a medication that is intended for short term use. However I feel that reducing it before there are any alternative coping strategies in place would be a very risky thing to do.

The letter ended up being three pages long but those are some of the concerns I raised. My support worker printed me off a few copies and I wrote at the end of the letter that copies had gone to my support worker, my CPN and my GP. Well, every time they send me a letter about something or another they send it to everyone in my care team so I figured I would do the same. All the letters have been posted now and I do have a little bit of anxiety about what the reaction to it will be but I know that I have the support of my support worker and she agrees that I’ve done the right thing so at least I know someone is on my side. I did also say at the end of the letter that it was not a letter of complaint against the psychiatrist, it was purely me wanting to have the opportunity to explain my concerns after feeling unable to do so properly at the appointment with him. I ended the letter saying that I would attend my next appointment on August 1st with him, but hoped he would have read my letter beforehand so we could talk about my concerns in more detail.

So that’s another thing done and dusted, well for the moment anyway. Hopefully they will see that I am trying to be sensible and rational and take my concerns into consideration. I need a repeat prescription on Wednesday and was just going to hand the repeat form into the receptionist but I’m now thinking it might be better to make an appointment and go to see lovely GP instead. I’m curious to know if she will support what I have said in my letter. She is usually very fair and I have a feeling she will say that maybe it is time for us to start lowering the dose of the Diazepam but I also think she will agree with me that there needs to be something in it’s place so that I can cope with situations that I can currently only cope with through medication. I guess the only way to know what she thinks about it all is to go and see her.

Anyways… I think I’ve rambled on enough now about all of that!

Yesterday I spent most of the day with a friend and I also got an email from my university tutor telling me I have to get up to date proof of being in receipt of benefits to apply for my course fees to be waived again when we start back after the Summer holidays so I’ll need to get that sorted out next week. I also finally phoned the mental health team to ask for an appointment with CPN#2 after a good 4 or 5 weeks of not seeing her (not her fault, mine for not attending and ignoring her phonecall and letter) but she isn’t back in the office until Monday so I guess she’ll get in touch then.

Today (Saturday) I’m having a quiet day as the weather is crap and my flat looks like a bomb site. My washing pile was getting ridiculously high as I pretty much spent all of last week in such an anxious mess that I got nothing done. I’m having a day where I just want to laze around in my pyjamas, do some little bits of housework here and there, work my way through my washing pile, watch shit on TV… a lazy day in other words.

Mood wise I feel OK-ish at the moment. Every so often I have some little thoughts that creep into my head out of the blue and start me thinking that I feel like I need to self harm, but I’m managing to ignore them for now. Although I have checked my hiding places a couple of times just to make sure that there are fresh packets of blades there… just in case… Then I catch myself looking at my legs and the horrendous scarring and feeling kinda sick that those scars are going to be there forever. And a part of me wants them gone, wishes I’d never done them, etc… Yet another part of me is like, ‘well you can’t erase any of those scars so you might as well add some more’. So not sure what’s going to come of these thoughts/urges yet, I guess time will tell.

Right I have rambled on for wayyy too long. And the washing machine has just finished another cycle so time to get off my fat ass and go hang it up to dry. I’m also starting to get hungry so time to cook up some pasta I think.

Hope you all have a nice weekend folks xx

 

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.