The Psychiatric Appointment: Long time no…shrink?

What is it about psychiatrists which make you a) forget half your own history and b) turn you into a nervous wreck?  I have a substantially different view of psychiatrists now due to my work.  Whereas before they were something akin to gods floating richly on massive clouds formed out of all my psychic shortcomings, now, having sat and had tea with them, shared my biscuits with them, having had them ask me my opinions on stuff and tell me stories from their childhood, they are FUCK ME! CAN YOU BELIEVE IT?! people.  Same goes for psychologists, one in particular who was incredibly funny and humane, and who likes Care Bears more than is really sane.

Still.  Yesterday I had an appointment with THE CONSULTANT whom I’d never met before.  And two extremely charming medical students who were asking me questions that made me smile.  I watched the busy little hamster in their brain, run, RUN! hamster, going down their imaginary assessment checklist… “We have to ask everyone this- any illicit drug use?” I smiled because I have assessed patients and recognise the minute long silence and scrunched up face of trying to remember what comes next.  Still- nervous I.  Patient I, and unused to being a patient now.  I picked my cold sore while I was there and got blood on my fingertip.  I did it out of habit and nerves (god, I love picking scabs) but know it will be written down as (because, c’mon, I would have done the same) as, “interfering with healing”.


He asked me how many times I had been with the crisis team (about 4, I think) and I completely forgot the massive 2008 overdose.  It wasn’t a deliberate omission, it was four years ago and it was in a headspace I can barely relate to. I hope nobody thinks I didn’t mention it on purpose or was trying to hide it- it was a big thing to me then, but I don’t really think about it now.

They asked me about my family history of mental illness (AHAHAHAHAHA) and how I was doing at uni.  I said I found it stressful and my sleep it out of whack due to shift-working but I am managing and doing well (I am- I got 80% in my last essay and have had glowing reports on placement).

Anyway, he agreed with me that I don’t need to be on a long-term antipsychotic, particularly on a dose that basically helps me sleep.  It is not a sleeping pill, and the health risks that I already suffer from are too great to use it as such.  So the plan is, I’m almost finished uni so this is a good time to stop taking it.  Cut it down by 25mg at a time for a few weeks at a time until I get to 0.  I am worried about not being able to sleep.  They asked me a lot about my sleep and I didn’t articulate properly why I have trouble sleeping.  I don’t have insomnia- it’s not lying awake.  It is partly not having medication which means I can’t sleep, but it is largely that I do not get sleepy at the same rate as most people. I can quite easily knock out 24 hours awake as my natural way.  It’s just the way I am, I like being awake and doing stuff so getting natural sleep is tricky- my naturally sleepy self is out of whack, and medication enforces sleep.  But we’ll see.

Lamotrogrine is being hoiked up gradually to 200mg and I have been advised to keep an emergency stash of Seroquel in the house for manic stuff, which I always intended to, it does the job.

So, it was quite a positive meeting.  I am kicking myself for stuff I didn’t say, but that’s the way of nervous appointments, especially when you haven’t had one in 18 months. They said they don’t need to see me again (hooray!) but will keep me open so if I have any trouble or get unwell, I don’t need to be re-referred and can be seen quickly.  I’m glad they don’t want to see me again as I was a bit concerned they would try to.  I don’t need CMHT input, just advice.

So hopefully getting off the life-vampire-yet-helpful-Seroquel will go smoothly, and I’m glad I have some support.  As I left they said good luck with the wedding, and I bloody need it.  We have approximately bugger all organised.

15 Responses

  1. This is nice to read, glad you are planning for eventualities and cutting down sensibly- I think if people can cope coming off meds they should too many continue to take them year after year because they think they should/ have to. Hope it all goes well for you. x

  2. […] Mentally Interesting and Other Stories visits her consultant. What is it about psychiatrists which make you a) forget half your own history and b) turn you into […]

  3. First day I went on Seroquel I was horrified to read in the side-effects leaflet about a “discontinuation syndrome” ~ which anyone else would call “withdrawal symptoms”, which as you would know include a feeling of severe irritation on top of insomnia and nausea… lovely!

    I’m not even sure the stuff is that effective. I still get low-grade “voices” when I’m on it, which risperidone far more effectively shut out. I still get depressed and cannot prove that the medication is making it any less severe.

    When I yoyo’d off risperidone and got depressed, I could pop just 2mg and feel a dramatic improvement by the very next morning. Quetiapine never did that. It seems to take ages to do anything more “therapeutic” than make me extremely drowsy.

    The first month on that stuff, by the way, was a disaster because I was spraying my feet for athelete’s foot and hadn’t noticed that “azole” fungicides are contraindicated. The miconazole in my spray made me so run-down and downright ill that in the end, even after stopping spraying, I just stopped taking the quetiapine for over a month. When I came back to it with a system clear of azoles, I was fine. But bloody hell, you wouldn’t imagine a simple foot spray could interreact with an antipsychotic so drastically!

    Re the bipolar i/ii debate: if you had paranoia or psychotic episodes you’d be bipolar i, else schizoaffective… surely?

    Have you ever seen “delirious mania” or catatonic excitement in bipolar or schizoaffective disorder? A weird thing happened to me when I was manic when my thoughts raced so fast I was unable to think in English any more and ended up with a single syllable racing round and round my head that I repeated out loud. I kind of lost contact with my surroundings when this went on, so it felt out of body and more to the point out of mind. This came on in attacks that lasted 3 hours or so every day as the mania peaked. It was super-intense and the nearest thing to outright madness I have ever experienced ~ far crazier than any hallucinations or any paranoia ever made me. I don’t know that it was a catatonic state, except that when I googled my experience lots of references to catatonia came back because I’d been “perseverating” or “verbigerating” and exhibiting “echolalia” (if that means repeating out loud sounds I heard in my head). O I don’t bloody know what it was but I thought as a trainee psyche nurse you might have some idea..? I’ve never met anybody in “real” life or online who seems to have had an experience like it… My shrink says I’m schizoaffective, by the way, because my psychosis was too florid for straight “bipolar” …

    • Not that I’ve seen- heard of it though. Not in schizoaffective disorder but in schizophrenia.

      The syllable thing was something I had too with racing thoughts- it would be stuck and go round and round, and I would become obsessed with it and think it meant something.

  4. Arent students just the greatest. Does the system change them or what? Something goes wrong.
    Im going to write a bookie wookie – a good one.
    Whats the best way to store it? I think I have inadvertently deleted your play from my hard drive.
    Last i heard you were a mental heathor not a mental healthee.

    • You can be both!

      • You can only do both if you can compartmentalize your mental illness and if you can do that you dont have mental illness.
        I cant for the life of me think what attracts you to mental health nursing.
        It cant be the administration or the security so it must be the standing around doing nothing.

        • Yeah, that’s what I do! Stand around doing nothing. Don’t spend all my time talking to patients at all. SO nice to have you back here to take me down a peg!

          • Students do talk to patients but I think that they look forward to the day they wont have to.
            Have you noticed how coppers always walk around in pairs. Do you think they are chatting about reducing crime in the local area or what was on telly last night? Wouldnt they be more effective on their own? Just trying to create a little bon ami – I bet you are exited about the royal visit.

            • Oh bugger off.

              • Thanks for the advice, theres nothing here anyway.
                If this is how you chat with your patients I bet they cant wait for the time you stay in the office.

                • This is my personal blog. You are not a patient. You are someone who, for the past four years, has mostly used this place to insult me or, as I think you see it, take me down a peg. Sometimes with the occasional flash of humanity thrown in for good measure. I’m not looking for fawning praise but something constructive would be nice. In my emails, when I got notifications for your comments, I put your address into the search bar because I recognised it. And four years worth of snarky comments came up. So I’m within my rights to tell you to bugger off. If I knew someone who, for four years in my real life only showed up to tell me I’m crap, then I’d tell them to as well.

  5. Seaneen: I just got your reply. Yes that’s right. Stuck with it and obsessed with it, as if it means something. Exactly right.

  6. I explain Bipolar in the following way. i didnt know what it was when i wrote this but so many people no tell me i nailed it. Have a listen

  7. Nice blog!
    I want to share my story with you, as it can be helpful!;TEDSao-Paulo
    take care!

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