Surviving Appointment No. 1

Having spent a fair amount of time planning (and worrying about) telling my psychiatrist that I’d stopped my Quetiapine, I was really glad that I had my hubbie there with me when we were waiting. My head was a confusing place to be. On one side I was hopeful that they would respect my decision and see it in a positive light, on the other I was terrified that they’d panic and assume I was ‘unwell’ and forcibly medicate me. By the time she was ready to see me my voices had got in on the act, picking up on my nerves and not missing the chance let me know I was in for it.

On my own, I have little doubt that I would have appeared much more confused and disorientated. As my anxiety levels soar, my brain has the tendency to lose hold of the thread that keeps my thoughts in line. I can struggle to think, and speak, clearly – making seem ‘unwell’ when I’m really ok (or at least I would be if I was doing something else). Anyway, as it was my hubbie’s presence grounded me and helped give me the confidence to get through the appointment intact.

We kept to our game plan (see an earlier post for more on that) and managed to sound both coherent and reasonable. We showed the necessary degree of flexibility whilst remaining firm – in that I said I’d consider a short term course of medication if I needed it in the future, but would NEVER take long term antipsychotics again. In short, considering I was a bag of nerves inside, I think we did a great job.

Her reaction was an interesting one. It really helped that she had a definite human side to her. She didn’t seem to be hiding behind a mask of professionalism and would have been quite likable had we met in other circumstances. She spent most of the appointment with a hint of startled bunny in her eyes, visibly unsure about how to proceed. She asked about my reasoning, gave me credit for being an ‘expert patient’ and having thought it out very carefully – but also told me that I was putting myself at risk. Her attitude seemed to be the standard line of ‘it’s not if you relapse, it’s when’. She also felt that I was already showing signs of this relapse (the voices, visions and tactile sensations I’d had since withdrawing). Still, she was respectful about it and I was pleased with how things were going.

As the appointment drew to a close I really began to feel for her. Her anxiety levels seemed to rise at the same time my hubbie and I got out of our chairs to leave. It triggered a round of rapid fire questions relating to my risk history (How many admissions have I had in the past? How long has it taken for me to relapse in the past? Have I ever been violent when I’ve been ‘unwell’? Have I ever been in trouble with the police?) which carried on into the waiting room. It was as if she’d been spellbound throughout the appointment itself and suddenly realised that she’d have to justify her actions to the consultant. I left with a crisis card, a promise from my hubbie to call them if he was worried and an appointment in one months time.

Afterwards, despite the overall negative outlook of near-certain relapse, I felt like we’d won a major victory. I’d been honest with the psychiatrist, treated them with respect and in turn they’d treated me with respect. Ok, so we had very different beliefs around the nature of mental distress and the use of medication – but we were being civil and listening to one another. YAY 🙂

One thing worried me, though. The rapid-fire risk questions and a comment that she’d have to speak to the consultant about it left me with an uneasy feeling in the pit of my stomach. OK, so they hadn’t even hinted at sectioning but my psychiatric history is pretty checkered and littered with sections, relapses and assessments of me as being particularly ‘non-compliant’. What if the consultant new more about me than this SHO and had different ideas about what should be happening?

A few days later I received a call from the SHO asking me to come in for a further chat about my medication and a formal risk assessment. She wouldn’t say anything more than this, but told me that she’d just spoken to the consultant (who had been away at the time). This sent me into an internal panic. If you’ve never been subject to the Mental Health Act you’d be forgiven for thinking I was overreacting. Sensibly I knew that I was unlikely they’d section me, but still feared that it could be on the cards.

Rather than worry the week away, I used Mind’s Legal Line to check out where I stood. I found that they could technically argue the use of a section given the ‘nature’ of my condition (and my history of relapse etc) but that it wasn’t likely and could be challenged if need be. This, and the really helpful advice from people I know working in the system – including a lovely psychiatrist – helped no end. Still, as much as I tried to view the appointment as an arse-covering exercise, it was impossible to quash the anxiety that was growing within me.

By the time the appointment came round (only a few days later, thankfully) I was in an appropriately shoddy state. My voices had gotten much worse and I’d started getting unusual experiences where it felt like someone was reaching in to my mind and trying to show me things. Numbers (7-7-6) were beginning to have meaning and I was feeling ‘on the edge’. I was coping, though, and knew that the anxiety around the appointment was playing havoc with my mind, rather than any underlying illness being to blame. I had rocks to hold to though – Tai Chi, the support of friends/family and walking our dog (Daisy) all helped keep me steady.

The risk assessment appointment was a nightmare. It lasted well over 40 minutes and – following a read out list of the increased risk of death, doom and destruction that people off their meds are apparently under – I was subjected to an examination of all the things in my past that could be cause for concern – including the abuse, self harm, suicide attempts, psychosis, hospital admissions, engagement with services etc etc etc. To give the SHO her due, she seemed almost embarrassed at some points to be having to ask these things and she certainly understood how difficult it was for me.

I was struggling to concentrate, unable to look her in the eye and my voices were getting louder as the questions progressed. By the end of the appointment they were shouting so loud that I could barely hear her above the noise. I felt completely shattered, as if I’d gone ten rounds with a heavyweight boxer intent on teaching me a lesson. Had I not had the support of my hubbie and the knowledge that people can, and do, recover without medication – I think I would have given up there and then. The system felt like a huge, immovable object and I felt very small indeed.

Walking away from the health centre, I felt shell shocked. We popped in to the coffee shop around the corner and spent some time taking stock. It was the first time my other half had felt the force of the psychiatric system, and we needed a bit of a rant I think. We chatted, poked holes in their statistics and reminded ourselves that I was stronger and more resilient than my medical notes showed. I needed to distance myself from being MedsNOMore the psychiatric patient/accident waiting to happen and become MedsNOMore the human being again.

For something that’s meant to be about keeping me mentally well, it’s darkly ironic that seeing my psychiatrist made feel so ill.