One of the biggest issues I have come across with regards to mental health services in the UK is that GP’s are our gatekeepers to specialist help, yet they have little understanding of mental health issues and what necessitates a referral.
I have found GP’s to be a mixed bag of knowledge with some being down right dangerous, but none of them eager to refer me into mental health services at any time.
In late 2009 I saw my GP who told me he had read a recent study in a journal which said that the anti-depressant I took was basically a placebo. As a result he took me off of it with immediate effect, no weaning off as you are supposed to (at the time I had been on the maximum dose of this medication for four years). He also never consulted the Psychiatriast who put me on it in the first place, who still today works in our local mental health services!
Within 6 weeks of this I was in hospital after trying to take my life, the psychiatrist I saw after this had never heard of the study this GP referred to, and put me straight back on the anti-depressants. I am still on those to this day.
My current GP is good but has a very black and white picture of mental health, it makes it very hard when trying to get her to see all the grey areas in which I, and many of us, live. She understands the extremes, anything but and you must be well.
When I was deep in depression which was strangling my every breath, she was wonderful and helped me more than I can say. But I have Bipolar so my mood sits at 100 different places and few of them are in the “normal” range. The psychiatrist I had been seeing last year had asked me to go back and see her when I moved out of depression (which for me can often last for months) and went into Hypo-Mania.
When I saw my GP about this, all she said was that I was Manic. I tried explaining that I knew I wasn’t Manic, but the Psychiatrist had wanted to see me when I was Hypo-Manic, which I was. I even had lists of things I had done that other people had been pointing out to me, because, quite frankly, I tend to be oblivious to my mishaps! But no I was just happy to her and potentially needing to come off my anti-depressant.
I saw her on three separate occasions asking for a referral back into mental health services before i ended up hitting full mania, having a really nasty psychotic episode and ending up in hospital. Where I was asked why I didn’t get referred back sooner…?!
I’m now having seen a new psychiatrist on a new medication to stabilise my mood and to manage my psychosis. I’m also being kept on my anti-depressant!
Yesterday I needed to see my GP for my prescription review. She asked what was happening with my anti-depressant now I was on the mood stabiliser and was stunned they were keeping me on it, more stunned they had decided to add a new one when I hit depression again (welcome to Bipolar Dr!)
She then asked me how my mood was, and I said it was better but I was rapid cycling, and the mood swings were really bad, that I would probably need to speak to my psychiatrist about increasing the dose on my mood stabiliser a bit. Her response was, its not depression, it’s just hormones.
I mean, seriously? I know as a woman my hormones contribute to my moods, but rapid cycling is something different. I may not have been depressed at that moment but about three times per day I’m suicidally depressed, then I’m so hyperactive and happy I can’t keep up with myself. I can’t make decisions about going out or doing something without changing my mind ten minutes later because the thought terrifies me now. That is not hormones!
At the moment I am still under a care co-ordinator and can speak with him about it all, but what worries me is getting back to this black and white world once this recovery is over. For however long it lasts and I’m doing ok that is great. But once I’m starting to get sick again I have to traverse this GP minefield of black and white to get back into mental health services, while I am sick and that terrifies me.
Even worse is knowing I am not alone, this problem is universal across this country, meaning at some point our GP’s have to start trusting That we know our illnesses, or crisis services are going to implode!
There is a really useful guide on speaking to your GP about your mental health which is available from The Mental Health Foundation.