Psychiatrist Appt- Should I Go?

I am still at this point contemplating whether or not I want to cancel my next scheduled appointment with Dr T. The practice is closed from 20 December 2010 ’til 4 January 2011 which means I have to make a decision in the next couple of days. There are a few things I’d like to spend my money on. A cancellation fee for less than 24 hours notice is not one of them. She’s fit me in right at the open of their new year, a lunchtime appointment for 4th of January at 12 noon.  I would feel slightly guilty cancelling when she’s squeezed me in like that, but cynical me is thinking, ‘Err, she’s only fit you in because why wouldn’t you forego your lunch break for an extra three hundred over dollars in your pocket?!’

I do have reasons for and against seeing her again.

When I’ve had abominable meetings with professionals, my distress will at times prompt me to act on impulse. Especially when it is gathered they intend on ceasing treatment with me or indeed take action in doing so. These past couple of weeks have been turbulent to say the least. The first blow came when it was implied Dr T may stop seeing me, leading me to take an overdose of Lexapro. Come two weeks later, terminating therapy with my psychologist has hit me harder than I anticipated, despite me being the one to initiate the end. These past few days have seen me fighting strong urges to overdose again, with death crowding my mind. I’m afraid going and leaving Dr T’s office for the last time may bring about a repeat episode. By not going, I would be protecting myself from the hurt of leaving with the knowledge that yet another mental health professional was unable to do anything for me.

Another reason I’m loathe to seeing her again is because I do not appreciate the one thing giving me hope for the future being stomped upon. Honest or not, being told I’m likely to struggle in Occupational Therapy next year when it is the one good thing I have going in my life, does not give me much incentive to see another year through.

So what are the reasons for seeing her then?

She could refer me to a clinical psychologist, a different one this time. With any luck, it may be third time lucky. With my luck, doubtful, but who knows…but it would save me the hassle of starting from absolute scratch in finding help for myself. If I do attend my appointment, I’ve decided I will accept her offer of a referral to a psychologist should she offer, but I’m not going to push it. If she doesn’t think I need support, then that’s just fine, she’s not the first person to have thought along those lines…

I am wondering though, does therapy really help? I’m not asking because I feel let down, I’m not asking because I’m hurt, I am genuinely doubting therapy will aid me to recovery. CBT? Tried that. Mindfulness? Tried that. Psychotherapy? Tried that. What’s next? The way I see it, I’m always going to be chronically suicidal. I’m always going to have trouble dealing with strong emotions. I’m always going to avoid, avoid, avoid my problems. Can therapy really fix all that, and more? Do people actually recover by participating in therapy? The concept seems foreign to me at the moment.

My last appointment, Dr T asked me what I wanted from treatment. My answer? “I don’t know.” I don’t know what I want, which doesn’t give much to work on in terms of what I want to achieve from treatment. Maybe I’m just not ready to work on my issues? But then again, when will I ever be?

Perhaps I should employ Differently’s method – it does seem far lass complicated to make a decision that way.

21 thoughts on “Psychiatrist Appt- Should I Go?

  1. ‘ I am genuinely doubting therapy will aid me to recovery. CBT? Tried that. Mindfulness? Tried that. Psychotherapy? Tried that. What’s next? The way I see it, I’m always going to be chronically suicidal.’

    I don’t mean to sound patronising, but whilst I know it seems like a lot to you, you have actually had really little in the way of treatment, and there are so many other options out there for you. You have also only tried one medication, and whilst I don’t believe medication is the answer, I do believe that it can help. I do think seeing another therapist would be a good idea, but whether now is the right time for that for you or not I don’t know. But there are lots of other therapeutic options, and then some things you have already tried, which can be absolutely useless when you are working with the wrong practitioner, but seeing someone else can make it a completely different experience. Again, I don’t want to sound patronising, but you are so young, and you have been in the system such a short time (in relative terms) and have had very disjointed treatment even then – sessions not often enough, no sustained length of period with any one therapist etc. Please do not write yourself off yet. There is still so much that you can try. Don’t give up.
    xxx

  2. I’m also in a real crappy place right now, but I think it’s due to the fact that I’m out of therapy. It seems to help me but you need to find someone you like and trust. It took me years to do this, I hope you make a descision that works for you.

  3. im currently selected for theropy but im still waiting i have been ok for the the last 3 mounth ive hit no black holes so far but theropy i belive will just nack my head i was hit hard when i left my support with my CPN problem being she had a soft spot for me i to am thinking of theropy wehter i want to go or not havent been in hospital for about 5 mounth so im doing ok

  4. Hey i think you should keep your appointment. On reading your blog i realise how different things are for you where you are to here in the UK. our psychiatrists are free unless you go private. I suppose the down side to this is the waiting lists. Luckily the waiting list for a psychiatrist is about 3 weeks but for a psychologist it is much longer. I have currently waited 18 months to see a psychologist and iv heard that the psychologists in my area have left and they are struggling to find more so the waiting goes on.
    When i was younger i wanted to be an occupational therapist but i didnt get the right qualifications. I hope you do well.

    • Funny, even when we see a psychiatrist privately and we pay for it, there is still about a 2 month waiting period before the first appt.. 18 months for a psychologist is absolutely appalling though. x

      • I was a really unusual case. I saw my psychologist within four months, but Psychiatry pissed and pissed and pissed about so it ended up being six to see them, and then it was only with an additional referral from the psychologist himself.

        But I was lucky vis a vis Psychology (well, I wasn’t in the end, but that aside). When I was referred for cognitive behavioural “therapy” several years ago I waited over a year to get assessed, another six months to even hear the result of that, another – what? – three or four months to be offered group “therapy”, which I couldn’t attend as it clashed with work meaning I was referred for individual therapy. I am still waiting to hear about this referral four years later!

        Ah, the joys of the NHS. If they weren’t seriously playing with people’s lives it’d be like something out of an 18th century comedy of errors.

  5. I wouldn’t like to give you advice because I think things like this are really important & you should do what feels right for you. But I think it would be sad if you missed out on an opportunity for help. I agree with Bippidee that there are lots of different things you can try – & all therapists work in a slightly different way.

    I hope things go well re: studying Occupational Therapy. That’s a great goal to have! I’m not sure how things work where you live regarding support for mental health problems while studying, but maybe it is something you can look into to reassure yourself?

    Thinking of you,

    outwardly x

  6. I honestly am torn. Therapy is ESSENTIAL to me but I know different things work for different people. If you feel as if after a session things go poorly and then you don’t have the support because of the holidays…I think it might be better to avoid that scenario until you have the support.

    xoxo
    -Lisa

  7. Please please don’t push your P-doc away before you have some other supports in place. I was lucky, but I know from others experiences and reading that it often takes several times to find a therapist that you really mesh with – a good “fit” if you will.

    I agree with Bip that there are other options out there. There lots of difference meds and different therapists.

    I’m concerned because I know what it’s like to have this fatalistic outlook on situations and just want to push everyone away so I can have a *reason* to OD. It is a nasty trap to get yourself into.

    (((((BtF)))))

  8. Hey, I agree that there are many options out there for you and you just haven’t found the right therapist or medication. I have been on many medication and I’ve been seeking help in some way for 17 years. I had one doctor for 13 of those years and decide to find another one. I have the one now that was my treating doctor in hospital. I think you should keep your appointment too. I know it’s hard but maybe you could ask your psychiatrist for a new referal for another psychologist. I think you should have another try. Believe me ODing is not the answer. I did that for years and it only made it harder for me to get help because the professionals would get sick of me doing that and didn’t think they could help me. I found they responded better when I called the mental health line in my local hospital and talked it out before I did anything. They may ask you to come in for an assessment and that could lead to a hospital admission if you need it. There is so much out there. You are too important, remember that each OD is damaging your body.
    *hugs*
    Sarah

    • Thanks Sarah. Can I ask what happens when you call the mental health line? What do they ask and the such? I’ve no idea what to do when I’m suicidal and close to ODing- I’ve tried ringing Kids Help Line a couple of times this past week, but lost my nerve and hung up without saying a word. What do you say to them when you ring up?

  9. “Do people actually recover by participating in therapy? The concept seems foreign to me at the moment.”

    Therapy does work, but you have to find what works for you. It’s similar to finding the right combination of medications. There’s so many different types of therapies out there–don’t give up just because the one’s you have tried haven’t worked. As for the therapy techniques you have tried, how long did you try them for? Did you give them a chance to work? Our thoughts and belief systems are deeply ingrained–it can take years and years for change to occur. It’s slow. But look back at your time in therapy; I’m sure you can see some change.

    “I’m always going to be chronically suicidal. I’m always going to have trouble dealing with strong emotions. I’m always going to avoid, avoid, avoid my problems.”

    Those deep-seeded beliefs need to be questioned. I don’t know all the details about what’s happening in your therapy/pdoc sessions, but when I start questioning whether I want to quit or not, it’s usually when therapy gets hard for me. It’s usually when my beliefs get pushed up against, and I push right back. Regardless of whether you find a new therapist and/or quit with your pdoc, you need to find support in some other way and continue to question those irrational beliefs.

    It’s learned behavior. You didn’t always feel suicidal, did you? You didn’t always have to deal with such strong emotions, did you? You didn’t always avoid your problems, did you? You developed those beliefs/behaviors/thought patterns over a number of years, and you can un-learn/un-develop them as well. You just have to give it time.

    In short, go to your appointment.

  10. Hi,

    Yes, go. There is no price to high for the sake of your health, and if it means tou have to admit to having less dosh this xmas, maybe friends and family will take your comittment to your need for recovery more seriously. But don’t do it for them: you cannot wander through life with thoughts of death Cassie. You have to want to be better and happier in yourself FOR yourself. No-one can do this bit for you. Christmas is a hard time of year for many people. I do not think it is wise to totally cut yourself off from all professional support right now. Equally you have to start talking honestly to the buggers to let them help you my dear. You need that opportunity Cass. Let yourself get well.

    Why don’t you cook down some of the things you tell us lot about and give that to the quack to read. There is no way that any of us are in denial that you need help, but because you find it difficult to express verbally due to self consciousness, it might be easier to let your psychiatrist read what bothers you, rather than you feeling tge pressure of initiating a discussion. Jyst a suggestion. Please stop feeling worried about what this psychiatrist thinks about you: they probably have far more freaky types on their books than you are (no minimising of your condition intended here). Be certain in that you aren’t a horrid person for thinking the things you do. You are however ill, and need a lot of help. I wish I could come with you and speak on your behalf to get you going so you aren’t afraid of saying how you feel. 🙂

    I know you’ll do what’s right for you. Just don’t od like that again, or things bigger than you may overtake you while you are too vulnerable to influence choices of your own volition.

    Big hugs, love and bravery,

    X Clarissa X

  11. does therapy work? well, yeh it does i think anyway. But it relies on the fact that you are wanting and willig ti make difficult changes. YOu can want to get better, but being ready to commit to changing is a completely different thing. Like, yeh you need a therapist you get along with-but the end of the day, its what you do that matters.

    Personally i hate mindfullness and all that jazz, it just gets on my nerves, but other aspects of dbt really help people-like distress tolerance, maybe have a look at that?

    love vic xxxx

  12. I’d just echo the others really. I know it’s a frustrating pain in the hole, but what have you really got to lose by going? And re: therapy, CBT and mindfulness are both a patronising pile of wank in my view, and ‘psychotherapy’ is such a varied concept. There are so many different models of psychotherapy out there, and it’s about finding which one works best for you. More importantly, it’s about finding the therapist that works best for you. Whilst I don’t think the type of therapy is unimportant, the relationship is really the key to making the process work.

    The public sector health services don’t exactly make this easy – certainly here in the UK you’re stuck with who you get unless you have some sort of problem with their practice and are willing to return to a waiting list. I’m not sure how it runs in Oz, but could you discuss the matter with the psychiatrist? Ask for a referral to someone you haven’t seen before?

    I think it was Bip that said also that medication, whilst by no means a cure, is a help for many people. In my experience, and from that which I have heard of others’, this really is a trial and error thing. Some work wonderfully for some people, others don’t, blah blah blah. I really think it’s worth trying another few and seeing how it goes.

    Note – I can’t ever see myself not being chronically suicidal either. It’s so far removed from everything in all my living memory that I can barely comprehend that such a state exists. However, I do think that therapy and/or medication – when applied in an individually appropriate fashion -can reduce the intensity of it, and can allow you to co-exist with it without constantly feeling it as a compulsion.

    Hang in there, Cassie. We’re all with you in this.

    Hugs and love

    Pan xxx

  13. I can’t answer whether you should or shouldn’t go – that’s your decision to make and I know that it’s a difficult one with all the pros and cons swimming around, without adding more confusion. I do hope though that whichever decision you make is made for the right reasons, and not to hurt yourself, or send a message, or indeed to keep others happy. There are plenty of people who have already commented/advised though, and are wiser than me.

    There was one part of your post that I wanted to comment in more detail on:

    “I’ve decided I will accept her offer of a referral to a psychologist should she offer, but I’m not going to push it.”

    I wonder if you are trying to test your psychiatrist is some way – to see if she cares, or thinks you are “worth” helping. Or perhaps sub-consciously it’s a way to gauge your self-worth – if you deserve help then it’ll be offered automatically. One thing I do know though is that doctors aren’t psychic and won’t know that you’re perhaps hoping for something unless you tell them, they can’t tell if you’re placing your entire self-worth and recover on them guessing the right course of action. I’d hate to see you lose out on opportunities to help and support because you didn’t ask. I’d also hate to see you further hurt because the psychiatrist didn’t “pass”.

    Also psychiatrists tend to respond more positively if they see you are actively engaging and looking for support, rather than wait for them to come up with suggestions it shows them that you do indeed want help and to get better.

    Whatever you decide I think you have some difficult decisions ahead of you, about what you want in life, what you want from treatment, and how you’re going to go about getting what you need.

    Take care,
    Differently

    PS Thanks for the link – it’s a guaranteed decision maker!

  14. I wouldn’t give up on therapy just yet. I think therapy is as much method (CBT, DBT, etc.) as it is having a relationship with someone. And those relationships don’t always work on the first try. I’ve seen several, several therapists and psychiatrists, and I think I may have stumbled on a combination that works for me. I think it’s also important to remember that if someone or something doesn’t work out it doesn’t mean that everything won’t work.

    Wishing you well,
    NOS

  15. Sorry for the late reply but when you call you say I’m feeling suicidal, you actually be very blunt about how you are feeling and usually if you are feeling suicidal that will ask you to come in for an assessment and you will talk to a nurse and then a doctor. I know it’s hard but it’s really important when you feel like that. They respond much better if you ring before you OD or self harm, because it shows them that you need help and you are trying to get help. If you need any more info, you can email me at sabby120@netspace.net.au. Please do email me if you want to ask anything else.
    *hugs*
    Sarah

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