Last psych appt

Yesterday afternoon I was seen by the doctors, and my community nurse/case manager also sat in on the meeting. I was asked whether I wanted to be discharged that day or the next, I chose to be discharged that afternoon. Though I still wasn’t great, I at least felt a little better than when I came in and I guess there wasn’t much point in staying any longer. We also discussed my medication, I still remain on 200mg of Pristiq and 50mg of Seroquel XR but have also commenced on 450mg of lithium as a mood stabiliser. It was either lithium or sodium valproate, but according to the doctor the latter has a greater chance of hair loss, weight gain and sedation occurring as side effects.

Spent this morning in tears as I emailed a uni lecturer about something totally unrelated, and in her reply she again brought up an incident last year which resulted in a general miscounduct and me getting into a whole load of trouble. It feels awful that I continue to have that held against me by a lecturer I will again have this semester despite me completing the disciplinary action that was dealt to me and having damn well learnt my lesson. I then attended the last session with my psychologist at the eating disorders program in which I cried some more both talking about this situation with my uni lecturer, and then saying I felt “A bit sad,” when she asked me how I was feeling about it being the last session. It’s the first time I’ve ever admitted to feeling anything other than indifference towards any psychologist I’ve seen as I’ve always been ashamed of feeling attached to or having any emotional connection to others, especially when it’s not reciprocated. Though it wasn’t easy attending knowing it’s my last appointment, I’m glad I did and handled it much better than I did the last time I had to change psychologists. It’s quite embarrassing when I remember how I spent the second last session crying, refused to come back for another session or to see the psychologist I was being transferred to, overdosed and ended up in hospital thus never having a proper concluding session, then wrote him an angry email about how useless therapy is.

I’m starting DBT next week with the group component running on Tuesdays and my first individual therapy session is on Thursday. I’m really nervous about DBT and how full on and strict it seems. At the end of my assessment sessions for DBT I was given a contract and asked to sign it, with rules such as not being allowed to miss a certain number of group or individual sessions, having to complete the homework, rules around interactions with other clients and your therapist not having contact with you for 24 hours if you’ve self harmed. I also have a lot of ambivalence about whether I really do want to change and to stop self harming or not, and so much fear when I think about doing so. Plus I’m hesitant about starting all over again with yet another psychologist knowing that if I do develop a connection it will feel like another loss when we have to cease therapy, especially after weekly appointments for a year. 

Pdoc appt at A St

I had an outpatient appointment scheduled yesterday with the psychiatrist registrar who was my doctor whilst I was inpatient. Unlike a year ago where I cancelled my follow up appointment after being discharged from M St, I actually did attend this time. It was a little disheartening to be back in the A St outpatients department, when I was prepared a year ago to never have to step back in there again. It was a short appointment. He asked whether I’d ended up getting 25mg quetiapine to use as PRN, to which I replied he didn’t, as I’d said before that it makes me too drowsy. He then asked what other medications I’ve had before as PRN. I told him I’ve had lorazepam before which at least doesn’t make me drowsy, but it seems as though he doesn’t want to give me benzos. He suggested propranolol instead which he explained is a beta blocker but can be used for anxiety. I’m a bit skeptical about using a beta blocker for anxiety, but I guess I’ll see…

He’s told me that even though I could probably just be managed by a GP, apparently E St (group program) require that clients are also be seen as an outpatient by someone at A St. It is for that reason that he said I will be referred to a community registrar, who will probably see me every 2-3 months. Well why even bother then, if as he said, I can just be seen by a GP? I don’t want to be given a psychiatrist appointment if they don’t feel like I need it, more that they are obligated to if I am to attend groups at E St. I’m beginning to feel that familiar temptation to sever all contact with mental health services again to save everyone the bother… Even though I know I’m being hypersensitive to this, being told I don’t really need to see a psychiatrist there feels a bit like rejection and my instinctive reaction to this is to reject their services first. Dammit brain, stop being so BPD 😦

Acupuncture

I went out to lunch today with my family and relatives. My auntie reported to us that my two cousins have been getting acupuncture, one to treat his acne and the other to treat her eczema. She then informed my mother and I that acupuncture can also be used to treat depression. “Oh,” I said, and didn’t comment further. “Are you still taking medication?” my aunt asked. “Yes,” I confirmed. And I don’t feel the need to ditch my medication for a round of acupuncture either. If it ain’t broken, don’t fix it I say. I’ll admit too that I’m a wuss and the idea of having needles stuck in me is very unappealing.

I remember at the beginning I was quite resistant to the idea of taking medication. However, I’ve now accepted that it probably does help somewhat, and it’s now just a part of my daily routine. Two tablets in the morning, one tablet at night.

I believe in Western medicine and there is proof in the clinical trials that have been conducted. I did study pharmacy at one point in my life after all. Although I am Chinese, I guess I’m a bad one, as I remain dubious about the efficacy of alternate therapies such as acupuncture. But hey, if my auntie and her children want to try acupuncture, all power to them. It will be interesting to see whether they notice an improvement. Meanwhile I will continue with my medication regimen.

Content

It’s been over a week now that I’ve moved out, and I’m beginning to settle in and even enjoy my new found freedom and independence. At first there were bumps, as I was pushed out of my comfort zone. I missed my home, where I had spent the majority of my life. There were tears as I wondered whether I could really cope and even contemplated picking up and going back. But now I’m glad I took the initiative to escape a situation I did not want to be in.

Moving to a new area, I went to see a new GP close by. He issued me the scripts I asked for; Pristiq and Seroquel, with enough repeats to last six months. Prior to this I had still been having only a week’s worth of medication dispensed to me at a time. Though it may be a little deceitful of me not to disclose this to the GP, I was tired of having to go to the pharmacy every week. Besides, I haven’t overdosed in 9 months and if I really wanted to, I could anyway. And for the moment, I don’t. Things are going well. I’ve finally moved out. I passed all my units at uni and will be going into my third year of occupational therapy in 2013. I have friends, and I even have a boyfriend now. The guy I’d been dating has become my boyfriend, in fact my first at the age of 21. And I too am his first, at the age of 25. For now, I am rather content.

Busy volunteering, studying & being a mental

Life has been rather busy up until this point. Doing things I want to be doing, as well as things I not so much want to be doing. Among that which I want to be doing, I attended a youth mental health roundtable a week ago. The first half of the day was spent providing feedback on the National Report Card on Mental Health. The group of young people in the room were great, all had such a wealth of experience and ideas to share and it was so inspiring to be part of this discussion on mental health. A range of issues were brought up including mental health services, mental health in Aboriginal and rural communities, mental health in schools, CALD issues, and others. The second half of the day was dedicated to providing feedback on the new youth mental health service that is currently in the process of being built. This new services is aimed at young people who are at ultra high risk of psychosis or emerging Borderline Personality Disorder. There were a couple of questions I brought up, BPD being something I feel rather strongly about given the prejudice that is often held against those with BPD, even when they’re in a vast amount of emotional pain and in need of support. One of my questions was regarding the six month limitation on this service. I wanted to know how six months is adequate for an illness such as BPD which often has a lot of underlying issues, and how they were going to deal with the issues of rejection and abandonment when the relationship is terminated at the conclusion of those six months. The answer I got is that their service is a starting point before going onto another service is required, which is fair enough, and that often if you’re clear with the young person from the beginning that at the end of six months they’ll have to move on, it will help so that the person doesn’t feel rejected. Is this usually the case? I don’t know. But I know for me, it’s part of the reason why I’m reluctant to see psychologists again. Because it just hurts too much when I’ve started to trust someone, they too leave.

Yesterday I was there while a conversation took place between the people who are setting up this new service. They were trying to work out how exactly ’emerging’ BPD is going to be defined for eligibility for their service. Another eligibility criteria is that someone has to have had a decline in their functioning. I asked whether someone who say self harms and are showing signs of BPD but are functioning fine in work/school/uni, whether they’d access this service. And the answer was no, they’d probably be accessing another service. It was interesting to me because there are definitions of mental illness that say it must impact on a person’s functioning. When I look at myself however, my daily functioning is very rarely impacted. I have never missed a lab class of uni due to feeling too depressed or anxious. When I’ve made a commitment to my volunteer work or going out with friends, I don’t think I’ve ever bailed because I was feeling too emotionally awful or anxious. The only time I have failed to attend these things is when I’ve been in hospital. Despite ending up in hospital at least once every semester that I’ve studied OT, I have not failed any classes and passed them all the first time round. So based on functioning, you could say I don’t have any serious mental health issues at all. But it’s my coping mechanisms and emotional reactions that get the better of me. Because things that most people are able to cope with in everyday life, I react by having a meltdown and overdosing. So it’s like functioning, functioning, functioning….then have a meltdown and crisis.

I finished my one and last exam on Wednesday. Though marks haven’t been released yet, I’m almost entirely confident I passed all four units. I’m thrilled because in three semesters of OT I’ve managed to pass three semester’s worth of units, whereas when I was studying pharmacy, in three semesters I hadn’t even managed to pass a full semester’s worth of units. Not to mention I’ve been inpatient in psych wards once per semester for all three semesters too during my OT course. I also went out with a group of my OT friends for lunch after we finished our exam, the first time ever I’ve gone out with friends from OT. Yes, after 1.5 years of studying in this course I finally have an actual group of friends that I belong to.

I’ve still been collecting my meds weekly from the pharmacy. An annoyance when I have to stop by on my way home from Uni on Fridays, an even bigger annoyance when I don’t have uni and have to go especially just to pick up meds. Using public transport. To make things worse, a girl I went to school with who was in my year and so we know each other, works at the pharmacy. I see her every Friday when I go get my weekly meds supply. Awkward. And so today being Friday, I went and was informed my box of Seroquel has run out and they’ll have to dispense a new script for me. Fine. Then the pharmacist asks me, rather loudly, “WFH, has the doctor lowered your dose of SEROQUEL?” Just announce to the whole pharmacy that I’m a mental, that’s fine… Turns our my GP faxed a script for two 25mg Seroquel tablets per night which I used to be on, instead of the correct one 50mg Seroquel XR tablet a night which I’ve been on since they changed it when I was in hospital. So it’s back to the GP I have to go, and there goes my plan to avoid her out the window. Not too keen to answer her probable questions about my not wanting to see the psychologist at A St. My answer if she asks what I plan to do in terms of getting help? Nothing. It’s my life and I choose and plan to do nothing.

I’m on break until Uni starts up again on July 9th and I have mixed feelings about this break. On one hand, it’s great to not have to do any study or uni work. On the other hand, it gives me quite a bit of spare time, too much spare time to dwell on how lonely I feel. It’s hard when I see people going out with their friends and I’m alone at home, reminded that I don’t really have people to hang out with. It feels pretty awful when it seems like everyone else has these wonderful close friendships and all these people to spend time with, and I don’t. I am headed to Melbourne and Sydney in a week though. Melbourne just for a couple of days to holiday as I’ve never been before, and Sydney both for a bit of a holiday and the Young Minds Conference, which I obtained a free ticket to.

Uncle’s adverse effects from Seroquel

It feels kinda odd when I’m not the one in the family who’s ended up in the psych ward yet again. Instead, this time it’s my uncle and he’s been in hospital for about one and a half weeks now. He’s in A St in fact, where I was attending outpatient psychologist appointments before I decided no more. He’d managed to stay out for a long time- in fact his last psych ward hospitalisation was about fifteen years ago. I’m not quite sure what’s worse, ending up in hospital every few months for the past couple of years, or being ill for so long that fifteen years later you end up hospitalised again.

I’ve been on Seroquel since November last year, albeit a low dose of 50mg Seroquel XR a day. It’s rather scary though that it’s the very reason for my uncle ending up in hospital. He experiences psychosis and was on Zyprexa before his GP recently changed him to Seroquel. 300mg and he was experiencing adverse effects. Tremors and shaking and urinary retention. Upon contacting his GP, he was told to go to the ED and from there, was transferred to psych. Even now, over a week after stopping the Seroquel, he’s still experiencing tremors and has an indwelling catheter because of the urinary retention.

I’m lucky that I’ve never experienced any severe side effects from the medications I’ve been on, which includes Lexapro, Zoloft, Pristiq, Seroquel, temazepam and lorazepam. But hearing about my uncle, it’s definitely something to be cautious of. I hope he’s better soon.

Met K

I met with K, the replacement psychologist for I, this afternoon. She acknowledged that yes, she is temporary while the psychologist I am meant to be seeing is away, so I may not want to go into the deep stuff when I won’t have the opportunity to get to trust her and see her for a longer period of time. And so we talked about general and some rather light hearted stuff. Stuff which included my cultural background, what I do when I’m not studying, where I did my prac placements, countries I’ve visited and would like to visit, and my cute little Maltese-shihtzu puppy. She also explained that when people are discharged from hospital they usually offer a psychiatrist appointment as follow up. “Psychiatrists can have some helpful things,” she said, which I struggled not to laugh at, but was told that ultimately it’s my choice whether I go or not. I see her again in a fortnight.

Later on in the afternoon I called to cancel the psychiatrist appointment meant for next Wednesday. “What’s the reason for cancelling?” I was asked by the receptionist. “Ummm….” I stalled, not expecting to have been asked. “Just so I can put it in the computer,” I was told. “Umm…I just don’t need to see him,” I answered. It’s not the principle of seeing a psychiatrist I object to, it’s that I’ve met him once and felt uncomfortable and he’s not someone I’m able to talk to. There have been a couple of psychiatrists I’ve found okay and would more willingly attend an appointment with. Unfortunately he isn’t one of them. While I was at A St to see K today, I saw that my psychiatrist whilst I was in hospital in October/November last year is now one of the outpatient psychiatrists at A St. See he was okay, why couldn’t I have been allocated to him? Instead I get allocated to the one I don’t feel comfortable with. Sigh.

Dr L provided me with new scripts today and typed up a letter, instructing me to hand it to the pharmacist. The contents of the letter basically asked the pharmacist to only dispense my medications weekly. That’s a big assumption to make, that I’d willingly hand over the letter to the pharmacist myself. Was very tempted to just not do so- how would Dr L know? In the end I did. I’d like to say it was my integrity and honesty, but really, it’s just me being afraid of the consequences I may have to face if I don’t and I’m found out. “It’s a good excuse to go shopping!” remarked Dr L of the weekly trips I will now have to make to this shopping centre. Except hey, I don’t have spare money to spend on frivolous things after spending $123 on Pristiq and Seroquel today. Yay!

Tomorrow I’m meeting up with M for lunch whom I first met when we were both inpatient in Oct/Nov. A social meet up with a friend? Well that’s something new. According to my diary records, it’s only been since February that I haven’t met up with friends. It feels a lot longer than that though 😦

Being made to get help again

It seems like I’m back on the ‘getting help’ bandwagon again. Huh. So much for my resolve to be rid of all services.

Received a call from the GP office this morning. 8:15am. Yep, not like I was asleep or anything… Was told that Dr L wants to see me and so I agreed to come in this morning. It seems as though she’s been bombarded with all these letters about me; from F Hospital telling her that I overdosed, from B Hospital telling her I’d recently been discharged, from the psychologist at A St telling her I’ve declined to see her, and another one from A St advising her how my medications should be managed.

Was asked by Dr L what I want to do if I don’t want to see anyone from A St. Could only shrug and shed some tears in response. She said she can’t comprehend being discharged from hospital following an overdose, slipping back into life where everything is the same, and deciding to accept no help whatsoever. And so she’s making me go see a psychologist again. Boo. Was told to either choose to go see the one at A St or be referred to a private one again, and come back with my decision in a week. I’m also about to become best buds with my local pharmacist, as apparently A St has advised her that I’m only to have weekly prescriptions. Yay, I can’t wait to become known to the pharmacy as the mental who can’t be trusted with more than a week’s worth of medication. FML. I’d complain about how humiliating it is, but then I’d probably get some smart arse commenting that I only have myself to blame for getting into this situation.

This afternoon I then received a call from K, the psychologist at A St. She told me she didn’t feel right leaving me be without any support, especially given my most recent hospital admission. I admitted I was upset and angry when I cancelled the appointment with her and “I guess” I could come in and see how things go. Not to mention Dr L is making me see someone anyway. Sigh. May as well go to the psychologist that’s free…

Both times I’ve spoken to K on the phone she’s sounded lovely. And that’s partly what scares me. I know she’s only temporary until I, the regular psychologist, comes back from holidays.  I’m afraid of getting to like her only to have her leave, like so many others before her. Knowing it’s unavoidable doesn’t make it hurt any less. I don’t have anyone in my life I can talk to about deep and emotional matters and it’s just so painful when that one person I do have disappears. It leaves me feeling all the more lost and alone. 😦

It seems as though today is mental health professional “Let’s contact WFH day” and in the spirit of it all, D also emailed me back. It basically said that he appreciates what I’m saying and is still happy to attend an appointment with me should I decide to see a psychologist after all. Feeling bad about the “bugger off and screw services” email I sent him, I apologised, explained I was upset and irate when I wrote it, and informed him I’m going to see K after all, though I declined his offer to attend with me. I learnt that people are more likely and willing to respond to a civil email. Who could’ve known…! Ten minutes after I sent it off, I received a reply back telling me not to worry, he didn’t take it personally as he thought I was probably just upset when I wrote it, and wished me all the best. Well that’s that then with clinical psychologist #4. Surely if it doesn’t work out with #5 and #6, I’m allowed to quit then…?

Driving Permit Conditions

A couple of weeks ago when I went to get my driving Learner’s Permit renewed, I was told I had to get a medical done due to ticking the ‘Depression’ box and listing my medications Pristiq and Seroquel down. Went to see my GP, got the form filled out and I went back to the Licencing Centre this afternoon. Got my Learner’s Permit and noted two new ‘Permit Conditions’ listed in addition to the one I already had regarding wearing glasses/contacts while driving. “Medical certificate before renewal on 28/03/2015” one was. That’s three years away, so fine, whatever. The next one however made me laugh. “Take medication as prescribed by medical practitioner.” Lol umm, what? First they question my fitness to drive because of the medication I take. And now my Learner’s Permit states I have to take my meds.

I understand why that condition may be imposed on someone that has, say, epilepsy. Having a seizure whilst driving because you haven’t taken your medication, yeah, pretty dangerous. But I don’t quite see the relevance of the Department of Transport directing me that I must take my SNRI antidepressant medication and atypical antipsychotic daily as prescribed. And really, how are they going to know? As S tweeted to me, she’d find it quite amusing if a police officer pulled her over and asked whether she’s been taking her medication or not. So would I.

Nurses not being nurses

I think some of the nurses here forget that their job title is actually ‘nurse’ and not ‘prison officer’. In the six days I’ve been here I’ve only had one nice nurse who’s taken the time to come and have a chat with me. Otherwise, all they seem to do is their checks at the directed intervals.

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For the past three days I’ve been given 100mg of the Pristiq instead of my usual 200mg. “We can’t increase it all at once, we have to slowly build it up,” I was told by the nurse yesterday morning. “But I usually have 200mg,” I said, confused as to why they have to gradually increase it when I’d been having 200mg all along. Another nurse then comes up close and says condescendingly, “Yes, but you overdosed on the higher dose.” See that’s what you get for misusing your medication and overdosing. I took my lone pink tablet and walked away in irritation.

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My hands were sticky from breakfast so I went to the bathroom to wash them before walking to my bedroom. I then hear my name being called by a nurse behind me. “Did you swallow the tablet?” “Yes,” I replied. “I was following you and saw you go in the bathroom. Did you spit out your tablet?” “No,” I exclaimed indignantly. After a few more exchanges he told me “I believe you, but don’t do something like that.” “I didn’t!” I protested before closing the door in his face with disgust. I do not appreciate being treated like a child and being accused of something I didn’t do. Why the hell would I want to give myself withdrawals??!!!

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The attitude of the nurses here may be too because MSC is more acute compared to 2K where I was in October/November last year. As a nurse over there said, it’s the least nutty of them in this city. Whereas there were only two patients who had stayed longer than the four weeks I was inpatient last year, many of the patients have been here for months, with the longest I’ve heard so far being eight months. Goodness, you’d be so institutionalised. Though the facilities are better here, with the single rooms, therapy room and all, I think I’d rather be in 2K. There are a few nurses that I like and and a greater proportion of them do do what they’re meant to do, which is nurse.