This is not your fault (also about nhs budget cuts)

Saw my doctor this morning. Appointments usually last 5 minutes, it’s a busy city surgery… this lasted 25 minutes, by the end I was just wanting to escape.

Had a very frank chat… starting off with showing him a note I pre-prepared as I don’t trust myself to be honest, to have the courage to not play things down. In the note mentioned intense periods of anger, anxiety and apathy (or dumb stupor likeness)… I mentioned other stuff that I’m not 100% comfortable mentioning here… but basically about confliction, intent, stupidity and courage.

Wasn’t going to show him the letter at all… but the wife got a hold of it last night and had warned that if I didn’t show it to him, she’d be booking an appointment and would tell him herself -.-

Told him that I was embarrassed and ashamed, that I was hating myself for stupid thoughts and impulses… that I was able to logically see how the deep want to do certain things would impact… the consequences: if I do A… B,C and D could happen. That I hated how my depression was impacting on others… on my wife… how I was doing at work… that I was pathetic, that I saw this all as just pointless attention seeking and I want it all to stop, want to just get on with my life without being so selfish and self centered.

It was this point that he just said “this is not your fault” “depression is not a choice”… I argued with him but he was adamant… can’t for the life of me remember much of that part.. probably me being a sceptic and ignoring reason. I do remember him saying I wasn’t stupid… that I would be stupid if I gave in, and that I haven’t done that.

He asked what the probability of me doing something was. Said that while thinking logically… the probability was low… but that I wasn’t always thinking logically, that to do something would most likely be impulsive and without thought. He said that if these urges come on I should see him… I replied that if I was in that position, I wouldn’t be telling anyone, I’d be embarrassed and angry… that showing him the letter was pathetic in itself. He reiterated that I had to let him know.

He wanted to refer me to the crisis team and I reminded him that they’d already shrugged me off 5 months back. That they wouldn’t help me as I believe I’m in that limbo situation… my self control is preventing me from doing anything that would warrant intervention.

He relented to this and actually agreed… said that budget cuts had made it so only those in extreme need of help are being helped.. whereas people like me are being left to just fend for ourselves… that on reflection he thought they prob say no again and that would be counter productive.

He also expressed disappointment that not once has my T (private) been in contact with him to give an update on how things are… said he’d never heard of her and though he wasn’t intending to be libellous, was curious of her credentials. Asked me how the sessions have been going and I said that it’s a mixed bag… some parts have been very helpful, other parts frustrate me… and that the down time in between (I see her every 2 weeks) can be hard going.

Has asked me to start IAPT sessions alongside… that it would be helpful for him to have an ongoing observation from those sessions on what help should be given.

Reiterated that I had to see him if things go to crap and that at the very least to see him again in 2 weeks.

Oh, probably an amusing anecdote:

Was chatting to the wife last night about how frustrated I was... that I was feeling terrible for the impact I've had on her and that I was sorry for being selfish and self-centered...

She just patted me on the hand and said "no, I understand... and that (selfish and self-centered) isn't the depression... that's because you're man"... said it so dead pan, couldn't help but laugh ... she smiled and pretty much had that way about her.

I'm in almost the same situation. Part of me wants to make a grand gesture just to get a service. Life shouldn't be this cruel. Glad you have a supportive gp. That your doc gave you 25 minutes means they are genuine in their desire to help.

Hi ToeJam, I've just got to reiterate too that the depression isn't your fault!!! And particularly after some of the things you've been through you wouldn't be human if they hadn't had some sort of adverse effect on you. Sure there may be some things you can do to help with the way you're feeling but that can sometimes be way easier said than done. And there will naturally be times when you can only take very small steps with real support.
And no, none of what you're feeling is pathetic or stupid, in fact just the fact that you're putting it out there shows you've got real insight and strength!! And nothing at all to be embarrassed or ashamed about!!!
As for the crisis team maybe you could just ask for them to assess you, they may not allocate you to anyone depending on their opinion, but even if they don't they'll still have that assessment on file if things do get worse/you really need them and they may take your situation a bit more "seriously" at that point.
Sorry not familiar with IAPT??? But would be good if you could get some (even a little??) input from psychiatric services, after all they would probably have a lot more experience/training/knowledge (hopefully!!!) than a standard G.P.
For your therapist, sometimes it can be a lot more damaging if unqualified/untrained therapists are leading you down paths you aren't ready to go down/the wrong paths. But it can depend on whether you're able to filter out what really isn't right/good for you, draw lines at what you're prepared to "accept", and use only what might actually be useful for you without taking the rest on board. But that can be really difficult..........
As for further support though, do you have helpline or crisisline numbers even the number for the Samaritans- and you don't actually have to be on the verge of suicide to call the Samaritans or anyone? Sorry if I've asked this before but the more support you have the better, there will be so many people out there for you not to have to do this alone. Including us!!!
Alison

I'm glad you took the note to your GP this morning, and that he actually gave you a longer appointment. He seems like a good doctor you really should listen to him when he says to call if things get worse before the two weeks until your next appointment. Even if you just go and let him know how it is getting it off your chest might help.

With your therapy is there anyway you can increase the sessions to weekly instead of fortnightly? Maybe that would help to give you more support right now. And if the doctor recommends this IAPT (no idea what this is) then theres no harm in trying.

And he is right, this is absolutely not your fault. We don't choose depression and everything that comes with it. Don't blame yourself or beat yourself up over it. You're doing the best you can

((((((((( TJ ))))))))))

Tj, I'm glad your doctor is supporting you in this. Depression isn't a choice. You didn't choose it and all that goes with it. I'm glad you let your wife know what is going on, too. It is very important that the other person realize it's not their fault either.

(((( TJ )))) My T reminded me this week that the depression I'm in isn't my fault. Somehow that was comforting because I find myself blaming myself a lot lately for being depressed. I have to remember that I come by it honestly too - - my great grandmother committed suicide and my grandmother had bipolar, in and out of the hospital her whole life. For some reason, the hereditary factor makes me feel less like it's my fault too. But I forget all of this so easily and am right back in the "it's my fault, I'm just a loser who can't deal with life" trap. Ugh. Frustrating.

Hang in there. I always enjoy your posts and feel they're useful.

Thank you for all the replies... when I posted first thing this morning, the adrenaline was pumping and it took me a while to calm down. Been at work, so I thought it best to respond when I got back home.

I had noticed your post in my other thread and noted similarities. As for grand gestures... yeah I know what you mean... I don't look at the impulses as that when they happen, but boy do I beat myself up for them once my brain kicks in... that if I did something, that's what it would look like, and as such it fuels the self hate

And yes... my doctor has restored my faith in GP's (went for along time refusing to get help)... I felt bad for taking that much time though... was thinking 'Christ, if I was sitting in the waiting room and my appointment was 20mins late... especially if I slotted it in before I started work, I'd be panicking'

Thank you Alison, had a nice chat with you in the chat function earlier today, so I hope you don't mind me replying in brief to this... just to say, as always, your post was great and thank you!

oh and a quick link to what iapt is about: IAPT |

Basically, it's a recognised counselling provider by the NHS. Therapists predominantly use CBT and a lot of doctor surgeries will have a couple of T's that come in to do one on one with people.

Thanks Secret If I was a little bit better off financially, I would love to do weekly sessions (my T has mentioned regret that bi-weekly is having it's toll)... but at £50 a pop... £100 a month is about as much as I can manage at this time.

The problem I have with the whole "see the doctor if things get that bad" is that I just feel so stupid with myself... and I get very angry... that by the time I saw him, that moment is likely to have passed (hopefully, god forbid an impulse becomes too much) due to berating myself like mad on the way to see him and then I just look like a total idiot.

Which... actually now I think about it, could have the desired effect... I don't have to go in if I've calmed down... but the actual going there might calm me down.

WIll have to think about that one.

right back at you Fuzzy

Yeah, thanks Gayle. I've tried to keep my wife abreast of what is going on, to include her in what is happening at the doctors, with my T (I tell her all about it)... so she can see and understand the process. We both went through many hard years of me refusing to get help, pretty much climbing up the wall... and it was chaotic for our relationship.

Thank you so much for your post! In my family I don't believe there has been any official diagnosis of mh issues before me (one of my parents had a fit when I got hospitalised, was convinced that I had irrevocably shut the door to many career opportunities) ... that's not to say they weren't there... but both of my parents come from very hard backgrounds where no one ever admitted to weakness.

With that said, my mum dealt with suicidal notions and anxiety when I was around 11 (I was already having problems) and, being a single parent, talked and shared with the one person she felt she could - me. That was baggage that in later years I am not overly fond of... but it helped her and I was glad to help.

When ever it was suggested that my dad should see a T, he just laughed and told that person to piss off haha.

It is hard sometimes to not fault ourselves... we all have faced and dealt with people who give their advice... tell us to just be happy etc etc... and it can have that knock on effect of making us wonder if we choose to be this way.

I have been diagnosed with depression for a long time... and even now, I just wish I would 'snap out of it'.

That's not likely to be that easy, but I'm hoping that one day after therepy and meds have done their work, I'll wake up and it'll be done.

Hi ToeJam, the IAPT sounds like a really positive move!! And the CBT should be a little more "structured" for you, so maybe that will be a bit easier in getting across how you're feeling, it may in some ways be a bit less "intense"?? I'd say go for it!!
Plenty of really good backing out there for how CBT can help some people with depression, but just take things at your own pace with it (shouldn't be any pressure remember!!) and bit by bit...........
Really good that your G.P is so invested in supporting you so much with what you're going through........so maybe a possible that if the urges come on/things are hard you WILL contact him in between times???!!!
Alison

This is also my situation.
Wow - honesty and insight (and that in 25 minutes)! I'm glad you presented him with the note - by that you cut through all sorts of potential murkiness. It appears he took it seriously.

Aside: Just for reference I had to go look it up: Improving Access to Psychological Therapies (IAPT) NHS

Thank you for reporting here on this meeting with your doctor.

The IAPT plan 'might' be beneficial this time round... will be using it (when and if I get an appointment... wait time is long, once I waited 3 months) in conjunction with the T I'm seeing (gp actually suggested this).

Problem I had with them before was the bad consistency... went through 3 different T's as they don't generally stay at any given surgery long enough to complete treatment. Was told each time it would be up to 20 appointments... and the max any stayed was... 8. So a lot of upheaval, restarts... and for me at the time did more harm than good.

As for my GP.. I can't argue, he is great... I'm my own worse enemy and it's something I've got to try and overcome... I just find it hard to keep going back and giving him more bad news... each time before I go in I feel soul destroyed and in addition to that... being honest when it comes to what's actually going on is easy to write here... not easy for me to say in real life.

I find it weird how open I am here... when I'm so very guarded with virtually everyone that knows me (exception of wife... and very minimum info to two people I work with, just because they have to know ), hell even to my Mum. None of my friends would even suspect... if things are bad, I generally don't socialise unless I really have to.

It's horrible... I don't know if you find this or not? But for me, I know that if that impulse in it's worse sense just went full out, I'd be screwed... and it's scary because I know that I don't always feel that way... that if I held on, the next day wouldn't be as bad.

This is why I am infuriated by the badly cut mh service... that 99% of the time, I'm able to 'fend for myself' as I put it above... but that 1% could cripple me and any help to prevent it is out of my reach.

That probably sounds melodramatic.... but I've gone all out before... and I was lucky.

**** it, don't mind me... just bit down about it all at the moment.

The honesty is good and I appreciate it... it's always preferable when people give it to you straight. Part of that conversation irritated me... but that was not his issue.. was mine. Essentially he insinuated that the only way the crisis team would take me on would be if I let go of my self-control and did what I'd written in the note.

Pissed me off to be frank, as I know he was not endorsing to do any such thing... just wish he hadn't said it.

Thanks... sometimes I wonder what use it is to report... it's an experience I guess, and if others find it useful, probably more so for UK residents... then that's great.... but yeah, on a personal level it's helpful to get it written... it helps me as well to consolidate and in my own way ask advice... as well as check to see if I'm just being an idiot from the feedback I get.

Bleh... hard week...