What do you have to do to get appropriate mental health help from the NHS?

[MatthewJ]

I went to my doctors distraught with despair because my wife had cheated on my 8 months earlier, and although i had tried my best to cope i was being swallowed by depression. i have had random dizziness or physical sensations of spinning since i was at school (18 years) and as a result of that i live most of my life near panic, i'm scared of people, scared of leaving my home, scared of my own thoughts. All of this was overcoming me after the separation from my partner of 11 years. My doctor referred me to Mind Matters in Wakefield, after about 4 months of waiting i finally get an assessment and now i have had 5 councilling sessions and although i was beginning to feel hopeful again i find out if i want more sessions i have to go back to my GP and will probably have to wait another 4 months for further help. what can i do? only recently have i stopped thinking about suicide daily due to the help from the councilor but now i feel i am on my own again and back to square one, i feel like someone was helping me climb out of a dark well and they've just taken their hand away. i am not an assertive person and i have enough difficulty just getting myself to go to the doctors let alone demanding anything of them, i always take the first thing they offer which is usually a presciption of a pill which has "may cause dizziness" listed as a side affect, which i promptly throw away. i asked for help from my GP and i feel he gave me the bare minimum and although talking to someone helped i only explored my problems i don't have any solutions or goals, there has been no significant change to the way i think. i'm so sick of living with my panic and dizziness and fear but sometimes it feels like the effort of getting better just isn't worth the trouble and i should just take the easy way out. please help me before i sink again, i don't feel i can take another 4+ months of being like i was, what do i have to do to get the help i need?

[Suzie40]

Have you ever taken tablets before? It's a bit of a shit cliche but they usually do work. If you start on a really low dose, say 5mg of citalopram, and work your way up to whatever dosage you need, you may only notice the desired side effect - feeling better. Sometimes any dose, however low, starts working quickly by the placebo effect it gives. Times I've been on meds, th placebo effect has carried me through nicely until they've actually kicked in.

[Hidden]

Hi I do understand how you feel. I had to wait 9 months for an appointment and then it was only to see someone to decide what type of talking therapy I needed! I had to wait another 3 months before I got to see someone properly.

Tell your doctor it is urgent and hopefully they can get in you again quickly. You have taken the hardest step and I am so glad it seems to be helping you.

Bev x

[Hidden]

Hi

You say you saw a counsellor but I wonder whether you have had CBT as that can be very useful for anxiety. Do go back and see your GP, if your GP is not very enlightened about mental health issues do ask to be referred to a specialist as it is your right. Suexx

[MatthewJ]

Hi, thanks for the replies. I didn't want to turn my original post into David Copperfield and in keeping it succinct i guess i missed out some important points. I am 31 at the moment, at 22 i was started on antidepressants, specifically Citalopram in 20mg doses, at 24 i had group CBT and at the time it worked well i even managed to come off the antidepressants, however the spinning / dizziness and panic never went away, even when i was at my most positive and relaxed and i eventually relapsed at 26 and went back on 20mg of Citalopram,

I'd like to say i've lived a happy life since then but the background problems never left so i just concentrated on living an easy stressfree life and focusing on one day at a time, i married my long term girlfriend on our 10th anniversary of being together, however 6 months later she became unhappy with her life for reasons she insists were outside my control, and ultimately cheated on me, and in late 2011 we separated.

When i went to my doctor in August 2012 and told him of all my problems the first thing he did was double my antidepressant dose to 40mg, it wasn't until i went back and pleaded for more help that he grudgingly penned a letter about my situation and referred me for further treatment (councilling) a letter i later learned he marked as "routine" in urgency. I guess i should have gone to the doctors earlier but i thought i was coping, so by the time i went to the doctors i was already at the extreme end of my tether, the following months were the hardest of my life, fighting the dizziness and panic while at work, the depression and loneliness when i got home and insomnia and nightmares when i tried to sleep.

I never really mentioned to my councillor these last weeks how close i was and still am to suicide because he made it clear during the meetings that if he thought i was a danger to myself he would have take action and inform someone, and i guess i have panicky images of being locked to a bed in a mental institute while the room spins around me for decades until i finally and with great relief die of old age. i'm not mentally unstable i'm just so tired of fighting anxiety and panic, it's been almost 20 years and i'm sick of struggling just keep enduring this nightmare.

I remember most of my CBT techniques but being relaxed and positive doesn't seem to affect my dizziness which is the reason for my panic attacks. When i've tried to explain my problem to doctors at the past they've given me pills for Labyrinthitis, beta blockers and diazepam. i might try them for a few days but i usually end up focusing on my dizziness and panic problems more to see if the drugs are having an effect and because my natural defense is to try to ignore the dizziness so it doesn't cause me to panic, when i focus it ultimately ends in panic (even through the diazepam) and i stop taking the pills. maybe the labyrinthitis pills would have worked but without proper diagnosis i am loathe to trust anything the doctors prescribe because it feels like i'm being fobbed off especially when they have dizziness listed under side effects.

I once had a "tilt table" test which is to find whether the dizziness is caused by a loss of blood pressure, and even though being strapped to a surface and lifted slowly from the horizontal to a vertical position caused a massive panic attack the results came back that it was not related to my blood pressure, i recently had my eyes dialated and was examined in hospital for possible glaucoma (false alarm from a high street eye test) and i asked them if there was anything present that might explain why things always seem to be spinning for me, the ohpthalmologist said there was no problem with my eyes.

Other than these i have never had any tests done to try to figure out the source of my dizziness and as i have panic attacks the doctors just assume it's a manifestation of anxiety. but as explained in my previous post i have trouble making demands of anyone in authority i just try to do as i am told. the tilt table test came about as a result of pressure from my wife. from my typing is might seem i'm intelligent (hopefully) enough to get what i want but when i am face to face with people i become a gibbering simpleton and just blurt things out as they rush into my panicky mind, and usually realise what i should have said about 2 hours after i get home and have relaxed.

apologies for the essay and the negativity, any feedback is very welcome and appreciated, i am trying to hold on and after so long fighting i'm not giving in easily, i just need to know where to go from here while i still care about getting better before the positive effects of the councling dissipate. please help

matthew

[daffodils in reply to MatthewJ]

Hello Mathew, i'm sorry to hear how your marriage ended....I have been there got the t.shirt. the end of your marriage has obviously set things off and sent you into a black hole. Firstly things will get better, secondly go back to your GP and tell him exactly how the counselling was helping and the suicidal thoughts, if he tries to up your meds, refuse, even ask to see another doctor, don't sit back and be ignored your important and deserve to be treated with more respect. My GP was good and referred me to counselling straight away, I also tried out some alternative therapies including one called SHEN, but these can be expensive but certainly changed how I was feeling. If things get worse whatever you do don't thnk of ending it all, life is precious keep the samartians number by your phone and call them whenever you have those feelings they are a great help. I'm sorry I cant be of much help, but your only young so please please don't give up. take care

[Hidden in reply to MatthewJ]

Hi Mathew, Do please take the rick and tell your counsellor how bad you are feeling - you have not attempted suicide so they will not lock you up - and ironically even people who need protecting are unable to get admitted for more than a couple of nights due to a shortage of beds so you really need not worry on that score! However your counsellor is unable to help you more deeply unless you tell them how you are feeling.

Suex

[Suzie40]

It's a shame that your councillor had to threaten to pass on concerns about you self harming. I guess it's something they have to do, but it kind of makes the sessions a bit pointless if you're having to think carefully about what you can and can't say. To be honest, it's the main reason I've never asked for counselling, because I couldn't trust myself to not say things that might end up costing me my career. It must have been really hard for you sitting there saying one thing, but thinking another. I don't really know any good words to say to people who are suicidal, sorry. You seem like a nice bloke, though, and I think the world could do without losing too many of those x

[Hidden in reply to Suzie40]

Hi Lucy

Unless you are a harm to others - ie a child molester or murderer or similar - the counsellor will not pass on information about you in a way that might harm your career. Yes they will discuss with their supervisor but that is in order to enable them to he helped to work with you in a way that is helpful, but they will not notify your employers or similar. If they did you would have a right to take legal action! Trusting a therapist or counsellor is scary and often takes a long time, longer than the NHS seems to be able to offer, but the boundaries are there and any decent therapist/counsellor will not abuse them.

Suex

[Suzie40 in reply to Hidden]

Oh my goodness, I wrote that a year ago! How things move on! X

[clive1060]

Hi Matthew sorry to hear about your situation i had to come off citalapram as it wasnt doing the job needed im now on venlafaxine 37.5 twice daily they are a much better tablet citalapram is the new prozac for the doctors cheap and chearful they dont like to spend their money do they. anyway suicidal thoughts go with the territory i myself had the same situation was left with 4 kids that was 20 years ago so theres light at the end of the tunnel, try and get youre meds changed and if no joy walk into the emergency room and tell them they will get the on call psychiatrist in to help if you keep talking to them they will listen tell the doctors the tabs are making you feel suicidal he must change them good look it will get better

[MatthewJ]

@daffodils - Thanks for the reply, I have a day off worked booked tomorrow and am going to go see my GP. I think the hardest thing about all of this is that I never really had any idea what I wanted out of life and no direction. So I concentrated on making my wife happy and living vicariously through her. Now I'm on my own and as well as losing my best friend, anchor and the source of all my positivity I'm just drifting from one day to the next. My fears and panic keep me from doing anything constructive because i'm scared to socialise, I don't have any friends and i'm so scared of change or thinking about the future that i just put all my effort into hiding away in games, books or TV. I realise all this is indicative of someone with depression and I try to push through all the negativity and envision something positive in the future to aim for, but I have no idea what I want or what would make me happy. Had a darker than usual 3 days so couldn't face these posts but feeling slightly better today.

@Suzie - the counciling was pretty ineffective, he kept saying it was person orientated or something. In summary it was like having a friend who I could tell my problems too and he gave back positive advice, the problem being that after 5 weeks or councilling i'm on my own again, having revisited all the negative things in my life and without that positive spin which I cannot seem to sustain I feel like I've been buried deeper in misery than I was before. Imagine making a friend and confidant who turns their back on you after a month and you never see again. Besides which he wasn't telling me anything I didn't know, I can see the good and bad in all situations, but when I feel there is no hope and i'm moping round the house on the edge of terror and tears, trying to think about positive things is like trying to stop a forest fire by throwing cupfuls of water into it.

@Clive - although the doctor prescribed 40mg of citalopram i've only been taking 30mg. These last few days i've started taking the full 40. I've never looked into the drug itself, it's always seemed to help me break cycles of negative thoughts, i don't even know if that's a placebo effect or what it was designed to do. The downside being that it's difficult to follow any thoughts through to conclusion even important ones such as what do i want out of life, and what will make me happy. seems to make all mental change like running in treacle. I don't like being on any medication but i think i do have a very cynical world view, is it possible to change the way you see things permanently. I had CBT and it helped for a while, became good at stopping negative or irrational thoughts, however it was always something i had to do consciously. If you focus on being positive and rational and optimistic for long enough, does it become a permanent state of mind, or will it always be a struggle? The advice about the emergency room is very much of a relief, now I know there is somewhere to go when all hope is gone.

Wish i knew what to ask for from the doctor tomorrow. If i was a more assertive person I would demand an examination from an Ear, Nose and Throat specialist or someone who specialises in dizziness related problems. Would also tell him that councilling is useless as I need to change the way i think, not just have someone point out the silver linings in the clouds. I would also like to know of places i can meet like minded people, so i can maybe make some friends who are in the same boat and i wouldn't be alone all the time.

I'll go in there with the best of intentions but i'll come out with another 4 months wait to see a councillor or a prescription for more pointless drugs, GPs just don't understand and don't care.

Anyway i'll try to keep you posted. thank you again for the advice and for listening.

matthew

[Hidden in reply to MatthewJ]

Hi, It is sad that you were only offered short term therapy as it takes much longer than 5 sessions for most people to trust enough to share how they are feeling. Of course you weren't able to tell the counsellor how you felt about being left alone at the end of such a short period of time and if you had been the counselling would still have finished. I find it so sad that often the help only ends up making people feel further despair.

Nobody can help you to fully overcome your depression once it is long lived, but it is possible for a lengthy period of therapy to help you to internalise ways of overcoming the feelings at a deeper level so they are no longer long lived but are just brief interludes in an otherwise reasonably satisfying life despite day to day problems. The problem is that the NHS does not have the funding to provide long term therapies and so increasingly people are offered only 6 weeks CBT or counselling plus meds, helpful sometimes in the short term but seldom a solution in the longer term.

I do not know what you can do, although it is important to remember that professionals do usually care but are unable to do anything to help which is not the same thing. In order to help yourself you can use this website for day to day support, the Samaritans phone line for emergency support, the local branch of Mind who may be able to provide you with a befriender, and if you are earning you might seek talking therapy from either a local clinic or private therapist. Other than that the best ways to help yourself are to eat well, keep healthy and try to meet people who might become friends - I know that's easier said than done but relationships are the only way to overcome long term depression and turn it into periodic unhappiness which is depressing but not neatly as bad as full blown depression.

Sorry if that sounds harsh, but we can't change reality as I know from my own experiences of seeking help within the NHS.

Suexx

[friday13]

Your dizziness, particularly of spinning does suggest that there is something wrong with your vestibular function and you should see an ENT consultant and have the array of tests to prove it. I have bilateral vestibular failure and there is now no registerable function left. It is very common for people who have vestibular failure to have anxiety and depression. Once you have a diagnosis of a vestibular dysfunction you can get vestibular rehabilitation exercises which will help strengthen what remains of your vestibular function and allow for some compensation within your nervous system. I was diagnosed in 1996 and have had repeated episodes of anxiety, during the last 12 months there has been a further decline in my vestibular function an increase in anxiety which has now led to a diagnosis of severe depression I am awaiting another appointment for vestibular rehab. and from experience I know it will help to reduce the many symptoms of vestibular dysfunction. If you find difficulty in asking for a referral to ENT when face to face with your Dr. Why not write to him, officially asking for the referral which is your right. You are not alone in finding that GP's don't understand and believe it or not I have had ENT consultants admit that their understanding of vestibular dysfunction and it's many symptoms is worse than mine. The best person to see after diagnosis is a neuro-otologist he specializes in the link between the vestibular system and the brain.

[Hidden in reply to friday13]

Benign vertigo is harmless and a common side effect of anxiety, also of many antidepressants, and also of prolonged stress so there may not be anything physically wrong but it is always worth having that checked out by a referral to ENT I agree.

[MatthewJ]

Hi everyone. So I went to see my GP I asked the surgery receptionist if I could see whichever doctor was most sympathetic as the previous doctor I saw there let me down, this turned out to be a very good decision as the doctor she recommended was perfect. Unfortunately i've just been put on a waiting list to see another of these out-sourced mental health companies - it seems the NHS' affiliation with Mind Matters has come to an end and this other company is called Turning Point. I'm on the waiting list for an assessment at the moment, was told it could take 3-4 weeks but had the option of doing it face to face or on the telephone.

However, I also asked the doctor I saw if I could see a specialist on dizziness or similar, and as it turned out one of the others doctors in the same practice specialised in dizziness related problems before he was a GP, so I made another appointment to come back and see him.

I wish I could have seen him when I was 13. Although I was worried mentioning dizziness and anxiety would inevitably lead to the same conclusion all the doctors made that the two are related, I explained that even when I'm at my most positive and relaxed the dizziness still occurs. He asked a few questions and said he "wasn't buying" an anxiety related dizziness as I had clearly put a lot of effort into understanding it myself and he trusted my opinion. I've never had a doctor that listened so well and trusted me before, it was an unfamiliar feeling! Anyway I did some quick tests like marching on the spot with my eyes closed and a rudimentary eye and ear examination. And he fired a few dozen questions at me, as I passed the tests and answered his questions my heart began to sink assuming it was all just going to point to anxiety related dizziness after all and i'd be stuck in the same boat.

However, his initial conclusion is that my Vestibular System isn't functioning properly. He's prescribed me Prochlorperazine and told me to juggle for 5 minutes twice a day to try and train it back up. At the moment we're just experimenting, I lead a very sedentary life spending most of my time sat in front of screens and it could just be that my Vestibular function has atrophied due to inactivity. The Prochlorperazine sedates the Vestibular system and he said to ignore the directions on the packet (5mg 3 times a day) and just take 5mg if i began to experience dizziness, the intention being of finding out whether the drugs would have an effect on my symptoms and hopefully to get a clearly diagnosis of the problem.

Unfortunately after a bad day of dizziness I decided to take 2.5mg to see how it would effect me and I found the sensation to be uncomfortable, and cause me even more anxiety. I couldn't put my finger on what was wrong just that as I walked around my flat things just didn't feel right balance wise, given my history of panic attacks i'm very cautious of anything which causes change to my orientation or balance, I don't drink, i'm extremely scared of heights and I even avoid things like lifts because the sensation of rising or descending without moving seems to make my anxiety level skyrocket and I have to fight just to stave off the panic.

What should I do, persevere with the drugs? it's hard to monitor a change in dizziness when the sensations of disorientation cause me anxiety. I'm doing the juggling but I keep thinking that during the ages of 15-20 i played football many many hours a week and the dizziness was still with me throughout that period.

Particularly interested with your opinion Friday13 as you seemed to preempt the GPs diagnosis with 10% of the information he had, very impressed.

[Hidden]

Hi

I'm sorry you are having such a hard time of things that you often feel suicidal - I went through those feelings myself a long time ago and can remember how extreme the anxiety was and how exhausting I found coping with it while continuing with normality. I can also identify with the dizziness which I think it a symptom of your fear of falling into complete exhaustion - a fear of having a breakdown. Having fear of something means we have a concept of it and so having a fear of falling psychologically into breakdown does indicate that you already know that experience and are frightened of going back to it. I also had that fear and came to realise that I'd had a breakdown many years previously. I wonder whether you had a similar early breakdown in your ability to cope with your feelings some time in the past. I know you said you had the problems when you were 22 but I'm wondering whether your problems during that period were triggered by something re-awakening a memory of earlier problems. I wonder whether there is an event in your earlier life, maybe in early childhood, that leaves you with a anxiety and symptoms of dizziness. It's just a thought. I had a bad fall (literally 7ft head first) three years ago and since then have had symptoms of vertigo and although most of the time they are not at all significant, when I lie down in bed, the situation where I was most unhappy as a child and cried with my teddy, the symptoms recur as soon as I try to turn over. The mind is incredibly complex and all sorts of things trigger subtle and not so subtle feelings and memories. If there is no physical cause for your vertigo, as there isn't for mine, then the natural thing for me is to think there may be a psychological causal link to something that made be anxious in the past. I don't know whether that will make any sense to you. I've just read that you already had dizziness when you were 15-20 and played football, that does suggest the symptoms go back to something earlier, an experience that caused you to fear anxious and have dizzy symptoms, fear of collapsing or perhaps the emotional confusion of being unable to understand. Sorry if all this doesn't help, it's just a thought. Hope you find a way to begin to feel happier. Suexx