Vituperations and Felicitations on the NHS

Lovely GP this morning.  I needed more anti-depressants, more sleeping pills, a new sick line and, in an unrelated issue, prescriptions for the allergies that are driving me mad (as if I wasn’t mad enough in the first place).  With the amount of paper I left with, I almost felt personally responsible for felling a number of number of Amazonian trees.

I wasn’t initially going to mention last week’s self-harm episode to Lovely GP.  I figured I would discuss the situation with the fucktards at the mental hospital with him first.  He prompted this conversation by asking if I had heard from them.  I replied in the negative.  Lovely GP shook his head and tutted, apparently exasperated.  Apparently he phoned them and asked what the fuck was going on.  They said they still had me on the waiting list, but were prioritising other mentalists who were “at greater risk”.  LGP said that he had told them I was losing my marbles and they just said they would get to me as soon as possible.

“Fair enough,” I said, deferentially.  “But would this change their minds?” at which point, of course, I showed him my shredded arms.

“This is unacceptable,” LGP raged.  “I will phone them again today.  If we pressurise them enough, they will move you up the list.  No offence but you clearly are a high risk to yourself if all this is starting again.”  I think his suggestion was that if I had been consistently slashing my body, whilst that would obviously represent a need for psychiatric intervention, the fact that I had only started doing so again suddenly and recently marked a demonstrable deterioration in my condition that required urgent assessment and treatment that he is (unfortunately) not qualified to give.

I felt oddly liberated by his supportive stance and denigration of his NHS colleagues, and advised him he was not the only one now that had contacted the asylum to remind them of me.  LGP was glad, and again stressed that he would phone them again.

We talked about with whom in the meantime I can discuss my issues, in depth.  Aside from the obvious weekly monologues to a certain someone, A is the most obvious.  LGP asked about my mother, but I outlined the reasons as to why I felt that was not only inappropriate, but in fact potentially damaging.  LGP agreed that not only would I potentially upset her, but I was at risk of putting myself under further stress.  Thank God.  I was beginning to wonder if it was completely out of order to exclude my mother from the true nature of my madness, so it is nice to have my view externally verified, by someone who knows what they’re doing.

LGP continues to be concerned by my episodes of mania, which as I told him are becoming worryingly more frequent.  I also tried to describe the simultaneous mania and depression from which I sometimes suffer, but I couldn’t quite find adequate words.  Nevertheless, the fact that I was discussing its presence at all worried him and, if any reinforcement was needed, it totally confirmed his determination to get the psychiatric fuckwits to take notice.

My new medical certificate signs me off for another eight weeks, and LGP obviously wants to see me at the juncture at which it ends.  However, he said had I not heard from fuckwit psychiatry within four weeks, that I was to go back to him then.  I got the impression that if that happens he might go half-mental himself.  He seemed very angry with them.  I don’t need him to be angry for me, I can do that on my own.  Perhaps I should have protected him too.  Having said that, I do need him to force this along, so perhaps I should be grateful for his fury with them.

Perhaps most importantly, he said I can stay on the sleeping tablets virtually indefinitely as long as I keep taking a week off every third week.  I hate the weeks off so much.  I fucking hate them so very, very, profoundly fucking much.  I cannot stand my insomnia.  I have now been lucky enough to find a myriad of other serial insomniacs online, with whom I can chat if I am awake all night, but I’m sure they of all people will know that, paradoxically, whilst the night is lonely and isolated, it is also difficult to concentrate on anything but your own thoughts, never mind social interaction.  This week I have been getting about three hours’ sleep a night, which is pretty good without medication for me, but is nonetheless nowhere near enough for me to function properly.  I have to maintain this sleeper fast until Friday night, which at present seems like an eternity.  However, if I have to have one week in three away from the things to enable me to have them at all, then that’s what I have to do.  Not having the medication at all is an idea too horrific to contemplate at present.

D’s grandmother was on (a low dose, presumably, of) horse tranquilisers for sleeping just before she died in February.  I wonder where I can get some of this?  It sounds fabulous.  I learnt of this horse-sleeper-for-people when D phoned me last night to check if I remained in this plane of existence, and if I was likely to actually continue to do so.  The resulting conversation raised some interesting questions about the role of the NHS in my treatment.

I was diagnosed with depression, and put on Prozac, when I was 14 – over 11 years ago now.  D opines that it was ludicrous to put a child on Prozac, but I am not sure I agree with that; it was the only drug I took that properly worked for any length of time.  Nevertheless, D’s contention that they should have arranged proper, real therapy right then and right there, is something with which I concur entirely.  In fairness, they eventually arranged a session of counseling with some bloke for me.  Patronising shite.  So then they referred me to an Adolescent Mental Health Unit – the woman was nice enough but it didn’t really help and I didn’t really trust her.  For all her efforts, I just didn’t really ‘click’ with her like I have with someone else.  Not that it mattered anyway, as she left her job there after a couple of months with me, and then the NHS left me to fend for myself.  (I will write in more detail about these therapist people when I finally write that post on all of my psychotherapists to date, you know, that one I’ve been meaning to write for about a fucking fortnight).

D is right.  It should all have been nipped in the bud then.  Maybe I could have developed some sort of life in my adulthood had they done something.  Maybe not, but the point is, I will never know now.  Since the advent of my 20s, I have had two major breakdowns (of which this is the worst), and it is arguable that I had at least a couple of additional less serious but still nasty further episodes.  This does not include the fact that my entire existence as a teenager was just a mess.  I missed loads and loads of school due to my mental health problems, and frankly it is astonishing that I have any qualifications at all.  Couldn’t at least some of this have been prevented?

D repeated everyone else’s disgust about the current situation with the seemingly-phantom psychiatrist.  My condition is getting worse, and yet them are still condemning me to my twisted and pointless life.  They don’t care.  It will be a laugh when I finally do meet this person, as whomsoever he or she may be, I already deeply distrust them, thanks to their decision to de-prioritise me.  Rationally, I do appreciate the indulgence of my conditions, and fully recognise that there are people out there with much clearer and real problems resulting in mental ill health than I do.  Nonetheless, I cannot believe that the fact that just cos I have no reason to be depressed and fucked up makes my condition any less real.  Psychiatrists of all people ought to be aware of this, surely.  Am I the most at risk?  No, of course not, which is why I wasn’t seen immediately, and why I didn’t expect to be.  But I am not four months’ less important either.  The more they make me wait, the more I am going to be at risk.  My suicide ideation is already out of control, and of course my self-harm fantasies have once again been realised.

A further point D made, echoing comments offered by A, was that should it really be considered normal that my condition has deteriorated after 11 weeks of psychotherapy?  The two of them have both asked what has actually been achieved by that process and what I have actually learnt to help me control and manage my conditions.

In response to the first point, and I have stated it elsewhere, I would argue that some deterioration was to be expected, given all the emotions and memories that are discussed in therapy.  They are things I have become adept at hiding, and have hidden (even to myself, in some cases) for years.  Actually thinking about them, verbalising them to someone, is bound to fuck me up, though hopefully that is short- rather than long-term(!).

As to the second issue, well, they have a point.  Some ideas have been mooted, but nothing ever confirmed.  Query: what is the point of psychotherapy?  Am I simply meant to resolve the unresolved in my mind?  Is it to teach me coping mechanisms?  Would I accept them even if it was?  Probably not.  I am not sure.  Maybe I need to work out what I want from it.  In fairness, I have been asked to do this, and haven’t done so.

I think my reliance on therapy is already evident from previous posts (here and here, for example).  I need it, regardless of whether or not it is curing me at yet (well, ‘curing’ is the wrong word; it can’t be cured entirely. But you know what I mean).  In fact, if you believe in psychodynamic psychotherapy (and I don’t know what I think yet), the fact that I obviously experience quite significant (if nebulous) transference is a good thing.  (Query: does all this count as ‘mentioning’?  Or if I avoid using names is that OK?!).  So, does the NHS fail here?  I think not.

It doesn’t fail with Lovely GP either.  Unlike his colleagues in the practice, he takes me seriously, tries his best to find workable ways for me to manage things and is now acting as my advocate to the psychiatrists (and the SSA as well, actually, as they are hounding him re: the DLA claim).  He wasn’t always there, though, and some of his colleagues and predecessors clearly viewed me as some attention-seeking brat with an attitude problem.

Still, at least the NHS is free.  Well, kind of.  The government stole a substantial whack of the salary I was receiving each month, supposedly to pay for its maintenance (though it was probably towards their expenses…).  The point is, if I am seriously ill, I will be treated until I am mostly well, not brought out of critical condition then left to my own devices like I would be in the USA if I was devoid of adequate medical insurance.  So I suppose I should be grateful.

You can probably tell that I’m not, though; not entirely, anyway.  It’s not all about the medics and other ‘healthcare’ professionals – a lot of it is about the people who take pure advantage of the resources the Health Service provides.  The hypochondriacs.  The demanders.  The eccentrics.  They overpopulate the service so that it becomes increasingly difficult to treat those that are actually ill.

Having said that, the blame can’t be shifted from the healthcare professionals either.  They should be trained enough to recognise a whinger from someone really ill and therefore should not fall into the trap of disillusionment (not professionl disillusionment, in any case).  They should provide the commitment they said they would provide when they joined the service, not fob you off with excuses, tell you to read self-help nonsense or advise you that the New Age is your friend.

It’s no one individual’s fault.  It’s the fault of a vast and complex system in which there are inherent flaws.  It’s not perfect, but can it be expected to be?  Nothing ever is, and it’s all that we’ve got – the least worst option.  Yet, no matter how much I try and defend it, I can’t get past the niggling sadness reminding me that things might have been different for me, if only this system had just intervened properly in the first place.  I know it’s really my fault for being a screwed-up twat.  The NHS is an easy scapegoat.

Really, though, could it have been different?

Sorry this is such a whinging and rambling post (as if they are not all whinging and rambling).  Today is a Bad Day.  I feel out of it, pretty depersonalised actually.  I feel rotten physically –  maybe it’s not allergies.  Hopefully Ebola, or some other fatal illness.  I am terrified and panicky and sad and keep thinking about walking in front of a high-speed vehicle, not that it would be fair to the driver.  I feel trapped and claustrophobic, but as I say, zoned out and depersonalised.  Hard to explain.  Not sure why.  Maybe a combination of feeling low mentally in general, feeling physically rotten and fear and dread about going to my cousin’s 50th birthday party tonight, which will be as claustraphobic and crowded as hell.  I want to be alone.  Just alone.  I have no idea how I will force myself to be social.  I don’t think I can.

But I’ll be alright, I always am.  More later in the week, if there is anything at all about which to write.

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One Response to “Vituperations and Felicitations on the NHS”

  1. Serial Insomniac Says:

    Reading over this entry, I’ve spotted loads of syntax and spelling errors. I had to leave fairly abruptly so didn’t get to proof-read the post, not that I really felt inclined to do so anyway. I will fix them, but not now. I do hope that in the meantime you can work out what I meant from the context. Take care all.

    EDIT (8.10pm, 20 May 2009): Hopefully it’s all updated now. Leave a grammar-Nazi comment if I have still missed stuff.

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