The Road to Diagnosis

Hello lovelies.

Over the years, I’ve met a lot of people who have been afraid of taking the first step to go and see the doctor about mental health.

I like to call it brain health.

Your brain is a physical thing. It’s producing these feelings, these behaviours. It’s important to look after your brain, as you would your lungs if you had breathing problems, or your heart if you had chest pains.

People come up with lots of reasons to be afraid of going to the doctor. Some examples I’ve heard are:

“What if they don’t believe me?”

“I don’t want medication, what if they make me take it?”

“It’s not that bad yet. I’m not suicidal so it can wait.”

I’m just going to be brutally honest here.

In recent years, understanding of brain health has lost so much stigma. Don’t get me wrong, the stigma still exists, but if you go to your GP because you can’t sleep, can’t eat, and feel empty/overly emotional all the time, your GP will almost definitely not tell you to “man up” or “just deal with it.” They will not expect you to simply get it together.

And if they do? You can put in a formal complaint toΒ PALS.

It is true that many GPs don’t have a lot of psychiatric experience, particularly older GPs I’ve found. However, they will be able to offer you medication based on your presenting problem (typically first line medications are SSRI antidepressants, like sertraline, fluoxetine, and citalopram).

If you have anxiety, they may offer you beta blockers (such as propranolol) to take when your anxiety is heightened.

Remember though: just because they offer you medication, it does not mean you have to have it! You can refuse treatment unless you are detained under certain sections.

Some counties in the UK have self-referral websites which you can go on and fill out an application for counselling. In other counties, your GP has to refer you.

Also – this is something that a lot of people forget:

It doesn’t matter if you aren’t suicidal.

It doesn’t matter if you are still able to work, or can mask your feelings well to the people around you. It is better to go earlier, before you become suicidal, so that you can get on the waiting list and start learning coping mechanisms as soon as possible. If you found a lump on your body that you thought could be cancer, most people wouldn’t wait until it grows into a giant third head growing out of your shoulder to get it checked out.

If you are younger (under 18) there are confidentiality issues if you go to your GP for things like suicidal behaviour or self-harm. If the doctor thinks you are a risk to yourself they have a legal obligation to involve your parents. For some people, having supportive parents is helpful towards getting early intervention for your mental health.

My experience, however, was that my parents did not believe I was struggling. My grades were good. In their mind, I was acting up. Attention seeking. They couldn’t see anything wrong. As a result, I had to wait until I was 18 to get the help I needed.

In my experience, my GP started me on citalopram and I was referred to a psychotherapist at the practice for help managing depression and anxiety. Psychotherapists are not trained to prescribe medications, but in therapeutic methods to manage your emotions. I was offered six sessions, which is fairly standard for counselling. At the end of those sessions I was referred on to the Community Mental Health Team (CMHT), because I was displaying dissociative and (at the time) psychotic symptoms indicative of a more complex, long-term problem.

A few weeks after my referral, I got an appointment with the CMHT for a month or so later. In my initial assessment they took my history and gathered information about my current brain health situation. They also got me to identify five or six of the main problems I was experiencing at the time.

Next, I was assigned a community psychiatric nurse (CPN). I’ll tell you all about her in another blog post. Anyway, my CPN also referred me to a *cough* useless *cough* psychologist. Said useless psychologist told me that I should consider getting new friends, because a lot of the people I spent time with had mental health problems too, and quite a few of my friends had autism. She asked me why I thought I gravitated to these people, instead of finding more normal friends. Safe to say I refused any more sessions with her after that.

I was 19 around the time I had intervention from the crisis team. I stopped working, I couldn’t cope with the environment. The combination of meds, alcohol, and severe dissociation I experienced at that time means I have little memory of that period in my life. Because of the crisis team, I was bumped up the list to see a psychiatrist. At some point around this time my meds were changed to venlafaxine. A joyous affair. One day I’ll do a post about different medications.

Anyway, that psychiatrist was amazing. She’d seen two of my favourite bands live when she was younger (The Dresden Dolls and Bowling for Soup). She took me seriously. Most importantly, she didn’t tell my to get new friends.

The second time I met her she changed me onto mirtazapine (WONDER DRUG …besides the weight gain). My useless CPN left and I was switched to one of the most wonderful nurses I’ve ever met. He did DBT and distress tolerance with me and it honestly changed my life. I had a final appointment with the psychiatrist and she told me I was too young (around 20 at this time) for her to diagnose me with BPD because my personality was still going through major changes having just come out of adolescence. She did diagnose me with EUPD traits and social anxiety disorder, though.

Over the past year, that psychiatrist left and I was put on vortioxetine by a different psychiatrist (who had never met me before and seemed like she was a representative from Brintellix come to sell me vortioxetine.) My CPN changed twice more, and I went back to see a different (far more impartial and professional) psychologist.

Following some major nausea from the vortioxetine, I had one more appointment with a DIFFERENT psychiatrist, who had actually read all my notes (which is insane – at this point I’ve been there about three years). He put me onto sertraline because of my PTSD, and finally diagnosed me with emotionally unstable personality disorder.

He understood that not all people with BPD explode.

Some of us implode.

And that’s where I’m at now.

I’m sorry this was a long post… If there’s anything you should take from this, it’s that the road to diagnosis is a long one. You will meet shitty mental health “professionals” who make your life harder at times, but once you find a therapist who engages with you and works with you, therapy will get easier.

Also, I understand that not everyone wants a diagnosis. Some people don’t find labels helpful, and that’s okay. For me, the diagnosis named the illness. It’s like the story of Rumplestiltskin – once she named him, she defeated him. Yeah, brain health is not that simple, but if I know what I’m dealing with, it’s easier for me to understand and compartmentalise it.

Personally, therapy felt like it was an antibiotic sent to kill off my identity. I’d been ill for so long I was my illness.

The biggest thing I’ve learnt these past few years is that there’s a person inside me. There’s a person beyond borderline personality disorder. And there is a person inside you too. I promise.

 

Thanks so much for reading!

Until next time,

Rowan.

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