Asking for help

06 October 2011 | 12:08 PM

Louisa

Topics: Someone who has experienced mental illness, Health professionals, Services

The last month or two have been quite tumultuous and it took me a while to realise that I needed more help. When your disorder makes you feel good, rather than bad, this is a difficult decision to come to. It can also be a difficult thing to achieve, because if you haven't asked for much help before, then no one spots that you need it. You need to actively seek out help, which can be difficult to find.

I think in the past I have suffered from appearing 'too well', and also, too cognisant and insightful. I have even been told by a doctor, "Well, you're an intelligent woman, so I can see you are ok." I can present very well - I have to do it every day at work. I can talk theoretically about the need to avoid certain behaviours and situations. That doesn't mean I'm actually going to do it.

I have yet to find a GP who understood much about Bipolar Disorder; certainly they didn’t spot the signs when I was at my most hypomanic last year. They didn’t link high libido and reckless sexual activity with the disorder, perhaps because this isn’t spoken of enough because of its sensitive nature, so it isn’t high on the agenda like over-spending is. In all, I saw 3 different GP’s who all had different explanations and none of whom were that concerned by my behaviour, even though I was explicitly asking for help with it. ‘It could be your tablets, but they usually depress libido so it’s probably not’ and, ‘It might be your age (mid thirties) but it's probably not.’ None of them asked me for important information like how long it had been happening and what my history was (so they didn’t know I’d been with my husband for 16 years and that it was completely out of character).

Frustrated, I tried to find a GP who specialised or was at least interested in mental health, but apparently all the GPs at my practice are generalists as a policy. Finally my behaviour became so disruptive (like I nearly lost my job and my marriage) that I went to a private psychiatrist who wrote to the GP to say they must refer me to Community Mental Health Team. I was greatly relieved by this, but unprepared for how unsupportive that experience would then be.

At the CMHT I have seen 4 different junior doctors in under a year. Each only stays for a couple of months as they have struggled to find a permanent person. Finally through asking my GP to write and by emailing the Team Leader of the CMHT myself, I managed to get an appointment with the actual Consultant for the first time. He was very apologetic about all the staff changes. When I asked about more regular support, in particular with the behavioural issues (I was very frank about the compulsive nature of it) his response was that I should try and get counselling through my GP practice. I should have asked for more (e.g. to see an actual psychologist) but I struggle with authority and don’t want to appear too pushy sometimes. He also said they don’t offer regular appointments (with the consultant) anymore, just help when you are in crisis.

My GP referred me for counselling through the surgery, but was doubtful they would be able to support me (because I’m under the CMHT). So, it feels like I’m going round and round again. Do they wait until you have screwed up your whole life before they offer psychological support? Is it just that there are people so much worse off than me who get priority?

If you're having difficulty accessing the care and provision you need and would like to talk to someone about what services could be available to you, contact our Advice Service on 0300 5000927 (Mon-Fri, 10am-1pm) or advice@rethink.org

Comments

Please note: Rethink accepts no responsiblity for the content of comments in the blog.

Getting caught between GP and CMHT

Last year I was caught in what seemed like an endless tennis game between my GP and the CMHT. I was under the care of the CMHT for four years and when I moved to a new town I decided I wanted a fresh start. Before I'd thought that the recurrent crisis were inevitable and recovery to a good quality of life was impossible. But in the new town the criteria for CMHT involvement were different and as I wasn't in crisis I didn't meet them. So I was left high and dry. The GP was unable offer anything because I was considered to have complex mental health problems. The 6 week counseling they could offer wasn't specialized or long enough. But I was not "ill enough" to receive care from the CMHT. I know I "present well". Most of the time I am rational and retrospectively I am insightful about my own emotions/ thoughts/ behaviors. This insightfulness has appeared in the last two years and frustrates me further because I am able to see the damage I am causing to my life and body but feel powerless to stop it happening again because at the time I have no realisation that I'm not being rational. Surely the emphasis should be on treating/ dealing with things before they lead to a crisis. They'd be far less mess to clear up and a far better quality of life for the patient. Four referrals and another crisis later and I'm finally under the care of the CMHT. I have a CPN but my ultimate goal of getting some psychological therapy may take some time as resources are scarce.

2. At 03:43 PM on 29 October 2011 Rachel wrote:

Me too.

I'm so similar in that my insight and level of intelligence and education have hindered me when it comes to a diagnosis or help from GPs and CPNs. Just because we're intelligent does not mean we don't feel the same level of despair as someone less so. Perhaps we need a different kind of support- more talking therapies perhaps, rather than help within our homes and with advocacy.

3. At 10:38 AM on 10 October 2011 Louisa wrote:

thanks

Thanks to Ruby, Deborah and Sarah for your thoughtful comments and feedback. I'm very sorry to hear that it is not just me, and I'm particularly concerned that someone who is as low as you - D - can still not find the right help. Waiting for 12 hours in A&E in that condition would surely be enough to tip anyone over the edge. I really hope that with the medication you start to feel better anyway soon, so that if you do get the CBT you will be able to benefit from it. In my experience any sort of therapy when you are that low is pretty useless. Unfortunately what you need is a safe place, some understanding and time to heal and that is not something the NHS can offer. Having said that I used to have private health cover and spent some time in a Priory hospital in a similar state - and for me, it doesn't actually matter where you are or who you are with. If I am that low, nothing seems to help. But time does heal. No depression lasts for ever, even though at the time you are sure it will.

4. At 11:03 PM on 09 October 2011 Ged wrote:

Asking For Help

Sadly that is the experience I've had - I've gotten used to my GP staring at me blankly with that "well what do you expect me to do about it?" look as I describe the depressive illness that's stolen years of my life, cost me jobs and relationships, cost me my friends, plunged me thousands of pounds into debt, destroyed my credit rating and had me staring at walls trying to talk myself out of climbing out of a 2nd storey window and throwing myself to the street below. "What do you expect me to do about it." It is.. it's only really annoying when I hear the platitudes about what a splendid caring system we have. I do sincerely hope it's true of the person saying it (and I hope they're saying it from a patient's perspective); it certainly isn't true for me.

5. At 03:14 PM on 06 October 2011 Ruby wrote:

reply

Thank you for this post; you touched on lots of things I can relate to. I have also been told that my intelligence, my insight means that I am considered to be"fine" or that there is little the CMHT can do for me because of it (which seems ridiculous!). In the absence of any psychological support, my GP practice provided counselling - even extending it for considerably longer than the allocated 12 wks, and the support given by both this counsellor & the GPs has been excellent. It's not ideal, but it's something. The questions at the end of your post? I find myself wondering the same things - where if you can present as "fine" it doesn't matter how you actually are, that functional seems to be sufficient, rather than quality of life. I wish that wasn't the case, that it's crisis management only. Surely without the rest of the support, crises will happen more often? So frustrating...!

6. At 02:49 PM on 06 October 2011 Deborah wrote:

Asking for help, Louisa's story

I know exactly how you feel, I'm currently in the grip of the worst and lowest feelings of depression and having had a meltdown/breakdown about 10 days ago i have discovered that the mental health help available is so sparse it is ludicrous, while it's not the practitioners faults; I have found that one department certainly rarely commumicates with the others including GP's so the patient has to do much of the chasing up and making sure everyone is kept up to date, I personally have found this exhausting and that it exacerbates my depresssion having to go over why I'm depressed, what led to my breakdown, etc so much so that I'm going to type up a general account of what is going on with me and hand a copy to everyone who requires to know! Having been on the waiting list for CBT since June-it's now October, things have gotten worse over a period of time and led me into a crisis. I ended up with dreadful waves of sadness and crying spells that went on for up to 4 hours non-stop and finally feeling and wondering if being alive and enduring this feeling of prolonged hopelessness is better than not being here...I ended up trying to check myself into my local mental hospital who were sympathetic but told me I needed to go to A & E so I went there and had to wait 12 hours from 2 pm until 2.30 am to see the only psychiatrist on duty due to low funding and cuts! He reffered me to the community mental health team who came and saw mw at home 2 days later, all they could offer me was to recommend my medication was doubled and to try to chase up the CBT referral from July!

7. At 12:59 PM on 06 October 2011 Sarah Long wrote:

so hard

Your situation sounds so familiar to me - well done on actually seeking help "on an up". But no - doctors never seem to acknowledge the difficulty / damage this side of the condition causes. Whenever I've been to the doc's it's all about depression, and the standard questions to judge how bad you are are all about depressive symptoms. Indeed, as soon as you "score" in the ok range, you aren't classed as needing help. Where is the standard questionnaire to judge if there's more to a person's mental health issues than when they get down? It seems so prevalent to me that it should be standard practice to ask. And yet we walk away saying, well, he didn't ask me this, he didn't ask me that - and those few times you actually raise it yourself, they pooh pooh your concerns or get uppity for you stepping on their diagnostic toes. Hey, I'm not calling you incompetent, it's just I live with my moods all the time, you've had less than 10 minutes to figure me out. Sigh, good luck and be well.