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Okay, time to give an update in the depression saga.
For those of you who missed last month’s installment – I have been having tearful, inconsolable crying breakdowns. Perfect Husband seems to think that this is an abnormal state, and an undesirable one for the future mother of his children to exist in. He seems to feel that his first act as a good father is to get me happy before I try to grow a fetus in my depressed, distressing womb. So I mention it to my doctor during my PAP test and she tells me that this is VERY important but that she doesn’t have time to talk to me about it, since I am just booked for a physical and she is moving to different city next Tuesday. She encourages me to try a mental health facility in the local hospital, and asks if I want her to keep my file. I say yes, since woman doctors are scarce.
I had no idea where exactly in the hospital I was supposed to go. Do I go to emergency? Or is there a special set of doors for people-who-need-help-but-only-kinda-sorta? Perfect Husband suggested I call 811, so I did. The guy I spoke to had no idea.
“I’m going to transfer you to one of our RNs. They have access to more information than I do.”
So I speak to a male RN. He asks me a bunch of questions and says that yes, I assess as definitely depressed. He doesn’t seem to believe that I can be this depressed without thoughts of suicide, and keeps saying stuff like “are you sure you aren’t having thoughts of death?” He can’t help me himself, but he give me the number to the local mental health centre and encourages me to call them.
I do so, but they’re only open Mon-Fri, 9-5, when the depressed population are sloughing their way through another meaningless workday. Thankfully, I teach puppy class Monday evenings, so I called Monday morning. When the lady answered the phone I explained that I needed to be assessed for depression, but my doctor was too busy for me so did they have someone who could do that for me? She asked for my address and then said irritably “That’s the wrong part of the city. You need to call the other branch. I’ll transfer you.”
Another lady, sounding older and more crotchety, picked up the phone at the other centre. I started to explain about my doctor, but she cut me off with a bored “hold please” and I listened to eighties power ballads for several minutes. When she came back, I shortened my story to “I need to be assessed for depression. Can you help me?”
“I’ll have to take your name and care card number and someone will call you back after I’ve put you in the database,” the woman said blandly. She took my information and hung up on me. She didn’t ask if I was suicidal. I waited and waited, and no one called. Just doing this runaround was putting me near tears. How many people do you need to call and say “I need help” to before someone actually helps you?
Just as I was getting ready to leave, the phone rang. The lady who talked to me on the phone asked me that same bunch of questions, and told me that I definitely assess as depressed. But she didn’t think she could help me. She recommended to me that I talk to my GP. I explained that I had, and my GP was too busy to talk to me about it, and had told me to call the mental health centre, and had then moved practices the next week. She sounded slightly shocked, and told me I should go back to the GP.
“Tell them that you want to book an appointment specifically to talk about your mood. She’ll ask you a bunch of questions, and then she’ll be able to prescribe an antidepressant or possibly refer you to a psychiatrist. I’ll fax her some information about what we have spoken about today, and recommend you for antidepressants and the “Bounce Back” program that we offer. Will you promise to call her?”
“I don’t know where she is, now.”
“I can find that out for you. The thing is, you could go to a walk-in clinic, but you should really have someone who knows your medical history, and besides, you’d need follow up care. I could try and get you an appointment here, but frankly we work by triage, and since you don’t want to hurt yourself, it could be a long time before we managed to fit you in.”
My mind filled with images of pressing masses of people each claiming to want to hurt themselves more than the guy next to him. “Take me next, not him, I’m much more suicidal!”
So I called my GP’s new office and asked to book an appointment for the day after I returned from vacation.
“Uh, yeah, that’s, like, next week,” said the guy.
“Yes, yes it is,” I agreed patiently.
“The thing is, I don’t have her schedule for that far in advance.”
“What, next week?” I asked.
“Yeah. Could you, like, call later this week, or even better, early next week? I should have her schedule by then.”
So while I was on the other side of the country, Perfect Husband called and asked to book an “extra long” appointment to talk to the doctor.
He took me in on Thursday, after I called in to work for being jet lagged. We sat and listened to a pair of women complain about taxes, low income housing, the general way that everyone spits on the poor etc. It was clearly half walk-in clinic, half not, because there was a sign up reminding patients that if someone was called in ahead of them, it was probably because that person had actually made an appointment.
They called me in.
“Isn’t that just typical?” one of the women muttered to the other, “see how the people with money get special treatment? I was here before her.”
“Oh, I’m sorry, when was your appointment for?” my husband asked her innocently.
I waited on the table for the doctor. I could hear her outside, finishing with a patient and then being pulled aside by a drug rep, whom she assured she was trying to give out as many free samples as possible. Finally she came in, took my file off the door, and said “what can I help you with today, Carol?”
“Well, I’m here to talk about my depression. I did what you said, but the people at the mental health centre sent me back to you.”
She furrowed her brow and looked at the file, which contained a single, blank, record in it. “Carol, I don’t have time to talk you about that today. I’m really swamped here. When I saw you before, did I tell you I was willing to take you as a new patient? Because I…”
“I’ve been your patient for two years,” I said, nettled. She looked at the blank file again.
“Oh. Well, then your file must be in storage.”
“I was told you brought your patient files with you,” I said, confused.
“Yes, but I put them in storage. The only files I actually have in this clinic are patients who said they definitely wanted me to keep their files,” she said disparagingly.
“But you asked me if I wanted you to keep my file, and I said yes,” I said, tears beginning to well up.
“Oh. Well, I don’t have it, and I’m absolutely swamped today, Carol, I don’t have time to talk to you about all this. What are your symptoms? Just crying a lot?”
“I cry a lot, I’m sad all the time, I have no energy, I crave carbohydrates, I’m gaining weight, sometimes I have insomnia and sometimes I sleep too much…” I reeled off. She scribbled something quickly.
“Well, that sounds like depression. You want antidepressants?”
“I don’t know… I’m worried about side effects. I don’t want anything that is going to make me gain more weight, and my libido is already low…”
“Carol, you can’t go limiting me like this!” she snapped. “Look, I’ll give you some samples of a new antidepressant. You come back in 10 days, and by that time I’ll have your file out of storage.”
Yeah, right. “Well, but, are these SSRIs? Are they safe for pregnancy?”
“Why, are you pregnant?” She asked, folding her arms.
“No, but my husband and I are planning to have a baby sometime in the next year…”
“Well, WHEN you decide to try for a baby, WHEN you get pregnant, THEN we can talk about whether to change medications or take you off of them. In the meantime, take these samples, and come back in 10 days.” She hurried me out of the room and went on to her next patient.
My husband found me coming back to the waiting room in tears which flowed for the rest of the day and well into the night. I just couldn’t make them stop.
Okay. Apologies in advance for what is likely to be a long comment.
I am so sorry that you had this experience when you finally did reach out for help. I’d like to say I’m surprised (and I AM surprised by your experience with the GP, she was way out of line) but unfortunately, the medical system is just not set up to provide wellness care. In every part of the country, trying to get mental health care through the public system unless you are suicidal or an immediate threat to others is extremely difficult.
I personally have never been to a psychiatrist. You do need a physician’s referral for that and they tend to be for more severe depressions and manias (think bipolar, or schizophrenia, that kind of thing). Psychologists, on the other hand, are highly trained; they are used to dealing with the kind of depression you are experiencing; and you can just call one up and make an appointment yourself – and most of the time it will be covered by your health insurance (check your individual policy but counseling is pretty standard in most plans these days).
Finding the right person for you can take time. And you may end up trying more than one therapist before you find the one you feel comfortable with. It’s hard too, once you’ve been burned the first (or second, or third) time to pick up that phone and try yet again… I know when Michael finally agreed to see someone last fall, I was the one who had to make the appointment for him. There is no shame in asking someone else to dial the phone for you.
Don’t let anyone give you a prescription (or samples) of an SSRI or anything else without having therapy as part of the solution. In university I went through a bad depression; the Dal health clinic gave me some Zoloft I think it was, and while it did level off my moods considerably (the hysterical sobbing and inability to crawl out of bed stopped) it didn’t do anything to help me long term. The way I look at it is that SSRIs or other meds are crisis intervention – they help you get your head up and function normally, so you can get to a place where you can think. The therapy then helps teach you coping skills so that when you have depressive episodes, or extra stress, or what have you, that you don’t sink into the despair crying / eating / self-loathing cycle that has characterized your life in recent months? years?
Once you find a therapist, remember that they are there to guide you through the process. You must be completely honest with that person. The more you censor yourself or say what you think they want to hear (“I’m the best at therapy! Look how good I am at this!”) the less benefit you’ll get.
Most important, Carol, keep reminding yourself that this is not going to be a quick or easy journey. It’s taken many years to get to this point. It will take time to get back to you. You may be surprised by the person you become. You may lose some friends and gain new ones. Just be gentle with yourself, okay?
Thanks. First step – a half decent GP. I’m terrified I won’t find one. And then what?
I’ll just say this – I’ve never had a GP be of any use to me when treating my depression. It’s always been a psychologist first, then when I decide to go on meds I go to any GP I can find and ask for the one I want.
I’ve tried Effexor, it made me listless and tired. Wellbutrin worked out much better although it fucked up my sleeping patterns for weeks.
Hey again,
Just a random reader — I put the comment up about wellbutrin.
PLEASE consider it. Ask your doctor or any clinic doctor about it. It does the following:
1. increases your sex drive
2. increases your energy
3. controls your appetite
4. works on depression
SSRIs will make you TIRED and WILL make you gain weight. Plus it’ll squash your sex drive. Everything your post said you are concerned about. SSRIs are notorious for working well but having awful side effects such as the ones I mentioned.
Ask for an SDRI (wellbutrin) or an SNRI (effexor, for example)….both work well together too.
I’m not a doctor, just someone who’s been through the same thing. The most important thing is to DEMAND to be referred to a psychiatrist. They know what they’re talking about more than a GP. My GP put me on wellbutrin for my anxiety and depression….my psychiatrist then told me wellbutrin doesn’t work on anxiety…so I’m on wellbutrin and effexor and both work wonders.
Please consider this. You NEED to be seen by a psychiatrist…however long that will take!
Thanks. As I said in response to your wellbutrin post, I was already hoping to be put on this drug. But stupid GP didn’t stick around long enough. *mutter mutter*
I didn’t check the last post before I posted this, so that’s great that you’ve done some research on this. Just make sure your issue isn’t anxiety because wellbutrin can make anxiety worse at the onset (and can come with some manic symptoms if that is your problem).
Anyway, like you said, your first step is to find a half decent GP. It can take some time because it’s often trial and error, but it’s not impossible. I went to over 6 doctors before I found my current GP, who’s wonderful. If you’re not comfortable with someone, then don’t go back!
It’s nice to know I’m not the only one with sucky doctors!
I have to give Perfect Husband the credit for doing the research – he looked for the ones that were safe for pregnancy and was like “uh… this fixes all your problems. Get on this!”
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Okay, so yes, this comment is a billion years out of date, but holy crap do I recognize what you went through here and feel for you. Sorry she sucked so badly, and glad that things are going okay a year later despite her.
Thanks. Yeah, I left a very nasty review of her on rate mds. I guess that’s the best I could do!
i’ve just read this and even though it was a while ago i feel compelled to comment. jesus, you poor thing. that is utterly AWFUL. i’ve been incredibly lucky with my depression and have a good GP (and also a GP as an in-law, which is incredibly handy) but even going to see them was bad enough, so i can’t imagine how awful this was. i’m so, so sorry she was so shit.
She really, really was! It worked out in the end, though.
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