Can anyone recommend a psychiatrist in London?

[luckywinner]

I am suffering really badly this time with depression. My GP is hopeless. I just want someone to take me seriously. I am lucky enough to have private health through dh. I just can't face carrying on like this.

[QueenofWhatever]

If you have depression, don't go and see a psychiatrist but a therapist. Ask your private health insurance to recommend some. Also if you feel your GP is hopeless, change GPs.

[luckywinner]

I already do see a therapist. I am on anti-depressants. I just don't know what else to do.

[Earlybird]

What sort of therapist do you see, and how long have you been going?

How often do you go?

Maybe the anti-depressants aren't the right ones for you, or perhaps the dosage needs to be changed.

[luckywinner]

I see a psychotherapist and have been seeing them for a long time, 5 or so years. I am dealing with some v difficult things in the therapy and it has really exacerbated my condition. I know I have to go through this to be the person I want to be on the other side. I take citalopram 20mg and to start with they were great and then I have had another really bad dip, about 8 weeks after starting the meds.

My gp, while I am sure was trying to help me, said I shouldn't be depressed. I have a lovely dh (which I do) beautiful dc (true!) live in a lovely place etc. Women who have to walk 5 miles for water should be depressed, were his exact words. I have another appointment with him tomorrow and I am dreading the lines he will come out with tomorrow. My fil, who is a retired GP, suggested I ask for a referral for a psychiatrist. I don't know what to do. I am soooo miserable. I can't carry on like this. It is not fair on my dh or dc.

[Nager]

er if you have the energy you should change GP and complain about him. That was an outrageous thing to say.

[livinginazoo]

Change GPs, they are not all that negligent and ignorant. My husband has been seeing psychiatrists for CBT and they have helped. Your GP should be able to refer you to a private one or NHS. Otherwise try calling BUPA or some private organisation and ask for advice on how to find one?

[ringmybell]

luckywinner, so sorry you are feeling so low, i could have written your post and i sympathise and relate. i too have nothing to be depressed about, but i am, have been most of my life. i'm not on ad's but maybe the one's you are on don't agree with you? i've tried them and tbh they made me feel more depressed and anxious and won't try them again.

i wanted to reply mainly because i've been questioning my psychotherapist (through private insurance cover). i've been seeing her for about 10 months now and i've had more lows in that time than i have had in years! i feel the therapy has has really exacerbated my condition also, but my therapist thinks that if i can understand why i feel the way i do (which i do) the causes bla bla then i will be better? but i fail to get how relating the past to everything now my behaviour, my feelings is helping? its made me worse tbh and maybe i'm meant to feel worse before better but i don't see how seeing her and to re-gurgitate (sp) everything i've told her over and over will help me.

i haven't seen her in 2 weeks (have been going weekly) and i've felt fine. lately i've been asking her about techniques to cope, to look forward rather than back all the time which has been so draining on me, and she seemed hesitant, i know she's not trained in CBT or pro CBT to that matter (apparently funding for psychotherapy has been cut and nhs now more pro CBT as is insurance companies as its a quicker fix), so i wonder if i need to keep on the process with her or if i should stop now and switch to CBT? sorry, don't mean to hiijack your thread, but you say you've been in therapy 5 years now and i wonder if its time for you to change too and ad's aren't the solution?

if a psychotherapist or anyone with knowledge of when/how this type of therapy will help will be very helpful to OP and me...

hang in there hon.

[anotherbrickinthewall]

if you do go private, I'ld be inclined to look for a consultant psychiatrist at the Maudsley who does private work. it might be that a clinical psychologist is more what you are after - IME as a patient, psychiatrists focus more on diagnosis and medication, psychologists on the whole picture, your past, your current problems etc.

[luckywinner]

Thanks for all your replies. I went to my gp this morning for my repeat prescription and he wittered on about how I shouldn't be depressed, about how I should think about going back to work, (i used to be a nursery teacher, there's a job I'd be good at right now), blah blah blah. My therapist is going to recommend someone to me.

My gp is an arsehole. I feel a bit better today as my mum is coming up, and the dc have gone back to school. However, this makes me feel guilty in itself as I don't seem to be able to cope when they are around. I was on a good run before half term. And then I crashed big time. All I can think is perhaps I shouldn't have had children. They are so precious to me and I am poisoning them.

Ringmybell, my experience with psychotherapy is that it definitely gets worse before it gets better. It is akin to opening a can of worms. Peeling back the layers can make you feel very exposed before you start to feel better. It is definitely a long term thing, so I can see why the insurance companies are so pro CBT.

How do you feel about going back to her?

[ringmybell]

luckywinner i am glad you feel a bit better today. some people know about depression but just refuse to accept it and think we can just snap out of it and sadly your gp sounds like one of them. however about going back to work, there might be something in that, how do you feel about it? is there a nursery attached to your dc school? i have gone back to work part time and its given me some structure to my week and where i am focused on something else rather than my own feelings all the time. although guilt of not being there for dc does linger as youngest not at school yet! so this could be why i feel okay since i haven't seen my therapist! who knows!

I'm not seeing her until next week, i guess i will go, but i dread going tbh. i'll give it until the end of the year unless something goes all pete tong!

As for psychiatrists, majority are anti psychotherapists and will mainly go down the medication route and could undo all your psychotherapist's work. so be careful as its a fine line to tread as in where it could all lead!

ignore your GP, sounds like an arse, chin up, everything will be okay. you definately SHOULD HAVE had your children, don't doubt that. its an amazing privilage to have them and i'm sure you're not poisining them.

[Earlybird]

I had many days when I left my analyst's room in tears, wondering why I was going there and whether it was helping anything - because it often made me feel worse. But, I am glad I believed in the process, and stuck with it.

Many times, I desired a 'magic pill' that would make everything better and easier. But the line between wanting and actually needing anti-depressants can be a fine one, I think. I had to be willing to examine/talk about/work on my issues - and that was hugely painful. Sometimes I had to simply let myself be unhappy and miserable but have faith that it would pass - I knew I was working through it all.

Personally I think anti-depressants should be a short term 'crutch' used in periods of mental/emotional crisis (unless, of course, you are a person with a true physical chemical imbalance who needs ongoing medication to feel OK).

Far better in the long term, imo, to persist with psychotherapy and/or CBT to learn to understand your 'demons', understand what triggers a spiral, recognise patterns, and learn to think/react/process things differently so that you don't sink into the mental mire (or sink less far, and come out more quickly).

Learning how to understand/manage your emotional state is a long and painful process. Terribly hard, but more than worth it in the long term.

You say you've been going to your psychotherapist for around 5 years. How often do you have sessions? Maybe you need to go more frequently when you are in the middle of something especially difficult.

[Wollstone]

I can recommend one. If you message me I will email you. My dh had serious depression and he was fantastic. He was recommnded by a GP friend.

He is excellent, good on meds advice and very pragmatic not quakish. He has is a consultant at one of the leading hospitals in London.

He is not anti pyscotherapy either.

[luckywinner]

Hi Wollstone that would be great. I will message you now.

[QueenofWhatever]

luckywinner that sounds like an awful GP. Do not go back! I really think you should complain - you don't have to do it now, but maybe when you are feeling stronger.

Five years IMO is too long to be seeing a single therapist. It sounds like the two of you have got stuck. Also the fact that you are asking for practical coping skills and your therapist is not helping is not good.

I have been seeing a therapist for a year, once a week for PTSD following abuse. I can honestly say I feel better than I ever have done in my life, more at peace and happier with myself and everything around me.

Partly I think its because I have a good rapport with my therapist. If I say this happened and it was awful, we have a laugh and say 'bugger, that was a bit fucked up'. But that's how I am in real life and maybe he is too. All I know is that it works for me. I also think knowing your therapist is 'anti-CBT' and it's about saving money/quicker is poor clinical practice. They should be doing what is right for you and CBT techniques could help you with the feelings of despair

I have had EMDR which sounds a bit snake oil, but has massively accelerated things for me.

[EldritchCleavage]

As for psychiatrists, majority are anti psychotherapists and will mainly go down the medication route and could undo all your psychotherapist's work. so be careful as its a fine line to tread as in where it could all lead!

This was not my experience, I have to say. My psychiatrist was very very good. My therapist referred me to him after I deteriorated (I was told it is common for this to happen: you lose all your defences/denial after starting therapy but it takes time to develop more functional coping skills to replace them with). He sorted out my medication (a psychiatrist may be better, even far better than a GP for this as they are expert in the medications available for depression. It really can take time to get the right one).

My psychiatrist was also enormously supportive of my therapy and, because I saw him only intermittently, was usually very helpful in gauging my progress. He urged me to opt for hospitalisation when I hit rock bottom. Without that, I might not have survived.

So I think that seeing a psychiatrist could be a good idea. You will get an asssessment of where you are now and advice about where to go from here, like what therapeutic model might work best for you: analysis, CBT, CAT, EMDR etc. At the least s/he could tell you from an expert point of view what a twerp your GP is being. How can any medical practitioner talk about 'should' and 'ought' where depression is concerned? You haven't opted for this as a lifestyle choice, have you? It's an illness.

[kizzie]

Your Gp is an idiot. Im glad he hasnt put you off from getting help elsewhere x

[luckywinner]

Kizzie, it has been a struggle, one I would have preferred not to have had.

Eldritch, that is really interesting. I wasn't really aware of that. I think I am experiencing what you went through. I have unravelled, and have yet to have developed the resilience inside myself to deal with how I am feeling. Did you receive in-patient treatment? Because right now, that is so appealing. I just want to give up. Not on life, but having to deal with this illness.

Thank you all for your messages, btw. It really really helps to just post nonsense on here.

[EldritchCleavage]

I had had 9 months of therapy when I began to deteriorate sharply. It took a few more moths before I would agree to go to hospital. Overall, it took 5 years to complete treatment, including 2 and a half years on medication. I have been in remission and symptom-free since then.

I didn't ever become a full-time in-patient because NHS provision where I am was a nightmare and private too expensive. I went in as a day patient (there all day then home to sleep) over a period, then kept up two hospital visits a week over another period, all the time keeping up weekly sessions with my therapist.

I was rather glad in the end that I had to do it that way. While I got respite from work and the everyday, I kept some independence and eased back into life better at the end of the intensive treatment period. To me, seeing friends and family away from the hospital was very precious and helpful. However, everyone's different and other people really needed to be in hospital, feeling safe and secure.

My psychiatrist's input was also very valuable throughout. For example, he put me on a high dose of citalopram for a while (60mg) as he deemed it necessary and it did really help me at the worst time. I suspect many GPs would not be happy prescribing so much, and a stray pharmacist put in his oar to tell me it was too high, but actually that's what I needed. Going to hospital every day meant I could be monitored to see how I was doing with the medication. As soon as it could safely go down it did.

I don't mean to proselytise my treatment model as the one for you-I just offer my experiences as food for thought. You do sound stuck, so even a one-off consultation with someone else might help you decide a way forward.