To want to see a psychiatrist?(6 Posts)
I've suffered from depression and anxiety for as long as I can remember. I had a breakdown of sorts a while back, due to an emotionally abusive relationship. In the past I've had counselling, CBT and CAT, none of which helped, particularly. The CBT was useless, and whilst the counselling and CAT were helpful in that it was good to talk about things for a hour a week, they did not help me long term.
My CAT therapist told me that if I wanted to explore psychotherapy, which took a different approach, I could do this via my GP. I felt very strongly that the counselling, etc. didn't go 'deep' enough and thought that perhaps psychotherapy would be worth a try. My mental health is worsening as I get older (I'm 47) and I often think that if it wasn't for my mum, who needs me, there's really no reason for me to be here. No children, can't work due to ill health, etc.
I approached my GP about accessing psychotherapy and to cut a long story short, I was turned down. The letter she received back from the psychiatrist at the hospital essentially said I wasn't a good candidate and should go down the 'Healthy Minds' route (local MIND centre, etc.) I've already done this, hence the counselling, CBT, etc. The GP also tried to get me into another place that offered psychotherapy but again I was turned down, due to funding. She has appealed this, but I suspect I will be turned down yet again.
I'm at a loss as to what to do. I feel I need support, but haven't a clue how to go about getting it. I strongly suspect that the image I portray is of someone who is coping pretty well, despite what I say about anxiety, etc. It's always been this way. I don't LOOK like someone with depression (ha!! What does such a person look like??!) And despite my illness (M.E.) I push myself every day to work hard at keeping rock bottom at bay. Because I know how impossible it will be to come back from that. I push myself beyond my limits with exercise because, despite it leading to a relapse, it provides a minuscule sense of achievement if I can push through and not die
At my last GP appointment, I asked the GP if there was anything I could do if I'm turned down again at this appeal and her response was along the lines of "no, not really". Not heartening
Does anyone have any advice on where I might go from here, or is this really the end? I should state that the obvious solution, see a therapist privately, is not an option due to financial situation. Thanks for reading, and so sorry it's an essay
I'm sorry you're having a hard time.
I think it's possible you've got your terms muddled up so you're chasing something that doesn't exist.
I see a psychiatrist every few months. I have a range of dx including Borderline Personality Disorder (BPD) and PTSD. I was referred to her via the GP - I can't remember the exact process but it was serious enough to involve social services at the time. After confirming the dx she now periodically reviews my medication and general health (eg liver function can affect cognitive functioning).
I also see a clinical psychologist every week. This is psychotherapy with a CBT/DBT flavour. It's about learning techniques to manage the psychological effects of the psychiatric disorder iyswim. He's a specialist in PTSD counselling although actually it's the BPD stuff we're dealing with at the moment.
Unless you are settling a different diagnosis or suffering an acute MH crisis I'm not sure what a psychiatrist could do for you. They aren't more talented counsellors: it's a completely different job. I suspect this is why you have been turned down, because the doctors don't think there is an underlying psychiatric problem that could be treated by psychotherapists rather than psychological problems to be treated with talking therapies.
Now, that doesn't mean you are not worth treating. I can't tell from your OP whether they're refusing to fund any more counselling at all, or just the particular sort you think will be useful, but it sounds like the latter.
If you felt that the previous therapy was useful but you need more, ask the GP if that would be possible again. Be candid about your anhedonia and any suicidal thoughts. Don't be afraid to cry.
In the meantime don't hesitate to contact The Samaritans if you need to (possibly by email). I've also had good support from the volunteer "listeners" (online private chat) at 7cups. In both cases you can be completely honest without needing to hold back as one does with friends and family.
Thanks for your response, UbiquityTree - I appreciate your comments. Perhaps you're right and a psychiatrist is not suitable for me. I'm just struggling to know what is. I guess I thought that psychiatry may take things a bit deeper and help me understand why I'm like I am in certain ways. I'm back on the list for counselling at MIND now, guess that's better than nothing. I think I actually wanted to find out if there WAS an underlying psychiatric issue that was causing such problems. Maybe there isn't.
Thanks again for taking the time to respond
I think you might be getting fixated on one treatment amongst many. You don't know that this is the right treatment for you. It seems like the experts don't think it is and understandably don't want to spend money on something they don't think is right for you.
I think you should look at the treatments that are being suggested for you. I have met people who feel that treatment from a psychiatrist is more effective than a therapist, but this isn't what research says.
Have you tried DBT?
I know you said seeing a therapist privately was not an option due to cost so apologies if this is not helpful, but I just wanted to say that it doesn't need to cost nearly as much as some people think.
I had CAT privately, it's a brief therapy done over 16 sessions and it cost me around £550 for the package... which for the benefits it brought to me was well worth it. I found it massively transformational.
If the NHS won't fund you, and you need to get better, is there anyway you could save up or get a loan? Or even if you can't do it right now, bear it in mind for if your financial situation improves in the future?
I can tell you, a psychiatrist in current NHS cannot offer what you are seeking, sorry. Talking therapies are a 'soft target' for cuts and a lot of the capacity got cut 4-5 years ago. Plus generic psychiatrists don't offer psychotherapy, just a quick quick of mental state, risk and meds.
Please don't rule out looking privately. I am not affiliated with this organisation, but it does offer reduced fees:
Eg if you can commit to 2 yr minimum of at least twice weekly therapy, your fees may be capped at a max of £25 a session. Obviously depends on whether you have a therapist with vacancies local to you and what approach you are interested in. I'd imagine therapists will be offering traditional, on the couch therapy through this scheme.
That was a quick google - check with a variety of professional therapist organisations eg ukcp, bap, Iga, iPa. Most of them will offer reduced fee or sliding scale fees for patients on reduced income. Might be more likely to see someone in training supervised by a training therapist, but again, they will be committing to your therapy over a substantial period.
For what, to me, it seems you are looking for something that sounds like psychodynamic or psychoanalytic psychotherapy. You are very unlikely to get this on the NHS these days, where once patients could be seeing consultant psychotherapists for years on the NHS now it is very time limited.
Availability in the private sector can be limited too, often by geography, with most choice round London and bigger cities.
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