What happens if I contact my GP? (mental health)

[TheAdventuresoftheWishingChair]

I'm hoping people on here can give me some information.

My mental health has suffered severely for the virus/lockdown. I have a long history of problems caused by lots of trauma but in the last few years had been doing well.

I am now finding it harder and harder to cope. I have a psychologist who I pay for privately and he has been absolutely brilliant but obviously there are limits in terms of how much he can be involved. In my really bad moments I have been considering contacting my GP but I'm not sure what extra he could do for me. So I wanted to ask if you or someone else has reached out when you were in a similar place, what did the doctor do for you and was it helpful? I have quite a serious fear of doctors because I was assaulted by one so it's very difficult deciding whether to involve my GP or not. I haven't even seen a doctor for years because of being scared.

I don't want to go on antidepressants - I took them for over 10 years and they didn't help (I tried several). Luckily I'm not actually depressed at the moment, I'm just experiencing a lot of intense suicidal thoughts and am getting a lot of urges to self-harm. I have never had input from a crisis team so am unsure of how helpful something like that is or what they do to support you.

Thank you.

They might offer you a referral to the community mental health team.

Is that a helpful service? I know it might differ depending on different regions and individual practitioners. But could it be as simple as someone ringing me up to check up on me that bit more often?

Can you self refer to the IAPT service? That is what I did when my mental health bottomed out 18 months ago

I just googled IAPT and my local one says it is for mild to moderate anxiety or low mood. I think sadly I'm in a more serious situation than that. It says I should contact my GP but I'm scared of doing so.

If you are suicidal and at risk of self harm, you may get a referral to a psychiatrist who would be better placed at choosing appropriate medication. I also don’t do well with anti depressants but anti psychotics and anti anxiety meds help me a lot when I’m in crisis which was a recommendation of a psychiatrist on hearing my history.

What sort of help are you looking for if you're getting therapy and don't want medication? Do you need a different therapist, or an inpatient stay? The GP might be able to help with that.

Anti-anxiety medication might actually be a route to go down. If I could numb myself for a bit I'd feel better. I know they are different medications to anti-depressants.

I don't know to be really honest Someoneelse. I'm just getting tired of keeping myself going and I'm tired of feeling so bad as well. My therapist is fabulous so I want to stay with him (really, he's incredible) it's just some days I'm so desperate to die and I'm getting through those moments alone at the moment.

Oh adventures i am beaming you so much love and light and hope right now. Having been in a similar position i would strongly recommend trying another SSRI, it may be just enough to take the edge off and give you some relief.

Is there any background to this, any trigger that could have caused these thoughts? Do you have someone in real life you could make aware, to help keep you safe?

Thank you

I would be advising someone to try more medication too if they reached out to me, I think I'm just that bit too scared. But I will have a think about whether I could try.

There is background, yes - I am dealing with an ongoing traumatic situation which has been made much worse by lockdown but it's potentially outing if I write about it here. But it's been very sad. I have some friends who know the situation and who are supportive but there's a limit to how much I want to message them and say 'I want to kill myself again today' because it's very upsetting for them and there's not a lot they can do. My therapist is letting me email him when I feel bad and it's so helpful but even with him, I don't want to bombard him because it's so intense at the moment.

I think it's just about doing this a day, an hour at a time, but I know given how scared of doctors I am that I might be shutting myself off from more support which could make a difference. It's just hard to pick up the phone when I don't know what action they will take if I do flag up I'm struggling.

TheAdventuresoftheWishingChair Yes you would usually have a care coordinator who keeps on regular contact depending on your risk level. You would also be under the care of s consultant.

Hi OP, as a GP I would encourage you to please make the call to your surgery. I am so very sorry to hear that you have been assaulted in the past and that you are going through such a hard time lately too. Well done for posting here, it is one step towards getting help and support.

If you have a look at the surgery website’s list of GPs it will mention if any have a specialist interest in mental health and even if not, if you mention to the receptionist that you’re feeling very nervous or ask their recommendation they should be able to book you in with someone who is best placed to help you gently. They will know which doctors are most approachable for mental health issues. At the moment most surgeries are doing initial appointments by phone or video, and whilst there are some downsides to this, it may be more manageable for those who struggle to go out of the house or who would feel scared in a waiting or consultation room. You could even start by reading out parts of your post above.

What would they offer? It will depend on each patient and doctor of course - but in general I will first be trying get to know you, try to get a understanding of your current symptoms and needs, and working out if this a patient I can look after by myself or do they need additional help eg from the local mental health team, the crisis team, social support, housing/financial advice etc and of course psychological therapy. I would consider together with the patient if and what medication may be useful taking into account your preferences and past experiences. I am always keen to take a holistic approach so at some stage we may start thinking about other things that could help you such as sleep hygiene, exercise, and other changes in diet and lifestyle. I would be offering you regular follow ups together for further support but also so I can continue to assess for any changes or need for increased support. It can all sound very daunting but I often explain to people that even if all we do is spend the first couple of appointments getting to know each other then when you are ready to take up some treatment options I will be ready.
Finally I would also give you contact details of further support, set up a follow up appointment and explain what to do if you reach a crisis point.

Good luck and I hope you feel able to talk to someone soon.

Thank you - that's incredibly helpful @flowersfortea

You've made it sound like a pretty non-scary process. I wish all doctors were like you!

You’re welcome. I appreciate that all GPs are different and practise differently too, but we are all trained in mental health and will be able to offer some help and support as well as referring those who may need more specialist help.

Just to add - even if you have never spoken to your GP, you can still ring a crisis team of you need to. You will be able to Google the number. Maybe write it down somewhere easy to find in case you need it at a time the thoughts are strong?

Oh really? I didn't know that. Thank you. I've spent so long avoiding doctors that I don't know any of this stuff. I will have a google.

If you have any trouble finding the crisis number then pm me the area you are in and I will look up the number for you.

I'm working with a Community Mental Health Team at the moment. We are still taking GP referrals, but they are telephone appointments. The Crisis Team is still working as normal.

Thank you Stompy, I've managed to find it.