Upset by GP - was she right?

[LunaNorth]

I’ve been on citalopram for six years, for generalised anxiety disorder, plus health anxiety. I suffer from OCD in the form of intrusive thoughts, too. All this is just for context.

Citalopram has given me my life back, tbh. I tapered off it two years ago, and all my symptoms returned. I went to see the GP who prescribed it, and we agreed that i should stay on it. She put it that some people need an asthma inhaler, some people need insulin, some need citalopram. All fine.

Until last night, when I had my review to get my script renewed. Some GP I’d never met rang and when I told her I’d been on it for six years, started to lecture me about how she only prescribes for 6-12 months; how after that it stops working; how people think they need it because of the withdrawal when they stop, but if they can ride out the bumpy time they find they get better; on and on.

She asked me nothing about my mental health, my history, nothing. Just kept booming, ‘nobody is going to take it away from you, but...’ and then launching into another lecture.

I came off the phone really embarrassed, anxious, doubting myself and I haven’t really slept. I also plunged into a big emotional eating binge.

I’m sorry this is long. I’m just cross but also wondering if she was right - not in her approach, but in what she was saying?

Thanks for reading if you’ve got this far.

OK yes, OrangeSharked, but 'many people' is not everyone.

It's really interesting to see how the comments on this thread differm depending on whether they come from people who have first-hand experience of long-term mental health troubles, or whether they come from people who make no mention of any first-hand experience with mental illness but still think you should take this GP who has never met you at her word.

@OrangeSharked

I'm assuming this GP has a lot of experience of prescribing and taking people off citalopram. So I would believe them when they say that many people do just need to ride the withdrawal symptoms.

It also gives you useful information. You have been on them a long time, longer than many and it might be worth giving it another go to come off. As the GP said no one is taking them away from you but its something for you to consider. Its possible the GP was annoyed with the previous GP for keeping you on them for 6 years.

I’m not coming off them. Not a hope.

@lunanorth

I've been on them 5 years. My brain chemistry isn't going to suddenly alter so there's no point taking me off them, it's like taking me off thyroxine
I'm on a low 20mg dose

Fuck that shit. I'm staying on mine for life as the alternative is crippling anxiety, and I'm not going there again. My brain doesn't produce enough serotonin, therefore I take meds to replace it.

Wanting to high-five so many fellow sufferers on this thread

My Dad has been on anti-depressants for many years now. Several times, different GPs have tried to wean him off and he ends up back where he was very quickly. Eventually my Mum went with him to an appointment and point blank told the GP that if my Dad was weaned off again, he would have to move out because the depression was too bad for his young children to live with. In my Dad's case, he just needs the drugs, in the same way I need thyroxine.

Just ask my DH whether he thinks it would be a good idea for me to go off citalopram, you will get an unequivocal answer

When I asked my GP how to manage anxiety he said I just needed to pull myself together.

Clearly it's at least partly genetic because so many female relatives of mine suffer from bad depression. The bright line is between the relatives who have sought help and the relatives who haven't (the former are leading happy lives, the latter not so much). My own DM had terrible depression but she never stayed on meds because she thought they didn't help. Looking back, I realise that she expected them to take effect immediately, whereas actually they can take as long as a month or two to kick in. I suspect she never stayed on them long enough to experience the benefits. And yes, my siblings had a difficult childhood trying to look after a depressed mum.

It's quite extraordinary for me to have been in touch with women relatives I hadn't been close to, and realise how similar our mental health symptoms were, and how we had all been prescribed similar meds completely independently of one another.

I just feel grateful to have been born in a century when this help is available. I wonder how many unnecessary deaths (eg Sylvia Plath) could have been prevented if people in the past had had access to the help we have now.

Meds don't work for everyone, but when they do work, it's madness not to take advantage of it.

@MintyMabel

When I asked my GP how to manage anxiety he said I just needed to pull myself together.

You need another GP!

meant to say, 'my siblings and I had a difficult childhood'

MY DS2 has been on a high dose of Sertraline since he was 16..he's 24 next month.
WITH his meds, his OCD is kept suppressed enough that he can function.. yes he has little blips, but he's ok. Without it, he's a terrified paranoid mess, who's intrusive thoughts make him think he's dangerous, and he's terrified to go outside.

ONCE a different consultant suggested he came off them. I think I was fairly clear in my response (I go with DS2 as he has autism too) and thankfully no-one has suggested it since. It's a chemical imbalance like any other medical condition...strangely enough no one has suggested he stops taking his Ulcerative Colitis meds to see if he'll be ok...

And he has CBT..yes it helps but itdoesn't correct the mis wiring in his brain!

@MintyMabel

When I asked my GP how to manage anxiety he said I just needed to pull myself together.

Fucking hell

The original GP likened your medication to insulin to manage diabetes. Absolutely right. If it works for you, it works for you.

I think there are a lot of people who don't understand how mental illness can manifest. I've had crippling anxiety since childhood and I've tried many things - talking therapy, exercise, beta blockers, just dealing with it 🙄. GPs actually tried to get me to try ADs for years and I refused, but then at one appointment a lovely doctor suggested that some of my other physical symptoms could be caused by stress and anxiety so I gave it a go. I finally felt "normal" for the first time in my life.
For me, when I am not on medication I suffer real physical symptoms such as a racing heart, shakiness, dry mouth and the inability to do many things such as making a simple phone call. It's not withdrawal symptoms- that's just the way I am without meds and no amount of pulling myself together will change that.

I recently started taking ADs and from the get-go my GP said I could take them as long as I felt they were helping, that it’s just like any other medication.

Perhaps the doctor was young and new? Nothing wrong with that. You know what you need so don't let her upset you and she said ''no one was going to take it away from you'' which is what you wanted to hear. She just felt she needed to give you a lecture.

Why is the GP who screwed up assumed to be young? People of all ages have shitty attitudes to mental health conditions. The GP who told me I just need to pull my socks up when I went to see them with severe suicidal ideations and an active plan was fifty years old - thankfully the GP admin team saw me walking out of the building with no help, had me assessed by another GP (oddly enough, a younger one), and I was placed on a section.

OP - she's right in some ways, and you are right in some ways. Sometimes coming off medications doesn't work due to the adjustment phase, sometimes it doesn't work because it's not the right thing to do.

Yeah Tara66 but a lecture can be very unhelpful for people who are struggling and full of self-doubt.

She should have trusted her colleague who has been working with the OP for 6 years and clearly thought it was right for the OP to carry on with the medication.

The whole mindset of 'I only prescribe these meds for 6-12 months' is very damaging. I don't doubt that some patients were able to discontinue meds after 6-12 months with no negative side effects, but that is unequivocally not the case for all patients, and this GP's 'one size fits all' mindset could be putting some patients in real danger.

@tara66

Perhaps the doctor was young and new? Nothing wrong with that. You know what you need so don't let her upset you and she said ''no one was going to take it away from you'' which is what you wanted to hear. She just felt she needed to give you a lecture.

She didn’t sound young she sounded like Margaret Rutherford but whatever her reasons, she needs to think about how she talks to people.

Thank you all for your comments. I’m sorry to hear how many of us there are, but it’s good that we’re getting the help previous generations couldn’t.

She’s wrong, guidance suggests 6-12 months (minimum, not maximum) for first treatment. If the symptoms reoccur, then 2-4 years minimum, with no recommendation to discontinue. A further reoccurrence if meds were reduced a second time would indicate the need for longer term treatment.

There does always need to be a trade-off between side effects and benefits but some people will need meds forever. My mum has been on all the drugs but does suffer form side effects. We had a cycle a few decades ago where the psych would alter the meds down, she’d relapse and end up being sectioned. Pretty much every admission was as a result of trying to reduce down the dose until my dad said no more.

I’m lucky that my side effects are minimal. Mad dreams, and that’s about it these days.

@Howmanysleepsnow

She’s wrong, guidance suggests 6-12 months (minimum, not maximum) for first treatment. If the symptoms reoccur, then 2-4 years minimum, with no recommendation to discontinue. A further reoccurrence if meds were reduced a second time would indicate the need for longer term treatment.

That’s interesting, thank you.