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.

This is why I'll sell my soul for my son to always see a private psychiatrist and not bother with these ignorant fucking GPs. He also has OCD. It's a lifelong condition. He takes ADs for it. He probably always will.

I'd complain about this GP.

Fucking tired of ignorance about psychiatric conditions like OCD. Evidence is that it is best treated with ADs and adjunct psychological therapy.

@catpoooffender

I have been on ADs for years due to OCD. At one point I saw a psychiatrist who said to just stay on them, basically. I don't have any issue with taking them for life and am always surprised at people who refuse to take them.

On the other hand the best therapist I ever saw was of the opinion that it might be worthwhile working towards coming off them. I refused to consider it. I know myself and my OCD and I'm not interested in going back to the darker times.

Exactly!

OCD is not depression. It's a different condition.

The usual ignorance is pervasive on this thread.

I’ve been on citalopram on and off since 2006. Been very much on it solidly with no breaks for over 5 years now. No one has ever, ever suggested it should only be prescribed on a short term basis.

Can you make an appointment with a different doctor to discuss your worries? It sounds like you need to and hopefully they will make you feel a bit better about it all. No one, least of all a medical professional, should be trying to make you feel bad for needing medication.

Yes, I'm glad the OP has bowed out of the thread as she said she had health anxiety anyway, and some of scaremongering about meds on this thread is quite unhelpful.

In my case, I have extensive experience of life unmedicated and life medicated. For me, the latter is phenomenally better, and unless some unforeseen complication occurs, I am making an informed choice to stay on meds for the foreseeable future. If I came off them, would I die? Probably not. But life for me and my close family members would become much more difficult again. For me, it's a no-brainer.

The problem (and I'm repeating what a psychiatrist and GP both told me) is that GPs are a bit scared of antidepressants. Anyone who is really seriously ill sees a consultant who does the proper prescribing. GPs either follow consultants directions or try out a few smarties on the worried well. They don't really know what they're doing, they're afraid to prescribe medications at higher doses because it's a job for a specialist. They're uncomfortable with people needing long term medication because people who fall into that category are usually seen by their superior. Consultants have no airy fairy ideas about everyone being med free. They would feel very differently and are well aware this is a recipe for chaos. They're more comfortable with medication because they know more about it.

If I had a serious query about medication for a mental health issue I would speak to a psychiatrist. Ditto any illness. Speak to the specialist.

You're 'stop it' shows how insensitive you are to mental health problems

You don't have a monopoly on MH problems, HoneyBadger and I think you should show some sensitivity by toning down the hyperbole.

I'm pleased for you that you've not been in that vulnerable a place and therefore see it as hyperbole to address it

You don't know anything about my MH, like I said you don't have a monopoly on it.

@LunaNorth

She gave me the prescription, which is why I’m wondering what the lecture was all about.

It was like she wanted to get it off her chest!

Sounds like it. Make a complaint.

When I moved after uni, I had to find a dentist.

I had a bizarre lady scream at me about tooth or gum infection, I forget which, and poor dental hygiene.

I was embarrassed and astounded because I didn't know anything was wrong.

When she stopped shouting, I said "where exactly is the infection" amd she laughed, said "oh you havent got one! I give this lecture to all new patients, it shames them into better hygiene. Yours looks quite good."

Yes, I complained and switched dentists.

I would be very surprised if the NHS are trying to save money on anti deps right now.

GPs do have a duty of care to check that medications prescribed are still needed, still in the patient's best interests etc. Therefore asking some basic questions about why you've used them for so long, whether you have tried weaning off them, been able to make lifestyle changes etc etc is normal. Any good GP should be doing that.

However there was really no need for a lecture or to make you feel unworthy of your prescription. The answers you have given here to all of those questions should indicate citalopram is still helping you.

@namechangingforthis19586

The problem (and I'm repeating what a psychiatrist and GP both told me) is that GPs are a bit scared of antidepressants. Anyone who is really seriously ill sees a consultant who does the proper prescribing. GPs either follow consultants directions or try out a few smarties on the worried well. They don't really know what they're doing, they're afraid to prescribe medications at higher doses because it's a job for a specialist. They're uncomfortable with people needing long term medication because people who fall into that category are usually seen by their superior. Consultants have no airy fairy ideas about everyone being med free. They would feel very differently and are well aware this is a recipe for chaos. They're more comfortable with medication because they know more about it.

If I had a serious query about medication for a mental health issue I would speak to a psychiatrist. Ditto any illness. Speak to the specialist.

100% this!

I'll turn tricks to pay for private psychiatric treatment for DS if I have to.

I'll never have another bloody GP trying to tinker with the meds he needs to function with autism, ADHD and OCD again.

@BeaLesshasty

HoneyBadger - stop it, no one is trying to make anyone feel weak for taking prescribed medication. I'm challenging your pseudo science that depression is caused by a chemical imbalance. I'm challenging people who claim depression is the same as diabetes with regards to the need for medication and I'm challenging the dangerous assertion that there is no hope for people who have suffered depression long term. There is.

I believe that most of this is actually true. That anti-depressants do help redress chemical imbalances, and also the comparison with insulin is a valid one. What makes that pseudo science?

@Mabelface

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.

Actually most of the body's serotonin is manufactured in the gut, so you should look to your diet really.

Some people can come off them, some can't. Which about sums it up really
I tried reducing mine to 10mg and started with intrusive thoughts again so it went back to 20mg which I'm fine on. I don't have any side effects at all. Thankfully I recognised the thoughts and went straight to the GP
My depression/anxiety doesn't seem to have any root cause/situational cause, I've had 9 months of counselling and loads of CBT, nothing else is offered so what do you do?

nothing else is offered so what do you do?

Feed your good gut bacteria.

@unwuthering like? I can't take anything live so probiotics etc are out
I eat pretty well, lots of fresh fruit, veg, pickled stuff, dairy, meat. Not fussy but am limited by other health issues (I'm technically not meant to eat uncooked fruit/veg/salad but..)

Beans. Short answer!

www.bbc.co.uk/food/articles/what_should_you_eat_for_a_healthy_gut

Oh I eat lots of them and various pulses etc mostly in salads to bulk them up a bit
I've also had around 70 courses of antibiotics over the years so I know that wipes out a lot of good bacteria but unfortunately I regularly need them

OP she is terribly ignorant. The first step in decent patient care is having a clear picture of the medical history & the context that medication has been prescribed into. The brain is so complex & for me, 'mental health' is no different than 'physical health' as it's all the same system, ultimately subject to the same dysfunction if hormone, neurotransmitter, etc., levels suffer dysfunction and need to be rectified. Sometimes that happens to be permanent.

The insulin for diabetes analogy holds;.you need the medication that you use and that's the end of it. Further, you don't need depressing, judgemental, flawed assessments lobbed at you out if the blue. No wonder you were upset. I would 100% raise a complaint.

I attended cb therapy for 2 years
Helped initially but the therapist felt i should see gp. I was put on lexapro 10 mg And it has been amazing. Coping with situations holding my
Own and having an amazing happy life. I was very reluctant at first but it has been my wisest decision.

I had all sorts of therapy when I was younger that no doubt helped me work through some traumatic stuff that happened as a child and adolescent but did not take away the fact that unmedicated I suffer with major depression. Mine is treatment resistant so I can still get breakthrough symptoms and it doesn't entirely go away but it is way more manageable and means I can work and be a half decent mother.

I also exercise, only work part time, take various supplements, look after my gut (I had bowel surgery a couple of years so my biome was trashed and it impacted on my whole health and so I've had a very direct experience of how far reaching the effects of your bowel health being messed up are), keep track of my underactive thyroid, make sure I don't isolate too much but that I do get plenty of down time alone, watch my thoughts, practice meditation etc etc etc to manage my condition.

If/when depression is kicking in for me I recognise it and know what to do and it is short lived and manageable because of all the tools and understanding and self compassion I've clawed out for myself over nearly 25 years of living with this condition.

Meds aren't the whole answer but for me they are what keep me in place to be able to do all the other stuff.

If I had to give up levothyroxine or antidepressants I would keep the antidepressants. Both depression and hypothyroidism are real conditions with unpleasant effects but I know which one is more life threatening to me (whether we're talking actual death or just watching your life crumble around you).

This is an interesting visual