To just stop medical care?

[shouldnthavesaid]

I've been seeing the GP regularly - i.e. once a month - since I was 16 years old, prior to that it was the school nurse. I've never really understood why, except that it was reccomended because as a child I was a young carer and I didn't really have anyone else to talk. Over time, I was encouraged to talk a bit about my younger childhood (from age 3, I was regularly left to care for my mum and baby sister alone) and things.

I developed an anxiety disorder, eating issues (binging and purging), self harming, suicidal thoughts. Eventually diagnosed with obsessive compulsive disorder, generalised anxiety disorder and severe depression. For years I old rarely leave the house (age 17-22). My GP when I was seventeen pushed me into going to university with my mums support. I did, and started seeing my university GP. That was in 2009.. I've since graduated and I still see her every four weeks and we talk usually once in between that.

I get on with her very well - we both know each other inside out, as in some ways had similar childhoods and I have confided quite a lot in her over time. To the extent I have written her a letter that she promised to keep private. I don't mind this, just the way things are and I've never really wanted to change it. In some ways it has really helped me knowing I am not alone and I feel she must care about me, when very few people actually do. I get a prescription for my anti depressants filled each time, she checks longer term medical stuff every so often but by and large it's not usually for physical medical problems per se, just to chat and make sure I am alright.

I don't think this is entirely normal. I have asked in the past and she said if it suits me, and doesn't bother her, it is absolutely fine and why not carry on as things are? I am usually given the last appointment so she doesn't end up running late, etc.

In the last week she has gone on sick leave - I am pretty sure why as she told me she was unwell and what with, etc. This happened before, two years ago, when I was still in university and arrangements were made prior so I would continue with 4 weekly check ups with one of the other GPs that she knew. They were lovely to me. One of the other doctors I saw in that time though told me I was weird, it was a strange situation and unhealthy and I was wasting everyone's time, etc. She said that my GP was just too 'nice' to tell me to go and sort my own problems out.

Anyway, GP came back to work last time and everything just filtered back to 'normal' pretty quickly.

This time, I don't know what I do. I have enough anti depressants to last me right up until May, which is fine. I don't know if I need to really contact anyone and stick to four weekly reviews whilst she's off? I don't self harm as much - although I have an almost continuous urge but I try to ignore it. I am purging, but I don't make myself sick so often. I know I'm unhappy, but I can carry on because that's normal for me. I've had as much therapy as I think could really help me.

I genuinely don't know if I should ask for the help to carry on, or if I should be sorting myself out and just stopping all these appointments? I don't know how supportive the surgery would be, when I spoke to them last week they said they weren't sure. I don't want to waste anyone's time.

I have spoken about this on mumsnet and I remember people found it weird - last time she was off sick - but I don't know who else to talk to. Hopefully it won't seem so odd this time around? I don't know. I appreciate any advice, although I'm a bit scared to post this!

I think it's lovely you have been supported in this way and not weird at all. You were a vulnerable young person and this was recognised. You have ongoing medical condition that needs monitored. If the monthly gp visits help you then screw any other doctor, she's giving you help you need.

I'd skip until your own doctor is back if you have had such negativity from other doctors

Honestly, while it seems to be helping a bit. Its not helping stop the self harming or the ED. I think (just a guess as I am not a professional) you need more help than a chat with a lovely GP, every few weeks. But no reason you can't meet with your gp as well as getting further care. I don't think stopping all 'medical care' will help. You are clearly still struggling and I hope you can get further care and assistance to help you.

I think you'd be better off being referred for some proper talking therapy. The appointments to chat, whilst nice, don't seem to include any goals to help you with your longer term difficulties.

It's part of your (mental) illness to believe that you don't need treatment, sorry. I don't want to say a lot because you've a lot on your plate, but whatever decisions you make should be made with lots of other people who know you in person and help you plan carefully how to proceed. it's fine to tell them how you want to proceed and ask for their support. Good luck. x

No, it isn't making a huge difference. I promise to her that I won't do anything because it seems to upset her, and my mum too, but the problems aren't going anywhere.

I had a two year lot of cognitive behavioural therapy overseen by a psychologist a couple of years ago. I've also had some sessions with a lead psychiatrist. I've also seen two unqualified 'counsellors', one nurse therapist, and one private therapist. The CBT made a big difference - it was a lot of work, but it did help a lot. I stopped going, in the end, as I felt I'd solved all I ever could - I thought I had accepted that a lot of things that happened to me, I could never change, and I would never be able to fully solve some things or change my reactions.

My GP has been immensely helpful - I couldn't ever thank her enough, but I'm scared I shouldn't see her so often and I shouldn't feel I am 'close' to her, if that makes sense. I don't want to tell the surgery how upset I am at her being off in case they get her into trouble, or something.

One of the slightly more worrying difficulties too is that I'm a healthcare assistant - yes, sounds silly but my boss assures me I am very good!! - and the ward I work on, if my GP has what I presume's up she will possibly end up on my ward. I wouldn't be comfortable caring for her, and I don't know how to handle that.

I've agreed with my mum that ill telephone tomorrow and ask to talk to the other doctor that I saw last time. She's on 'duty' tomorrow so could be difficult getting to speak to her but I will see.

I've been taking my meds, so that's good. I went out for a walk for a good three hours too with the dog and mum and now waiting on a takeaway will see how tonight goes.

Thank you so much for taking the time to post, I forgot to say x

She sounds wonderful but I think the key to this is what happened when she was off sick.

It suggests that you have become reliant on her (I am not surprised - she sounds fabulous) but that the relationship is not transformative.

Could you try weaning yourself into talking therapy and have one gp app followed by one therapy for a while then make it 2 therapy and one gp?

I have no idea if this is possible but it is surely worth asking

Do you get a report in the morning at work? If it were me on my ward, I would have a quiet word with whoever was in charge that day & ask if you could work on the opposite team as you know this person. There should be no need to go into how/why/what context you know the patient in, it's for the patients' protection as well as yours.
We've been known to switch staff between wards when necessary in this sort of scenario, it's not unheard of. Or move patients depending which is most appropriate, but definitely don't let it worry you.

How about extending the appointments? Don't stop them completely but maybe see the gp every 6 weeks? If that works every 8? Xx

That was the plan - GP has suggested it lots of times, and I did go six weeks or so and then when I rang to arrange more tablets, 'where have you been, when are you coming back to see me?'

I maybe interpret it wrongly but I think sometime some things she has said, if I told someone else she could get herself into trouble. She's never said anything 'wrong' but I know she has been unprofessional.

It's such a difficult situation all round. If she wasn't off I'd just leave it I think but her not being there means that I'll need to some extent to explain all this when I try to get meds - explain why I get four weekly reviews - , that's what makes it harder and why part of me feels I should walk away altogether..

The doctor phoned, and she was really nice :) she's very reluctant to change anything as it's had problems in the past - I ended up with a catheter when they last increased my meds due to retention, but she's said I might be OK to stop the tablets I'm on and switch to something else. She thinks Prozac might be the next one I'd be offered. I'm a bit unsure as I've been taking escitalopram for I think five or six years but she said it might be less effective over time.

As far as she knows, my usual GP should be back at work in the next week or two, I've to call on Monday and ask. She said it's not a long term sickness situation - explained everything which helped. There's also very little chance of her ending up on ward anytime soon so that's a relief too.

I wonder if they are right and it is actually possible for anti depressants to become less effective over a long time? That would make a lot of sense and explain why I feel so strange. It's like my head wobbles at times - physical feeling - and I can't think straight or concentrate at all.