To have stopped psychiatric meds and to avoid doctors?

[ProzacAndWine]

Okay, I kind of think I am a bit U. But no one around me has really been telling me I am, so I guess I'm asking for opinions.

I have a long history (20+ years) of various MH issues, various diagnoses (various anxiety diagnoses, BPD, eating disorder, depression, a dissociative disorder etc), but mostly these days lumped under a Complex PTSD umbrella. I've been very unwell at times in the past, but mostly I'm sort of functioning these days, despite lots of symptoms and quite a quiet, careful life. In the past I used to see a psychiatrist, a CPN and had NHS therapy, but haven't "qualified" for any of these for the past 8 years. I do see a private counsellor, though, luckily!

The past few years have been a constant cycle or either a GP or some other professional insisting that I need to see a psychiatrist and be under proper care, referring me for assessment, me having the assessment, and being told I don't qualify. I'm not quite sure how many times this has happened recently. The "lower level care" isn't available for me, because my diagnoses are deemed as too complex, and I'm not acutely unwell enough for the higher levels of care, so really I'm just thanking my lucky stars I can pay for the private counsellor, as that's all I have. My GP is lovely and tries to help, but she keeps insisting she wants to keep referring me, and I'm sick of it, so have stopped seeing her, really. The assessments are horrible, and always leave me doing much worse for quite a while, and the rejections feel very invalidating, when you've "bared your soul" to a stranger.

Now, one of my voices has always kept insisting I should not take medicine and not see my GP and generally not talk about my mental health. I've given in. I've not seen my GP since November-ish. I've stopped my anti-psychotics and my anti-depressents. DH seemed mildly concerned and told my GP, but I've reasoned with them both it's to do with side effects (which are a real issue), and that really I'm fine, and if I feel worse I'll start them up again. I have no such intentions. I think it's mostly to do with the voice being childish, and there being some "if you're not going to help me, I won't help myself" feeling, which I know is very stupid!

I'm suddenly questioning myself. I had a physical health issue and had to see a paramedic this week. Turns out the same paramedic has met me in the past while I've had a bad dissociative crisis, although I don't remember when this has been. He seemed EXTREMELY worried to learn I had quit my medications and still wasn't seeing a psychiatrist. Honestly, he's been the first person who's reacted like this, and it's shook me. Everyone else has been making little murmurs, while telling me that really, it's my choice, and to do what feels right for me.

I don't really know what to do. Since I've stopped the medication, I've stopped gaining weight and stopped feeling like I'm in a stupour half the time. On the other hand, depression is starting to swallow me up, I'm withdrawing from friends and hobbies, and generally don't feel well, physically or mentally, and I have more compulsive behaviours (skin picking at an all time high, for example). I think I'm starting to drink too much. But going back to the GP and starting meds again would feel like "giving in", rather than a healthy decision to make for myself. The voice is absolutely raging against the idea, whenever it pops in my head. (For what it's worth, none of the medications have ever really affected whether I have the voices or not.)

If I go back to the GP, do you think I can refuse another referral? I know for a fact it would go exactly like the previous ones, and would only result in another refusal.

Sorry for the rambling. Thanks if you bothered to read.

The voice telling you not to see your GP doesn’t have your best interests at heart. You should go to your GP.

Please get to the GP asap....you need your meds... continuing the way you are going will not end well!!!

I didn’t want to read and not reply. That all sounds really difficult and complex. What does stand out is that you sound like someone recognising that you’re entering a dip, but because you think asking for help will lead in a direction that a part of you doesn’t want to go in, you don’t want to admit to needing any help? Is that fair?

I think part of taking control of your mental health is realising when you need support. There’s a key point, when you realise a need, but you’re not so far down the rabbit hole that you can’t see that anymore. It sounds like you’re at that point.

Could you discuss this with your doctor and GP? There are always options with different meds and different doses. Perhaps what you had before wasn’t right for you.

Sorry if that isn’t very helpful, but please don’t close yourself off to support. Your voice that tells you not to seek help, sounds like a tricky one rather than a supportive one. It must be exhausting arguing with that urge. Can you talk to dh? And be completely honest?

Oh and just posting this is huge. You are already reaching out, you just need to reach a bit further to you’re dh and GP.

I would definitely go see your go, you already realise the things creeping back are not positive.Finding the right medication and levels is difficult but you want to avoid a stay in hospital so I would restart your medication with your GP’s help.I hope it goes better for you soon

Please go back to your GP and show them that post. You don’t sound well at all and it sounds like you need urgent intervention.

You need to take care of yourself. You are a worthwhile person and you deserve to be given good treatment and care. Your GP and DH sound supportive and sympathetic and I would urge you to turn to them and tell them what you have told us. And you know drinking will just make this worse I’m sure.

Have a huge unmumsnetty hug and a big bunch of . Please take care of yourself and get some support.

And do not listen to that voice! It does not want the best for you and is destructive!

What would you say to a friend in your position do you think?

I think you need to look at it a bit differently, rather than 'giving in' seeking more help surely is the healthy decision to make for yourself...

You need to go back to your gp ignore the voice & get a psych referral.

They can prescribe different anti psychotics that will hopefully get rid of the voice.

I take high dose Aripiprazole which took a few months to kick on properly but got rid of my paranoia & delusional thoughts - not completely but almost. I have schizo affective disorder.

I’m so sorry to hear of your multiple referrals and getting passed back to your GP every time. I was in the same boat until I got pregnant, and then everyone started taking me seriously because apparently we only matter when a baby is at stake.
If your GP is able to provide you with the correct prescription (my anti psychotics had to be prescribed by a psychiatrist initially, but I think my GP would be able to continue prescribing them if i were to stop seeing the psychiatrist) I would ask them to do that but refuse any future referral because it’s just a waste of time and energy for you. Tell your GP why you are refusing it- surely they’ll realise that it will cause more upset putting you through it again and again. Please try to ignore the voice telling you that you’ve given in. Life with mental health issues is a constant battle especially when you don’t have the correct care and support, you are stronger than you realise.

Thanks so much for commenting all. I'm taking it in. I think I've been caught in a stubborn "I don't need any of this!" phase, and it's humbling to see it's not really working.

I think I will have a proper sit down with DH and talk about it. He's usually very supportive of all, and will come to the GP with me, if I get scared about going there.

O god, the Venn diagram of 'too mental' and 'not mental enough' - know this one well.

Is there any chance you could fork out for a private psychiatric appointment if the NHS aren't helping? If not, can you go the taking DH/someone supportive with you to the appointment and having yhem advocate/push for you route? Sometimes the o ly way to go is to literally not leave the office until they agree to help and it's so hard doing that alone. As one who's been there, you are clearly unwell and need proper meds and management xx

OP I am normally all about no meds, minimal intervention etc but I think you really need to be careful.

I would print off the OP and show it to your GP. Unwittingly it sounds like her interventions are making things worse for you, and she needs to know so she can consider another approach. I am sure she can help you.

How many times have you been through this cycle of referral->assessment->refusal/rejection?

I think you should go back to your GP perhaps with your partner and have a ‘full and frank’ discussion about what can be done to break this cycle.

It’s absolutely not acceptable to keep forcing you through this assessment and discharge hoop jumping exercise.

I’ve been through it three times in three years and it’s bloody awful so I know where you are coming from with this. The difference being, I’ve had problems with the type of treatment I’ve been offered not being appropriate for my diagnosis vs not meeting any thresholds for treatment at all.

Which I find terribly upsetting for you, because it sounds like I’m much less ill than you... it really is a postcode lottery isn’t it?

Anyway. I think your GP needs to get more involved and come up with a better plan than just shooting off another generic referral that ends with nothing.

For example, I am going through my third hoop jumping exercise, all just to get a 12-18 session course of trauma based CBT (and emdr) as per the NICE guidelines for PTSD. My GP has finally realised she needs to intervene in the assessment process more so has chased up her own written letter that should have gone off with the referral yet somehow didn’t (I had to get her to resend 4 times in the end), and then she phoned a pysch in the service to verify that they actually have trauma based services (still not quite clear though positive noises were made), and she had to resend multiple times a previous pysch report which mysteriously kept getting lost etc etc etc. and I’m not yet through the hoop jumping! Sigh...

But, it’s been FAR easier this time with the support of my GP.

Oh this is awful, you poor thing.

But you really do need to be taking the medication. The question is, which ones. This might be the opportunity to try a different medication to see if you can find one that doesn't leave you feeling in a stupor all the time.

Op if you can afford I'd consider a private psychiatrist.

I'm assuming gp didn't prescribe antipsychotics and they were originally prescribed by a psychiatrist or similar mental health professional.

From your post you realise your withdrawing from friends, lack of meds is starting to impact your life negatively.

Please, please go back to your GP, you sound really unwell, so sorry that you are going through this

I Understand but GPS are there to help and even though I don't agree with anti depressants - as long as you are having a bit more of a life on them than without then that's the main thing.

I would get back on them or atleast look at other ways of helping with depression before you go to far into it x

I wonder if you might get some support and advice from the charity MIND?

I'm sorry the system has been letting you down like this. It's fairly logical to want to stop playing a game which you can't seem to "win" in terms of the referrals leading nowhere and I agree that this is what you need to talk to your GP about.

Her approach, although well-meaning needs to change as it's at the centre of what's been happening. You can see yourself that you're replacing the medication with unhealthy behaviours and that self medicating with booze or self soothing with skin picking don't help to relieve depression, (I bloody wish they did). It sounds as if this has come to a head and so at the very least you've identified that you feel reluctant to participate in a medical process which has let you down. That's rational really.

You're right however, that it's a rather "childish" petulant approach (although I totally understand) - you deserve treatment which you're not getting, hiding from the medical profession won't make it magically appear, or make your depression or PTSD go away.

I hope you can go back to the GP and talk it through in a positive way and that the system stops dicking you around (live in hope)...

WellThisIsShit I had two or three assessments with the secondary services last year - I think two referrals from my GP and one from the crisis team via hospital. It's frustrating that there's no way to even see a psychiatrist for a medicine review in my area, without getting past the secondary care assessment.

Private psychiatrist isn't really an option financially, unfortunately.

I've been on various anti-psychotics in the past, and the latest one I was on was Promazine (it was initially prescribed in A&E one time, and GP was able to keep prescribing it - never seen a psychiatrist about it), which actually had much less side effects for me than the second generation ones (on which I just became a ballooned up zombie), which is why I stuck with it for quite a while. I wouldn't want to try another second generation one.

I think I might ask the GP about some different type of antidepressants, though. I've been on Citalopram, Setraline, Paroxetine and Fluoxetine - on the last one for many many years on the maximum dose. I hear there are completely different types out there, though, that I've never tried.

DH is working from home, and I've just suggested we go out for a coffee and lunch. Thanks all

Please see your GP and show them your original post.

It sounds like you've been through quite an ordeal, and I can understand your reticence to about going through it again if it doesn't lead to any help. Have you had any specialist trauma therapy to deal with the C-PTSD? I know you've said you don't have the money for a private psychiatric appointment but what about speaking to a specialist clinical psychologist about what you're going through? Sadly the general NHS treatment pathway is medication but there are alternatives out there which may be more beneficial to you.

Actually when you get back into the system contacting MIND is a really good idea. They can advocate for you to get appropriate treatment.

I also took all those anti depressants with little result even at maximum dose. I’ve since been prescribed imipramine alongside my anti psychotics- it’s a tricyclic and I find it much more effective. Another friend on anti psychotics takes a different tricyclic and also has good results. The right combination of meds can be a lifesaver, I hope you are able to find yours.