... to be freaking out about a GP appointment? [warning: possibly triggering]

[NotMyRealName11]

Name change for this.

I managed to get a GP appointment today because I'm really struggling to deal with a sexual assault which happened a few weeks ago (it was in public, during the day, two strangers). I tried to put it out of my mind and just carry on, but it's really not working and I've kind of got to the point of recognising that I need help. I tried to mention it in an appointment a few weeks ago, but I chickened out.

... I'm sooo stressed that I'm either going to chicken out and cancel the appointment altogether, or that I will flake out when I get there and say "Oh, I just feel anxious, it's a combination of things" (which is what I said the last time...).

The things I'm freaking out about, in no particular order:

• That I could have an STI
• That they'll contact social services and tell them I'm not fit to look after my child
• That they'll want to do an internal examination (and natch I've had this before, I just have a weird phobia about it at this moment)
• That they'll tell me I mustn't go back to work
• That they'll tell me it's all my fault
• That they'll be angry because I didn't go to the police
• That I'll just start crying.

Please, somebody just tell me to be an adult and stop catastrophising!

Also - I don't actually think you were rude at all. People who are in serious pain are often short with doctors, particularly if the doctor isn't actually listening to them or meeting their needs.

I'm a lecturer at a university and I have a card with first aid type instructions of what to do and say (and not do and not say) when someone reveals they have experienced sexual violence. Its bloody ridiculous that a DOCTOR wouldn't have that basic provision and hence be able to interact in a more supportive way with you.

Can you take a trusted friend with you?

Sounds like a really poor experience OP, I'm so sorry. How long till your normal GP is back? I know you'll probably find it harder than ever now but I would make an appointment with them and start the process again with someone you know will listen and understand.

Thank you...now I feel rubbishy that I was rude and stroppy on top of everything else!

I think she did read it (at least she sat there with the paper sort of reading out loud "sotto voce") but I guess she was trying to be sensitive by not referencing it, or else she felt uncomfortable, I don't know.

My usual GP is back Friday but I will have to fight tooth and nail for an appointment. She's the nicest GP ever, so her appointment slots are like gold dust! (Sometimes almost amusingly nice - my OH once saw her for something really mundane, like tonsillitis, and she was like "oh you poor thing, bless you!" and he apparently got quite freaked out by the sympathetic nature of the response - since I'd been reacting more along the lines of "don't make such a fuss" - and was like, "er, yes, could I get some antibiotics please?")

I should have just stayed and tried to calmly say what I was trying to say, but I just couldn't handle it. So pathetic!

Where are you based? Maybe one of us can go with you (is that allowed)? Totally anonymous to you and with no skin in the game. Just safety in numbers and all that.
And do try to tell your partner! This is not your fault. If someone had mugged you, you’d probably feel different. The sexual assault stigma is a horrible feeling but wholly misplaced. You did not do or cause this. Someone assaulted you and did it to you! It is not your fault (even if you were blind drink and wearing a bikini top and a miniskirt - which i am guessing you weren't - but just to hammer the point home. If someone assaults you sexually, they are at fault. Just them!

I'm so sorry this has happened. Like others have not for one second is this your fault. Its the fucking arseholes who have done this that need to be shot. Please do go to the doctors and I hope you find the strength to report it to the police for yourself and for the other women who they may prey on.

I'm gutted to read how your appointment went, as a therapist who often works with people who have experienced sexual trauma. It sounds very unhelpful!

If you're experiencing anxious and paranoid thoughts after a sexual assault, that's very normal. I wouldn't recommend antidepressants at this stage and definitely wouldn't be thinking about psychosis!

If the anxiety persists more than 4 weeks after the assault, it could potentially be PTSD www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/
(obviously I have no idea what symptoms you have and haven't assessed you so don't take that as gospel.)
This means after a trauma, the memory of the incident is stuck in the wrong part of the brain, as it's so big and distressing, so it causes symptoms like being jumpy or feeling unsafe, flashbacks or nightmares, and avoiding things connected to the trauma.
Sometimes over time the brain just naturally processes the trauma by itself and it all settles down.

If you do think you have PTSD, if you're in England you can offer self-refer for therapy for that without going via the GP.
You can google 'IAPT' and your local area to see what your local service is.

GP surgeries keep a few appointments back each day for emergencies. My GP has squeezed me into one of those on more than 1 occasion. If you ring reception and say that you have MH problems and are having a crisis because of a sexual assault and really need to see Dr X because she knows and understands you they'll hopefully be able to find a spot for you. I know GP receptionists often get a bad rep on here but in my experience they do want to help and will squeeze you in if they possibly can. You could also ask for a telephone call with your GP if you can't get a face to face appointment and if you can explain a little bit to her she'd probably find an appointment for you.

Op, you need to be kinder to yourself, give yourself permission to feel however you want. There’s no rule book, and you need to allow your emotions without beating yourself up. The GP you saw sounded shit, and I would actually consider a complaint.
Please try and get an appointment with your regular gp. If you call reception, maybe the locus will have put notes on your record, so you don’t have to tell anyone if that makes sense.
You sound like you’re being so brave.
I do think you should tell your partner, you’ll probably have to at some point, and maybe he could come with you?
Sending you massive hugs. Xx

AHHHH bless you.
I hope you have as good a GP as I have.
Please don`t cancel and I agree write it all down and give to your GP.
Wishing you all the best and sending air hugs.

Oh, OP, I'm so sorry.

I saw your thread earlier and typed a post about 'what to do if the dr is not in fact sympathetic'.......and then deleted it as I thought it would be unhelpful. I checked back as I hoped you had had a good experience.

I'm really sorry to hear not.

So, I am in no way an expert, but just as an ordinary person who has had a similar experience to you and met with the same type of response-

• some Rape Crisis centres/ SARCs have a buddy system where someone can attend appts with you, like smear tests and such. I would ring the SARC back and basically just cry/ rant/ do whatever you need, and ask if they can possibly help.

• if you want just an STI test, sometimes GUM/ STI clinics run separately and on an anonymous basis at hospitals and you can self-refer. Try googling to see if there is something like that in your area. They are very experienced in this sort of thing. You might also try family planning if no GUM clinic.

• alternatively, at our practice, nurses can do swabs. Nurses may be more practical and used to, well, nursing someone and handholding. Maybe ask for a new appt with practice nurse if the above suggestions don't work?

And yes, it's awful to be kicked back like that. Mine was a consultant gynae of all people who just looked disgustedly at me and said 'I don't feel able to support you'. IME frontline medical staff get very little training in dealing with SA survivors, which is shocking considering how common it is. And some get by with innate empathy and decency, but many really don't respond appropriately, and it's very hard to cope with when you have revealed something that can feel so shaming and degrading.

Take care x

Firstly well done for going and managing as much as you did, it's quite common for patients in your situation to make and even attend several appointments before being able to really deal with sorting things out.

I'm sorry she didn't handle things much better.

However, I'm on mirtazipine I think you misunderstand psychiatric medications and how they're talked about here.

"Anti depressants" cover a wide range of medications that aren't just for "classic" depression but which also treat anxiety and other conditions.

Reason is "anti anxiety" meds have a poor reputation in this country because they used to be basically the tranquilliser range of medication which we now know are highly addictive and caused a lot of problems.

Mirtazipine is effective for many wrt intrusive thoughts, anxiety etc

Not generally a fan of wiki for such things but it's very user friendly for those not used to reading swathes of medical stuff

en.m.wikipedia.org/wiki/Mirtazapine

I'm on it for ocd. It's not working particularly well for me on that score but psychiatric meds are quite "trial and error" so it could work well for you.

It also "kicks in" quicker than other anti depressants which would I think be of benefit to you.

Also the low dose has a slightly sedative effect and increases appetite and as I suspect sleep and appetite may be eluding you it could help with that.

No medication shouldn't necessarily be the first option but the fact is MH services are woefully underfunded and talking therapies are hard to access and you need help now.

But it can help you to cope until you can access the support you need.

I'm also gutted to read about your appointment and SO ANGRY that the doctor didn't help you or offer any useful assistance.

Without further context, it's hard to see why she only offered you antidepressants over things like an STI test or contact details for people who you could talk to (like charities?). No idea why she went down the medication route? Like it's all in your head? I can only speculate that she didn't think the assault could transfer an STI?? Unless you didn't get far enough to ask about this.

I'm trying to think of other ways you could access support...

Can you can email or drop a letter into the surgery FAO Nice Doctor before Friday? She might not see it until next week but I'm certain she'd get the receptionist to phone you and make an appt after reading a letter from you? Check their website. I was very surprised to see my GP had a form you could use to email in!!

Maybe scrap visiting the GP altogether and go visit a sexual health clinic instead? At least to begin with. They deal with everything from STI testing to putting in coils and whatnot. They'll be used to working with victims of sexual assault, I'm sure. I've heard they're often better to visit the GP for anything to do with sexual health.

Try to see your usual GP.

In the meantime you can speak to the Samaritans or Rape Crisis for help and advice if you need it.

www.samaritans.org/how-we-can-help/contact-samaritan/?gclid=EAIaIQobChMIucXU19my5AIVRbDtCh0W9gMAEAAYASABEgL5vPD_BwE

rapecrisis.org.uk/get-help/

More options here as well

www.itv.com/thismorning/rape-helplines

So sorry you’re going through this OP - this is why I recommended going to a SARC earlier (I know you’ve already spoken to them and they told you to go to GP, which puzzled me) because this isn’t really a GP thing - it sounds like she did offer the things she is able to (first-line medication to help with symptoms you reported; referral to a specialist for more concerning symptoms - neither of which were inappropriate suggestions) - what was it you actually wanted from the appointment? A GP isn’t going to do an STI test there and then, in most places they are only available at sexual health clinics (or via SARCs usually). Absolutely she could have been nicer and listened to you and it sounds like she was pretty insensitive which is unacceptable.

I’d suggest speaking to the SARC again as usually they can offer STI testing (done by someone trained and experienced in looking after sexual violence survivors) and appropriate counselling as well.

Thank you, all.

I can see that there was sense in what the GP recommended, I'm just a little bit wary of going down the long-term medication route (I'd almost prefer something for kind of short term anxiety alleviation, like diazepam - but I know that they don't like to hand that one out because people can get hooked and start knocking them back like smarties - I did ask, but she said N. O. which is fair enough, since she'd never seen me before and I could be a tranquilizer junkie for all she knows!).

I mentioned that I was concerned about having paranoid thoughts and she asked what they were. I told her it's mainly things like worrying that somebody would attack me on the street, or break into the house at night and do something to me or my daughter. It was then that she mentioned that this could be a sign of psychosis and suggested the hospital psychiatry referral. And I'm scared about that for the reasons I put in my original post (more paranoia!).

We didn't get as far as discussing the STI issue.

I think what threw me was that we discussed all of this, but as if it was generalised anxiety, because she never referred to the actual incident. Maybe she does think I imagined it and it was more psychosis? That didn't occur to me and now I am petrified! I am certain I didn't imagine it though, because I remember exactly what happened and (without being too graphic) it was quite rough and afterwards there was... bleeding.

I will call the SARC again; @Kyvia I think the reason they recommended me to go to the GP is that their waiting list for talking therapies is closed at the moment and she suggested I might be able to access that through the GP and that they might be able to book me for the STI screen there too. Unfortunately our IAPTS is a GP referral one... but I will try the SARC again and maybe I'll go back to the GP surgery and try to take on board more of what they suggest.

Thank you, everyone who had replied.

If you do have to go back to the GP for IAPT +/- STI testing referral then maybe you could have that stuff written down as what you are hoping for at the moment. I did think that the whole point of IAPT though was that you can self-refer. When I’ve used it, it was an online self-referral and I had a phone assessment within a week each time.

Sucks that your local SARC is closed to new cases for counselling! That’s pretty appalling. Lack of funding I expect. No help to you at all, rubbish.

In the meantime I hope you’re able to just look later yourself, concentrate on basic self-care stuff.

Oh sweetheart, sending you virtual hugs (if you want hugs because not wanting contact would be perfectly normal at the moment).

The GP's reaction is making me really cross. Having paranoid thoughts about being attacked again is a normal reaction to being attacked. She sounds very inexperienced.

Below is a link to a self help guide for survivors of rape and sexual assault. You probably won't feel up to reading everything right now but this is from p.25 "After a sexual assault, it is common to feel anxious about being assaulted again. It is also normal to see the world as dangerous and to think of others as untrustworthy"

www.kch.nhs.uk/Doc/pl%20-%20819.2%20-%20a%20self-help%20guide%20for%20survivors%20of%20rape%20and%20sexual%20assault.pdf

Do you have anyone you could tell in real life?

You are doing amazingly well. Don't beat yourself up about your reactions - they are all normal. What happened to you wasn't your fault - you didn't consent; whatever else you did/didn't do doesn't change that fact.

Oh my goodness, that did not go as I expected. The GP you saw yesterday was crap. I’m so sorry. I’m even more sorry that you have to brace yourself and do this again. I wish I could help you out!!! Can you imagine how you would talk to a friend if this had happened to her? I can say from experience that the longer you leave telling your partner, the harder it’s going to be. (And you probably won’t be surprised to find out that he will probably be wonderful.) I really hope your really GP finds you the right help STARTING with STI screening for your own peace of mind. (Put it in your note!!!) Big hugs!!!

Thank you again... it means such a lot to have this support. I have loads of close friends and a wonderful partner in RL and yet I can't tell anyone. I just can't get the words out, and I feel so... dirty.

I just feel like I'm losing my mind. I can't sleep, I don't want to eat, I keep crying about nothing... I just can't get myself together and I feel so, so, SO helpless to help myself. It's just pathetic!

NotMyRealName11 You're not being pathetic at all, the GP let you down, but the way you feel after what happened is totally normal, you just need a hand getting the right support now.

Is it that you don't want your partner or friends to know, or you just don't know how to tell them? Is there anyone you can just show this post to, so you don't have to get the words out? X

It's partly that the words don't come out; but I'm also worried for them to know. I just feel ashamed...

And my English has gone to shit! "Don't want for them to know" [eyeroll] I must be tired...

I know its hard to beleive in other people after two fo them did such a terrible thing to you, but I'd honestly be surprised if they don't react the way we all have on here. I think they will have your back!

Do you know anybody in a more pastoral role who might have some training in supportinve listening? Or maybe you could try a support phone line so that you can practice getting the words out?

Just think how you would feel if a friend told you this had happened to them - I'm sure you wouldn't judge or think badly of them at all, you'd want to help them. Look how supportive every person in this thread has been, and we don't even know you. Your friends and partner love you and will want to take care of you

Who's your best friend in a crisis? Getting an STI test booked, finding some counselling options, etc are practical things they could help you organise, and handhold you through if that's what you want? I'd hate to think one of my friends was going through something like this alone, am sure that yours would feel the same. If you think it would help you, consider letting someone know somehow? xx