Psychiatric assesment tomorrow - what to expect?

[weighingitallup]

Long history of anxiety, had job that i lost because of it (and bullying bitch of a boss but thats another fred). Now hit with depression and i truthfully feel like i have been hit by a truck.

Started about three weeks ago with sleeping pills (zopiclone) not taking them now, sleeping ok ish. The anxiety got to mammoth proportions couldnt get dr appointment, GP prescribed diazepam over the phone, appointment next day to start citalopram. Ive taken citalopram before - 40mg but no terrible side effects (apart from passing out when i had an orgasm )

Was on 10mg citalopram, it didn't really help the anxiety, so upped it to 20mg and i feel terrible. Have for the first time in my life been suicidal - DP took me to the drs today, she agrees with me that its not a citalopram side effect just everything getting on top of me.

I still FEEL like i don't want to live but i wont act on it, i know how it would affect my DD and i have to be here for her. I attacked my DP verbally today, shrieking at him that i loathed him and wanted him to die :( He almost left but i begged him to stay. He has been pretty cool with me since - i can't blame him really.

So Dr made what she said was an urgent referral to the psychiatric team - i got a call from the receptionist?? today appointment tomorrow. But what concerns me is that it is with a lady i have seen before and all she did was refer me for counselling that did bugger all for me, ive had counselling, ive had cbt, it doesn't work.

I don't want to feel like this anymore, i need to get a job and start contributing to my family, right now i just feel like a useless lump, a tumour in the midst of my family that needs to be excised. This is not me - I used to be fun, i used to be the one everyone could rely on for a good laugh - not anymore. Im unrecognisable big fat blimp. I used to be pretty now i just want to shave my face off with a potato peeler.

What does it take to make people see that i need help and not be palmed off with counselling? I know they dont have a magic wand but i need this to stop and i need it to stop now - if it gets worse, i wont survive.

anyone?

Hi I just noticed your post and in particular the bit about being suicidal not being a side effect of citalopram. I'm horrified that a gp would say that. Suicidal feelings are a well documented side effect of citalopram and indeed SSRIs in general. (Of course that's not to say that you feeling suicidal is due to citalopram).

As to the assessment you'll just be asked loads of details about what you're feeling, what's been going on in your life, how your sleeping, eating etc. If this isn't the first time you've been suffering from anxiety/depression you'll be asked about your mh history (eg times you've suffered and what, if anything/known, what brought them on etc).

It sounds like because you've not responded to the citalopram the assessment will look at what medication to prescribe you. If you are deemed ill enough and your particular health authority area has enough funding you might get more support like a community psychiatric nurse. I was asked what I thought would help me.

Last time I had an assessment I was told they couldn't help. The time before that I was 'palmed' off with a higher dose of the anti-depressant I take (venlafaxine) and another drug (quetiapine) was added into the mix. I share your pain with cbt - it didn't do much for me either. I'm now on my second time through a cbt course and it's no better.

Is your DP attending your assessment with you? If you feel like you need the support you can take someone (you can where I live). I hope it goes ok.

Sorry I forgot to mention that you'll be asked about your suicidal feelings ie how likely you will be to act on them, how you would do it, any plans you may have etc. Just be honest though I never am. Don't forget to ask any questions if you are unsure of anything being said. Good luck.

DP wont be able to come as its at school pick up time, i asked for an alternative but nothing until monday!! FFS!

When the GP (and myself) said about not thinking my feelings were due to citalopram we haven't discounted that it may be a side effect - i just don't feel like it is. I have only been on the citalopram less than two weeks now so i do know i am likely to feel worse before i feel better, which is why i was given the diazepam. (2mg so i know its a placebo thing really)

I really hope i don't get fobbed off but then i don't know what i will say if i am asked what i think will help me, i just don't know. CBT was a non started and i had a year in counselling basically navel gazing, not really useful. Spent all the time whinging about DP which was unfair and unproductive.

I am obsessed with getting a job but when i got one i coudlnt cope (but bullied and no support - am thinking of making complaint)

I have two thoughts, one is that i will just take all my tablets (but probably don't have enough ) the other (which plays on my mind alot as it has happened to people i know locally) is that i will walk in front of a train (this is more of a fear that i know i will do this one day if that makes sense, rather than actually wanting to do it, like i will be hypnotised and just do it even though i dont want to) That is very very scary

Yes that does make sense. I think you've just got to be honest so that whoever is assessing you can make the most appropriate decision. Since you know that cbt and counselling were unhelpful to you, do let her know.

I know what you mean about not knowing what would help though. I often find this question hard too. The only time when I knew what would help (because I'd been having similar help from Mind) I was told that it wasn't an available option. Maybe ask your dp what he thinks might help you. Sometimes an outside perspective is good.

Hi I don't know if my reply is too late because it is now tomorrrow.

Psychiatric assessments usually look into your past, how have you felt, any significant events, what has helped etc and then look at what is going on for you right now in terms of your feelings and if you do have any elements of risk.

Be honest about your feelings and thoughts, they can only help you if you are honest.

Counselling can cover a huge spectrum of concepts and so I would not be surprised if they encouraged you to engage in some form of talking therapy. Medication and talking therapy seems to be the way forward for most people.

I hope it went well.

Thankyou x

Hi fluffy - how are you getting on? Ive namechanged (lucyellensmum usually) and ive posted a fair bit on your posts. Are you doing OK just now?

I have stopped taking my meds and i think i feel better for not having them although the anxiety is creeping back.

Thankyou for posting fluffy - you are such an all round good egg and i always think of you x

I am not brill at the moment but I have a long thread at the moment so I won't clutter yours up!

Have you had the assessment yet? It will probably be with a nurse or support worker which can be less indimidating.

You need to take the meds, but I guess it is about finding the right ones, ssri withdrawal can make you feel rough as well so it is worth keeping up with them.

My battery is going so I have to dash but lots of luck and like I say be honest, even if it feels scary to be so honest. That way you can get the support you need. Look after yourself.

XXX thanks fluffy im to be there at half three im terrified actually