Argh FFS - crisis team judgement

[elementofsurprise]

Trying not to completely lose it here. Just had ridiculous conversation with woman from the crisis team. She asked what would help, usual script, I said I thought therapy. Had to explain TWICE that primary care IAPT won't see me ('too complex') and secondary care repeated ignore referrals and have asked my GP not to re-refer because I'll only be disappointed.
For 5.5 years I have been trying to access therapy. Since I broke down. I was almost there once, but services kept getting cut and rearranged.
Explained this to her.
Her response was "Well, if you're not willing to try to access the services..."
ARGHHHHHHHH
Explained again, I keep goingto my GP, he keeps referring, they won't see me.
Response: "If you're just going to get annoyed with me..."
FFS! Am I not entitled to sound just a tad frustrated in this situation?
Managed to remain calm and explained yet again, for 5.5 years I have tried to get therapy so am feeling a bit hopeless now. Understandably, I'd have thought. Apparently I should just keep going back to the GP (even though it makes me feel worse and more hopeless cos GP can't do anything.)
Pointed out definition of madness was doing the same thing gain and again but expecting different results.
Feel hopeless and worthless. Want pain to end. Want to be good enough to be treated nicely and loved. (I thought I was but apparently not from how people treat me. Don't want another thread about that though.)

[Gems16]

*in general

[Gems16]

Yeah I know what u mean some people aren't that lucky 2 have good friends and family,what I meant was that's just how I feel at the moment but tbh that could all change at anytime, I find I could be OK for months then that dark cloud just seems 2 come back out of nowhere! I don't know enough about aspergers 2 comment on it but I can relate when u say mental illness can really affect your relationships, there r times I feel like the whole world is against me and I just don't like people on general!

[elementofsurprise]

Thanks for the replies.
Gems Unfortunately many people don't have a loving family or good friends around them. Being mentally ill for years can have that sort of effect. I have tons of aquaintances, and fairly arms-length friends, but not so much people I can be open with.
AS is Aspergers syndrome.

[wannabestressfree]

Aspergers syndrome?

[Gems16]

Sorry don't mean 2 sound dumb what does AS stand for?? I've never been good at getting abbreviations on these forums! Lol. I think all of us feel like that sometimes (like u don't fit in) even the most confident people, some people r just better at hiding it than others. I find that as u get older too u start 2 care less about what people think of u, as long as a have a few good friends and a loving family who cares what anyone else thinks

[lottielou7]

You shouldn't feel numb, that's not good. I think people are depressed for different reasons so I agree it shouldn't be a blanket treatment at all. I take sertraline for my anxiety. I have found it brilliant and it doesn't affect my sex drive at all. GPs shouldn't just give them without a full picture. I have AS so have grown up with a feeling I don't fit which I think has caused some of my issues. But also anxiety is so common in people with ASDs.

[Gems16]

Lottielou7- its not that I'm against antidepressants its just I don't think they help in the long run and I think doctors just hand them out 2 freely instead of actually trying 2 get 2 the root cause of why someone is depressed. When I started on antidepressants they did help my mood a bit but personally I wouldn't consider them a long term solution for depression. Mainly because of the side effects, I found that after being on them a while I neither felt happy or sad in fact I just felt numb and void of all emotions, I thought about it one day and I couldn't remember the last time I cried. Also I found that they completely take away ur sex drive. Not ideal when you're a young married couple

[lottielou7]

Gems - you are right. If you have the wrong therapist then it's worse than no therapy. I had a therapist tell me I was pathetic and to pull myself together. Needless to say, I decided not to waste £45 an hour on her any more.

I don't understand why people are so against anti depressants though. They have been wonderful for me - I see everything differently.

[Gems16]

I totally get where ur coming from, I suffered really badly with depression after the birth of my first son I found that all GPS do is throw anti depressants at u instead of actually trying 2 get 2 the root cause of the depression. Anyway my depression got so bad that I got 2 a point that I couldn't be alone with my baby I just couldn't cope my husband nearly lost his job cos he had 2 keep taking days off. One day he made an emergency appointment for me and the gp was a young new doctor he was the first gp I'd seen who I felt took me serious he referred me straight away for talking therapy. I went for that therapy a week later and the person just talked 2 me like I was a piece of shit! She made me feel like I shouldn't be there I told her sometimes I have thoughts of harming myself and she implied that I shouldn't be saying things like that cos social services could take my son. I came out of there that day feeling 100 times worse than when I went in. And it took a lot for me 2 open up like that. That was 6 years ago and I've since recovered from all that but I just think the system is a joke when it comes 2 mental health you'd nearly need 2 be hanging from a rope before they'd help u. I really hope u get the help u need

[elementofsurprise]

Sorry, didnt mean to sound so bleak in reply before. Just feel really hopeless if I'm expected to do things I can't actually do in order to be allowed help. I feel really rubbish and try not to think about what I can't do, but focus on what I am getting done. I'm still in bed right now, having a bad day. Going to drag myself to shop now. Feel a bit like whats the point, im still not good enough. Meh.

[elementofsurprise]

Oh, and regrding them making things up - seriously, they do. Friend came with me to my last appt. with them, and afterwards was gobsmacked and described the person (head of CMHT!) as a "duplicitous bitch". Sounds harsh but was very apt. She lied to me and when I tried to clarify acted like I was doing somthing wrong and shooed me out. And she was way better in that appointment than previously, I guess because someone else was present.
I find this very hard - they say things that throw me completely, they throw curve balls, and its so hard to get my head together to question or reply or point out their inconsistency. It makes my head spin and chest tighten at the time, then later I know what I should have said and can simply explain the inconsitency or logical fallacy, but I just cant at the time.
Plus the whole BPD dignosis seems weird - as I said, its like they have tried to make me fit the dignosis. So they interpret things in a way to try to skew them and make them fit. So a classic example, although old, would be that they saw me as "idealising then devaluing" my boyfriend. (Was 19, he was 31 and abusive). Actually, I consistently loved him (or whetever the fuck the attachment is in abusive relationships... I know about paradoxical attachment...) but was often hurt and baffled by his behaviour.

[elementofsurprise]

Finchley

1. The next nearest surgery is really overstretched, the receptionists are dragons (I used to be at this surgery and this was a big issue so I changed), and current surgery is very close so can get there easily even when very unwell. Also has lovely receptionists and is willing to do phone appointments and generally be helpful in that regard - I felt like an unwanted nuisance at other surgery and too scared to ask for help. There aren't any other close ones.
   I ws really pleased there was a new GP but I've only seen him once, need to make another appt. I'm just terrified of DWP stuff though, which is why it means a lot that the other GP was helpful with that.
   
   
2. I don't know which professionals would be involved in my care. Surely at most it'd be a CPN or social worker, GP, and therapist? The threshold to acces a CPN or social worker fro the CMHT is really high. Also, I cn "hold a relationship" but don't know if they can! Cancelled appointments at last minute, randomly being discharged etc... I suppose there's a the crisis team too, and I do know how to access them. I'm concerned that as I don't meet CMHT criteria, I'm not allowed therapy as not allowed the accompanying support.
   
   I have tried googling, but cant find any info on local services.
   
   I will ask GP when I see him.
   
   
3. I wasn't talking about self-medicating with alcohol. I was talking about parties and going out and stuff, when in my early 20 and others - 'normal' people - would get stupidly drunk and so on. And live in messy houses and so on - I was always quite sensible in comparison. I found it baffling that I was considered to be this unstable, immature freak by services when I was the one with career plans, a tidy home, sensible diet, people though I was older than I was etc. It's a lot better now as others seem to have grown up, I guess, but I still find it amazing sometimes the sort of mistakes and rash decisions people make compared to my careful weighing things up (moving in with new partners quickly is a classic), and yet I'm supposely the 'mental' one. Professionals who have seen my flat always seem surprised it's clean/decorated (by me!), and the last care-coordinator I had briefly, seemed astounded and quite frustrated that I was doing all sensible things - she was an occupational therapist so I guess it meant she had nothing to work on in that respect.
   
   they aren't necessarily evidence that you are tackling your mental health straight up and bettering yourself day-to-day. If you've always done them it's hard for them to be seen as a day-to-day continuous improvement of current stuff
   
   This makes me feel really awful, and hopeless. Not your comment, just the reminder that I'm treading water and not getting anywhere, despite trying so hard. Yes, I've always done those things but I don't find it easy. Cooking a meal from scratch when you have to face going out for the ingredients, concentrating whilst cooking and cleaning up, actully feeling able to eat at all. I feel bad that I struggle with these things, but I do. I have learnt new skills such as some DIY, basic woodwork, I do some gardening (tiny garden)/growing veg. So some is new skills and some is just doing stuff. I am studying part time now, that was new in October. I was planning to write over the summer between this OU course ending and new one starting in Oct. I have other hobbies but struggle to find the time as daily life stuff and coping with how I feel takes time and energy. I have tried volunteering but am no good at committing to certain times and it takes so much out of me and throws everything else... This is what I mean by very functionally impaired - I keep trying to step it up but crash. Completeing this OU course is a big thing for me. I don't always manage to get out of bed everyday...
   How on earth am I supposed to show improvement when trying so hard everyday just means I'm standing still? If I could just get better and go back to work and stuff without them, I'd not have asked for help. Feel like I'm too useless to be allowed help now.

[Finchley26]

Good Morning elementofsurprise.

1. Why couldn't you change GP surgeries? I'm curious on this as no one should be putting barriers into your way about who you receive GP care from within your area. Either stay with the new GP, or change, but make sure you build up a relationship with them so they get to know you. If you change - some GPs specialise in, or have a special interest in, mental health. Ask around and see if there are any GPs in your area that have this. Also, use the NHS choices website to find reviews of the practices, but remember that people are more likely to write reviews when they are in a bad mood. That said, if all the reviews mention poor care for people with mental health it's probably not the practice for you. Feel free to ask to go in and speak to Practice Manager's about the care their surgery offers and how they run before you register.
   

1. Support networks are more about having professionals involved and being able to hold those relationships with professionals treating you (unless you have children and then it changes slightly) in my opinion. So, your GP would be part of that, as would the practice nurse if you've ever seen them, and any other people you have involved with your care, or support services. It's also about knowing where to access support as well as actually accessing the support currently.
   

With regards to knowing about specialist support services oustide CMHT your GP should be able to find out for you what's available. Google is also a good option and local mental health trusts usually have a list of what they offer on their websites. Alternatively you could phone up the Maudlsey, Cassel or the Tavistock and ask them to recommend a service in your area. The other option is to phone up the local QCC (or whatever acronym it is nowdays) and kick up a stink and ask them to find you a service as you've been let down.

1. Yes, you can ask to see a psychiatrist. Some of them operate outside of the CMHT. I'm really surprised your GP hasn't arranged this for you already as in my experience most GPs don't like having traumatised patients on their patient lists without demonstrating that they have had them assessed properly and received guidance on treatment. If your GP thinks you are traumatised are they following the NICE guidelines for treatment of PTSD?
   

1. These things you list "paying bills, rent, kept home tidy, eat healthily, dont get stupidly drunk even when 20" are all great, don't get me wrong, whilst they do reduce mental stress, they aren't necessarily evidence that you are tackling your mental health straight up and bettering yourself day-to-day. If you've always done them it's hard for them to be seen as a day-to-day continuous improvement of current stuff.... Hopefully you can see what I am getting at there. Also, most people who self medicate with alcohol that I know don't get stupidly drunk either, but they are still self medicating.
   

One more thing that I want to say, is when you say this "they sort of make symptoms up in their head and interpret things bizarrely " honestly, I didn't know how ill I was until I started to get better and there were times when I felt very cheated and very pissed off (I got accused of self harm once and that really pee'd me off as it wasn't actually true). Looking back now I can see why people were saying some of things that I didn't agree with, even if they weren't saying things for the right reason, it was at least a big plus that they were picking up on things... Not an easy thing to get your head around when you aren't feeling that great.

Again, hope this is helpful to you.

[Finchley26]

Good Morning elementofsurprise.

1. Why couldn't you change GP surgeries? I'm curious on this as no one should be putting barriers into your way about who you receive GP care from within your area. Either stay with the new GP, or change, but make sure you build up a relationship with them so they get to know you. If you change - some GPs specialise in, or have a special interest in, mental health. Ask around and see if there are any GPs in your area that have this. Also, use the NHS choices website to find reviews of the practices, but remember that people are more likely to write reviews when they are in a bad mood. That said, if all the reviews mention poor care for people with mental health it's probably not the practice for you. Feel free to ask to go in and speak to Practice Manager's about the care their surgery offers and how they run before you register.
   

1. Support networks are more about having professionals involved and being able to hold those relationships with professionals treating you (unless you have children and then it changes slightly) in my opinion. So, your GP would be part of that, as would the practice nurse if you've ever seen them, and any other people you have involved with your care, or support services. It's also about knowing where to access support as well as actually accessing the support currently.
   

With regards to knowing about specialist support services oustide CMHT your GP should be able to find out for you what's available. Google is also a good option and local mental health trusts usually have a list of what they offer on their websites. Alternatively you could phone up the Maudlsey, Cassel or the Tavistock and ask them to recommend a service in your area. The other option is to phone up the local QCC (or whatever acronym it is nowdays) and kick up a stink and ask them to find you a service as you've been let down.

1. Yes, you can ask to see a psychiatrist. Some of them operate outside of the CMHT. I'm really surprised your GP hasn't arranged this for you already as in my experience most GPs don't like having traumatised patients on their patient lists without demonstrating that they have had them assessed properly and received guidance on treatment. If your GP thinks you are traumatised are they following the NICE guidelines for treatment of PTSD?
   

1. These things you list "paying bills, rent, kept home tidy, eat healthily, dont get stupidly drunk even when 20" are all great, don't get me wrong, whilst they do reduce mental stress, they aren't necessarily evidence that you are tackling your mental health straight up and bettering yourself day-to-day. If you've always done them it's hard for them to be seen as a day-to-day continuous improvement of current stuff.... Hopefully you can see what I am getting at there. Also, most people who self medicate with alcohol that I know don't get stupidly drunk either, but they are still self medicating.
   

One more thing that I want to say, is when you say this "they sort of make symptoms up in their head and interpret things bizarrely " honestly, I didn't know how ill I was until I started to get better and there were times when I felt very cheated and very pissed off (I got accused of self harm once and that really pee'd me off as it wasn't actually true). Looking back now I can see why people were saying some of things that I didn't agree with, even if they weren't saying things for the right reason, it was at least a big plus that they were picking up on things... Not an easy thing to get your head around when you aren't feeling that great.

Again, hope this is helpful to you.

[lottielou7]

I managed to get under the care of a psychiatrist, only after I reported psychotic symptoms. I was never severely psychotic and not at all in recent years. OP, if I were in your shoes I would find another GP - a completely different practice. And then explain that you feel you really need a psychiatrist. I think that under the current government mental health services have been cut even more. I was lucky to have been ill before the Tories got in.

[elementofsurprise]

sadie This keyboard is rubbish for typing fast on. If my thoughts are coming faster than I can type (with two fingers!) then I make more mistakes and forget to go back and correct typos. (there's been around 10 in this paragraph so far.) I don't normally get so shaky and confused, it's just if I try to explain how I feel/my experiences and people don't understand or even get cross with me - that does it. There's nothing else in my life that triggers me like that.
In general I'm a bit of a grammar nazi, and also wince if people use incorrect English in speech...

Finchly Thanks! Going to go point by point as I have questions...

1. GP's was a bit of a nightmare, couldn't change surgery for various reasons. However, a new one has started there! I've only seen him once but he struck me as very efficient, and was very encouraging and reassured me it wasn't me but I was "just stuck in an inadequate system". My last GP was good at keeping the DWP at bay though, so am a bit worried about changing over...
   
   
2. I don't know if there's a specialist service. I have tried and failed at finding out the structure of services/what services are available. I can't seem to get hold of this information, as people just say (in the patronising voice reserved for children, animals, and mentals) "Go and see your GP" if I ask. Did you or you GP know of the other service? Is there a way to find out?
   Also... do you think not having support is going against me then? I don't really know what to do about that. I have one person who will sort of be with me if it's bad but we cant talk about it cos too different. During the private therapy a friend I had really trusted got into a relatioship and dumped all their friends and that was really hard - I suddenly lost my confidant outside therapy. So I think I'm 'safer' from that pov without 'support' but i guess services don't think so!
   Does make me feel like a pathetic loser that no-one wants though. It seems horrible for MH services to reject the already unwanted and rejected.
   
   
3. Services send me edited versions of letters. Old GP used to print out the full versions he got for me. They were quite rude about me but I'd still rather read them. The 'other option' is always 'under the care of your GP' . I am usually discharged by letter so can't ask questions - calling them to clarify anything gets me told they won't speak to me as no longer on their books . The last discharge letter I have (approx 18months ago) advises GP not to re-refer me.
   I can't ask to see a psychiatrist - can I? AFAIK it has to go through CMHT, and they won't see me... Do I have any rights over this?
   
   
4. I've always tried to make my life better. I've always been sensible about paying bills, rent, kept home tidy, eat healthily, dont get stupidly drunk even when 20, etc etc. If they actually realise this, they then use it as evidence I don't need help. Their CPNs are helping people who can't look after themselves properly. (I'm in a deprived area with huge council funding cuts.)
   
   Oh, and both old GP and new one think I am traumatised, not BPD. Old GP was quite shocked at the diagnosis - he deleted it from my GP record as a current dx. (Still on psych records, obvs.) However, no-one else seems to listen to me, and they sort of make symptoms up in their head and interpret things bizarrely - like they are trying to make me fit BPD rather than look at it with fresh eyes.

[Finchley26]

exWifebeginsat40 Hey, well done on getting sober. I hope you're proud of yourself - it's an awesome achievement.

And I agree, it definitely opens way more pathways for treatment if your sober. All of the services around me say that they will refer anyone self medicating to the appropriate addiction service prior to offering them therapy.

[sadie9]

Hi Element, hope things going ok today so far for you. Did you meet up with that local agency you were going to contact?
I am wondering why sometimes and it seems to be in the evening/night times, when you post the spelling is all garbled and not written properly and no punctuation. Whereas other times your posts are very well written, grammer perfect etc. Do you notice that yourself? Just wondering is there something else happening to you in the evenings that makes it so different - like a severe mood swing or something. It is a very marked difference like someone else writing them.

[exWifebeginsat40]

sorry lottie I overreacted to your post.

and yes, finchley, now I'm sober the services are definitely more open to me. while I was drinking there was no help they could give me as I was single-mindedly destroying myself and all my relationships.

my GP, the psychiatrist and my support group are all, weirdly, very relaxed about self harm. as long as I can self-care appropriately when needed and don't endanger myself they just say it's part of my coping strategy. well, yes, but it's awful!

I hope you're doing ok today OP. is there one thing you can do today to move things on a bit? even googling Advocacy services in your area and emailing them for info on how they work?

[Finchley26]

OP. Don't know you, only just signed up and unsure how you read through other user's post history... So apologies if I have misunderstood anything or if you've tried these things already.

I get it. I spent years being bounced around CMHTs whilst I slowly got more and more poorly. Looking back it was frightening.

1. Change GPs. Get a non-loccum GP in your area if possible who you can build up a relationship with. Your GP should be your advocate. Don't be afraid to use them. During my most sickest days my GP saw me every single day. We both "fired" the CHMT and he immediately got me into a specialised service and got me in it without a waiting list.
   

1. If there's a specialist service you are thinking of that is where you want to be make sure you know their "rules" for taking you. Otherwise they will refer you back to the CMHT until you are showing you meet those rules. For trauma they tend to like it if you have a support network / meeting people daily, are not self medicating too much and have control over self harm / suicidal thoughts. I can get you a link to a document that explains all this in more detail if you think that would be useful?
   

1. The communication within mental health services is appalling. Please make sure you are copied in on every correspondence and immediately ask questions if you are not accepted into a service and particularly ask for other options if they say you aren't going to be taken into that service. Ask to at least see a psychiatrist to get an updated / review of your diagnosis so your GP has something concrete to go with.
   

1. Basically, demonstrating you're trying to make your situation better yourself is actually a really positive step forward with all of this. If you can find any local support groups or reduced fee counselling sessions that may be helpful. I know this is going to sound a bit weird - but do you know your diagnosis (ok, yes, BPD, just re-read, would still get this updated) and do you know what you need to get better?
   

Just as a total aside, I was diagnosed with BPD (even though I didn't hit the criteria for self harm and suicidal tendencies and the unstable relationship bit) within an hour of meeting a psychiatrist. It was only through building up that relationship with my GP (and them speaking to another psychiatrist) that they realised I was actually severely traumatised and didn't have BPD at all. Hence why I would definitely ask to see someone for a proper and recent diagnosis. A lot of the knowledge surrounding mental health has changed recently.

Hope some of that is helpful to you.

[elementofsurprise]

• to add, for context... I carried on, just trying to survive, so experienced a lot of stuff I didnt process, just trying to survive. By a few years later, I though I was ok and it was all in the past, in fact I was really happy.
  Then I broke down in 2010, it all sort of hit me at once and I started getting really low and having intrusive memories of that time, and others.

[elementofsurprise]

lucsy thanks, but you misunderstand me. I meant this thread has made me spin out. I'm normally just quietly depressed, trying my best to get on with things everyday to make my life better. The things you have suggested are what I am like all the time, trying to enjoy little things and constantly pushing myself to do stuff. I'm just completely worn out with it.
Normally I dont 'spin out'. When I am starting to feel quietly suicidal I someties think I sould maybe tell someone or ask for some support, and being criticised and having peope not grasp the situation and not understand - that is what makes me spin out, potentially. So normally I avoid asking for support, I had thought a forum of fellow sufferers would be 'safe' but clearly not.

I would also like to point out, in general, that I was diagnosed (without due process, by a GP who's not supposed to...) BPD in 2004/5. I went to see the GP to ask for counselling due to feeling overwhelmed at work and getting fired from jobs cos I couldnt fight back the tears. He said I was "probably just one of those people" and was very reluctant to refer me on. I was 19. Anyway I mention this because before 2007 people with BPD diagnosis were excluded from services, this was quite normal. It also meant exclusion from related services eg. homeless services. So I was very, very alone when young and vulnerable and needing help from these services. And professionals would really dehumanise people with that diagnosis - this is what happens when people have to routinely act inhumaely to others, its well documented. I've had outright lies written about me, and one psychiatrist kicked me as I was kneeling on the floor begging for some help (purposely kicked me, I mean, whilst saying "get out, there's nothing wrong with you", because BPD wasn't seen as a mental illness). It's terrifying how many traumatised people have been abused by the system. Its quite different now - they may be unhelpful, and the previous discriminatry attitude still lingers to some extent, but you won't actually get hardened older nurses telling you you're a waste of space, colluding with your abusive partner, that sort of thing. Perhaps I am shit for it affecting me, but it really does, and people have no idea what the services were like, and wouldn't believe me if I told them. And these people wrote the notes that haunt me to this day and make other professionals dislike me before they've met me.

[lottielou7]

My original post was to Jaffodil. I think the OPs words were twisted by her in a very unkind way. I think she has been treated unkindly at some points on this thread. It's no wonder she's paranoid if people are making it worse.

I really just hope she's ok. It's a raw issue for many of us with MH issues. I just know how awful it feels to be isolated and she sounds utterly miserable. You can't see more clearly until you have a decent psychiatrist.

[lottielou7]

It's not a rule - it's called being a decent human being and not kicking someone when they're obviously already down.

It's not rocket science.

[exWifebeginsat40]

wait, so this isn't a debate now? how will you enforce this rule? because it happened to you does that mean it happened to me and I somehow didn't notice?

I certainly haven't said OP is attacking mothers.