Psychiatrist appointment

[LtBenson]

I've been referred to the CMHT after a near suicide attempt at New Year. After talking to one of the nursing team, she recommended a psychiatrist appointment, which is tomorrow.

I'm really nervous, and have no idea what will happen. Will she just want me to talk about it all again? It feels like that's all I've done for the past month 😪 .

I think we all suspect it's at least partly hormonal, hopefully she will have some new ideas for me.

Hi, i'm sorry you're feeling so rubbish. Were there any triggers to make you feel that way?
If you are already on medication then I suspect a psychiatrist would want to review and possibly tweak that, or add to it, if they feel it is not working.
How old are you? Peri/menopause can have hideous impacts on our mental health, I can testify to that, so if you're not on HRT that's definitely worth exploring, but important you stay safe xx

Sending hugs.

In my experience with NHS psychiatrists, appointment one is always taking a history and asking about your current referral. So they go back through your childhood asking about family / trauma, working life, when did symptoms appear, all that jazz. I know it's very repetitive answering the same questions from multiple professionals.

I've had two different psychiatrists - both are actively uncomfortable discussing suicidal ideas ideation, attempts and self harm so there's never been any need to go into more detail than why / what your feelings were / what stopped you if you had ideation but ultimately didn't follow through your plans. It's always been brushed over far quicker than the discussions where I have to insist that I had a happy upbringing and no trauma.

After discussing your history and current feelings in my experience they ask what you are looking for in terms of help rather than making suggestions. Now I'm nearer peri age I was sent for full bloods by my most recent psychiatrist to rule out hormonal / thyroid complications. Turns out I'm still okay there but am at the low end of the spectrum on B12, vitamin D and iron - as I already take a multivitamin that should have sorted these she got the GP to prescribe additional vitamins and a B12 injection. The B12 was a revelation, my memory is now slightly longer than a few seconds. I keep a notebook with a list of medications I've tried before because they seemingly never have that even when they've taken it and added it to their notes every appointment. They will usually offer DBT or CBT as well as a first line way of encouraging you to challenge your thinking. In our area they prescribe a month of medication, write to your GP to ask them to do a repeat and say you'll see them in 8 weeks time to reassess. I'm seen every four weeks as I'm treatment resistant but the medical secretary has let slip that 8 weeks is a target and actually is 12.

In my area they tell you that you have a psychiatrist appointment when you have a referral from CMHT / GP but you get there and appointment number one is actually with a nurse and then if you satisfy their requirements your next meeting is with an actual psychiatrist. This has happened on both of my referrals following attempts despite seeing a CMHT nurse who took my history in the first time and already being known to them the second time. I just wanted to prepare you for this potentially happening because both times it's floored me that I've gone hoping for some help and it's back to waiting for a few more weeks.

I hope your appointment goes well and your psychiatrist can help you plan a way forwards. Please keep going, one second at a time, one minute at a time.

Thank you both for replying.
My GP started me on Venlafaxine so I am gently increasing that.
I'm 53 and already on HRT, but the GP was reluctant to change it previously, despite me thinking I needed to. And here we are.
And now she won't change it while we are increasing the anti-depressant!
I am depressed, but whether hormones caused it or make it worse, I'm not sure.
Hopefully, they might tweak my HRT as well then?
It's just a lot to deal with.
Thanks again

I saw a psychiatrist when I had pnd, in all honesty by the time the appointment came around I was feeling quite a bit better anyway and the appointment served as a really interesting debrief. The psychiatrist politely guffawed at my GPs approach to prescribing, he felt I should be on a higher dose (sertraline) and I was glad of that input at the time.

I was grateful to have the time and space to really talk it all over, as a GP appointment is always so short. It was very helpful.

Good luck with your appointment, I hope it helps.