[245/365] so much work

[cosmolinguist]

Awesome name stuff nonwithstanding, I've had a frustrating time with trying to access health care lately.

I did refer myself for counseling, as the GP had asked me to. I had the assessment from the third party that this has been outsourced to a week ago. I have been through this process two or three times, but what I'd forgotten from the last time was that I hadn't actually gotten it from them; I'd had to be referred on to something else when I said "No more CBT please" because all they really do is CBT. (That time I'd ended up referred to this person. I never followed up on that entry but: we didn't talk about therapy goals the next week and the week after that I had to cancel because I was busy or sick or something, then I got discharged from the service because I couldn't bring myself to schedule another session; I didn't even get any kind of reply when I returned a consent form saying she could use a recording of one of our sessions in her supervision or whatever (she wasn't quite done with her degree and needed people to agree to this, so I feel like it deserved at least a perfunctory thanks!)).

So I went through this assessment -- anxiety, depression, blah blah -- and only when we got to the end did the guy ask if I'd tried this before and I said "No CBT" and then I remembered haha, oh shit, all he can offer me here is CBT. I also emphasized that...it's not so much that I'm requesting someone who knows about LGBT+ stuff and disability, just that if I don't get that it'll be a waste of time for both me and them. He said he had to meet with his supervisor and he'd be back in touch this Thursday. Which I completely forgot about until he rang yesterday. In his tortured circuitous way, he said I should get my counseling from the LGBT Foundation. Which I would've done months ago except when I checked their website they were like "We are not letting people refer right now," they clearly just didn't have the capacity. The LGBT Foundation is the source of the only useful therapy I've ever ever had so of course I'm totally fine with trying it again. It's just frustrating that, like I said there, it's such a short course. 8 or 10 weeks is not going to be enough for me.

So I did that referral last night, which is fine. It'll be at least a few months before I can even start that though.

And today the GP had planned to call me back. She's been updated on the counseling referrals, she seemed pleased about that. Asked how I was doig and I said I was not doing as well as when I talked to her three weeks ago, particularly my sleep is terrible again. She was sympathetic, apparently having had some of that kind of "waking up too early" stuff that I get -- sleep-maintenance insomnia, it's called. She was symnpathetic to my complaint that all the advice for how to deal with insomnia is about having trouble getting to sleep in the first place and I'm actually pretty good at that, that's not the problem I'm having.

But she said sleeping pills aren't actually great for this, they make people drowsy but they can lead to the same kind of early-waking problems I'm having, and you don't go through the sleep cycle in the same way so you don't get deep sleep... We talked about medication a bit and she was back on her "well long-term anxiety and depression is best treated with talking therapy so that should help your sleep..." shtick. She also acknowledged that she's telling me there to hang on for something that can be a while in the future (if indeed it helps at all, I thought but didn't say; I've just had such rotten luck with counseling). She thought if meds weren't working "there must be something else bubbling away under the surface" and I don't think that but I do think if someone's tried five anti-depressants and none of them did anything, another isn't likely to be much better.

So that's it! I've just had a lot of phone calls and rigamarole to get me to a webform that took me two or three minutes to fill out and which I would've done six months ago if I could. It's hard not to be a little discouraged, even though it's not like I've had any better luck other times that I have tried to access mental health care particularly.

Comments

[lilysea]

Gah!

ALL THE EMPATHY AND SOLIDARITY!

I've had a terrible time trying to access psychologists

and then finding that almost all of the psychologists who I've seen as a patient are TERRIBLY IGNORANT about physical disability/chronic physical illness.

I read about other people's experiences with psychologists, and it's like they are living in a different universe to me, an alternate universe in which psychologists are actually helpful.

And yet, I know there are ~some~ helpful psychologists out there, because two of the people I follow on Dreamwidth are psychologists who try their socks off.

This may not be helpful so feel free to ignore

[angelofthenorth]

There are at least 2 anti depress ants that are indicated for treatment resistant depression now - vertioxitane and aripiprazole. V is only in the last 5 years on the market. We discussed it for me when I last saw the psych and psych pharmacist. The problem is they're both psychiatrist prescribed. I'm currently on aripiprazole 20mg and duloxetine at a very high dose and that just about manages my bipolar depression episodes.

I went through a lot of antidepressants. What helped was a great psychiatrist, a psychotherapist (not just counselling) for 18 months and the right drugs.

Have you mapped your episodes of poor sleep? I know you have the records on here, but if your GP is thinking other stuff is underlying then could you get data together to help them?

Good luck with all of this. Being treatment resistant is one of my fears as it took so long to find the drug combination and people combination to help last time. But it can happen even after 65 years in mum's case :)

Re: This may not be helpful so feel free to ignore

[cosmolinguist]

No this is really helpful, thank you.

[silveradept]

Here's hoping for an exit ramp towards something working soon.

[cosmolinguist]

Indeed! That sounds great. Thank you.

Arrrgghh

[jesse_the_k]

Such frustration. Much sympathy.

Re: Arrrgghh

[cosmolinguist]

Thanks. <3

[otter]

I shared this article with my psychiatrist this week. She says her clinic group is starting to talk about it, but she hasn't really got a good response to it yet.

https://www.psychologytoday.com/us/blog/side-effects/202207/decisive-blow-the-serotonin-hypothesis-depression

[azurelunatic]

I have sleep maintenance insomnia as well as the other stuff, and these are things that I've done to varying but overall good effect. Some are incremental, some are not. I have two main approaches: first solve any physical discomfort problems, then make sure my brain is kept calm and bored enough to fall asleep.

* Got a new mattress (expensive!) which helped stop me from waking up in the middle of the night from pain.
* Started taking an evening painkiller.
* Resolved the worst of my clogged nose.
- medicated spray
- aggressive allergy treatment
- most recently a Z-pak course of antibiotics, for something completely different but it cleared up the sinuses AMAZINGLY
* Got my partner to be more intentional/careful about snooze button use
* Got the cat a course of radioactive iodine to treat her overactive thyroid (reducing the morning yell session to a lower volume, shorter duration friendly reminder)
* I do not in fact enjoy a weighted blanket on top of me, but rolling it up makes it perfect to rest my top leg on when I'm side-sleeping
* The sleep study turned up mild sleep apnea, but this was before the nose stuff was under control and the insurance did not cover the CPAP because it does not change clinical outcomes, and honestly I only use it if my breathing is actually compromised, but I had to jump through that hoop to access sleep medication
* Actual sleep medication (trazodone, a sedating antidepressant and most importantly NOT a benzo)
* Anxiety medication so my brain is not full of thoughts like brass bees in an iron lampshade
* White noise to mask sudden noises that might wake me
- solo app first that let me mix noises
- then my sleep app integrated a lullabye feature, with random bonus sounds so the brain doesn't get used to the pattern and detect deviations
* Sleep app, Sleep as Android to help spot patterns and log common reasons for being awakened
* Low-light phone games in the sweet spot between interesting enough to hold my attention so I don't turn to a more activating app, and dull enough to not keep me awake if I start to fall asleep while playing
* Sleep podcasts, specifically Sleep With Me, to hold my attention with my eyes closed until I fall back asleep
* Calling the bluff of my insomnia and getting out of bed. The best thing is if I have a task that the ADHD parts of my brain find extremely tedious, so tedious that it would rather fall asleep than do the thing, then I can go *back* to bed
* Eye mask, working through a series of masks that Did Not Work for me until arriving at a long microwavable neck wrap and putting part of my blanket under it; I plan to custom-make something with glass pebbles as the weights so it can be more cool
* Temperature control in the bedroom, via mini-splits and a heat pump, but also a spray bottle of water and a small fan

[barakta]

How frustrating. I hope you can find stuff that works for you somewhere.

Not surprised LGBT Foundation ran out of capacity, similar happens to universities where GPs understandably bounce students to the uni cos NHS services are limited/crap.

Random thought (feel free to ignore), is there any scope in redoing a PIP application to add MH stuff and see if that could be upped at all which might give you private therapy options? Happy to help with that, I have a MH focused document too. Equally I recognise massive cripmin, stress cos DWP are shitheads and keeping things safe is also vital.

[cosmolinguist]

My PIP application already has my MH stuff in it.

And I do earn enough now that I could pay for private. Just gotta start looking for someone I guess.