Extremely annoyed this morning by my visit to the GP.

[KayeS]

Went to my GP this morning to discuss my ongoing back pain but actually mainly to ask for medication in regards to my anxiety.

The only appointments they had left were with a Locum doctor even though I rang them 3 minutes after the surgery opened.

Anyway I saw this doctor and we discussed that my x-ray results were normal and that my fears of a spinal tumour were unwarranted etc etc yada yada yada...

Anyway onto the anxiety. I explained to her how long I've been suffering with it, and how I've tried counselling and have just started CBT but I feel that it's not helping/going to help much and I really need something now as the anxiety is ruining my life. Her response? "Give the CBT a go first...". So I explained again that I will see the CBT through, however not only do I kind of feel like it's not going to have much of an effect, but I also need something more immediate as the anxiety is really getting out of control. She insisted I just stick with the CBT alone for now and if that fails, then I can try medication. I have had this discussion with a doctor about 4 times now over the last year. They really do not understand how much anxiety can make someones life a living hell. I went today for HELP with my ANXIETY so that I can at least attempt to get on with life, but they basically refused. I wasn't demanding tests for my imaginary health problems. I wanted to sort out the ANXIETY.

Now I just feel utterly hopeless in regards to my anxiety and health worries. There's no one else I can turn to for help now with it. All I have are these CBT sessions. I don't even know how long that is supposed to go on for. 10 weeks? So 10 more weeks before I can even suggest anxiety medication to the GP again. Wonderful.

[pulisa]

I feel your very understandable frustration. Can you book another appointment with a GP you know and stress that this isn't a spur of the moment decision, you have very good insight into your long standing HA issues, you are aware of how a combination of meds and CBT can offer the potential for the best results, you are totally fed up of getting fobbed off by blinkered and ignorant GPs....?

Well maybe not the latter although it might help you re the "unbalanced mind" aspect for meds:D

[KayeS]

Lol I think I'm going to have to. I'm just so p****d off that I have to go back again for the same thing. I feel embarrassed as it is every time I go there because I've been so much. With my surgery, you can either book in advance with a doctor you want and wait 3-4 weeks for an appointment, or you basically call up at 8am on the day and they give you an appointment on the same day but with whoever's available so you never know which doctor you're going to see.

I was really hoping to get some medication today and start to feel better.

[sandie]

How about sitting down and writing a lengthy letter to your GP - explaining things from your perspective. How while you are more than happy and prepared to go with the CBT, that you also need something NOW to help alongside the CBT; meds may make it easier to implement what is necessary as a result of the CBT sessions.

You could finish the letter (which you might want to address to whichever GP you feel is likely to be more responsive), by asking them to ring you to offer an appointment at which you can discuss the contents of the letter ?

[MyNameIsTerry]

It's a locum for a start and they will be less likely to make a real decision over a quick fob off since they may never see you again. Also there is a financial cost to the surgery, a long term & debatable one, so they will be less likely to make the decision. You've just started therapy and in their eyes you've not given it long enough so they have an easy "out . Therapy is as effective as some meds after all.

You would be better seeing a regular GP or one you have a good connection with. A more balanced decision will take place. They may still want to monitor the therapy but if in their opinion you are not coping, they will probably start meds. Given the therapy they may try short course meds at first and again monitor but if you head into SSRI's please be realistic because the side effects window will likely halt your progress if you experience the typical start ups. Use the Meds board for support too, you will get different people than this board who are going through it and there are some long running support threads on there for people.

People are often negative about therapy early on so convincing your GP could mean explaining how things have suffered despite counseling over a longer period.

[Fishmanpa]

First off... Good for you for taking the initiative! With all the negative posts about doctors passing meds out like candy, I found this one surprising and in some ways noble. Perhaps she was thinking about the side effects and such? One can only surmise. I agree in that many times, meds in conjunction with therapy, especially CBT can be beneficial. CBT takes focused effort and if your mind is full of head trash, it makes doing the work difficult. Something to quiet the mind can help get the work done.

That being said, I agree with the others in making another appointment and bringing it up again. It's wise to make notes so you keep on point with your discussion. Keep in mind, that it doesn't have to be a SSRI or the like. Perhaps something milder with less side effects may be just enough to do the trick.

Keep at it and don't be discouraged!

Positive thoughts

[uru]

Doctors proscribe medicine on the basis of research and national guideline. In the UK this is often NICE.

http://www.nice.org.uk/guidance/cg113/chapter/1-recommendations#principles-of-care-for-people-with-generalised-anxiety-disorder-gad


Treatment options
1.2.16 For people with GAD and marked functional impairment, or those whose symptoms have not responded adequately to step 2 interventions:


Offer either



an individual high-intensity psychological intervention (see 1.2.17–1.2.21) or
drug treatment (see 1.2.22–1.2.32).


Provide verbal and written information on the likely benefits and disadvantages of each mode of treatment, including the tendency of drug treatments to be associated with side effects and withdrawal syndromes.
Base the choice of treatment on the person's preference as there is no evidence that either mode of treatment (individual high-intensity psychological intervention or drug treatment) is better. [new 2011]




All research suggests that CBT is as good if not better than meds. Meds might help but they might not, -go and check out the med section and see how many people have problems with them.

[Sunflower2]

Last year I was discharged early from seeing a clinical psychologist and I had to go to my gp about 3 times until they realised how much of a mess everything was going to get in if they didn't do anything to help me. I even called up one day and spoke to the gp on duty who finally took pity on me and booked me a double appointment with my regular gp to really explain how bad I was feeling. I also made a list of everything in my life that my anxiety was affecting.

If you're not happy with the response don't sit and wait until you get worse and it's harder to get back under control. It's a pain but someone who barely knows us can't really see our situation from our perspective unless you really really stress how bad it is. It does also help making a relationship with one gp, even if that means booking appointments well in advance. Mine knows all about my issues and medication and therapy etc so we both are on the same page. It also means I get referrals through straight away because he also knows it's not seen as something unnecessary.

As for the meds, I'm the opposite I was offered them by every single gp I saw and each time I refused until the last! Different doctors have different opinions on how to treat patients! But, as I said, if you're not happy then don't wait weeks and weeks!

[KayeS]

I appreciate the advice guys, thank you.

I'm going to try and get another appointment this week with a GP that I've seen before and is more aware of my situation. I was hoping for that today to be honest but I think some of the doctors are away.

In regards to the CBT, although I am fully willing to see it through, I really do feel like my mind is so full of anxiety that I just imagine myself just worrying about my health issues during the sessions and then simply being too anxious outside of them practise what they tell me to do. Right now my anxiety is really REALLY high and I'm on the verge of booking a private MRI scan of my spine :/

[Magic]

KayesS, Private MRI are very expensive.
I do feel for you about your situation.
If you manage to get an appointment with a GP you can discuss the issue with the spine ex ray too. i do agree with what the above have said about meds.
Good Luck

[MyNameIsTerry]

Doctors proscribe medicine on the basis of research and national guideline. In the UK this is often NICE.

http://www.nice.org.uk/guidance/cg113/chapter/1-recommendations#principles-of-care-for-people-with-generalised-anxiety-disorder-gad



All research suggests that CBT is as good if not better than meds. Meds might help but they might not, -go and check out the med section and see how many people have problems with them.

That's just the GAD guidelines and that's only one section so the others should be observed and the one higher than this shows how a dual meds & therapy treatment is appropriate in more severe cases. The problem is there are no HA guidelines because HA isn't a medically diagnosable condition.

HA is a common term and it spans GAD, OCD and the Somatoform Disorders. Of the 3 only GAD & OCD have NICE guidelines and if you look at the OCD ones you will find they are quite different to the GAD ones.

So, in discussing guidelines for HA, you need both and the patient needs to know which they have to determine which to use. This can be problematic since GP's often don't even know themselves as they are not qualified to diagnose mental health conditions in much detail.

I also wouldn't advise anyone to look for bad experiences of meds because you will find them for every med in existence. What you won't find is all the people they have helped because it's mostly bad experiences that are reported. NMP is safer in this context as there are support threads too and people saying they have been helped. Cognitive Bias is a problem for anxiety sufferers so you need to learn how to approach these things realistically but also with an open mind and that can be a problem.