View Full Version : Referral to psychiatrist
I wasn't sure where to put this post, so apologise if it's in the wrong spot.
I have anxiety issues that have got significantly worse over the last 2 years. I have diagnosed myself with agoraphobia, I struggle being in places where I don't feel safe. This stops me doing so much.
Anyway, I was seen by a consultant in December because after having pneumonia twice I have never felt well. ........aching limbs, dead legs, dizziness, generally feeling so unwell. Dr said I fitted classic symptoms of ME/CFS. He started me on amitryptelline for pain in limbs but as I'd told him I have anxiety and low mood he said they would help for that too.
This morning I've gone back for another appointment with him (I couldn't go on my own so my mum took the morning off work to come with me). He was completely different today. He was really dismissive. He said that he hadn't realised how significant my anxiety was, and that he's not sure whether my symptoms are ME or all anxiety. He said that if the amitryptelline isn't working at 30mg then I should just stop !!! I said I was keen to get to a dose which is recommended for anxiety/depression which is at least 50mg. He said "anxiety and depression really isn't my thing.....I'd just tell u to take some diazepam". I said I wasn't happy taking them on a regular basis, so he's going to refer me to his colleague, a psychiatrist.
My mum was in the room at the same time, she said she thought the problem was anxiety as well and not ME. I am so upset and cried all the way home. I liase with the mental health team at work so I know how great they can be.....BUT I don't want the stigma of being referred to a psychiatrist. I know that sounds bad but I just want my old life back and don't know how much longer i can keep up this facade. Has anyone else got anything positive to say anout referrals as I need a positive slant.
Thank you in advance, :weep:
Hi Michelle :hugs:. Sorry you have had this bad experience. What was this consultant's speciality? Unfortunately I have come across docs who seem to get frustrated and lose interest if the first thing the prescribe for you doesn't work and they just wash their hands of you.
I was very unhappy about being referred to a psychiatrist some years ago, stood on the doorstep of the building thinking things like "is this what I've come to?". But if you can detach yourself from thinking about things like stigma (yes it does exist but people generally don't need to know you are seeing anyone), can you see that this might actually be a good thing? As well as allowing you to talk about your problems, a psychiatrist should have much more expertise is what medication might help you. It was also after being referred to a psychiatrist that I got CBT.
You might feel upset about this at the moment but given time you might be able see things differently. I have CFS and there's a very close tie-in with having that and anxiety/depression so it can be really hard to separate the symptoms.
Honestly, you really can turn it round and view this as a positive thing xxx
Considering that most Gps know very little about Anxiety and Mental health .Its a good thing to have been referred to a Specialist .It gives you a better chance of getting the right treatment and Medication .In some countries its seen as a good thing and shows you have Status to have a Psychiatrist .Personally I dont see it as a bad thing if it helps you get well .Many arent as fortunate to get this help so early on and have to pay private .So be thankful for that ,People neednt know ,its up to you who you tell .You have anxiety ,its not like you are a psychopath ..Its no good going to the Grocers to get your Car fixed .The same applies to your health .Good luck and look on the bright side ..sue x
ElizabethJane
26-01-11, 17:42
There is no shame in seeing a psychiatrist. I'm sorry that your consultant has mishandled your case. You could still be suffering from ME and anxiety as well. It sounds as if he needs to show a bit more sensitivity towards his patients. I have suffered in the past by insensitive people. I now have a brilliant psychiatrist. Please try not to worry about what others might think about your attendance. The psychiatrist will be able to offer you the best possible treatment for your anxiety. Take care. EJ
Thank you JaneC, Suzy-Sue and Elizabeth Jane.
Jane, I know you are right, a psychiatrist is the right person to see, as they may be able to look at my medication and suggest something that others haven't.
The consultant I was referred to was a rheumatologist. I was referred to him as my GP agreed with my conclusion that I may have ME/CFS. The first time I saw him he was really positive. He said I fitted classic symptons of ME, and he said that anxiety and depression are common with ME. He said the amitriptylline would help with this. I am flabergasted that today he says that anxiety is really not common with ME and he thinks my symptoms are more anxiety.
I tried for 2 years to not start medication. mainly because I thought they masked the main problem and when I try to come off them the problems would still be the same. I used St Johns Wort for a long time which helped with low mood but not anxiety. I am now disheartened that he said "I don't really know a lot about anxiety".....that wasn't what he said on my first appt.
I'm not sure what to do now about increasing the dose of tablets. Unless I address the issues by not practicing avoidance then it will all come back when I stop the meds won't it?
Oh I don't know....He's made me feel really negative now........Damn Him :mad:
Well he got it right first time in that both anxiety and depression ARE common in people CFS/ME. Why he said different today? :shrug:. Weird, but don't let him get you down Michelle. Maybe he doesn't know any more about CFS/ME than he does anxiety (which wouldn't surprise me as it's classed as a neurological disease :doh:). In short I wouldn't really pay much attention to anything he said :hugs:
As for the meds, any idea how long it'll be before you see the psych? If it's going to take a few weeks, perhaps you could speak to your GP in the meantime? xxx
Hi Michelle,
It’s a shame that your GP is being rather uncertain about this. At least now he’s admitted that he isn’t certain, and instead of muddling on, has referred you to somebody more knowledgeable. The word ‘psychiatrist’ does have a sort of stigma about it, but a better term might be ‘mind specialist’ as opposed to chest specialist or heart specialist. An expert in a particular field when your doctor’s ‘general’ level of knowledge isn’t enough.
“I'm not sure what to do now about increasing the dose of tablets. Unless I address the issues by not practicing avoidance then it will all come back when I stop the meds won't it?”
That’s true. One thing to bear in mind is that a psychiatrist is medically trained and as a result is often more biased towards meds than therapy. Sometimes one is the best approach, sometimes the other, and often a combination of both. What meds do is lessen some of the feelings and emotions, making it easier to cope, but they cannot address the underlying causes of those feelings and emotions. It’s a bit like using a crutch for a broken leg – it helps the person to function. But it would be foolish to use that as the be all and end all of it, and do nothing to heal the bone so the crutch was no longer needed.
Take care :)
Nigel
ElizabethJane
26-01-11, 19:31
Hi Michelle,
It’s a shame that your GP is being rather uncertain about this. At least now he’s admitted that he isn’t certain, and instead of muddling on, has referred you to somebody more knowledgeable. The word ‘psychiatrist’ does have a sort of stigma about it, but a better term might be ‘mind specialist’ as opposed to chest specialist or heart specialist. An expert in a particular field when your doctor’s ‘general’ level of knowledge isn’t enough.
“I'm not sure what to do now about increasing the dose of tablets. Unless I address the issues by not practicing avoidance then it will all come back when I stop the meds won't it?”
That’s true. One thing to bear in mind is that a psychiatrist is medically trained and as a result is often more biased towards meds than therapy. Sometimes one is the best approach, sometimes the other, and often a combination of both. What meds do is lessen some of the feelings and emotions, making it easier to cope, but they cannot address the underlying causes of those feelings and emotions. It’s a bit like using a crutch for a broken leg – it helps the person to function. But it would be foolish to use that as the be all and end all of it, and do nothing to heal the bone so the crutch was no longer needed.
Take care :)
Nigel
Dear Nigel I think it is true to say that the 'old style' psychiatrists were only interested in a 'diagnosis' so that they could prescribe the correct meds. These days it is very different.Psychiatrists are interested in treating the whole person whether it is meds and therapy or meds on their own. My psychiatrist prescribes meds but also offers treatments where appropriate. I was seeing psychiatrists in the 80s and they were more interested in getting me off meds and into talking therapies. I hope you feel better soon Michelle.
Hi Elizabelth,
That’s true, things have improved a lot. But there are good and sometimes not so good, and I was just trying to point out that many psychiatrists see things from a medical angle and therefore are more inclined to reach for a medical solution. So I was just trying to say that being aware of the full picture makes it easier to make the right choices for our own personal circumstances.
Take care,
Nigel
Just to add my experience has been very much the same as EJs, Michelle - the focus very much on talking and CBT rather than meds, although I was taking meds (if that makes sense).
ElizabethJane
26-01-11, 19:51
I just don't think that is true anymore.I know that I am very fortunate as I am very proactive in my treatment options. I also believe that ssris and snris such as the mirtazapine that I am taking alter brain chemicals and make us feel less depressed. I would challenge any such statement that these drugs 'lessen some of the feelings and emotions' That is a myth. Anti ds do not stop you feeling. If you are prescribed sedatives or older style anti ds such as dothiepin can 'lessen emotions'.
I’m glad that you have a good relationship with your psychiatrist, and I agree that meds not only help some people cope with a difficult period, for others they’re essential for their long term wellbeing.
I only have second hand experience myself, and unfortunately that fits the not so good category. That doesn’t make me anti meds or anti psychiatrist though. There’s a right tool for every job, and sometimes several tools are needed to complete the job. It’s just good to be aware of all the options.
Nigel
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