NHS not helping me?

[Ssmith]

Hi guys,

I've been struggling on and off for 5 years with depression and anxiety. In the last few months, I've been going through one of the most severe episodes I've ever had which is leaving me incapacitated. I have extreme anxiety 24/7 and am extremely fatigued all the time. I'm really struggling to cope minute by minute (for more symptoms that i have, look at the post i wrote the other day)

I've been to the doctors numerous times who will only give me diazepam and zoplicone. I'm on citalopram which isn't working and they won't change it. I'm on the waiting list for IAPT which I've been on for 4 months now. I've asked for a referral to a psychiatrist or the CMHT but they keep on dismissing it. I'm not getting any better, probably getting a lot worse and I've considered going to A&E a couple of times. The anxiety is unbearable to live with. I had an episode similar to this 5 years ago which, somehow, i managed to get through on my own. What can i do to get treatment? I say to the doctors that I'm not as calm as i appear to them and i am struggling every single minute of the day

---------- Post added at 10:58 ---------- Previous post was at 10:47 ----------

Just to mention, the IAPT service I've been put forward for is the 6 sessions of guided self help which I'm almost certain will have no impact on me because of how bad i am and how long I've had it. I've been told that the most intense psychotherapy has a waiting list of over a year...

[uru]

Is it possible for you to pay for private counseling?

[Ssmith]

I've been seeing a counsellor for about 3-4 months. She's really nice but I've actually got a lot worse whilst seeing her (my deteriorating condition isn't due to her). Because I'm out of work now, i really can't afford to do it anymore as well.

I worry that i need to be sectioned. I feel so severe. Even the littlest of tasks is nearly impossible to do. My mind feels so fragile and i just feel like i'm getting no help which is making me feel more hopeless

[uru]

I know it's not a perfect solution but can you get hold of books on CBT or anxiety management? I've found them very useful at times.

There might even be some youtube videos which can help.

[Ssmith]

I've tried those but unfortunately, i don't find them very personalised to my situation and it's incredibly hard to do any of them when I'm in this state. I'm actually feeling a bit calmer in the evening for no reason. It really is confusing me :s

[pulisa]

It's nigh on impossible to distract yourself in this state. Just sitting still for 5 mins is a major achievement

[uru]

I find posting on this website very helpful...

[Ssmith]

Yeah this website is brilliant. The people on it, like yourselves, are really understanding and kind. It's invaluable to have somebody tell you everything is going to be okay sometimes

[MyNameIsTerry]

It's the same in my area, red tape & inflexibility.

My GP said I needed CBT and when I got there I was told "the system" is that you have Level 2 services first such as Guided Self Help. The person assessing me said I needed CBT but that's just how it works. Yet on this forum I since seen people told they can miss that stage and go straight to CBT so there are obviously issues with some providers playing the political game by using the levels to manage their numbers rather than provide the right care.

It's 12 months for the CMHT minimum around here. There is an additional issue too in my area that if you are put on the CMHT waiting list, they take you off the IAPT one. Also, if you start Level 2, they don't put you on the waiting list for CBT until you finish and this adds more months hence why I feel they misuse NICE guidance as a management tool. I had to complain about that because they admitted Level 2 wouldn't be enough so I expected I was in the queue for CBT whilst having that short therapy.

[lior]

Hey Ssmith.

I was on an IAPT waiting list while I was suicidal last year. I'm not suggesting this as a strategy for getting attention, but I managed to get an appointment a few days more quickly because I had felt suicidal and had rung up the helpline that they gave me. Did they give you a helpline number to ring? I think it's a local mental health helpline, forgot what it's called.

Things I would do if I were you:

When feeling extremely unbearably awful:
- Go to A&E. Don't feel bad about it - mental health is as serious as physical health. You might encounter untrained nurses who are unsympathetic, yes, that is a danger - but you also might get guidance to calm down. Sometimes things get so bad that it is worth taking the risk so that you can calm down - when things can't seem to get any worse.
- Ring the local mental health helpline number if they gave it to you
- Ring the Samaritans (it does charge you a bit if you call from a mobile phone)
- Ring a friend (but try to not ask for more than any one friend can give)

When feeling awful:
- Be super nice to yourself. Forgiving. Do activities you enjoy.
- Find as many opportunities as possible to find joy.

CBT is valuable. One thing I'm not sure you know is that they won't give you any other kind of treatment until you've tried CBT, because it does help a lot of people. But they insist that you take 3 months in between CBT and another kind of treatment so that CBT training can be practiced in your daily life.

No matter how bad you are, I'd recommend CBT. There's some really useful habits to learn that do make a difference.

I went through a bit of a struggle myself - I did 13 weeks of CBT (I'd signed up for 6 weeks, they had to keep extending it because I was so bad). Then I waited for ages for an assessment when I moved to a different borough, and had a traumatic assessment process, and then they didn't offer me treatment because they are underfunded - and they knew they couldn't offer me treatment in the first place. Where you live has a massive impact on what treatment they can fund.

What I ended up doing was going to a psychotherapist who didn't charge me anything until I got a job, and then she charged me only what I could afford. If I can get this, so can you. Lots of psychotherapists do pro bono work. Can you look for psychotherapists in your area? Can you ring them up and see if they might take you for a nominal charge?

My friend who's also suffered with depression has found somewhere that charges her £10 a session - that's not too bad, considering that some places charge £70.

Another thing that might be useful for you to know is that if you're in a really truly terrible headspace, you can't actually do any of the long term self work that is going to make your life better long term. You need to get yourself stable enough to make the space to do the self work. If you feel that bad, it's probably because of something that's happened in your life that you need to confront. There wouldn't have been much point in me going to psychotherapy while I was off my face feeling suicidal - I wouldn't have been able to think about all the stuff that's made my life bad. Maybe not everyone feels the same way, but I'm glad that I went to CBT before I went to psychotherapy.

They probably won't let you do CBT at the same time as psychotherapy - so if you do end up in psychotherapy, you'll probably be taken off the CBT list.

Hope this helps in some way!