Today was my long-awaited psychiatrist appointment. After more rapid mood swings and two absences in a row from my voluntary job, I needed to see Dr Nutkins-May more than ever. Husband had already insisted on coming with me and luckily for us, he got the day off work – he did take in my appointment letter just to let them know he wasn’t just looking for a birthday break – so if I needed another voice, I had him.
We walked in, and as usual he asked me how I’d been. I told him the truth and he was surprised to hear how much I’d been struggling, given how stable I was for most of last year. Husband pointed out that I was indeed stable, but then after the wedding I kinda just crashed. Dr Nutkins-May said that it’s common for the aftermath of a built-up event to be pretty downbeat, and I could probably agree with a few weeks of being depressed but not months of constantly shifting moods. I know I have no problem with being married, nothing in life has changed so dramatically that could explain all this. In fact, life is pretty fucking good right now in the grand scheme of things, and yet I am still a wreck.
I asked if I could try lamotrigine along with the venlafaxine I currently take to see if it helps. My friend Blue takes it, and recently Charlotte has been tweeting and blogging about having it added to her medication regime. He said it was worth a shot, so he’s started me on two weeks at 25mg a day to see how I go. Of course I’m apprehensive as I am with any new medication, but it’s worth a shot. We also spoke about lowering my dose of venlafaxine too, as he thinks 225mg might be doing more harm than good. It is a pretty hefty dose of a pretty hefty drug, so all we can do is wait and see what the lamotrigine does. There’s also still the diazepam there for bad episodes, which is good.
Husband enquired about having access to a CPN, but it seems there’s a six month waiting list and Dr Nutkins-May has to build up a good enough case for me to be even considered to be taken on. It’s utter bullshit that paperwork and politics take priority over patient care, but that’s apparently how the world turns. Luckily though, I am being referred to an Administrative Nurse Practitioner to see inbetween psychiatrist appointments, so my medication can be monitored and prescribed, plus I can explore further treatment at a more frequent rate. Dr Nutkins-May believes this will work in my favour in regards to gaining access to a CPN too. He’s a smart man, a little unorthodox but smart nonetheless.
We also discovered today how treatment for mental health is determined, via a system that rates the severity of conditions through numbered ‘clusters’, the lower end starting at number 1 all the way through to the very extreme end at 17. From what he described to us, Birmingham Healthy Minds won’t take any patients that are cluster 3 and above, and they are adamant they won’t take bipolar or borderline patients – although he didn’t say why, he didn’t exactly argue when I said it’s probably because we’re allegedly the patients that psychiatrists dread treating. Dr Nutkins-May thinks that attitude is just wrong, and that’s why I trust him to continue treating me.
(As is stands, I’m apparently cluster 11, though I currently bounce between that and 15 at my worst. If you want to know more about this weird system, feel free to download this PDF. It’s a pretty good read if you want some knowledge of psychiatry behind the scenes. There’s also this one, which is far more detailed as it’s for clinicians.)
So, I’ve got my prescription and I start the lamotrigine tonight just in case they make me drowsy. I suppose this a warning to everyone I know in real life too, just to say I’m on new medication and it will probably affect me in some way, be it through side effects or intended brain changes. As always, just bear with me. I’m trying to find what works for me and helps me deal with this stupid disorder.
It’s been really hard to get by most days. Not been keeping up with my uni work, still have plenty of other projects I should be getting done but I’ve just not had the will or energy. There’s a pile of washing up to be done, and brushing my teeth has become optional.
All I can do is try. I’ll keep you all updated on my progress with the new meds, plus any exciting work developments if they come.