martavee
03-11-2007, 07:27 PM
I would just like to gain some insight from you into how the NHS works here for people seeking mental health help. This way I'll know what kind of service I should expect and determine if I'm satisfied with their treatment of me. If I'm not satisfied then I will be seeking a private psychiatrist.
I am an American, age 24, that currently lives in England. I moved here in September for law school because I want to be a solicitor. Have been diagnosed the past ten years with general anxiety disorder/panic attack disorder/depression/PTSD by general doctors. I've been on and off SSRIs for those disorders, but never stuck with them because I didn't like how they made me feel.
I went to a NHS GP here in England in December and tried two different SSRIs between then and February. Had a horrible reaction - the worst ever. Basically this time around it was a complete breakdown. Finally I have been granted an appointment with the local NHS psychiatrist via letter. That is this Wednesday and it states that the appointment will last approximtely one hour and that the East Sector Community Mental Health Team Manager will also be present. I'm probably just extremely paranoid, but is this normal that someone is overseeing the appointment? One of the times that I called the psychiatrist's secretary (my doc had screwed up and forgotten to refer me which I caught onto after two weeks of lost time) she once mentioned something along the lines of "If we decide to take your case." I don't recall the context of that comment now. So now I'm all paranoid that they won't help me because (a) I feel like they don't take me seriously (b) I'm American. I have this weird belief that they feel like I'm wasting government money because I'm American :confused: (even though I'm eligible for the NHS due to being a full time private student).
It seems like I only ever hear negative things about the NHS. I had suggested to my GP in December that I feel I've been misdiagnosed all these years and that I'm BPII. They said no, we'll stick witht he past diagnosis. Then after my first complete flip out (which was very scary) in early January I brought it up to the GP that SSRIs have that result in BP people. She chose to ignore my concern and told me to take sertraline (another SSRI) for six weeks. That totally screwed me over. I had to drop my law course - luckily the school is allowing me intermittent leave to return next year. But there is the issue of my student visa with Home Office ... they may choose to not renew it because I've had to take an intermittent leave :( I have become a prisoner of my flat because I am so out of it. My emotions are all over the place.
I don't see how one hour is enough to evaluate me.
I am an American, age 24, that currently lives in England. I moved here in September for law school because I want to be a solicitor. Have been diagnosed the past ten years with general anxiety disorder/panic attack disorder/depression/PTSD by general doctors. I've been on and off SSRIs for those disorders, but never stuck with them because I didn't like how they made me feel.
I went to a NHS GP here in England in December and tried two different SSRIs between then and February. Had a horrible reaction - the worst ever. Basically this time around it was a complete breakdown. Finally I have been granted an appointment with the local NHS psychiatrist via letter. That is this Wednesday and it states that the appointment will last approximtely one hour and that the East Sector Community Mental Health Team Manager will also be present. I'm probably just extremely paranoid, but is this normal that someone is overseeing the appointment? One of the times that I called the psychiatrist's secretary (my doc had screwed up and forgotten to refer me which I caught onto after two weeks of lost time) she once mentioned something along the lines of "If we decide to take your case." I don't recall the context of that comment now. So now I'm all paranoid that they won't help me because (a) I feel like they don't take me seriously (b) I'm American. I have this weird belief that they feel like I'm wasting government money because I'm American :confused: (even though I'm eligible for the NHS due to being a full time private student).
It seems like I only ever hear negative things about the NHS. I had suggested to my GP in December that I feel I've been misdiagnosed all these years and that I'm BPII. They said no, we'll stick witht he past diagnosis. Then after my first complete flip out (which was very scary) in early January I brought it up to the GP that SSRIs have that result in BP people. She chose to ignore my concern and told me to take sertraline (another SSRI) for six weeks. That totally screwed me over. I had to drop my law course - luckily the school is allowing me intermittent leave to return next year. But there is the issue of my student visa with Home Office ... they may choose to not renew it because I've had to take an intermittent leave :( I have become a prisoner of my flat because I am so out of it. My emotions are all over the place.
I don't see how one hour is enough to evaluate me.
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jgr01
03-12-2007, 08:06 AM
Hi Pieke,
Firstly, let me say the NHS is a good system, but all sytems/people etc make mistakes! The BIG PLUS is that we have a welfare system that will cover rent and provide other living benefits (I have been on Incapacity Benefit for 10 mths)
. It may only be a small contribution £280 per month but it is something.
I have had good and bad experiences with psychiatrists in the UK. I was originally diagnosed and treated by a private pdoc after a breakdown (I had private medical through work) 7 years ago.
The bad experience was with a locum NHS pdoc (temporary) who just didn't have the time for me - tbh i think he thought i was unhelpable. I wasn't prepared to accept my condition. My current NHS doc is excellent. I only get half hour at a time but he remembers me; is strict and unswerving with the severity of the condition and also pointed out how to get the benefits after another breakdown last April.
I can't comment on whether you are BP11. That is what i am though. I take Depakote 2000mg per day, have been for about 10mths now.
You should probably look at the NHS.org or Government website for more info about foreign entitlement. I do have a friend from South Africa who became Schizophrenic 3 days after arriving here and she has been supported for 2 yrs now and is also enrolled in college. She did work here some years ago so I assume paid National Insurance contributions from her salary. These are basically the monies deducted at source from your salary to pay for the NHS - much less than private costs in the US!
I also suggest you ask your doctors on Wednesday. These questions in your head (whatever your condition) will be causing unnecessary worry. When you know the facts you can plan your next steps which is positive and not leaving you in a maelstrom of limbo.
Good luck
Juliet
Firstly, let me say the NHS is a good system, but all sytems/people etc make mistakes! The BIG PLUS is that we have a welfare system that will cover rent and provide other living benefits (I have been on Incapacity Benefit for 10 mths)
. It may only be a small contribution £280 per month but it is something.
I have had good and bad experiences with psychiatrists in the UK. I was originally diagnosed and treated by a private pdoc after a breakdown (I had private medical through work) 7 years ago.
The bad experience was with a locum NHS pdoc (temporary) who just didn't have the time for me - tbh i think he thought i was unhelpable. I wasn't prepared to accept my condition. My current NHS doc is excellent. I only get half hour at a time but he remembers me; is strict and unswerving with the severity of the condition and also pointed out how to get the benefits after another breakdown last April.
I can't comment on whether you are BP11. That is what i am though. I take Depakote 2000mg per day, have been for about 10mths now.
You should probably look at the NHS.org or Government website for more info about foreign entitlement. I do have a friend from South Africa who became Schizophrenic 3 days after arriving here and she has been supported for 2 yrs now and is also enrolled in college. She did work here some years ago so I assume paid National Insurance contributions from her salary. These are basically the monies deducted at source from your salary to pay for the NHS - much less than private costs in the US!
I also suggest you ask your doctors on Wednesday. These questions in your head (whatever your condition) will be causing unnecessary worry. When you know the facts you can plan your next steps which is positive and not leaving you in a maelstrom of limbo.
Good luck
Juliet
wackywayne1965
03-12-2007, 10:32 AM
Hi ive been dxd for 5 years with bp 1 was 1st ill when 19 im 41 now, my early experience with nhs was bad(long story)but was over 20 years ago.The last 5 years on the whole the NHS as been brilliant,in the way i've been treated,it can depend on the local trust you see some are better than others but treatment and meds should be free,also you have insight into your condition which helps both you and pdoc. regarding 1 hour thats quite a long time for 1st meeting.If your not happy with treatment/ooutcome,you can contact following bodies;PALS,or MIND,or mdf bipolar organisation all will give you free help and support. all the best.
martavee
03-12-2007, 08:15 PM
Thanks Juliet and Wayne for the response :) Gives me hope that is much needed at the moment.
Lisacheckm8
03-13-2007, 09:45 AM
Hi,
You mustn't get too paranoid about another person being present at your evaluation or the comment about whether they will take on your case. The psychiatric hospitals now will only accept cases that are going to prove difficult to treat in the community. I have been refused in the past simply because the GP sent inadequate info.....but I have since been seen at the psych hosp and have the diagnosis of BPAD (not been told if it is I or II) I have recently been put on 15mg Zyprexa and 400mg Tegretol. It is also normal for the 1st appointment to be an hour long.........(just try and have your history organized in your head coz thats basically what they will be after) With regards to the other bod being present I have never heard of that, but just maybe it is to ensure that no cases that can be dealt with in the community are passed onto the hospital .... I really don't know. Just chill and I hope your appt goes well (hint .... dont try and tell the docs that you think you are BPII they really dont like it;)
Take care
You mustn't get too paranoid about another person being present at your evaluation or the comment about whether they will take on your case. The psychiatric hospitals now will only accept cases that are going to prove difficult to treat in the community. I have been refused in the past simply because the GP sent inadequate info.....but I have since been seen at the psych hosp and have the diagnosis of BPAD (not been told if it is I or II) I have recently been put on 15mg Zyprexa and 400mg Tegretol. It is also normal for the 1st appointment to be an hour long.........(just try and have your history organized in your head coz thats basically what they will be after) With regards to the other bod being present I have never heard of that, but just maybe it is to ensure that no cases that can be dealt with in the community are passed onto the hospital .... I really don't know. Just chill and I hope your appt goes well (hint .... dont try and tell the docs that you think you are BPII they really dont like it;)
Take care
martavee
03-13-2007, 07:28 PM
Hi Lisacheckm8 - I'm a bit confused as to what you mean by 'if the case can be dealt with in the community'? I'll be sure to freshen my memory on my medical past. Thanks for the reply.
Sharonamy- I just replied in another post asking about your referral. Do you know if your MP sent the referral off to the pdoc yet? Mine 'forgot' to, which I didn't find out until I called the pdoc's secretary to get an estimate of the waiting time. She was able to tell me that I hadn't been referred yet - maybe you should call the pdoc's office too and at least check that you've been entered into the system?
Sharonamy- I just replied in another post asking about your referral. Do you know if your MP sent the referral off to the pdoc yet? Mine 'forgot' to, which I didn't find out until I called the pdoc's secretary to get an estimate of the waiting time. She was able to tell me that I hadn't been referred yet - maybe you should call the pdoc's office too and at least check that you've been entered into the system?
martavee
03-14-2007, 05:21 PM
Well I have mixed feelings about the appointment. I'm actually very glad the mental health team manager was there to overlook the appointment because I feel he took my situation more seriously. I was a bit frustrated with the psychiatrist. I'm usually a tough person but she made me cry a few times - she was very snappy/rude/cold. "Oh you're just moderate" blah blah blah. She seemed so condescending.
I learned that here in England they don't recognize bipolar type I and bipolar type II - they just recognize the BPAD like you mentioned Lisa. In order to have this diagnosis they say I'd have to have had an incident where I was hospitalized with psychosis. I mentioned that I had read that with BPII you don't have to go into a psychosis state - that's when they told me how it was different here.
The psychiatrist was a bit annoying in regards to my SSRI history - she said that I never gave them long enough! I said what!?!?! I once gave paxil a whole damn year and then after a six month break I tried it again for six months ... all the other SSRI meds (I think three different types apart from paxil) I tried out for six+ weeks. They make me flip out to the point where I become a hermit rocking back and forth/pacing back and forth or running around endlessly never wanting to stop.
The appointment lasted well over an hour - roughly an hour and 45 minutes. The psychiatrist said she felt I didn't need a CPN but luckily the mental health team manager that was sitting in chimed in and said that he felt I needed one. The psychiatrist said she'll be sending me out a letter next week after the mental health team meets where my case will be discussed. She says she doesn't think they will diagnose me with BPAD considering they just recognize the type I with psychosis (I'm speaking in American terms there). Instead they see me as having a cyclothymic personality, which is a minor form of bipolar. She doesn't see me as ever having a major depressive episode even though I've been diagnosed in the past with depression and I've had periods where I'm not able to function at all. Because I still have a roof over my head I guess it's not serious that I just lost £6,000 from having to pull out of school due to my condition and that I might lose my visa/be exported :rolleyes:
So the letter I get sometime next week discusses the different medications they use for cyclothymic ... I believe the anti-psychotics at a much lower level then what you prescribe for BP. Lithium they don't do for cyclothymic. I stated that I want something that is weight neutral and she snapped saying "Oh, I'm not interested in prescribing your medication" - that's when the team manager said that the CPN along with a psychologist will do that. Ugh and I'm going to start crying again because as I read about the cyclothymic disorder I just want to scream WAS THE FLIPPIN PSYCHIATRIST DEAF??? It says that no mixed episode should be present - I feel that's what I experience most of the time. Ugh and from reading about major depressive episode I do think this has occurred at least twice in my life. Both times where I stopped functioning. Sorry if I never attempted to take my damn life, but I learned from a close family friend killing himself when I was young that suicide is never appropriate - you often ruin so many peoples lives. That doesn't keep me from hoping though that maybe this wine & pill binge will be the one time that I don't wake up.
:blob_fire Sorry if this is long and rambling but I just need to vent. I'm just feeling so frustrated and angry. I spent three hours of just power walking around aimlessly after the appointment.
I will stick this out for a month. Maybe after the team meeting when they discuss my case next week someone will feel differently than this outpatient consultant psychiatrist lady. If I still feel the way I do now then I'll be seeking the private route. I just don't appreciate someone telling ME how I feel when they cut me off when I try to say how I feel because it's "not part of the question".
Blargh and I'm crying again because I feel so hopeless. I know I should have taken care of this back in the states before moving to the UK but at the time I thought it wasn't worth the money. My private insurance had just ran out and I've always had this thing about spending my parents money. I'm quite frugal. Even when I was young (we're talking eight and beyond) I'd look for the cheapest item on the menu - probably because my brothers would always order the most expensive! Anyways, I felt guilty 'wasting' money on seeing a psychiatrist so I just kept telling myself "Just get by, you can address this later, who knows ... maybe how I feel will go away."
Oh and I'd like to say the pdoc scolded me for not having my medical records from when I was 15. I've lived in three states and two countries since then. Sadly I've always put school over my health.
I learned that here in England they don't recognize bipolar type I and bipolar type II - they just recognize the BPAD like you mentioned Lisa. In order to have this diagnosis they say I'd have to have had an incident where I was hospitalized with psychosis. I mentioned that I had read that with BPII you don't have to go into a psychosis state - that's when they told me how it was different here.
The psychiatrist was a bit annoying in regards to my SSRI history - she said that I never gave them long enough! I said what!?!?! I once gave paxil a whole damn year and then after a six month break I tried it again for six months ... all the other SSRI meds (I think three different types apart from paxil) I tried out for six+ weeks. They make me flip out to the point where I become a hermit rocking back and forth/pacing back and forth or running around endlessly never wanting to stop.
The appointment lasted well over an hour - roughly an hour and 45 minutes. The psychiatrist said she felt I didn't need a CPN but luckily the mental health team manager that was sitting in chimed in and said that he felt I needed one. The psychiatrist said she'll be sending me out a letter next week after the mental health team meets where my case will be discussed. She says she doesn't think they will diagnose me with BPAD considering they just recognize the type I with psychosis (I'm speaking in American terms there). Instead they see me as having a cyclothymic personality, which is a minor form of bipolar. She doesn't see me as ever having a major depressive episode even though I've been diagnosed in the past with depression and I've had periods where I'm not able to function at all. Because I still have a roof over my head I guess it's not serious that I just lost £6,000 from having to pull out of school due to my condition and that I might lose my visa/be exported :rolleyes:
So the letter I get sometime next week discusses the different medications they use for cyclothymic ... I believe the anti-psychotics at a much lower level then what you prescribe for BP. Lithium they don't do for cyclothymic. I stated that I want something that is weight neutral and she snapped saying "Oh, I'm not interested in prescribing your medication" - that's when the team manager said that the CPN along with a psychologist will do that. Ugh and I'm going to start crying again because as I read about the cyclothymic disorder I just want to scream WAS THE FLIPPIN PSYCHIATRIST DEAF??? It says that no mixed episode should be present - I feel that's what I experience most of the time. Ugh and from reading about major depressive episode I do think this has occurred at least twice in my life. Both times where I stopped functioning. Sorry if I never attempted to take my damn life, but I learned from a close family friend killing himself when I was young that suicide is never appropriate - you often ruin so many peoples lives. That doesn't keep me from hoping though that maybe this wine & pill binge will be the one time that I don't wake up.
:blob_fire Sorry if this is long and rambling but I just need to vent. I'm just feeling so frustrated and angry. I spent three hours of just power walking around aimlessly after the appointment.
I will stick this out for a month. Maybe after the team meeting when they discuss my case next week someone will feel differently than this outpatient consultant psychiatrist lady. If I still feel the way I do now then I'll be seeking the private route. I just don't appreciate someone telling ME how I feel when they cut me off when I try to say how I feel because it's "not part of the question".
Blargh and I'm crying again because I feel so hopeless. I know I should have taken care of this back in the states before moving to the UK but at the time I thought it wasn't worth the money. My private insurance had just ran out and I've always had this thing about spending my parents money. I'm quite frugal. Even when I was young (we're talking eight and beyond) I'd look for the cheapest item on the menu - probably because my brothers would always order the most expensive! Anyways, I felt guilty 'wasting' money on seeing a psychiatrist so I just kept telling myself "Just get by, you can address this later, who knows ... maybe how I feel will go away."
Oh and I'd like to say the pdoc scolded me for not having my medical records from when I was 15. I've lived in three states and two countries since then. Sadly I've always put school over my health.
martavee
03-14-2007, 06:16 PM
Well actually I wasn't diagnosed with BP back in the states. Another gal on this board that lives in England is from the US and she was diagnosed with BP before. Personally I've been diagnosed with general anxiety disorder & panic attack disorder at the age of 14 or 15, then depression around 19/20, then post traumatic stress disorder around 21/22. I just was never aware of bipolar disorder except for one person I knew that was bp type I - he would become very violent/manic/suicidal.
Lisa, I'm sorry to hear about what it took before you were finally diagnosed properly. How are things now for you? It's quite sad that people have to hit an absolute rock bottom before they are taken seriously. This whole experience has made me almost want to switch the area of law that I'm interested in from intellectual property/entertainment to mental health rights :confused:
Lisa, I'm sorry to hear about what it took before you were finally diagnosed properly. How are things now for you? It's quite sad that people have to hit an absolute rock bottom before they are taken seriously. This whole experience has made me almost want to switch the area of law that I'm interested in from intellectual property/entertainment to mental health rights :confused:
plainjayne
04-01-2007, 01:16 PM
the nhs has been great with me too and it is when you get to see locums the trouble starts! stick with 1 or 2 docs so they know your case it only makes me stressed when i have to explain myself to new people the mht will just evaluate you and decide who you need to see and then you will get full access to the system eventually just be patient and dont worry they all take you seriously and are all sympathetic good luck
martavee
04-01-2007, 07:55 PM
I never received my follow-up letter that was supposed to be sent after the 14th March appointment. I called this past week about that and it shows in the system that letter was sent out the 20th. In it is a list of medications and it's about my next appointment, which is with the CPN? I thought that I had one more appointment with the psychiatrist but apparently not. I'll be calling again this week to request a second letter so that I may go to my community psychiatric nurse appointment knowing what's going on. I'm a bit lost at the moment. :blob_fire
Sorry I haven't been writing much lately. In a bad place with too much negative energy that I can't do anything productive with. My head hurts :( I know that one day I will feel better and I keep telling myself that, but I just don't see how.
Sorry I haven't been writing much lately. In a bad place with too much negative energy that I can't do anything productive with. My head hurts :( I know that one day I will feel better and I keep telling myself that, but I just don't see how.