1/20/2009

Meditations on a theme

Aw, I feel so loved, you dear, dear souls. People holding out on commenting again until I start commenting on your posts again - soon, soon. My Google Reader is morbidly obese with feeds, and I'm ever so slowly working my way through the mountain of unread posts. Work hecticness has prevented me from having proper lunch hours, which is prime blog-reading time. I get home in the evening and all I want to do is look after my kid and clean, so I just keep falling further behind in my reading.

I don't know what it is with this medication, but damn it if I didn't get positively giddy at the prospect of tidying up the flat the other day. I was sitting at work, giving my mind a chance to wander, and that's where it went. My stomach jumped in anticipation of doing dishes, picking up toys, and doing laundry. I faint, I lose half my body's blood during periods, and I have an innate desire and joy to clean - this stuff is great!

I thought I'd give a bit of background regarding this whole prescription debacle lest we all lose our heads and shake our fists at the injustices of the NHS. When I made my first appointment nearly two years ago, I was in a state which frightened me. My anxiety was dominating everything, and staying home with P all day, every day, did not help. I had a couple ocular migraines, my hands shook all the time, and I couldn't sleep. I made an appointment to see my GP, my gradual relief building as it got closer. I started crying as soon as I entered her office, and spent most of the appointment gasping for breath as I recounted how miserable I was. We all know what the recommendation was at the conclusion of that big old waste of time.

I tried again about nine months later. I was back at work, which wasn't the immediate balm I'd thought it would be. I saw a second GP, who advised me to take a walk. Ah yes, the age-old cure for depression and anxiety. After that, I just gave up and became resigned to the fact that I'd have to learn on my own how to deal with it all.

So what is right? Most GPs here won't dole out an anti-anxiety/depression medication upon the first request. Conversely, many US doctors are quite happy to shower their patients with any medication they desire. I know this first-hand anyway, but I also see it with my Mom. There is a faint rattle when she walks, she's so jacked up on medications her doctors have convinced her she needs. She is a relatively healthy woman amazingly, yet her plastic bag of pill bottles is the largest Ziploc freezer bag which can be obtained legally without rousing the suspicions of homicide detectives. I'm upset that she thinks she needs all of that in order to get by.

In my experience, you'd be hard pressed to find someone in the UK without a serious medical condition who takes anywhere near the amount of medications my Mom does. The Dude's parents are a few years older than my Mom and have health issues ranging from severe back problems to liver conditions, yet they don't need a separate room to house their narcotics. The Dude's grandmother is in her late 80s and I don't think she takes any more than one or two medications with any regularity.

I am annoyed with my doctors for not doing something sooner, but then again, is it right to see a patient for five minutes then prescribe a medication on that brief period of exposure? I suppose ideally I think it would have been best for the first GP to perhaps recommend I come back for a follow-up appointment in a few weeks' time, then ascertain the appropriateness of medication. Instead, she told me from the outset that she thought medication didn't solve any problems - what use is that when you should be trying to help people? I think I will always fail to see how the numerous issues caused by very heightened and constant tension, anxiety, and depression - can ever be the better option than being on medication temporarily.

Any thoughts?

15 comments:

elizasmom said...

I am so sorry you had to suffer that long. It takes courage to admit you need help, and to have it fall on deaf ears again and again is just... WRONG. I am so with you on the need for a middle way between throwing meds at every problem or stiff-upper-lipping your way through life. Sadly, I've no great ideas on how we get there.

Glad you're back!

The Girl Wonder said...

My issue is that being medicated ISN'T temporary. I tend to believe it's by design (after all, it's in the pharm. company's best interest that you take them as long as possible). When I started taking SSRIs for my anxiety, it was after a major traumatic event but I wasn't nearly as crazy before I started taking them as I have been trying to get off and stay off them.

The permanently screw up your brain chemistry and it's been really, really hard for me to stay off of them because it feels so much better on them (isn't that true of most addictive street drugs?) but I refuse to be a slave to the drug industry. Anyway that's just me and my personal thing.

I know they help a lot of people and I'm glad you are feeling better!

Erica said...

I think there needs to be a middle ground. (You: Gee, Erica, that's sure an original thought.)

I found it to be very easy to see my GP and talk about my depression and anxiety. I walked out with a script, but I go back to her for regular follow-ups. It's not like she shoves the medication into me and goes off on her merry way.

I'm heartsick about the fact that it was so hard for you to get help. It needs to be easier for those that truly need help to get it. So many things I read about the NHS (re: The Daily Mail) are so negative. As I don't have any positive experience with them, it seems like a disasterous system to me. Then again, here in the States we have people who don't have insurance and can't afford treatment so they go without. No one's system is perfect, huh?

wheelsonthebus said...

ideally? a gp wouldn't ever prescribe anti-depressants. a psychiatrist would.

Tash said...

"I have an innate desire and joy to clean - this stuff is great!"

You will send some for my husband, yes?

Ok, I just wrote (an deleted) a diatribe that would've hijacked your comments. In short: It should be easier to find what you need, to switch in order to get away from harmful side effects, and to get proper oversight from professionals responsible for their category of drugs (and not every category under the sun) so you don't become addicted or worse.

"I think I will always fail to see how the numerous issues caused by very heightened and constant tension, anxiety, and depression - can ever be the better option than being on medication temporarily."

Yes. I was never against AD's in the abstract, but never thought I'd ever need them. And the temporary usage far outweighed what could've happened during that time. I like to say they actually allowed me to grieve.

Moira said...

Hi ... I have suffered on and off for years with depression and my gp is wonderful. Always prescribes, takes ages to tlk and follow up but also sent me to a wonderful psychiatrist who i then saw along with a councellor. But i know i am lucky. Most doctors on the nhs dont seem to have time .... or am i being kind?

the nhs can work but you have to have the right gp - sounds like america is at the opp extreme and i know from my aunt canada sounds the same!

calliope said...

I don't know the ins and outs of the British health care system (other than to drool with jealousy that there IS a system!) but I do know that I am ever so thankful that the 3 times that I have done anti-D treatment it was so so easy to get help.

That being said- I DO think Americans are prescribed too many drugs. Just looking at the meds my Grandmother has been on while in my care is a mind blow. Granted she has Alzheimer's and in the beginning there is this sort of throw everything at them and let's see what works attitude. But now she is on very few pills and I feel like that is best.

I am So effing glad that you are getting help.

xo

hairyfarmerfamily said...

Firstly, no issues here with SSRIs. Big history of depression in my family.

Secondly, I need to have you to stay here, stat, before this Must Clean vibe disappears.

Thirdly, our personal experience of the American pill thing - when is gets out of hand - is similar to yours. Hubby's twin brother married a (raving hypochondriac? Or just typical of her times?) girl from Kentucky and stayed there to live; when they last came to stay over here, she pretty much needed an extra suitcase for drugs. Their daughter is being brought up to be just the same. She is a tiny tiiiiiiny touch wheezy... so she spent most of last winter sleeping in an air tent, and over here, had to be nebulised nightly - on Daddy's knee, glowing in all the attention. I forget the context, but one day I told her (5yrs old at this time) cheerily that I was sure she was ok, and she looked at my in horror. "But I'm not! I'm sick! I'm SICK!"

Sigh.

Is it my flawed understanding, or does the current US health system mean that American doctors are more or less paid to find something wrong with you? My GP is pretty tight with a prescription pad too (occasionally pissing me right off thereby), but he usually turns out to be right. It DOES generally clear up without antibiotics, steroids, etc.

Not so the blues, unfortunately.

kate said...

Well, I'm one of those pill-happy people. I'm in my 30s and I take 9 different pills a day, and at least 5 other medications on an as-needed basis. I affectionately call my doctor Dr. Pinata, because she is one of those who will offer a prescription if one exists.

This, I think, is different than having a doctor who insists that I need particular pills to survive. She offers it, if I decide that I do want a pharmaceutical solution. She also offers dietary and other advice as solutions, too. And about half the time, I decline whatever pills she offers, and she never makes me feel as though that's a bad thing.

I think my perspective is kind of different because I've had three separate and fairly serious health issues (PCOS, anxiety issues and gallstones) that were completely ignored by my doctors for well over a decade, despite my numerous pleadings for something- ANYTHING- to help ("you're too young to have 'x'" was the frequent cry of the assholes I saw for years). And so, when I hear about doctors being stingy with offering whatever solution is available, it really pisses me off. I am pissed that you had to work so hard to get the aid you need.

If I didn't run, I could probably cut out the allergy pills and the singulair and the inhaler. If I was like many doctors and presumed that PCOS was only a health-risk to people who were trying to conceive, I could probably cut out the met.formin. If I still had my gall bladder, I could cut out the antacid. If I was trying to get knocked up right now, I could cut out the BCPs. If my brain was right and I didn't suffer from panic attacks, I could cut out the occasional klon.opin.

But the fact is that the life I lead is so much improved through these various drugs and I wouldn't have it any other way. I celebrate the fact that I've found a doctor whose first goal is to BELIEVE me, and her second is to FIX whatever is broken.

I think this is fresh on my mind right now because my (now former) BF insultingly told me that she was "seriously worried" about the amount of medication that I take. And after one by one explaining the reason for each pill (as an asthmatic, I can say that you can quickly go from being "a little wheezy" to "struggling to breathe" in a matter of seconds and regular use of nebulizers is very effective at keeping that extreme reaction at bay), she still made snide comments about how I couldn't be sick because I took "so many vitamins", and how I couldn't need to go to the drug store because I had "a whole pharmacy in [my] bag".

And I'm telling her, over and over again, I wish I wasn't asthmatic. I wish I wasn't allergic to mold and tree pollens. I wish I didn't have PCOS. I wish my butthole wasn't broken so I didn't have to slather it in specially compounded creams and cram myself full of fiber supplements. I wish I still had my gall bladder. I wish I had finished school 10 years ago so that I wouldn't be stuck trying to finish now and thus wouldn't have to take the pill to avoid pregnancy. And still, she insults me (and my doctor) by presuming that I'm obviously too stupid to advocate for myself and refuse these clearly unnecessary treatments, to pay close attention to what I'm putting in my body.

But none of these things is the case, and as a result, I happily consume whatever medications will keep these conditions from making my life miserable. I don't want to wake up and take nine pills, but more than that, I don't want to have to compromise my health and comfort in order to avoid that.

I run. I stretch. I practice meditation to relieve stress. I eat very healthily. I take my B vitamins to keep the brain happy. I take the multi vitamin to make up for any missing nutrients in my diet. And GUESS WHAT? None of that solves anxiety. None of it solves PCOS. None of it solves asthma (as a matter of fact, the running makes it worse).

Man. I really didn't mean to rant, but I obviously am thankful that I've been able to finally find one of those American doctors for whom the reputation of tossing pills blindly at patients (and sucking off the big pharm in exchange for some pens) holds true. My life is infinitely better for it.

.

Geohde said...

My two cents is that depression and anxiety have real honest to goodness biological basis in changes in neurotransmitter systems in the brain so I personally have always felt that witholding medication is unjustified.

If I refused to treat somebody's angina, I'd be in all sorts of poo, and depression should be no different.

yes talkign therapies therapeutic relationship/alliance blahblah whatever they call it these days but TREAT the problem say I.

J

Meg said...

Hey, what happened to the feed on this post. Was just coming over to give you a quick nudge and say "miss you" and whatnot...

I'm glad to hear you are feeling better. As a fellow anxiety-sufferer, I know just how that feels, the constant jittering in the stomach, the near-panic. So bad when its bad.

I think its difficult to find a balance with this medication stuff, though. Anti-depressants are incredibly easy to get in Aus. And I don't know if i ever told you about the story of my brother, who was prescribed z.oloft by a GP for "social phobia" at the age of 12 and who was sent immediately into paranoid psychosis by it? (diagnosed with schizophrenia at 12, fun...)

So I am certainly wary of people prescibing this powerful medication without really thinking about it. But you should not have had to endure years of this. She should've taken you seriously - I hate that "suck it up" bullshit. Mental health is not always a matter of "taking a walk".

Rachel said...

Pru - I feel you. I spent my 20s basically being a rage-a-holic and it really came to a head in 2004 and I did the same thing you did - went to the doctor, spent 20 minutes sobbing, the whole thing. She put me on drugs, wonderful, wonderful drugs that did little except make me GAIN WEIGHT and sleep. The sleeping was a welcome change, the weight gain, obviously, was not. I'm working on that part of it now.

I'm glad you're feeling better, and I'm sorry I haven't been one of those people who has been trying to cheer you up. It's because I suck, basically. :-)

Major Bedhead said...

I think your feed is broken.

There does need to be a middle ground when it comes to anti-depressants. I know many doctors in the US prescribe them like candy with no suggestion to see a psychiatrist or even a prescribing nurse practitioner. IMO, it's dangerous doing that.

I've had varying degrees of success with anti-depressants, with Cymbalta being the best of the bunch (SSRIs give me allergic reactions), but no insurance means no medication. So I'm struggling thru this until we get health insurance again. When we do, the first thing I'm going to do is get back on the meds because without them, I am a mess and barely hanging on most days.

Defiantmuse said...

My mother has the same issues. She's been living in the UK for a few years now and every single time she is having some sort of health issue she bitches about how the GP never wants to prescribe meds for her, meds that she took here in the US that she knows will work. It's an uphill battle every single time for her.

You're right though....it's a tough line. I think US docs WAY over-medicate. And I appreciate the caution with which UK docs proceed but at the same time - they shouldn't allow their patients to suffer.

I've gone back and forth on my own personal issues with anxiety and depression, etc. I have been on and off a couple of meds and at the end of the day decided to just self medicate with xanax donated by a friend on the days when I'm really stressed. The depression is another thing that comes in waves and at different points in my life I've had different ideas of how to go about dealing with it.

I think that there are definitely certain lifestyle changes that can help depression and anxiety (dietary changes, meditation routines, herbs, etc.) BUT sometimes the pharmaceuticals are what help you reach the point that the other stuff is possible. I don't know that it's a long-term solution for some people (those who are at least functioning) but it helps you get a handle on it in the short-term.

fisher queen said...

I haven't read through everyone's comments, so sorry if I am repeating what has been said already-

On your first visit to the GP, you should have been referred to a psychiatrist. A psychiatrist would best be able to evaluate 1)if you needed meds 2) what kind and how much and 3)if talk therapy would be helpful. GPs, even helpful ones like the one you are seeing now, are simply not qualified to properly handle those questions.

It doesn't have to be a choice of extremes. With proper oversight, medications such as yours (and mine)can be used temporarily, and for lasting benefit.

Has anyone referred you to a psychiatrist? Were any other medications ever discussed? Have you thought about talk therapy? I'm sorry to be so nosy and pushy- it's just that I have so been there and I really don't see you getting the kind of help you need.