In brief, then, the story so far is that I worked out from google that I had dermatillomania (skin picking) and anxiety and was already booked in an appointment with the docs to talk about my skin but now I am about to talk about my anxiety.
I had seen this doctor before, so I recognised her but I’m sure she wouldn’t know me from the hundreds of other patients that she has seen in between now and then. I remember thinking last time that she was very helpful, but quite cold.
I had taken a list, so that if I couldn’t get out what I wanted to say, I could at least show her what I wanted to talk about. I immediately burst out crying (which is pretty normal for me!).
“I think I have Anxiety”
And the doc’s whole expression melted and I saw her soften, and warm up.
“Ok. Tell me a bit about the symptoms that you have experienced, and we’ll see whether you fit the criteria.”
“I feel a sense of dread, all the time. I over think everything, and I jump to the worst conclusions for every situation that I can’t control. I also have felt my heart racing quite a bit. And finally the other day in the library, I got the strongest feeling that was telling me I have to go home now. Like when the SIMs people run low on “home” and get ill. That’s how I felt.”
“Ok. Well the best thing that you could have done is to tell someone. That is the hardest bit. It sounds like you are indeed suffering from Anxiety.”
She took some more questions about the type of worry I was having, and she narrowed it (or broadened it, I guess) to Genrealised Anxiety Disorder. This means that your worries aren’t specific to one thing, but are spread over many things.
“How long do you think you have been having these feelings?”
“Looking back, I think I have had this since childhood, but it has been strongest this academic year, since my workload has increased.” [I’m a teacher]
“So do you feel like this at work?”
“No, not at all. I feel very good and confident at my job, that seems to be the only place that I am safe from the anxiety, but when it gets to a half-term it becomes terrifying. And how I feel now [in the 2 week Easter holidays] makes me really scared about the six week holiday.”
“Ok Amy, it sounds like actually the fact that you are working so hard, and then finding it so much harder when you stop, that this is work-induced. You are working so hard and are so busy that you push away the anxiety and don’t deal with it until you are forced to, which is why it’s getting worse.”
We talked about my work-life balance (HA!) and my super long commute and the responsibility that the school puts on me, as well as my own high standards.
“Ok Amy. There are three things we need to talk about now. The first is medication. I can offer you two different types. Propanalol is something that you can take as and when you need it. When you feel panicked, this will kick in and reduce the physiological symptoms like your heart racing and the sweating. This can often then calm the mind down too. Do you want some of these?”
“Now the other type of medication I can offer you is one that you take every day, and it works to retrain the brain to deal with your serotonin levels. At the moment, your brain chemistry is saying you have enough serotonin and letting the excess go, but in actual fact, you don’t have enough and your anxiety is the result.”
“I’m not sure that I feel comfortable taking something that messes with my brain…”
“I understand. Lots of people feel like this, and you don’t have to take them if you don’t want to. Some people want to deal with this without medication and that’s fine too. It’s up to you. What I would say however, is that people are worried about messing with their brain… but without being cruel… if you feel like this – your brain is already messing up!”
I couldn’t argue with the logic but I was still uncomfortable about the thought of mind-altering drugs. We left the topic for a moment.
“The next thing I want to talk to you about is talking therapies. I want you to give these people [hands me a leaflet] a call to make an appointment AS SOON AS YOU LEAVE HERE. Please don’t put it off. Please call them as soon as you leave here. Ok? Promise?”
“Promise! I’m not worried about talking to someone, I think I need it!”
“Ok good. Finally, I want you to start trying to distinguish between what is the anxiety talking, and what you think is an appropriate response. It doesn’t have to be at the time, it can be in hindsight. And I don’t want you to let the anxiety stop you from doing anything ok? If you do, although it will feel scary to do the thing your brain is telling you to NOT do, it is important to see that you will be ok if you do.”
“OK, I will try.”
“Now, is there anything else you want to ask about?”
“I think I’m ok for now, thank you.”
“What are we thinking about that medicine?”
“I want the as-and-when one. But I’m still scared about the other one. I will get the prescription for it but I won’t necessarily take it. Is that ok?”
“Yes, that’s fine. Think about it, and you have it if you want it. I would recommend taking it, to get you to a better place for the talking therapies to work, but honestly, it’s your choice and people can do it without this medication too. Just don’t stop it suddenly, after two weeks you will become adjusted to it and the effects can be pretty bad if you stop it abruptly after this point.”
“What side effects are there with this one, citalopram?”
“Oh… just nausea mainly.”
Points to take away:
- Remember those last words for another blog post: citalopram.
- I was so grateful for this woman, we ran way over the allotted 7 minutes and she didn’t rush me at all.
- I was so impressed with the range of advice and options there were for me, and how seriously she took me.
- The relief of having my self-diagnosis confirmed had an amazing effect.
- However now, I was officially “mentally ill” and that was a strange, strange feeling.