Today I saw my psychiatrist. Eventually I told him what happened (well, nearly happened) on Saturday. He too, like my psychologist, immediately wanted to admit me. To his credit, he didn’t force me but respected my choice to not go back into hospital. He said that the situation was just short of where he would have been both legally obliged and able to force me into hospital, as in – if I had been in immediate danger.
He made it very clear that he would have much preferred if I went. But thanks to the trust we’ve built up over the years (he’s been treating me for 7 1/2 years now), he trusted me enough leave the practice. He openly said that he was taking a huge personal risk, because ultimately if I kill myself soon after seeing him, he will be held responsible. I’m really grateful that I have a doctor who trusts me like that.
I’m ok-ish for now. He increased the dose of one of my medications, and changed one antidepressant over to another. He normally does not like to change more than one thing at a time, but he realised that right now is not the time to experiment and take it slowly, but that I need help RIGHT NOW. He also reassured me that there are still a few more options out there.
I seem to have developed a tolerance to the Dexamphetamine, which was what really saved me last time, but I haven’t reached the maximum dose, so for the moment increasing the dose is at least possible (and that’s what he’s done). If that keeps happening, there are other stimulant medications that work in a similar way, and might help instead. And if that all fails, there is TMS (although that will require hospitalisation because it’s otherwise too expensive) and DMS, which involves implanting an electrode into the brain to stimulate a particular spot in the brain, and is really a treatment of absolute last resort, and pretty radical, as it involves major surgery.
He also organised an outreach nurse from the hospital where I’ve been an inpatient before, to visit me at home. I didn’t even know that that was an option until now, so that’s a good thing. I am grateful for all the options that are available to me, knowing fully well that I am very privileged. In Australia, while there are basic mental health services available in the public health system, the number of hospital beds and other resources in the public sector don’t even remotely match the requirements. I have private health insurance (which I will always keep up even if it is to the expense of everything else that’s not absolute essential to bare survival), and that has given me access to this really good private psychiatric hospital where I’ve spent far too much time in the last few years, and it will also now pay for that outreach nurse. My estimate is that my health insurance has already paid at least half a million Australian dollars towards my mental health care over the last 7 1/2 years, since my first admission. I am very lucky that I have those options. In Australia, if you have continuous cover (never had a break in having insurance), they cannot by law increase your premium or exclude you from cover for anything that was previously covered, no matter how much you have claimed. Again, I am very lucky that this is how it is in my country. I know that, especially in America, the situation is very different for many people.
Sooooo, I did believe my psychiatrist, that there are still a few options out there, and I haven’t reached the end of the road. Given that, it was a good thing that I didn’t go through with it on Saturday.
But, I still don’t feel any better. I am still in a world of pain. I still long for death. I still am unbearably sad. However, tomorrow morning I will start on my new medication regime, and I just pray to God that it will make a difference. I have follow up appointments with both my psychologist and psychiatrist next week. They both went out of their way to fit me in even though they are usually booked out for weeks or even months in advance. I really am so lucky to have that level of professional support.
And last, not least, thanks to those of you who supported me over the last few days. It has made a difference. My best wishes to all of you!