A Really Nice Consultant

I was there early, but then I always am; I can't help it. I sat in the garden having a cigarette while I waited for it to become a more reasonable time to go into out-patients. Having reported to reception to say that I had arrived, I sat in the waiting area until I was called.

My consultant was talking to someone in his consulting room when I arrived and when he called me I found out that it was a medical student that he had been talking to. He asked if it would be okay if the medical student stayed, and having agreed he invited me to take a chair. We then got down to introductions; he asked what I wanted to be called so I said that I didn't like being called by my full name so asked him to use the shortened version that I have used since I was about 11, He introduced himself and said I could either call him M or Dr S-M and then the medical student introduced herself. Then we got down to business.

First of all M asked me about the Home Treatment Team and my dealings with them. He said that as he was in effect their boss he would be interested in what I had to say and that I was to tell the truth. I was going to anyway, so I said that some of the people that I had seen were very good but with some of them I felt that they were just going through a mental checklist of questions and I felt that they really weren't that concerned about the answers. He took that onboard and thanked me for my frankness. He also asked me whether I was getting any other support and I said that I was having psychotherapy once a week at the moment and that this was likely to carry on until Easter and that JR, my psychologist, was going to refer me back to the hospital (which is the headquarters of the Mental Health Trust) where I had been receiving psychotherapy before.

Having read the notes from the HTT he said that when they had discharged me I seemed to be getting on quite well and he asked how I was now. I told him that I was very low and having asked why this was I replied that I had not got the job that I had seriously thought I had a very good chance of getting. We then discussed what the job was and when I had been told that I hadn't got it and he asked what my reaction had been on receiving the news. I said that I had been angry, devastated, felt that I was incapable of doing anything and that from that moment my mood had taken a nose-dive and I had lost what little self-confidence that I had built up over the last six months or so.

We then moved on to how other things were in my life:
Smoking - far more than I usually do when I am depressed (I don't smoke when I'm not depressed)
Sleeping - Not very good; can't get to sleep most nights and have to resort to sleep medication to ensure that I actually get some sleep once in a while
Eating - Just not interested; haven't cooked a proper meal for some time, didn't eat anything yesterday and made do with a cheese roll on Saturday
Energy - Haven't got any
Concentration - Totally gone; unable to concentrate for anything for longer than five minutes
Drinking alcohol - Normally don't touch the stuff but have been indulging over the last few days and I have drunk about half a litre of ouzo (purely because I had it in the house)
Suicidal thoughts - Yes, I'm having them and I thought about gathering all the tablets together on Friday but didn't do it

Having gone through these questions fairly quickly we concentrated on the eating and sleeping ones a bit longer. I was asked if I thought I had lost any weight and thinking about it I said that I probably had because certain things seemed to be a bit loose. Then I was asked if the reason that I couldn't get to sleep was because I had things whirling around in my mind. I have been asked this question many times and I have to answer in the same way each time. I am not aware of having things whirling about in my brain when I lie down to go to sleep; I try to read before going to sleep each night, but recently I have found it difficult to concentrate even on what I would call easy-reading books. At the moment it's Harry Potter and the Philosopher's Stone that is causing me problems; it has taken me a week to read the first chapter.

We talked about how my ability to concentrate had gone completely and that I had not done any knitting for about 10 days now, which is pretty unusual for me because I just love to have lots of things on the go so that I can pick and choose what to work on and normally I will do at least three hours knitting each day when I am well.

M then decided that as my depression is proving so difficult to bring under control for any reasonable length of time that the time had come to add a second antidepressant to the one that I am already taking. There was discussion of admission to hospital if I don't improve or if I get worse than I am at the moment but this time I will know what to expect so it won't be so traumatic. We talked about my time in hospital last year and M asked whether it had been helpful and I said it had because I really didn't feel safe on my own at home and it was definitely the right thing to have happened.

So armed with a prescription for the additional antidepressants I was almost ready to leave. All that was left to discuss was when I would see M again. He said that he normally saw patients every four to six weeks, but because I was so low and because he wanted to see whether the additional antidepressants were starting to have any effect that he wanted to see me again in two weeks. I was also told that if I felt myself getting worse that I was to ring him or leave a message and he would get back to me and we could talk about what should happen.

So what was M like? Well, he is young for a consultant and I have to say that I found him very easy to talk to which is not always the case. Having read so many accounts of the problems that others have had with psychiatrists, all I can say is that I think that I am very lucky with the consultant that I have been allocated.