So I had my first psych consult.
My appointment was scheduled at 9am with a Dr Smith* (*not his real name). At 9.10am I was called by a Dr Jones* (*also, not his real name), a young doctor who looked fresh out of whichever medical training he had recently completed – he didn’t look much older than me. I wondered if he was perhaps a nurse who would be giving me a preliminary consultation, before seeing the Doctor himself. No, Dr Jones would be seeing me; he explained that he was part of Dr Smith’s team and so it was essentially all the same thing. Funny, I thought I had an appointment with Dr Smith. Perhaps he has a more important case to attend to. I have to be honest, I wasn’t convinced by the swap and, as much as I am ashamed to think that I pre-judged him based on his age alone, it’s true. It is very unfair I know but, when it’s your health at stake, you want to be reassured by an experienced pro who has seen so many cases that s/he is absolutely certain that s/he will be able to cure me, because, by now, it’s just part of the day job. But, at this point, I am grateful for anyone and, as my Dad pointed out to me later, I could have had an older doctor that knew nothing. Plus, Dr Jones is very nice, and listens intently to everything I am saying, repeating what he is picking up as I go along. It’s reassuring that what he is reflecting back to me is pretty accurate, I am grateful for his attention to detail.
So begins a rather humiliating questionnaire that goes into every possible detail of my existence, right down to the fact that I was delivered by caesarean section, that I was jaundiced as a baby and had a squint correction at two years old. Struggling to see what any of this is going to do to help them understand my OCD, but they are the pros, wearing the metaphorical white coat. Dr Jones asks me to go into the details of the OCD manifestations that I had during childhood, and they all come flooding back, like the most unwanted guest at the shittest house party. And so I remember the hours spent tapping, counting, switching lights on and off, retracing steps, saying prayers in my head over and over again, all so that my parents wouldn’t die. I was convinced that, if they did not do any of these things, they would die. The religion that was so often my comfort could also be my enemy – I was scared of God, of what God would do if I was in any way a bad person. Surely, the first thing would be to kill my parents. I feared for their lives. I remember once when I was very small, my Mum had a bad throat and coughed up a small amount of blood, I thought she would die. One of the most vivid nightmares I have ever had was one where my Dad died. He was away for work at the time and I had to go and sleep with my Mum in her bed. I was obsessed with doing everything I could – via magical thinking and ridiculous rituals – to keep my family safe. Of course, none of this does keep them safe, but it’s a risk I was never able to take. When you are that small, and genuinely afraid that your actions will kill your parents, there is a terror that you cannot shake. And it’s not something I could tell my parents, because then they would know I was a bad person. See how it gets you, with its vicious little claws. It’s a knife to your throat and a gun to your head, choose. Looking back now, if I could say anything to my nine year old self it would be to tell them. Tell them everything. You won’t be told off. They won’t be angry. You are not a bad person, and they will not love you any less. But I’m 31 – it’s easy to say that now. Back then, most people didn’t know what OCD was, not really.
Once the in-depth questionnaire was over, Dr Jones called in the aforementioned Dr Smith, who I learn is the consultant psychiatrist. I must admit it felt like the sole focus of the session became about trying to convince me to take yet more medicine. I have been on the same medicine – at the highest dose – for four and a half years. In general I have found that the medicine helps to take the ‘sting’ out of OCD freakouts. They are still there, but the physical ache that often accompanies them occurs less frequently, and the mind fever is ever so slightly less intense. They have helped me a great deal and have kept me afloat. I would still like to be free of them one day. When I went to the doctor a few months ago she attempted to refer me to the psychiatric care straight away. She was told to prescribe me with an additional drug (which I won’t name) to the one I was already taking and, if that did not work, the psychiatric team would consider consulting with me. My doctor admitted that she had never come across this particular drug being used for OCD, but she advised that I try it anyway because, after all, she is not an OCD specialist. I, however, objected to the idea of taking another medicine: having spent the best part of four years wanting to come off the medication (and its accompanying side effects) that I am on, I certainly didn’t relish the idea of swapping my daily shot of my medicine straight up into a medicine cocktail du jour. I took the prescription that my doctor printed anyway and bought the medicine. It is still sitting on top of my bookshelf.
I could not bring myself to take the medicine. I had read the papersheet of doom and, of course, it made for shit reading, they always do. I researched the drug and its use for the treatment of OCD: I was surprised to learn that there was very little out there to suggest that it was regularly prescribed to treat the mind demon at all. It didn’t appear on a single list that I found of drugs used for standard and specialised OCD treatment. I wrote to an OCD specialist in London, he expressed surprise at my being prescribed the drug, explaining that it was usually used for generalised anxiety disorder, as opposed to OCD specifically. With all of this in mind, and not wanting to take a drug recommended to me by a complete stranger who had never met me – besides which, how do they know that prolonged use of all of these chemicals is not going to kill me anyway – I decided to hold out on the drug front. And I felt like a naughty schoolgirl for doing so. So I did not relish being, once again, in a situation where I felt the need to fight to not have to rely on pills to fix me. All I want is a professional to talk to, someone who knows this illness and who really understands it.
When Dr Jones asked me what I wanted from the psychiatry sessions, I gave the simplest – and I would have thought, most obvious – answer that I could: I want you to cure this OCD. I do not want this demon in my head anymore. He seemed surprised by my answer.
They told me they would consult with my CBT therapist (who has been treating me for depression) before switching my medication, that they would let my GP know when to switch over the medicines and that they would give me a call to confirm all of these conversations that would be had about me, but not involving me. Maybe I would be referred for specialist psychotherapy, but it was all a bit hazy and ill-defined. They said they would have a follow up meeting with me in two months. I must confess that, at that point, you do start to wonder if you are the only person in this room who is crazy, because to ask someone who spends most days climbing the walls of her own mind to wait yet another two months for help, seems a bit cruel and more than a little bit like a fist in the face. I questioned the two month waiting period (which would bring the grand total since initial referral to seven months) and Dr Jones tried to reassure me that hopefully it wouldn’t be that long and that he would try to get the ball moving. I thanked him and, despite my disappointment, was grateful to him for understanding. Looking back, I recognise that, as much as I am at the mercy of this system, so are they. They are doing the best that they can with the limited resources that have been permitted to them by the palace of Westminster, one hundred and thirty miles away. That’s because the government, in all of its infinite and boundless wisdom, has decided that mental health just doesn’t really matter.
All in all, I left my first consult wondering what the hell had just happened. I cried all the way to work, wondering what on earth was the point in anything.