Seeing the psychiatrist
So I saw the consultant psychiatrist today, and he turned out to be an Unexpectedly Reasonable Man. He listened, quite respectfully, and didn't just rubbish my opinions.
He asked a whole stack of questions, not just about my OCD, but about any other mental health issues I'd had, or that members of my family had had. So I told him about my father's depressive breakdown when I was five, and about my brother who was diagnosed schizophrenic and died (possibly through suicide) at the age of 22. And then I felt a bit weird about having told him these things. Sort of exposed and vulnerable. Wondering whether I should have kept quiet.
He even asked about the mental health of my grandparents! (About which I really know very little. They didn't seem noticeably unhinged in any way, but who knows.) He also asked me which particular subjects I had studied for my philosophy degree (!) (and seemed to prick up his ears when I mentioned free will and personal identity - he wrote those down).
When he asked me if I had myself ever suffered from depression, my initial instinct was to say no - after all, I have dealt with and overcome my depression, and it is just the OCD that I wish to address now. But - damn my aspie honesty! - I found it very hard to lie when faced with the direct question. So I said that I had experienced depression, but it turned out to have a physical cause - and explained to him about the nutritional approach I have used to deal with it. He was sceptical about this, of course. His view seemed to be that gluten intolerance and an otherwise personally inappropriate diet might cause extreme tiredness, but not actual depression - and that a change in diet could not profoundly affect one's mental state.
There's a gap in the logic there somewhere. Obviously, he believes that physical intervention can affect mental state - for he is an advocate of antidepressants (and, presumably, other psychopharmaceuticals). So he believes the brain can be affected by chemicals - but what is food made of, if not chemicals? What does he think neurotransmitters are made of, if not amino acids? Fairy dust? These psychiatrists seem to be materialists one moment and dualists the next. But at least he was respectfully sceptical.
He did have a go at pushing the anti-depressants at the end, saying that the recommended treatment for OCD was to use both therapy and drugs. But I told him that I had already made some progress using Exposure and Response Prevention without drugs, and that I felt I would rather keep on like that, at least in the first instance. (Particularly since, as he admitted, the dosage of SSRIs for OCD is higher than that used for depression.) I feel I have made so much progress over the last four and a half years in learning what my brain needs to work well and keep my moods buoyant. I really don't want to throw some alien chemical into the mix to upset that hard-won balance.
Well, he agreed to refer me to a CBT specialist, and in the meantime I will go on seeing my current nurse therapist every four weeks or so (which, since her recent change of approach, I am ok with). He warned me that there could be quite a long wait before I get to see the specialist, and asked again whether I wouldn't like some SSRIs while I am waiting. He is certainly pretty keen for me to take the things! But I stood firm.
(Pardon disorganized prose style - I am drunk)
Swahili
I can now sing "One man went to mow" in Swahili!
Mtu mmoja alikwenda
Alikwenda kulima shamba
Mtu mmoja na mbwa
Walikwenda kulima shamba
He asked a whole stack of questions, not just about my OCD, but about any other mental health issues I'd had, or that members of my family had had. So I told him about my father's depressive breakdown when I was five, and about my brother who was diagnosed schizophrenic and died (possibly through suicide) at the age of 22. And then I felt a bit weird about having told him these things. Sort of exposed and vulnerable. Wondering whether I should have kept quiet.
He even asked about the mental health of my grandparents! (About which I really know very little. They didn't seem noticeably unhinged in any way, but who knows.) He also asked me which particular subjects I had studied for my philosophy degree (!) (and seemed to prick up his ears when I mentioned free will and personal identity - he wrote those down).
When he asked me if I had myself ever suffered from depression, my initial instinct was to say no - after all, I have dealt with and overcome my depression, and it is just the OCD that I wish to address now. But - damn my aspie honesty! - I found it very hard to lie when faced with the direct question. So I said that I had experienced depression, but it turned out to have a physical cause - and explained to him about the nutritional approach I have used to deal with it. He was sceptical about this, of course. His view seemed to be that gluten intolerance and an otherwise personally inappropriate diet might cause extreme tiredness, but not actual depression - and that a change in diet could not profoundly affect one's mental state.
There's a gap in the logic there somewhere. Obviously, he believes that physical intervention can affect mental state - for he is an advocate of antidepressants (and, presumably, other psychopharmaceuticals). So he believes the brain can be affected by chemicals - but what is food made of, if not chemicals? What does he think neurotransmitters are made of, if not amino acids? Fairy dust? These psychiatrists seem to be materialists one moment and dualists the next. But at least he was respectfully sceptical.
He did have a go at pushing the anti-depressants at the end, saying that the recommended treatment for OCD was to use both therapy and drugs. But I told him that I had already made some progress using Exposure and Response Prevention without drugs, and that I felt I would rather keep on like that, at least in the first instance. (Particularly since, as he admitted, the dosage of SSRIs for OCD is higher than that used for depression.) I feel I have made so much progress over the last four and a half years in learning what my brain needs to work well and keep my moods buoyant. I really don't want to throw some alien chemical into the mix to upset that hard-won balance.
Well, he agreed to refer me to a CBT specialist, and in the meantime I will go on seeing my current nurse therapist every four weeks or so (which, since her recent change of approach, I am ok with). He warned me that there could be quite a long wait before I get to see the specialist, and asked again whether I wouldn't like some SSRIs while I am waiting. He is certainly pretty keen for me to take the things! But I stood firm.
(Pardon disorganized prose style - I am drunk)
Swahili
I can now sing "One man went to mow" in Swahili!
Mtu mmoja alikwenda
Alikwenda kulima shamba
Mtu mmoja na mbwa
Walikwenda kulima shamba