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I’m not eatingly disordered, just a bit screwed

November 20, 2008

Well, I guess the good news is that I’m off the fluoxetine and will soon (as in tomorrow) be starting to take my new friend, tally. I just have to actually go and collect him from somewhere. It was a difficult task to persuade my doctor to take me off it, instead of upping the dose. I don’t understand why she doesn’t understand… Does what I’ve been experiencing really sound like a normal side effect?! If so, then quite frankly, I’m not exactly willing to give this citalopram a go. I don’t want to be 5ft above where I am physically located jumping on my bed cracking my head on the ceiling and skipping through town singing. Do I explain things wrongly or something?! So, well, that’s that. Which brings me onto the title of the next topic: eating disorders.

She’s wanting to diagnose me, so she’s given me some sheets to read about anorexia and bulimia, which I will do at some point, and to tell her what I think. Good bit of self diagnosis going on here I see. Except, I don’t want this. In a way at the moment I can pretend I’m fine, that my eating is a bit skew whiff but not totally and there’s nothing really wrong with me, I just perhaps don’t eat as much and often as I should and I have a tendency to binge. Great. But the idea of having this name following me scares me, upsets me. I don’t want to be like this; I know to get treatment I have to accept the problem is perhaps bigger than what I want it to be and to give it a name, but is that really necessary? Can’t we all find somehow a magic medicine and then it’ll all be over? My doctor didn’t want me to come off fluoxetine because of it’s use in eating disorders, but well, I think I need to come off it. I felt bad about saying this, she’s the professional after all, but I don’t want to be skipping through town again or being as high as a kite, it doesn’t agree with me. So, I’m going to read that stuff and tell her next time I see her, whenever that may be. I’m really considering a change of doctor may be in order, however, because I just don’t feel completely right with her. I feel it’s an in and out and shove you to other places. Maybe I’m wrong. I’m just feeling screwed over by that place now.

Today, I also met one of the counsellors from the university counselling service, and hated every single second of it. I was crawling all over and just wanted to get out. I want my old MH people back, the person from “that place in town” the MHW at my doctors’ here… someone that knows me, doesn’t patronise me and sit in a rocking chair rocking back and forth. It just doesn’t go. I like speaking to people in vaguely the same age range as me, not someone who’s about 60 and is like my grandad. I felt so, so uncomfortable and he kept asking questions about my family… I’m running away from them and I don’t want to think about them. It made me want to cry, so I shut up shop. I want my old counsellor back. At least I got on with her. We mutually decided that perhaps right now counselling wasn’t for me, and that I could always come back if I needed. I’m pleased I found a way to say this instead of getting embroiled into a situation which could possibly have not worked to my advantage, and made me worse. I think I now have to think about what kind of help I actually want: counselling, CBT or something else… Just I really am unsure. All I know is that I want 2 people and 2 people only, which are 2 people I can’t have (okay, in theory I could have 1 if I moved back home, but that will not be happening any time soon (hopefully!)).

I don’t know what I want but at the same time I do. Just the NHS says no.

7 Comments leave one →
  1. cbtish permalink
    November 20, 2008 5:28 pm

    It sounds like a normal side effect to me. The World Health Organization says:

    There may, however, be brief episodes of mild mood elevation and overactivity (hypomania) immediately after a depressive episode, sometimes precipitated by antidepressant treatment.

    It’s as if when you come out of depression very fast your mood can overshoot for a while. It means the fluoxetine was working. As soon as the initial low dose has started to work, it’s usual to increase it to the full dose, perhaps in stages. This is meant to prevent you becoming depressed again, so you won’t be hypomanic again either. Hopefully citalopram will be a gentler ride for you.

    Most people like to be diagnosed. It makes them think the doctor knows what’s wrong. You’re right to suspect that it’s not really necessary. For example, a good CBT therapist would not care much about your diagnostic label. But the NHS needs to label you, so if you need the NHS, you need the label too.

    Counselling and psychotherapy don’t work well unless there’s a good relationship (a “therapeutic alliance” in therapist jargon). If that doesn’t happen early in the first session, then the counsellor/therapist is probably not right for you. Why not go back to your old counsellor, if you at least get on well?

  2. November 20, 2008 6:22 pm

    cbtish, I’ve moved cities, so I can’t unless I move back home (and I really don’t want to!)

    I’m beginning to wonder if I was wrong to come off fluoxetine and am angry at myself for not sticking it out. Grr.

    About diagnosis, I think I just want to hide… but you’re right. They need to know what’s wrong.

  3. cbtish permalink
    November 20, 2008 8:57 pm

    Oh, I see. Sorry…I haven’t read all your posts. Well, I hope you can find someone where you are who you can relate to. In my opinion, it’s OK for you to refuse to see someone who’s patronising or who rocks back and forth. (Really? Rocks back and forth? Words fail me.)

    Having grrr’d about fluoxetine, I suggest you forget it. It’s water under the bridge. You were understandably spooked, and your GP supported your decision, even if reluctantly. I think it’s a good sign that she’s firmly on your side.

    What I meant was, the diagnosis is just a label. It doesn’t really tell you what’s wrong. They’ll try one diagnosis, then maybe change it without warning. The change of label doesn’t mean that anything about you changed. It just means they are trying to make the NHS system match your needs.

  4. November 20, 2008 9:00 pm

    Don’t worry. I have a lot of posts so it’d take time, I don’t expect everyone to read everything!
    I have basically refused to see him. I was so flipping uncomfortable it was horrible. I just wanted to dive towards the door! And yes, he was rocking back and forth… random!

    And yeah, true about them changing it. I guess I’m still pretty new to the system really, and things started off easily!

  5. November 22, 2008 3:52 pm

    Wow – lots going on in your appointments of late. Med changes are always tricky – you want to have some semblence of control but really you don’t know the first thing about how each individual drug will interact with your particular system. I’m off meds after a year + on Fluoxetine. I had “fake happiness”, a general “blah” effect with less subtelties of emotion (not that I really allow myself to feel emotion anyway…) and all the negative side effects – insomnia, tremors, etc.

    As for a diagnosis – any clinician who sees a diagnostic code on paper and assumes they know your clinical picture and how to treat you should be avoided at all costs. If you need a diagnosis to get treatment (I’m in the States so I’m not sure how it works across the big pond) then by all means, I say go for it. But admitting you’ve crossed the gray fuzzy line from disordered eating to eating disorder is the hard part.

    Best of luck. I think they should add “skipping” to the side effects on the label!!!

  6. November 22, 2008 6:53 pm

    Hi novemberblue,
    I can really relate to what you say about not allowing yourself to “feel” anything, I do that too… It’s something I discussed with an old counsellor and it’s going to take some undoing and a lot of upset to undo all those years!

    Luckily I’ve not come across someone who goes only off the paper and not my actual picture (actually thinking back I might have but maybe not. My memory is so bad!) I think you’re right- admitting this will be difficult; I can openly say I have a problem but any more? Maybe not!

    And I’ll write to the manufacturers 😉


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