Hi all

[loubielou]

Thought I'd post in here so I can tell you a little bit about me, and hopefully I'll 'meet' some of you as I go along.

I'll be 30 this year and was first diagnosed with depression when I was 16. I was on and off meds for a good few years, with the depressive episodes always being treated as 'reactive' to a particular life event. Then, at 24, my marriage broke down and I spiralled into my worst depressive episode. Since then I have been on citalopram 40mg once a day, with only one period of trying to come off them which was spectacularly unsuccessful after approx 6-8 weeks. This is when I was told I have clinical depression, and it is not reactive but an on-going condition. I'm still not entirely sure how I feel about this.

During the last few years on citalopram I have occasionally slipped into mini episodes of depression, that thankfully only usually lasted a fortnight at most. As I suffer from M.E. this often compounded the problem.

About 4 months ago I experienced a difficult and highly stressful situation at work, it wasn't until the problem was effectively resolved (for me personally at least) that the full impact of the experience hit me. For a few days I slowly sunk deeper, until I completely fell apart one evening. My anxiety levels sky-rocketed and I became deeply depressed.

My GP has referred me to the local Mental Health team and I have my first appointment on the 8th. I have no idea what to expect and would love to know if anyone can give me an idea, as being prepared will help with my anxiety levels on the day I'm sure. Other than Drs appointments I'm not really leaving the house at the moment, and am signed off work. I've never experienced anxiety levels quite like these before.

I have now started Mirtazapine, whilst simultaneously tapering the citalopram dose. This is because the GP feels that after having been on a relatively high dose of citalopram for a number of years it may now be less effective - has anyone else experienced this?

I am also beginning telephone counselling, which is available to me through my employment union. The first appointment for that is on the 16th.

I was also given Lorazepam for the anxiety, which I'm avoiding taking unless I really can't cope.

I have quite a few questions, but I'll leave it at that for now and look for more appropriate places on the forum to ask them.

I guess I've ended up here because I feel a bit of a burden on my close friends and family, who, as wonderful as they are, have fortunately not experienced depression themselves and I feel it might be useful to talk to others who have 'been there done that' as it were.

Hmmmm so much for my intention of keeping it brief... sorry about that! But anyway, this is me, and hello to you all 

[Pip]

  I'm glad your GP is helpful.

[SteveW]

Hi there. I can tell you a bit about CMHT's. I have dealt with two, one in Lincolnshire and one in Leicester. I suppose you are familiar with the way CMHT's tend to be structured. They employ psychiatrists, clinical psychologists, social workers, OT's, CPN's, Support Workers and sometimes more. My current team has a "horticultural therapist". I don't know what she does but it isn't looking after their own small garden space. It is a pig sty.

Policies differ as to which professional you are likely to see for your assessment. Both the teams I have used, used all the different professionals to do initial assessments, so it was really down to chance who you got. But it wasn't critical. If they felt the need they could just refer you to one of the other professions. Last time I saw a CPN who referred me to a psychiatrist and a clinical psychologist for the assessment. I was deemed to be "complex".

What the assessment will involve will be a discussion of your situation and how it has developed. Most people find things much less stressful than they imagined. I was also given a pencil and paper test- The Hopkins Symptom Checklist, and a test of depression depth called Beck Depression Inventory. But in Leicester I didn't get any of that, just the discussion. CMHT's are variable.

They can do different things coming out of the assessment. They can decide that the care you are receiving from your GP is enough and refer you back without taking
you on as a case. They can take you on as a case and draw on the different resources within the team. Finally they can decide that some other agency would better suit your needs, and they could refer you on. They could of course both take you as a case and refer you on as well.

Difficult to know what else to say. If there was anything specific you wanted to know, just ask, I'd do my best to answer, although I am a shade short of  optimum functioning at the moment.

Love

Steve

[stewart]

Hi loubielou, welcome to the forume,
it is right that some people buitd a sesistance to a particular medication, or a medication is changed beause another is added, but citalopram and mirtazapine go ok together

[loubielou]

Thank you so much for the replies and welcomes.

Stuart - Thank you, it is good to hear that this resistance to meds can and does happen.

Steve - you have no idea how much your information helped, I didn't even know what the LMHT might consist of professionals wise, so I now understand it a lot better, thank you.

[SteveW]

One thing I should have mentioned about CMHT teams. Some of them discuss referrals as a group before they take any action. It is quite possible for your first meeting to end with "Thanks for coming. We'll be in touch."  This can be experienced as something of an anti climax. If it happens to you don't regard it as  a problem, it is just the way some teams work.

[loubielou]

Wow that's a really good point thank you Steve. Think I've kind of had the appt as a bit of a milestone in my head, like everything will start to get better from then, so it's good to be aware that I may have to be patient.
Thanks again.

[SteveW]

You shouldn't have to wait too long. My team used to meet to discuss referrals every Wednesday. So if you saw us on a Wednesday it could be 10 days before you heard from us.