Raffles

I had to take a year out between second and third year of Uni because I had a crisis -- just in case it helps to hear that this can happen. Is she receiving Disabled Students Allowance? I was allocated an hour a week from a mental health support person. Not a therapist, but someone who could help me keep on track with studies, touch base with. One time, when I was becoming quite unwell, they came with me to the GP to advocate for me. They were also great at helping me navigate the extenuating circumstances process.

I hadn't appreciated the Oxford clinic is tertiary. Thank you for explaining things, Ashley.

It really shouldn't have to be so convoluted to receive appropriate treatment. I've seen your posts about your experience - the system needs radical improvement so these things don't happen. Hope your current CBT+ERP is helping.

Do you know how feasible it is to get referred through patient choice? It's not as simple as just asking when you see your GP - your local CCG still have to sign off/fund it?

I was more wondering whether you'd heard what the waiting times were like/how referrals are going for the new clinic, since it could be helpful for members! It is interesting to hear how these documentaries are created though. Paul's principles are solid and admirable, and Nadiya is just downright amazing.

I think that last part is crucial in recognising how Nadiya could have got treatment so promptly. The NHS and the BBC/show producers may have valued its awareness-raising potential, demonstrating good CBT. The specialist centre in Oxford has only recently opened its doors for referrals, and it says on their website there's no waiting times at the moment apart from administrative ones. So theoretically, at this point, anyone could be referred and seen relatively promptly. I don't know if you could request it through patient choice from your GP, and I imagine getting your Clinical Commissioning Group to agree to fund the referral (if you haven't exhausted local resources first) could be tricky... Any ideas, @Ashley? I only know about the above because I've been through the mill of local CBT (through my GP, then CMHT, then private, then IAPT) and so have had grounds to request a referral to another specialist centre, CADAT, through the NHS Highly Specialised Service. I've had to research it to convince my CMHT to make the referral. The charities (OCD-UK and OCD Action) have really good resources explaining the NICE guidelines and referral routes, but I can imagine if it's people's first time using services it can be bewildering to know what to do for the best. People shouldn't have to go so far afield to access appropriate treatment, or wait as long as they are.

It's your first session, right? Maybe ask the therapist if you can speak to your mother together if you're going to have another home visit, if it would be beneficial for her not to be there. I hope it goes well for you.

Knowing a bit about the structure of NHS services, and who Paul is, did make me feel keenly aware that the show has been produced with a narrative hook/storytelling element. It does seem rare for someone who, in the course of the narrative, hasn't been involved with services before, should be referred to a specialist centre rather than local IAPT -- although if you're savvy, do your research, and exercise patient choice it's possible. I imagine the team making the show with Nadiya would have helped research the best options. Perhaps the BBC Action Line explains more details about how to access treatment. It would have been better for me if they'd said who Paul was, and he was consulting for the show to explain how CBT and the diagnostic process works. It felt... intrusive seeing Nadiya in therapy, although I'm also glad they communicated the rawness and how it can be hard work. I'm glad the clips were brief, and I really hope she's continued with therapy and reduced her suffering.

I'm glad to hear it!

No worries! I really feel for you. I also have a healthy appetite, when well, and the times I've lost it have felt pretty scary. When you're anxious and go into the fight-or-flight response, the body temporarily shuts down some processes, like digestion, to boost the ones that can help you escape. We don't usually notice this because it's meant to be brief, until you're free of danger. Unfortunately with anxiety disorders and depression, you can't just fight or flee the threat, so the state lingers. Hope the Sertraline gives you your appetite back soon. I tried sipping a lot of lukewarm herbal teas when I was last that bad to try and feel full. Chamomile with honey actually helps my nerves a bit! Ginger's good for nausea, and mint is soothing for the stomach.

Do you get migraines, Sufferer? As I think I mentioned in another thread, maybe consider the possibility you're mis-attributing symptoms of anxiety/sleep deprivation to side-effects. Or a mixture of side-effects and symptoms you're paying attention to now there's a new variable with the medication. The stiff shoulder muscles could be due to anxiety-tension? I don't notice I clench up when I'm stressed until my shoulders start aching! If you can take a warm bath, or use a wheat pack/hot water bottle on them, you might get some relief. It's easy to say, but try not to engage with rumination about how long you might take meds for. It's individual to everyone.

I get that. I only take Diazepam if I'm so anxious my chest hurts and I'm close to inconsolable. It's a last resort -- and I certainly wouldn't want to take it regularly since it can stop being so effective, but it's good to know it's there if I can't reduce intense anxiety by other means. I think I said in your other thread on appetite, it only took a couple of weeks after starting Sertraline again to be able to eat normally. Getting that sustenance inside me made the world of difference in being able to cope day-to-day.

I didn't phrase that particularly well -- I'm aware of the increased risk of suicidal thoughts in the early stages of taking SSRIs. It's why, as you observe, they should be used with care and monitoring by Doctors.

Sleep deprivation can do that too! And cause headaches. I know it's another medication, but you could consider asking your doctor to prescribe a short amount of diazepam/another benzodiazepine. Taking them long term can cause dependency, but a small prescription to take when you're intensely anxious can provide a bit of respite. It might help you relax a little and ease your muscles.

Ah, you poor thing. That really is familiar. I tend to realise I'm properly sick again once my appetite bites the dust and my stomach becomes upset. It's a clear signal to seek support. It's usually a mix of acute anxiety with depression tagging along that does that. Feeling physically rough also makes it harder to cope with the mental stuff. I had to really fight to get food in me in the morning, and could only manage things like smoothies, soup, yoghurt, mango, bananas. Anything cold and gentle. Fortunately, after roughly a fortnight back on Sertraline my appetite returned and my stomach settled. I hope the same happens for you.