"Why Do You Bother?" (2009)

'Where are your emotions?'

A psychologist once asked me why I never seemed to get upset during our appointments.

'You don't get angry when you talk about things that happened, it's like you're telling a story. These are serious, traumatic life events...

Where is your anger?'

I didn't know what to say. 

I still don't.

I've had to explain some of this mental health stuff to so many Doctors, Nurses and even more Doctors that it probably has become like a story. And I've tried not to let the details upset me because I've had to go through them so many times with so many people. Would getting angry or upset have made any difference?

A few years ago I asked my Doctor if he could refer me back to the hospital. I wanted to speak to a Psychiatrist because I didn't feel as if my medication was working. I wasn't sleeping... I was getting short-tempered... I was staying at home, closing the blinds and not answering the phone... I knew those signs were bad.

My Doctor didn't want to change my medication without the input of a specialist, so he said he'd write to the Mental Health team. 

That was in March.

So I waited.

And I waited.

I went back to see my Doctor to see if they could hurry things up (they couldn't).

And I waited some more.

In June I got a phone call from a member of the 'out-reach team'. A nice lady asked  if I'd had any thoughts about harming myself and I said 'no'. She said I could call the crisis team if things got worse and I'd receive an appointment in the post.

So I waited some more.

They did send me an appointment - but it wasn't with the Psychiatrist. In September I had a face-to-face assessment with a member of the out-reach team. After six months they wanted to see if I needed urgent help.

By this point, I'd been back to see my Doctor another couple of times and they'd made some sympathetic noises but there wasn't much else they could do.

I was eventually sent an appointment to see a Psychiatrist at the end of October! Hoo-fucking-ray!

I made some notes about how I'd been feeling - just in case I got tongue-tied when I saw the Psychiatrist. I didn't want to waste a single second of my appointment in case I had to wait a long time for a follow-up. 

I even turned up at the hospital half-an-hour early, just so I could compose myself and read through my notes... 

That's when I found out that the entire clinic had been cancelled.

The receptionist said: 

'We contacted ALL of the patients and ALL of the patients have been offered rearranged appointments at the next clinic'. 

I hadn't gotten a letter about any cancellations. Nobody had phoned. There had to be some mistake... 

I got a filthy look for daring to ask that maybe, just perhaps, was it possible that I'd been missed out? 

The receptionist tutted loudly, sighed and went and found the BIG APPOINTMENT BOOK. She flicked through the pages muttering; 'everybody WAS informed, everybody WAS written to, everybody HAS been given a new appointment'.  

But she couldn't find my name in the BIG APPOINTMENT BOOK. She said 'oh, that's interesting' but her manner didn't change in the slightest. She said I should have 'phoned to confirm instead of just turning up'. She said there'd 'obviously been a breakdown in communication between departments' and she'd 'make sure somebody sent out another appointment in the post'. 

My head was spinning. I had my notes in my hand. 

I said: 'But I can't see anybody today?'

 The receptionist didn't even look at me. 'We'll send you out another appointment, but the next clinic is already full...'

Was that a moment when I should have gotten angry? I could have kicked off - not just about the cancelled appointment (and the fact I was never told about the cancelled appointment) but also because the receptionist didn't have to speak to me like I was a complete fucking idiot.

The problem was - I felt like a complete fucking idiot. I've always felt like a complete fucking idiot. When shit goes wrong, I assume it's my fault and that's just my regular, natural frame of mind. I am a complete fucking idiot. So When the receptionist said I should have called to confirm (even though I'd never done that before, and nobody had ever suggested it as a possibility) it made perfect sense. 

This was my fault. I deserved this.

 

By the time I finally did see a Psychiatrist I'd been waiting eight months for expert help. I was ready (again). I had my notes with me (again). 

The Psychiatrist sat with his back to me - but that was OK, wasn't it? He was using a computer, so he had to sit at a desk and maybe that helped him to concentrate. He typed as I spoke and I found that reassuring - he must be listening and making notes. I told him my symptoms had been getting worse in the Spring - and he interrupted with a question that completely floored me:

"Why on Earth did you wait so long before getting help?" 

So I explained. I told him about the outreach team and the phone calls and the cancelled clinic and the breakdown in communication... 

And he nodded his head and continued to type... 

I told him what had been happening - that my moods had been worsening, that I was staying in the house more and that I was finding it difficult to speak to people... it was the usual stuff but it was getting worse and I explained that I hadn't been at work for over a year and that my employer had dismissed me because of my sickness record...

He interrupted me again. He said:

"Right, so you are finding it difficult to cope now that you can't provide for your wife and family? And now that you're not the provider, you don't feel like the man of the house and your lack of a job is making you very depressed?"

And I felt smaller and more hopeless than I had for a long time. I thought I must be really terrible at explaining things - or maybe I hadn't explained things in the right order. I looked down at my notes. 

I had tried to explain to him (and I tried at least twice more before the end of the appointment) that I was depressed and anxious before I lost my job, and it was feeling depressed and anxious that ultimately cost me my job...

"Yes, yes, yes..." he said, "It's perfectly natural to feel like this when you lose your job and you somehow feel like less of a man. Unemployment is a common cause of these feelings..."

And then I realised what was happening. 

He wasn't bloody listening. 

At least, he wasn't listening very well. 

He was skim-listening. 

Maybe he wasn't typing up notes on his fucking clickety clackety computer as I spoke, maybe he was playing fucking Free-cell or writing his fucking shopping list. He certainly wasn't fucking listening to me. He'd picked out a couple of words I'd said - maybe some of the descriptions I'd given of feeling hopeless and useless, and he'd put them together with some of the other things I'd said about my employer - and that's how he'd made his mind up. A 'best fit' diagnosis. He was saving himself time and effort by fitting me into a well-known pattern. He'd probably seen a lot of people who were depressed after losing their jobs.

 

And then he wrote me a prescription for some different anti-depressants. 

I asked him if I should pursue alternative things like exercise or healthy eating and he said the medication would work within three months. I told him that anti-depressants had caused me to put on weight in the past, and he nodded and said that most of them have side effects.

I came away from the appointment thinking:

Should I be angry about this? Should I be kicking off and demanding better answers? Should I have to put up with this crap? Is it too much to ask that people listen?

And then I thought: 

What's the point? They can't do anything. Even if they listen, they've only got tablets. If I get angry they'll probably frame it as being a part of my mental illness and threaten to withdraw 'treatment'.  

What if I just accept that I'm not going to get any better? What if my life is just going to be a cycle of dark moods, anxious thoughts and different medications? What if I stop asking for help because the specialists leave me feeling worse? What if I just give up?

But I couldn't. 

I don't know what I'd been expecting. Maybe I was hoping that after so many years, so many appointments, so many tablets and so many rude receptionists - there might finally be some answer, some solution... some miracle.

About two years ago, I asked to see my medical notes. I wanted to see if there were records of missed appointments, rearranged clinics etc. 

It took them a few months but a huge bundle of papers eventually arrived. It was mostly dull - they'd printed out every letter I'd ever been sent - but some of the emails between various Doctors, Psychiatrists, Psychologists and Nurses were quite revealing. 

There seemed to be a general tone of exasperation - some of them seemed genuinely puzzled that I was asking for help. It felt like they were all saying: "what does he want from us?" There was also a slightly snooty air to these emails - as if they were in on a private joke, as if I (as a patient) couldn't be expected to understand how therapy or medication are supposed to work. So maybe I'd already been given the correct solutions/medication, it's just that I was too stupid to realise it.

As for my anger - there's been a lot of that in the last few years. I'm angry with myself for still having these horrible symptoms and I'm angry with myself for believing that the 'experts' were going to listen to me, take me seriously and help me to get better. Yes, I know they're overworked and underfunded and blah blah blah - but this has been my life for over twenty fucking years. 

And honestly? It does piss me off when alcoholics, drug addicts, wife beaters, abusive partners and fuck knows who else get more clinical support, second chances and understanding than I ever have. So here's my anger : boiling fucking hot!

But hollowed out and flattened by sheer bloody exhaustion.

 And now I know it wouldn't have made any difference if I had gotten 'angry' with the Psychiatrists, the Psychologists or the Receptionists. They'd have just washed their hands of me a bit sooner, and then sent each other some smug emails to celebrate.

Maybe I would feel a tiny bit better if, over the years, I had told a few people to fuck off.