Just got back from first psych appointment

Well...it didn't go as well as it could have done, but perhaps better in some respects than I imagined.

I've waited 3 months to see a psychiatrist on the NHS and didn't feel rushed - was in there for an entire hour and felt the guy was listening to me. However, he said he didn't believe I had a personality disorder because I was in a relationship that was working (albeit that I am slowly screwing things up) and could work (although am self employed and just about scrape by so I can pay for food and rent and rarely leave the house). He said that to have a disorder, I would need to not be functioning at all.

He said his diagnosis was borderline, paranoid and depressive traits. I'm not sure how I feel about that - I wanted an official diagnosis of some kind so it would be easier for me to explain to people and I could say I have "XYZ" and they could just look it up if they felt so inclined, especially as I've had the same problems for 20 years now. Despite me trying to explain my problems to people closest to me, I get the feeling that still have no idea about the tremendous pain I'm in from day to day - they just don't get it because I've become such an expert at masking it in general day to day situations, so feel that when I tell them what's going on in my head, they don't really believe it.

At the end of the appointment, I ran various meds I wanted to try past him and he kind of dismissed them as wouldn't be "initial" things to try and was of course being very textbook about the whole thing, so instead has put me on Seroquel (can't remember dose but will be a lowish dose to start) after I refused to take any SSRIs, but didn't seem to want to give me Abilify for some reason. I told him that under no circumstances did I want to have any sexual dysfunction problems or motivational issues as that would mean I can't work and then can't survive.

I'm very concerned about weight gain as have issues with my weight and not exercising as it is, but hopefully, this will help my paranoia and split thinking a lot more without turning me into a zombie.

What was disappointing was that he said he would refer me to a psychologist for CBT (I asked for DBT and he just said I'd get CBT even though I told him I'd had this before and it didn't work). He said a psychological assessment could take 2 months and then I'm looking at another wait before I see a psychologist. Pretty annoyed with my GP as made it clear when I went at the start of December that I wanted therapy as well so assumed he'd also put in a referral for that at the same time! Arrrgh...more waiting. Hopefully though, if I'm feeling more motivated, I can actually work on doing more self help and my own therapy. We'll see - I pick my prescription up Thurs am.

I wouldn't be too worried about the psych saying that you have traits as opposed to an outright disorder. That's a pretty common event nowadays, and most therapists will transpose the words traits and disorder. I'm not certain why they do it that way now, but my guess is that it's less emotionally traumatic for people who don't suspect that they have any mental health issue to be told "you have traits of these..." versus "by all medical definitions, you're crazy", though they probably use a more medical term.

I'm sorry to hear that you weren't referred to DBT, as you had asked for. I can't say that I've been through CBT, but from my own experience, DBT is definitely helping. It could be possible that DBT isn't even available in your area - that's the only reason I can think of that would explain why the psych would put you in CBT, knowing you've been there before.

Don't go too hard on your GP for not referring you to a therapist. If CBT is anything like DBT, one of the first things they make you do is end any outside therapy, as they don't want any other therapeutic methods conflicting with them. If your GP has experience with patients in CBT/DBT, he possibly anticipated this and didn't want to set you up, only to have you quit your therapist a month or two later.

I also wanted DBT, but they failed to provide it and instead offered a place in psychotherapy.

I'm not sure what to say right now, but just thought I'd mention that I can relate, also that I've been offered CBT again despite it never helping me previously.

It's frustrating when professionals won't give you what you feel will help.

Thanks for your replies.

Sorry - I wasn't very clear on the whole personal therapy thing. This is something I've decided to do (not using a therapist, but self help books/exercises) when a month after seeing the GP, he told me I might be looking at another 2 months before I saw someone - he doesn't know I'm doing any kind of personal work.

I suppose I'm very surprised that after just one meeting lasting just shy of an hour, a psych would be able to say "I'm diagnosing you with XYZ"!

I'm glad DBT is working well for you, Casper - how often do they offer you sessions?

Smiggles, what's the "place in psychotherapy"? Is that generic therapy that uses a combination of approaches? Sorry to hear you weren't offered DBT either. I wonder how many specialists there are in this field, although I'm in a city so I would think there would be a fair few. Oh, if only private treatment wasn't so damn pricey!

My dad has somehow managed to get art therapy of the NHS but then I know he's been in therapy for donkeys years and is a bit of a challenging case, so maybe they have a kind of "wave" of treatments they offer and will only offer you another if you fail to respond well to the suggested approach? Who knows, but yes it's frustrating not to be given more of a choice as the NHS website seems to imply that you have more control over your choice of treatment.

Similarly, Seroquel isn't my preferred med to try initially and I'm battling with myself over whether to even go on that journey. On the positive side, this whole thing has reminded me that I shouldn't put all my faith in the NHS to help me and that I really need to tackle as much of this myself as I can. The personal work certainly isn't easy - all too easy to get distracted and procrastinate and am coming up a Great Wall of resistance, but that's to be expected.

Generic therapy would be my best guess. this is my only problem with mental health services, the system is slow and corrupt, I can't even inform you about the therapy I'm provided with. I'm located just south of my county, so it's a good hour and a half journey to reach the city for my psych appointments, sad thing is, I can barely tell you that it's worth it. I just really wish they would take these things more seriously and have more placement available, you're spending all this time under psychiatric care and make little to no progress unless you're at risk of harming yourself or others.

An hour and a half travelling?! I would assume that's once a week or fortnight as well...are you in the US? I'm sorry to hear that you're not feeling full benefits of it, particular with that kind of journey. Is there any chance you can change therapists (although I don't know if that would help)?

Yes, it does seem to be that way - unless you're at a point where you're totally off the rails and at immediate risk of harming or suicide, you seem to be treated as a low priority. Makes me wonder just how many people could have been saved in their general and recurring suicidal thinking had been taking a bit more seriously, rather than waiting to the point where they're having an "episode" and thinking has got out of control. When I told my dad about having to wait 3 months after my initial appointment, he joked "You could be dead by then!" - some would possible deem that inappropriate humour on his part, but he's bipolar himself and knows all too well how the system has worked (or not worked) for him in the past when he's had a crisis.

In the UK, we're supposed to be seeing a lot more money invested in mental health, but from my last reading, they're not meeting their targets for children's mental health by any degree and certainly from my own experience, things have changed quite a bit - when I saw the GP back in 2013, they were all over themselves trying to offer me help, and before that, I used to get letters requesting a mental health review to check I was ok, even though I wasn't in any kind of therapy or even asking for help.

Don't get me wrong - I'm thankful to live in a country where people can at least get access to free healthcare, but there are certainly other hidden "costs" (like being offered inferior, cheaper drugs with more side effects than those that have been shown to be more effective in treating people), and I hate the way the government is now enforcing a ban on all psychoactive substances this April (including those that haven't even been discovered yet!) to further limit people making treatment decisions for themselves - especially those of an organic nature (iboga, kratom, etc).

Nope, I'm from England too. I had an appointment with my psychiatrist for today actually, but I'm not in the UK atm so I cancelled. I agree with you, I remember one time I was waiting to be called through by my psychiatrist and noticed a chart on the wall, it was basically saying where things meet, if at all. a lot of the requirements were marked off as inadequate and poor, but that's just for the specific facility.

I'm in twice a week, for a year: once a week for skills training (in a group) and once with a one-on-one therapist to discuss the bumps, bruises and backstories of my week, as well as how I did, or can deal with them, should they re-occur.

you sound more depressed than anything. and I've never met you and I am not a doctor

I'm not sure if you were speaking to me...?

and I've never met you and I am not a doctor

- don't you mean "BUT I've never met you and I am not a doctor"?

Based on several studies, most people with BPD also meet the criteria for depression during their lifetime.