Psychiatrist.*****Warning; Full blown BPD RANT

I saw my Consultant Psychiatrist this morning, bright and early at 9am, well I was there at 9am. She was late. REALLY late. So I was not only grumpy from being up at silly o'clock, I was also extra grumpy at her her inability to prioritize her patients. I went into the appointment feeling unimportant and like I was a hassle to her. 

She started out asking about how I was tolerating the increase to 60mg of Prozac (Fluoxetine). I haven't had any major side effects comparable to the nausea and increased anxiety I experienced when I first started. We then moved on to talking about whether it has had an effect on the frequency of bingeing  episodes. This is where I hung my head in shame and admitted that for it to have worked I would have had to let it stay in my stomach for long enough to enter my blood system. I explained that I had been getting sick after breakfast recently.

I was expecting a full on lecture, and even though I could sense her frustration, she very gently recommended that I try the liquid formulation of the drug. She explained that it is less easy to get rid off and will absorb quicker into my system. I will give it a go, and see how I get on! Fingers crossed it doesn't taste revolting!

I also moaned about my sleep issues (once again!) to which she suggested laying off the caffeine and that I should concentrate on practicing  sleep hygiene,  which, now, in retrospect, was the right thing to have said, as sleepers and me do not have a good history, especially if there is even a small niggle of suicidal thoughts going on.

I don't really know what I was expecting from the visit. Maybe I wanted her to just 'fix' me and for me not to have to put any work into my recovery. I think I also wanted her to read my mind and understand just how scared and terribly depressed I feel. Which, of course, is simply stupid.

Anyhoo.... she doesn't want to see me for another FOUR MONTHS! So either I didn't get across to her how shit I  am doing, she doesn't think she can help me, or she feels that I am doing just fine and dandy for the moment!

Ok rant OVER

Let me eat more Prozac

I am all motivated today. Maybe its the increase in medication. I saw my Consultant Psychiatrist yesterday morning and we agreed that I have been tolerating the 20mg of  Prozac (Fluoxetine) well enough for the last two months to double the dose to 40mg. The plan is to gradually get up to 60mg which is the evidence based dosage for bulimia nervosa. According to Healy D (2004) Let them eat Prozac. New York: New York University Press. pp 124–148.

"Fluoxetine dramatically, by 40-50%, decreased the frequency of panic attacks in two controlled trials of panic disorder patients. In three double-blind trials, fluoxetine significantly decreased the number of binge-eating and purging episodes of bulimia nervosa. Continued year-long treatment of the patients, who originally responded to fluoxetine, was more effective than placebo for the prevention of bulimia nervosa episodes."

I have to say that I am somewhat at ease taking a drug which has so much empirical research to back it up. My Doctor instilled confidence in me that I will see results when the dose is high enough. She described how she has seen it herself and has faith that it will work in conjunction (of course!) with DBT.

I feel a lightness coming back to my sprite. As if the fog is clearing and I can breath easier. It is most certainly due to the three pronged treatment approach (medication, DBT, and the right attitude.) Without each of these aspects in my treatment plan I have seen the devastating result of self destruction.