I’m in the mood for some philosophical thinking around psychology/psychiatry.

Reality is defined as the state of things as they actually exist, as opposed to an idealistic or notional idea of them and psychosis is defined as a loss of touch with external reality, as per Google of course. These seem like simple definitions, but lines get very blurry very quickly.

Let’s start with religion, so many people claim that they hear or see God. a very minimal percentage of this group get a psychosis diagnosis. But if you hear voices that are from other not visible beings you’re “psychotic”.

Some scientists believe that it is more likely we live in a simulation than not. We could be the Sims 100. Imagine if all my depression could be attributed to some loser picking the gloomy trait for their sim…

Anyway, this whole thought came about because the psychiatrist asked if I had ever heard voices. Which I have but only when I’m trying to get to sleep so I don’t think that counts, well hopefully not.


My Psychiatrist is an Idiot

My Psychiatrist is an Idiot

So last week I saw the psychiatrist, in short, they were an idiot. They, first of all, wouldn’t shut up about therapy bullshit. It’s not that they were wrong, but the reason I was referred to a psychiatrist was that the general consensus of the people who had assessed me was that I was too busy to be able to do therapy properly. Which is true.

That wouldn’t be too bad but the medication option was to switch out venlafaxine for sertraline. The Psychiatrist was all like, have you tried sertraline? And I was like, no, but I have tried fluoxetine and escitalopram. For anyone who doesn’t know their antidepressant pharmacology, which apparently includes psychiatrists… Fluoxetine, escitalopram and sertraline all fall under SSRI. General guidelines say try one SSRI for about 8 weeks if there is still no response switch to another SSRI for another 8 weeks or you can increase the dose it varies a little bit. But overall once you have tried two SSRI you then switch out of class, which is when I was put onto venlafaxine.

Fluoxetine, escitalopram and sertraline all fall under SSRI. General guidelines say try one SSRI for about 8 weeks if there is still no response switch to another SSRI for another 8 weeks or you can increase the dose it varies a little bit. But overall once you have tried two SSRI you then switch out of class, which is when I was put onto venlafaxine.

Venlafaxine is classed as a SNRI so instead of only inhibiting the reuptake of serotonin it also inhibits the reuptake of noradrenaline. A lot of Drs will use venlafaxine to switch out of the SSRI class as it offers some additional opportunity for response with a minimal increase in side effects. I also take mirtazapine which is an atypical antidepressant so is also not a SSRI.

Anyway back to me, because that is the real importance of this rant… My main point isn’t what the guidelines say, it’s that when I tried both the SSRI’s I had no response at all, they did nothing. I got no side effects, but also no response, it was like they weren’t there. When I took venlafaxine above 150mg I have an improvement in my concentration, but other than that not a lot happened and long term I got a lot worse purely because my depression just wasn’t being treated.

Then sometime late last year I managed to convince my GP to add mirtazapine on top of the venlafaxine. Which within a week actually did something. I mean not fully recovered but at least it pulled me out of my suicidal phase.

The thing is the fact that my response to mirtazapine occurred so fast would suggest that the venlafaxine may have contributed to the response. Don’t get me wrong this combination is far from perfect but it is doing something and to seriously rock the boat by removing one for a fucking SSRI is just stupid based on my past history of response.

Anyway please tell me someone else follows my logic. If anyone got this far that is…..


So after the last time when I tried to ask for help with my studies I was told to make a Dr appointment, I did. They increased my medication so that’s something. But they said they would refer me to the mental health team because I would be better suited there. Which would be great if I wasn’t already with mental health a month and a half ago, but they decided I wasn’t sick enough. Typical mental health care, it’s all just circles. 

I’m supposed to be getting some free councelling though, through another seperate thing that is short term. Even though throughout my medical records it specifically says”needs long term psychological support “.

Where do you draw the line?

So many places have “criteria” to be accessed. But what is functionally impaired anyway? Why do I get left out because I am willing to just have a panic attack whereas others would just completely avoid the situation. Why am I considered ok because I can interact with people while I’m on the brink of tears? When I just have to hope my words will come out ok. 

This is starting to become regular at work, over the last week. I don’t have any sick leave so I have to go. I can’t afford to not have a job, so I have to have one, so I show up, I function. There is no other option. Having a job means I can’t get funding for counselling, so I don’t have one. My meds are too complex that GPs don’t like to touch them, so I should really have a psychiatrist, but I can’t afford one. 

I get told I should talk to x and just say “I’m feeling anxious what should I do?” But I’m too anxious to do that. People say it’s normal to be sort of anxious in knew environments, I’m fine. But how anxious is normal anxious? 

The types of people you meet

Does anyone else have this thing, I don’t know how to explain it…? It’s like you interact with some people, and they are nice, but you just know if you bring up the whole depression thing they just won’t get it. They will respond with oh exercise, or some sort of herbal bullshit. 

Then there are the people who you know will act like its and inconvenience to them, for fuck sake, throse whiny bitches. They are the worst. It’s not even that they don’t understand, they are just to self absorbed. 

Anyway, right now at my new job I’m like when should I drop this bombshell, maybe I never will. I would love to do it while everyone was praising me or some shit, hey guess who is mentally fucked. I really hope one day I’m invited to do some motivational speech or some shit because I’m all successful and shit. That would definitely be the best time.

Just to add because the tiny bit I have reread of this post, quite a lot of swearing. These are my unfiltered thoughts. In person I filter this a lot. 

Acting ok..

I have become quite good at acting ok when I’m not, now I just have to somehow turn acting ok, to acting happy. Because looking just ok is never ok-enough to other people. 

Is it just me? Well I’m sure it won’t be, Blut am I the only one who wishes something shit happened in their life so that all this shit would make sense. 

I need to make some friends here, like I’m fine now, but could be good to have some people outsides or to talk to. I may try find a counsellor, however they are expensive so maybe not… We will see if I find myself needing to vent to someone especially if I need to vent about work, as the added bonus of confidentiality is always useful.