Sunday, July 10, 2016

Is that safe?

This week I saw a nurse practitioner for my medications. I had never seen this lady before but had heard good things about her from my therapist and a psychiatrist that I had seen before he retired. I had multiple appointments scheduled before but every time I was supposed to see her, the appointment had gotten cancelled for one reason or another. So I was highly anticipating my appointment with her.
Recently, I've been having difficulties taking my medication because my gag reflex is so strong that I either feel like I'm going to throw up when I take my medications or I actually do throw up. It's not been fun. So I've been off of my medications for over a month now. I can tell the difference between me being on medications and me not being on medications and it's not a positive one. My therapist was aware of this and had sent her an email explaining the situation so she would know what was going on. So I was really looking forward to this appointment to address the issue with her.
I was really disappointed in the appointment. I left the appointment so frustrated I was almost in tears. Here is a list of reasons why I was frustrated:
1) I arrived there and she made multiple comments about my weight. I'm not bothered by my weight but if someone makes comments about it, it really bothers me. She commented that if I was having trouble with my appetite I should be losing more weight than I had, like my weight was proof that I was lying about my symptoms. She asked me why I thought I wasn't losing more weight and then proceeded to question me about my eating and drinking habits. I explained that while I do drink a lot of soda, I generally eat fairly healthy. I eat lots of fruits and vegetables as well as protein like chicken. So I didn't know why my weight was where it was. She lectured me about my eating habits which just irritated me.
2) When we began discussing me being off of my medications, she commented that I was on a lot of medications and that I seemed to be doing fine without them. She then asked if I should just stay off of medication. She made a judgment based on my appearance and wanted to keep me off medications based on that judgment. She didn't take into consideration the fact that I was on a lot of medications for a reason. She also didn't evaluate me by asking about my symptoms right away, she just assumed by the way I looked that I was okay.
3) While discussing whether I should go back on medications or not, she asked me what I was doing to help myself. I told her I was seeing my therapist twice a week and doing good work there. She asked me about attending groups and I said I couldn't because of my work schedule. She then said that I should focus on my mental health and work is just something extra. But it's not something extra for me. Work is part of my identity and not just a part but a key part. She acted like I should just drop everything to attend as many things as possible and that work wasn't important. However, if I had gone in there not working, I probably would have gotten a lecture about that. Just frustrating.
4) Probably the MOST frustrating part of the entire appointment was when she asked me what I do for work. I responded saying that I work in a daycare. Her response was "is that safe?" I was dumbfounded and shocked to say the least. I understand the need to ask if I'm at risk for harming someone else, but there are a thousand other ways that question can be asked. Additionally, the question just perpetuates stigma. Almost every job has some aspect of working with other people in it so if she was really concerned about me being homicidal, she should have asked that. However, instead, she revealed that she has an idea about people with mental illness that they shouldn't be caring for children. What about the people with mental illness who have children of their own? Why can't someone with mental illness care for children if they are safe with them? Just because someone has a mental illness doesn't mean they can't work a job and do what they love in their job. People with mental illness are no different than someone who has a physical illness. If that person can physically do their job, there should be no questions on whether or not they should be working that job. As the appointment continued she also made multiple jabs to me about my job. Anytime something came up that she disagreed with, she would make the comment "is that safe for the children?". This just bothered me even more. My job is a HUGE part of my identity and something that if anything, helps my mental health and gives me reasons to keep going. It gives me a reason to get up in the morning and something to look forward to. An attack on my job is very much a personal attack because of how important it is to me. Not only that, but my bosses are aware of the full extent of my mental illness and if they didn't feel comfortable leaving me alone with children, I wouldn't be left alone with them. Additionally, I'm freaking good at my job. Not trying to brag or anything when I say that but when you get noticed by a corporate worker on how well you do with curriculum with the kids, that's kind of a big deal. Plus, all the parents in my class love me and so do the kids. So the comment about whether it was safe or not to be around children was hurtful and frustrating. What a way to perpetuate stigma.
5) Another thing that really frustrated me was the expectation that I could choose whether or not to have symptoms. She made comments about my sleep, my appetite, and my suicidal thoughts. I had to explain the fact that I was chronically suicidal and she proceeded to ask me why. Like I could control the thoughts. I can't. I can choose whether to dwell on them or act on them or not, but I can't control the thoughts themselves. That's just something that is part of my reality and something that has to be monitored. And when it came to my sleep and my appetite, I can't control whether or not I can't sleep or sleep too much. I can't control whether or not I have an appetite. I wish I could, but I can't. That's all part of depression. If she wants that to change, maybe she should be trying to work with me on medications to help that.
6) The last thing that frustrated me was what she did with my medications. She wanted me to restart my medications on the same dosages I was on before, which isn't a good idea because it makes for an increased risk of side effects. I need to be built up to the dose I was on. And she wants me to choose what medication I start first. She doesn't want me to start all the medications at once, but gave no guidance on which ones I should start first. So frustrating and not helpful.
Overall, the appointment was a huge disappointment and so frustrating. Even when talking with my therapist, she was frustrated too. She knew I didn't like the person I saw and knew I wanted to see someone else. However, she said she would talk to the nurse practitioner first so that she didn't get in trouble. She is supposed to look into that and hopefully get back to me.

I think what is most troubling about the whole thing is that the nurse practitioner works in the mental health field yet still stigmatizes patients. How can someone with so much experience in the field still carry so many uneducated views about mental illness? This is one of the big problems with the mental health system. The people who are supposed to be the ones helping the patients and decreasing stigma, further it. So much change needs to take place to start eliminating stigma. It starts with one person at a time being willing to step up and say I will not accept the stigma anymore.