Annoying and perplexing

I’ve been on a low dose of Citalopram for years and my prescription had run out. I phoned the clinic to order a new prescription. I was told I needed to come into the clinic and see the doctor. Fine. I get in there and the doctor starts lecturing me on depression, that it’s not a physical thing it’s associated with reaction to outside factors – eg social or financial problems, best treated with help from a psychologist and that the medication I’m on, sometimes people stay on for one or two years, sometimes longer but that stopping the medication needs supervision from a psychologist.

I’m a little astonished because I didn’t expect any of this, he was treating me as if I was newly diagnosed. I’m there to get a new prescription precisely because I’m aware that I can’t just suddenly stop taking the stuff. In fact this doctor has frequently pointed it out to me. It seems a little unfair. I point out that I have been on the medication considerably longer than one or two years, and that I’m on the waiting list to see a psychologist. It’s been two months, I’d been warned there was going to be a long wait. The doctor says perhaps I need to look elsewhere if I can’t get in to see someone soon.

I don’t mention that for all the years I’ve been on the medication this is the first time a doctor has initiated talk about a psychologist, that two months ago I was the one who asked for the referral. At the time I was well gratified at the response, I was quickly whipped onto some government sponsored program, spent a couple of hours being assessed by the clinic nurse and was shunted off to the psychologist clinic in Ipswich to be re-assessed.

Like a broken record the doctor then mentions that people can be on this medication for one or two years, sometimes longer. He is from a non-English speaking background, perhaps he didn’t understand me – I repeat yes, I have been on this medication for 3 perhaps 4 years. Then I wonder if I am the one being obtuse. Is he telling me that I should be doing something to get myself off it, that there are problems with long term use? I ask about long term effects, he says they are nil, that the medication only increases the seratonin levels in the brain and that seratonin is a hormone that helps people’s ability to cope. He says that depression creates conditions where there are low seratonin levels, it can be combated with staying active, maintaining a healthy mental state. He asks if I go to church, this can also be beneficial.

Ok then, so the point of this lecture is that I should be doing more about ending my reliance on the medication. Not very helpful in the circumstances, but I finally get it. I leave feeling a little angry at the doctor, but I guess he was just doing his job.