Trainwreck!

Well, that was a disaster.

It is fitting that the end of the psych road is a brick wall with razor wire on it.

I knew my appointment with the med nurse would go bad. I just didn’t think it would escalate so quickly. I am sure the 8 am appointment didn’t help.

She accused me of being argumentative and paranoid, but she was the one who kept arguing about a point that wasn’t relevant. In 2016, I discovered a company that provided pharmacogenetic testing and had a contract with the VA. However, she kept insisting that it wasn’t true.

She claimed in her medical report that she offered to set it up, which is a lie. That helps me to know that I made the right decision to walk out. People in the psych field often lie in their write-ups. Some of the time, they read like they are setting themselves up as the hero(guess who the villain is?), or they are covering themselves for their bad acts in the session. A lot of the time, it just proves that they don’t listen at all.

That is why I never read what my psychologist wrote. I thought the sessions were useful, and didn’t want that to change my opinion. Who knows? Maybe she wrote accurate information. She hasn’t been a therapist long enough to get that all-too-common arrogance that people in the psych field are famous for. The therapist is awesome, which was a massive but happy surprise.

Next, I told the med nurse that I wouldn’t accept Lamictal from my neurologist - not that she would offer such a horrifyingly dangerous drug. Med Nurse dismissed the idea that most psych meds are dangerous drugs. She said that benzos are dangerous. They are not as dangerous as most other psych meds, and I don’t abuse them, so it is irrelevant. I am very fortunate in that way. The danger of benzos are massively overstated. Yes, they have abuse potential, but that doesn’t make them dangerous in and of themselves. Someone with a history of dependence should be cautious, as always. When I was taken off them after taking them for a few years, I had zero withdrawal effects because I didn’t take them on a set schedule. In a good week, it would just be one or two dosages. During a bad week, it would be five to seven, and I was given enough for 14 per week.

I just stopped taking them cold turkey.

She did say that she was willing to talk about increasing my benzo but not 30 pills a month, even after I told her how I had taken them before. Way less than 30 a month, but it was nice to have a buffer for bad stretches. The half a milligram does nothing for me. Even 1 mg doesn’t completely help, but I am more than okay with that. I hate meds that I can feel in my head, and I don’t feel anything specific with 1 mg. So that is probably as good as it can get.

Lastly, I brought up ketamine therapy. I told Med Nurse I was mad that she didn’t offer that. She said this was only our second appointment. That was a mindboggling statement that showed that she had an irrational and limited thought process. All she had to offer were the typical, harmful list of pet drugs that every shrink I have had does. Seriously, there is no logic or science in it.

To her credit, we went through the long list of meds I tried that didn’t work and hurt me in the first appointment. An actual psychiatrist said that my depression is intractable - which he has no way of knowing for sure, but is likely true.

So, given my history with meds and the stubbornness of the depression, her big idea was more drugs that would likely only hurt me.

Ketamine scares me, so I did not ask lightly. I was very nervous to even ask for such a scary thing, and she was rude about it.

It made me so frustrated that after going over my history, it didn’t occur to her that trying a treatment with no long-term side effects might be worth looking into. Like I said, an irrational and limited thought process.

Worse, I talked to my therapist later that day on the phone, and it was obvious that she was just passing a message from the med nurse. The therapist said that they only consider ketamine therapy when a patient suggests it. Seriously? What if the patient didn’t know about it? More evidence that firing the med nurse was the best idea I have ever had. There is no way that is policy. As reckless and cruel as the VA is, I just can’t see that.

Honestly, given the abysmal success rate of psych meds and their dangerous and painful side effects, ketamine should be a first-line treatment for depression. It is less risky, even though the treatments might be rough. Temporary suffering for the possibility of gain is always better than long-term suffering for the possibility of gain.

What makes this worse is that I know I am a borderline candidate for ketamine because of my psychosis. It is pretty light, and I think it shouldn’t disqualify me, but I would accept the results from an MD’s evaluation.

She mumbled something about not being able to do it right now. That was it.

I walked out at 8:12, I think.

She threatened me that if I left, she would only give me one more prescription of Klonopin, which turned out to be another lie. I told her I would never walk back into her office again and left.

I have been threatened by psych workers before, and I don’t tolerate that kind of abuse and manipulation.

I think my therapist was disappointed, but she should have been happy that I advocated for myself.

Granted, I am not great at confrontation. My normal passivity made it impossible to confront the sadistic med nurse more helpfully. But, she wasn’t listening to me anyway.

I only went to her for help with sleep. It never came up. No one in the VA has shown any concern for the fact I sleep poorly and am exhausted all day. Not once. The best I get is, “some people just don’t need a lot of sleep” as if I didn’t just tell them how tired I am all the time.

I feel bad and feel like a failure, and I should. I am a failed, bad person sub-human.

I told my therapist later that day that maybe I should try someone else. She seemed pleased with that and said she would put my request in. About a week later, the med nurse’s nurse called me, and he told me I just had to write a letter requesting a new one and could bring it in or mail it.

Grrr!

How annoying.

Why isn’t the request my therapist put in enough? Turns out the nurse lied to me. I guess those two are pathological liars. It’s a good thing I spent the 40 minutes, each way, driving my letter in. The lady at the desk said I have to fill out a form and that they don’t accept letters.

So I filled it out.

It has been about three weeks, and have not heard back. It seems that they decided I am beyond help. They are very likely not wrong.

The hour and 45-minute wait to see my therapist was awful. I brought a book to read between appointments but could not concentrate. My mind was racing, and it eventually turned into mindless pacing. It didn’t even matter that I severely aggravated my foot. It was weird, almost obsessional.

When she came to get me, I couldn’t even look at her, and she commented on it. Obviously, the med nurse told her something about what happened. It was likely the same lies that she wrote in my records.

I had a to-do list to talk about but as usual, we got off that track and talked about other things. Most of those other things are unimportant. By the time I was able to slip in what I wanted to talk about, the session was over, and this was the last appointment. Yet another reason why this one appointment every two weeks for six months is a horrific and unhelpful idea. I would love to discuss it with the genius who came up with this. It is a VA thing that may or may not have originated in the local office. Now, if I want to go back, I have to request it and hope that she is willing and able to see me.

Like I told my therapist, the VA has become very cruel over the last ten years or so. This program is a prime example. There was no time to talk about everything I needed to, no time for her to get to know me and my issues. She spoke about her impressions of me. She is not wrong, but it is very incomplete, and it is not her fault.

I could have limped down to the front desk and put in a request right then and there. I wanted to do it, but I was thinking perhaps some time to digest what the therapist put forward is the better path. If I am allowed to go back, I will be more assertive and take much more control of the sessions. We meandered far too much, but that was my fault because I was all over the map. It should be more helpful to put myself on equal footing with her, instead of allowing her to lead me.

I think she would like it as well. She thinks that I am more passive than I actually am.

It is strange. She mentioned that I sometimes brought things up as an afterthought, and she was shocked that we didn’t talk more about those things. They seemed important to her but were of little consequence to me. That gave me pause about my insight or lack thereof.

It seems that she has gained my total trust, an odd thing.

After the last appointment, I realized that no matter how bad things went in my mind in between appointments, I was always less than two weeks away from another appointment. Right after the last appointment, it felt that a safety net was gone. That feels oddly dependent. So, it is probably good that I take some time to evaluate everything and make a plan.

Still, I think two to three appointments a week for six months is a good initial start, and then re-evaluate from there. Too bad I am not worth it for the VA to assign me a psychiatrist. If I could have seen one for a little while, they might also see how severely messed up I am and might have been able to influence it enough to happen.

Well, that is unlikely.

I am nothing so no one will listen to me or help.