Shane

Brief Outline: Shane was diagnosed with anxiety and depression. He was prescribed a high dose of antidepressant medication and overdosed (self-harmed) one night. He is no longer on medication and has weekly informal counselling with a GP he likes. He also takes part in events organised by a local charity.

Background: Shane is at college. He lives with his mum and two younger sisters. Ethnic background / nationality: White British.

More about me...

Shane was diagnosed with anxiety and depression. He’d been working as a volunteer with people going through mental health issues, so was familiar with the symptoms of depression and the way it affects people. He was helping his girlfriend through depression, too, but didn’t talk to anyone about his own difficulties. 

Eventually, encouraged by his family, Shane made an appointment to see a GP about nosebleeds he’d been having, which he thought were stress-related. This was when he was diagnosed with anxiety and depression. 

The GP who diagnosed Shane introduced herself by her first name and saw him weekly. The consultations felt quite informal – instead of facing each other across a desk, Shane and his doctor sat next to each other and looked at the treatment options on the computer screen together. He also felt that the GP was very empathetic and talked from her own experiences. This GP became Shane’s regular doctor. Shane had mixed experiences of other GPs who he had to see when she was away. He disliked being ‘passed around’ and felt that seeing a different GP each time was ‘not what you need from a counselling experience’. He also felt that some doctors weren’t very good at talking to patients, despite their qualifications and medical knowledge. 

One of these doctors prescribed Shane antidepressants, which he found effective initially. However, the dose was gradually increased over time and, in the end, he said he was taking the highest dose a patient under 23 could take. The side effects made Shane feel groggy, tired and forgetful. He ended up overdosing one night (self-harming) and his friends called for an ambulance. Shane spent a night in hospital where he was assessed. That night he also had to tell his mum how he’d been feeling.

After a night in hospital, Shane continued taking medication for some time before stopping completely. He recalled feeling uncomfortable having to go to the pharmacy with bandages on his arms where he had harmed himself, but his main reason for stopping was to avoid having to go to hospital again. He resumed his weekly consultations with his regular GP, whose first word to him when she saw him was ‘sorry’. Shane appreciated this and it showed him her genuine concern. Since then, he’d also been in touch with counsellors from the crisis team, and participated in local groups where he could talk to people who’d gone through similar experiences. He also went back to college.

Although a full 24-hour GP service sounded unfeasible to Shane, he felt it would be helpful for surgeries to have at least one doctor working after hours. Shane knew about online counselling services but said, ‘I don’t feel like talking to a screen is the best way to help yourself’. He found some websites helpful, though, including MIND’s website and Psychology Online.
Shane advised parents to encourage their child to visit the doctor. He also suggested that young people having mental health problems should seek help as soon as they can, read about mental health to gain understanding, and try volunteering in charities and relevant organisations.

Shane saw a nurse after he’d self-harmed. She seemed cold. He thought that might have been because she sees so many people with different problems.

I've seen the nurse on one occasion because of an incident with self-harming in which I was too terrified to go to the hospital when I really should have. So I went to the doctors for that and, when I went to see her, she seemed very, very cold. But that might just be because she has to go through several people of varying severity and circumstances, stuff like that.  So I guess that might make you cold-hearted because you don’t know when's the next time you're going to see them and what state they're going to be in, so yeah. 

Shane was helping his girlfriend through depression. His mum noticed that he was short-tempered and suggested he should see a doctor.

The way I think, I prefer to help others than get help myself. So, because my girlfriend at the time had depression, I didn’t want to off-load what I was feeling onto her because she was struggling with stuff herself. So I sat and helped her rather than try and help myself.

Yeah. Did you talk to anybody at all or no?

No.

No. Did anyone know you were struggling at all then, or they just thought, 'Oh he's doing alright; he seems to be doing alright.'

My mum noticed attitude differences. I was a lot more short tempered and I was doing stuff that I wouldn’t normally have done, so....

Were you…were you at sixth form or school or college?

I was at college, yeah.

College, yeah. So you were…you're doing a course, yeah?

Hm mm. 

And then how did it come about – you mentioned family members said, you know you should go to the doctors. How did all that come about?

It came about just because of…well I… at the time I was having rather frequent nosebleeds, which I'm guessing would have been associated with the stress and anxiety and stuff like that. 

So, with that going on, they went and said that I should go to the doctors to see if anything was wrong. And during that they essentially diagnosed me with depression, anxiety and stress. So, yeah, that’s how that came about and then the counselling started later on.

So, when you went to the doctor's surgery that time did you go with somebody – a family member – or by yourself?

No, with the way my family works, my mum's a single parent who works, and my sisters are at school and college.

So you went by yourself?

Hm mm. 

Shane was prescribed a high dose of antidepressants, which he used to overdose on. It was then that he had to tell his mum what he’d been going through.

It was a combination of self-harming and the tablets, and I ended up having some friends that I know call me an ambulance and essentially be carted off to hospital for overnight assessment, which wasn’t fun at all, so yeah.

So your friends were around were they or they came over or something?

They drove over just because we were helping each other out with that sort of stuff.

So they knew what you were going through?

Hm mm 

They had gone through something like that as well, or were going through it?

Yeah.

So did you find that they could understand a bit more then? How, you know, having gone through that, or did you find everyone's experience was so different?

It was different in a way because the people, my friends that came round, they had divulged this stuff with their family whereas I didn’t, so it was varied in that respect. But other than that it was mainly the same stuff, and it actually helped having them there because they knew the ambulance crew that came to pick me up, so it was a lot more personal and informal and stuff like that.

So their families knew what was going on with them, but you hadn’t talked to yours, no, because it's something…it's very hard to talk about these things. And you went to the doctor. Was that the first time then that your family kind of realised what was going on or.....

Yeah, because my friends said that they needed to take me…phoned for me and called my mum just because next of kin and stuff like that. So, I ended up with my mum driving to the [name of] hospital, and I had to tell her there and then that…what I was going through because I couldn’t exactly hide it anymore because I was in a hospital bed.

And then you would have…did you…you stayed overnight; you said you had tests and things like that.

Hm mm. 

And that wasn’t a nice experience?

No.

Were you able to come back home the next day or did you stay in for a few days or more than a few days?

I stayed in from six o'clock Friday till four o'clock in the morning on Saturday, so I was home within a couple of hours. But because of the experience that I had with the hospitals it sort of, I guess in a way it haunts me just because I have nightmares of the hospital machines and noises that they make because I had to sleep there. So I guess it affected me psychologically of the noises that the machines made.

Shane likes having informal counselling with his GP, which feels more like a chat. He can talk without giving everything away, and it feels that it’s not all about him.

The way it went about was just she ended up introducing herself, not as Dr, it was, "Hi, my name is Ashley [not real name]." I can't actually remember her first name because I know her by sight now. But yeah she set it out very informal, and then instead of it being a table in-between us, it was next to each other looking at the screen to check if there was any options, which eventually there was because, with her help, I got involved with the crisis support team and also [a local service], which is another counselling service. 

Yeah. On the very first appointment that you went to see her, what kind of impression did you get of her?

I could tell that she's been affected by mental health stuff in the past just because of the way that she talks about it, because you could tell that there was empathy with it. So she knew what she was talking about and she's also experienced it, so I think that’s why I got on with her so well.

You mentioned you had counselling with her?

Hm mm 

When did that…how did that all start up?

It was…I guess it wasn’t professional counselling. It was more informal counselling just because we both talked about what was affecting us and stuff, which was good because I could offload what was affecting me with the depression and stuff like that. And she could say like trivial matters because she wasn’t affected by depression at that current time. So it was like I wasn’t just giving everything away. There was some give and take with what was being said and stuff, which helped a lot because it didn’t feel like I was essentially being forced to comply everything that had happened to me.

So it almost felt a bit more like an informal chat?

Yeah, more a conversation than counselling I guess, yeah.

The GP talked to the computer screen and made no eye contact. Shane was ‘in and out in 5 minutes’.

I guess I was just being irrational with like my thoughts and stuff because I guess I just had broken sleep and stuff like that. So, with my thoughts, it was scattered. So it was go back to the doctors and then ended up with the medication, so yeah.

So that doctor that you saw, read the notes and saw, 'Ah this is the medication that’s been written on the notes.'

Hm mm. 

Wrote a prescription for that?

Yeah.

So the doctor you saw the day before, you felt a bit more at ease with her. How about that doctor you saw the next day, can you tell me a bit about that doctor?

I was in the room for five minutes; was very, very rushed. They didn’t keep eye contact. They talked to the screen and not to me. And there was also a table in the way so it was very isolated and segregated between professional and patient.

Did that doctor introduce himself or herself?

No, they just said, "Hi," and, "Are you [participant’s name]?" and stuff like that and…

And did you mention that you'd been to see a doctor yesterday and had a chat about how you were feeling?

Yeah.

And then the doctor...did…was it a he or she?

He.

He. Did he ask you many questions or just said, "Ah, this is what's written and I'll prescribe you that."

Essentially just looked on the reports and prescribed me that. I guess it was just an off day for him, I don’t know. But yeah, I was in and out in five minutes and, yeah.

It was good ‘offloading’ and Shane felt better after seeing his GP. But it felt ‘wrong’ going to the chemist with bandages on his arms.

I always felt that I was helped when I left the doctors straight away, just because I had released some of the stuff that I was keeping to myself, which was a good point I guess. But I also felt wrong with myself in a way because, after the doctors, I made it a routine to go to the pharmacy directly afterwards. And later on I felt wrong in doing so because of the hospital incident, and I had to go and pick up medication with bandages on my arms for a mental health disorder in which everyone in the pharmacy could clearly tell it was for the self-harming and stuff.

If someone's in the same situation how could that have been easier because you went for counselling and then you went to the pharmacy.

Hm mm 

Is there anything that could have helped there?

I guess with people in that situation actually having the pharmaceutical, I guess, goods in a way, having them with your doctor so at the end of your counselling or session or appointment, they can give you said medications and stuff like that, just because they…if they think it's good for you, they’ll give it to you. And if they don’t it…they won't, or at least talk to you about it. And just because they know you a lot better than the person behind a desk at the pharmacy.

So what the doctor was going to prescribe after she spoke to you, if she could have written the prescription, somebody could have fetched it while you wait in the waiting room or something?

Yeah just stuff like that so that it's a lot more like you're not being moved around in a sense.

So for five months you went to see her. Can you tell me what, you know, you said some of the good things was that sometimes you felt like you talked about things that you'd kept to yourself. Can you tell me the good points about going to see her, and then the things perhaps that weren't so good, please?

OK. Well one of the good points was the offloading and stuff, but also I guess the…it was the sense that I was finally beginning to help myself which, for me, was a rarity among anything just because, as I said, I prefer to help others than myself. So that was a good thing about it. 

I guess also the fact that I…I felt like I was being I guess like specialised in a way because normal people have fifteen minutes and stuff like that, and I ended up with half an hour which I feel like I cheated other people in a sense just because I was given double their time, but also happy and glad because I had that extra time. 

The bad things was probably I guess the moving around of doctors when she was not present I guess. So that was a bad thing. Another was with the going to the doctors I had – before the hospital incident – I was missing a lot of college days which brought me even further behind.

Shane was seen by members of the crisis team. He decided to stop taking antidepressants as he didn’t want to end up in hospital again.

What kind of health professionals were there?

There was…I got seen by two members of the crisis team. And then the next day I got phone called by them, which I've said, but they went through and they talked to me about what I'm willing to divulge just because they needed to go through like a meeting with my mum to tell her what was going on. And that her son wasn’t crazy, which she probably was thinking at the time of seeing me in hospital.

Because a lot of people don’t know very much about these kinds of things. It's not out there for everyone to know much about, which we'll talk about later about, you know, raising awareness and getting people to know more about that.

OK yeah, sure.

So you then came home. Were you given any more medication at that point or.... Can they just stop the medication or they had to wean it down to lower doses?

The medication continued just because they thought that it might help. But it was not given to me, it was given to my mum… 

…so she could keep a hold of it. When I did eventually stop the medication it was just an impulse decision of I don’t want to go back into hospital. And I just quit the forty milligrams on the spot, which hurt for a couple of days just because of the effect of the drugs trying to get out my system and stuff like that, yeah.

So when you say you hurt for a couple of days, the symptoms – were you getting…?

I'm guessing withdrawal, yeah.