He does have a full doctors title, but his first name is Darren. It just doesn't sound like a name for a psychiatrist. I used to have fish called Trevor and Alan. That wasn't quite right either. I expected Jasper or Dr Farnworth St.John Smythe or something posh and unpronouncable. He's very calm and quite small. Its funny the things you remember about people. I once worked in a hostel for homeless women, and one lady had webbed feet. Nobody had ever noticed before until I mentioned it. Anyway, I get a full 45 minutes going over my assessment information and discussing what I am willing to do in terms of recovery. I am a patient that is willing to go to any lengths for recovery. I have a husband and children whom I love and want to be emotionally, mentally and practically available for. Some patients do not want to take medication, or have therapy or talking treatments, or even engage with psychiatric services. Some are so ill that they can't do any of the above even though they would like to. Being controversial here, some people actually prefer being ill to being well. On some level it works for them as they get attention, people caretake for them and its easier than facing a long and arduous battle back to sanity. Recovery is hard work, sometimes painful and upsetting and takes committment. And courage.
Lets take a snap shot here about the term, Insight. Insight is your ability to see the truth of your situation, a perception and intuition about the reality of your circumstances. Throughout the whole of my journey I have had insight, even in the darkest psychotic moments. I have a gripped onto the distant reality and remained objective. Its been an absolute Godsend and I feel pathetically grateful for it. However, knowing whats going on with your thoughts doesn't stop them sadly. Knowledge is not power. If I had lost that insight, I may well have ended up in hospital, away from my family. That was not what I, my CPN or my psychiatrist wanted.
SO we have our chat and a am given a diagnosis of clinical depression and OCD, of the Pure O variety.
"‘Pure O’ [...] is a form of OCD that is distinct from traditional OCD in that it features no outward manifestations; instead, both the anxiety-inducing obsessions and the relief-seeking compulsions of OCD take place only in the mind. With ‘standard’ OCD, the compulsions manifest as physical rituals, for example excessive hand-washing, checking or cleaning. With ‘Pure O’, the compulsions manifest as unseen mental rituals, but they are compulsions nonetheless [...].An example of ‘Pure O’ would be a person who suffers with distressing blasphemous thoughts or someone who fears harming or abusing loved ones but does not engage in any overt compulsive rituals."(http://www.ocduk.org). Thoughts are just that. Thoughts. Doesn't mean you are an axe murderer just because you thought about it.
The problem is you believe that you might do it even though you really don't want to. The thoughts will always go against your value system, which is why it is so hideously anxiety provoking. Pretty much your own mind plays nasty tricks with you and induces enormous anxiety and fear. Its like living with a snuff video in your mind the whole time. Also, the lower your mood, the more aggressive the intrusive thinking. I'm told I need to increase my citalopram to 60mg (the maximum dose) as its proven to stop the mind horrors. He also suggests, after a period of stability that I attend cognitive behavioural therapy, and at some point possibly psychotherapy. He tells me I am going to be in psychiatric services for a while. "What's a while?" I ask. "3 to 5 years" he says.
I get back into my car and sob my heart out.