Ask Nurse Jenn - Our Resident Mental Health Nurse!

[Sophie_M]

Hi everyone,

This is a thread for asking questions of our resident Mental Health Nurse, Nurse Jenn who pops into the forums regularly.

PLEASE NOTE as per our community rules, Nurse Jenn won't be able to answer questions about medications, these are best discussed offline directly with your mental health professional.

BEFORE YOU ASK NURSE JENN PLEASE CONSIDER THE FOLLOWING POINTS:

• Nurse Jenn’s time is limited! We cannot provide an ongoing dialogue with Nurse Jenn in this thread - one post/question per person please
• We'd recommend you have a look through the forums before posting here to see if your question has already been answered by Nurse Jenn, our other members, or if there's information about it already on the beyondblue website.
• If a question pops up that has already been answered previously, or if alternate resources are available, one of our moderators will reply and direct you to the link.
• When writing your question, imagine you are speaking to someone in person i.e. provide a clear and detailed post with enough information that outlines how Nurse Jenn can help you.

Background

From Nurse Jenn

Long ago I was struggling to find my way in my career. I was training to become a registered nurse and I didn’t seem to fit into the traditional ‘medical model’ of delivering care.  Then I started my mental health rotation and I found my place in helping others. I am now 45 years old and have been in the mental health field as a nurse, manager, educator, project officer, advocate… for over 22 years across several countries and cultures (Aus USA Canada NZ).  I have experience in a number of different child and youth mental health teams, early psychosis teams as well as adult and older adult hospital settings. I have also worked as the manager of the beyondblue NewAccess program and understand what it’s like to live regionally where services can be limited. 

Working with people around the globe has made me aware that worry and stress do not know age, culture or country. It is a phenomenon of being human. I have felt it myself in different periods of my life and seen struggle it in loved ones and people everywhere.  I have felt the traumatic loss of a close friends death by suicide (as so many have) and recently experienced the extreme joy of becoming a mother.  

I am thankful everyday that I can walk beside people who need some support to find their own balance and strength. I am very grateful to be here on the beyondblue forum with all of you.

I hope that my professional and personal experience can provide you with some support, direction or even just an acknowledgement that what you are going through is real, and tough, and that you can achieve more than you know.  

[Beetle]

Hi Jenny

I cant find anything about inpatient treatment in private hospitals.I suffered a Traumatic brain injury 10 month back which led to severe depression and anxiety. I am on meds. I struggle at home as my brain injury limits me so much. I cant drive,work, shop,go out, exercise or do fun stuff. Household and garden is really hard to keep up with.Brain shuts down.

My Psychiatrist suggested an inpatient treatment in a private hospital.( its under work cover)

I am not that keen as I know once I am back the house and garden will be a mess and it takes me weeks to organize that all. I only have been in a public MH hospital. It wasn't too bad but very noisy. What do they do in a private facility? Just give you meds? I am no good with groups and heaps of people due to my braininjury ( sensory overload) I wonder if they can do anything for me there? Do you have any experience in that department?

Thanks so much

Beetle

[Nurse_Jenn]

Hi Beetle,

Great that to see you reaching out on the beyondblue forum for support. Your question is a tricky one as not all healthcare facilities, inpatient wards or private mental health wards are the same. I have been employed in both private and public and have had positive experiences with both and have also seen both types of facilities require some improvement.

Private facilities do not usually accept people who are under the Mental Health Act, at least not for very long. What this generally means is that all the people who are there are 'voluntary' and the facility has less acute people. This results in the focus (from what I have seen) to be more on therapy and treatment rather than stabilisation of crisis. Also people who attend the facility have to pay so it is quite different than a public facility in that the grounds are often better kept, the food is a bit more upmarket, people have their own rooms and televisions and it is generally quieter. In my experience a private facility has felt calmer in its overall vibe - though I have only been employed in a few.

There will been different approaches to therapy at each centre but in one facility I was employed there were different therapy tracks. This meant that there was a day program for people with anxiety, a different one for people with substance use and a yet another for people with mood issues. The programs were diverse with some activities being didactic groups (talking) but others were behavioural activities such as gardening or mindfulness. I also know that many of the people who were admitted were able to take leave fairly regularly to attend to pets, gardens, visit family, go out for dinner, etc. There are some activities that are just social that you have the option to attend. You still have a nurse assigned to you that supports you each shift that supports medication management, physical health issues, assessment of symptoms, etc.

My suggestion would be to do a facility tour prior to accepting an admission. I am certain that this can be arranged or at the very least, discuss the facilities program with the Nurse Manager or Site Manager. You may then gain a clearer picture of the centre your Psychiatrist has recommended and can make a more informed decision. Another thing to consider is that you could try the facility for a few days and if you don't like it, you could discharge yourself.

Wishing you the best possible outcome,

Nurse Jenn

[jessrobb]

Hi Jenny,

so when I was in high school I found it really easier to talk to my school counsellor but now that I'm older and have been out of high school for a couple of years I have found it very hard to ask or talk to my parents for help when I need it. At the moment I would like to go see my GP to start talking about getting some help but every time I think or go to ask my parents for help I get too anxious and can never get the words out/ approach my parents. The other issue is that I'm not working at the moment so I don't have the money to go see my Gp, so I kind of have to ask my parent.

Thanks

[Nurse_Jenn]

Hi jessrobb,

Welcome to the beyondblue forum. It is great to see you are reaching out here for support. You have identified some issues with worry and feeling anxious about discussing with your parents that you are needing extra support. I want you to know that this is 100% normal. Bringing up to your parents this sensitive topic of needing help can make you (or anyone in the same situation) feel vulnerable.

I have a few suggestions that might help you get the support you need so you can get to your GP.

I wonder if you have ever contacted the Kids HelpLine where you could talk to an operator about the stress of discussing your mental health with your parents. Sometimes by just talking to someone, even once can help you find the strength you need. The number for the Kids HelpLine is 1800 55 1800 and their motto is Any time. Any reason.

Another suggestion is to contact headspace. You can read about headspace by going to this website www.headspace.org.au

By going to the website you can find the closest centre to you or use the e-headspace tool. Headspace is for young people 12-25 and focuses on mental health care in a way that is accessible for young people. You may have heard of it but if you are really delaying getting treatment due to cost and not wanting to discuss issues with your parents, you can go to a centre and make an appointment. There are counsellors and Doctors there however sometimes there are waitlists.

Telling your parents may result in relief once you get over the obstacle. Obviously this is easier said than done. You could try writing a pros and cons list of what the outcome would be if you talk to them. Chances are the pros would outweigh the cons. Perhaps you have another close friend or family member that you trust that you could talk with? Could they then help you bring up the subject with your parents?

Another option is that if you can’t talk with your parents to get support, you could find a GP that bulkbilks so you don’t have to pay the appointment fee.

Getting help sooner rather than later can be really important so things don’t get out of control. If you do feel things spiraling in the wrong direction and you feel unsafe contact 000 or Lifeline on 13 11 14.

It sounds like you want to bring your parents into your support circle and finding the strength to do this can be tough but worth it, especially if you get on a positive path to healing and wellness sooner than later.

Wishing you the best possible outcome,

Nurse Jenn

[Sblogger]

Hi Nurse Jenn,

After 8 years on antidepressants I’m now down to 1 tablet every two days under the guidance of my doctor. Unfortunately I am suffering back side effects from withdrawals. Mentally perfect feeling great but those shakes, vomiting and dizziness I’m feeling are taking a toll. I took 2 weeks Annual Leave as that’s all the entitlements I have (no Sick Leave) so I need to go back to work next week, are there medicines doctors could prescribe me for my bad days to help me survive working? As not going to work is an option. Or would doctors prefer not to medicate

[Nurse_Jenn]

Hi Sblogger,

Welcome to the beyondblue forum. It is great to hear that you are working closely with your doctor to taper down your antidepressant medication and that you are feeling mentally well. I am sorry that you are experiencing such pronounced side effects. I know from my experience that coming off antidepressants can be really tough for some people. Hang in there. These side effects don’t usually last.

I would definitely suggest going back to your doctor for a review if they are so pronounced that you are feeling unable to return to work. I cannot say what your doctor will decide in terms of best management or if they will prescribe you additional medication to help combat the withdrawal effects. What I can recommend is to keep a daily record for a few days of the side effects your experiencing...ie. what time of day they occur, what the side effects are, what you were doing etc. This will help your doctor understand exactly what you are going through when you have your appointment.

I also wonder if your dietary intake, activity and fluid intake might be recorded to see if there is any correlation.

I know many others have had experiences coming off antidepressants and I encourage you to search the forum using the search feature.

Please post and let us know how you go with your GP.

Wishing you the best possible outcome,

Nurse Jenn

[Luna_Eclipse]

Hi nurse Jen,

Ove been struggling a lot lately and I go to the drs every single day. Last night I was trying to relax listen to music to fall asleep then all of a sudden I felt this cold numbness in my head that trickled down into my face and my whole mouth and tongue went ice cold numb all they way down to my stomach. Then my heart rate went crazy! Ended up at my local urgent care. Nurses checked my blood pressure heart rate and did a ecg and dr told me it was just a panic attack that nothing is seriously wrong with me. The problem is by the time I got home it all came back again and today I’m still having the symptoms of the cold mouth and stomach. I went to my local GP who did all the same tests and everything is normal. I had full blood work done and everything was normal. Is it really just panic out of the blue?

[Nurse_Jenn]

Hi Luna Eclipse,

I am sorry to hear you are not getting clarity on your symptoms. This experience sounds really distressing and must be very uncomfortable. Be kind to yourself during this period where you are figuring out what is going on for you.

I am not able to do any type of diagnosis but it is really good to hear that your investigations by your GP have come back normal.

If your symptoms are related to a panic attack I am curious as to what type of treatment options your GP presented you with? For example, did you get a referral to a psychologist to help learn strategies to deal with the panic or were you prescribed any medication. (Or are you on some already?)

One activity to start completing that can be helpful is writing down what has been going on for you just before the symptoms you are describing ie. what did you eat, what time of day, what were you thinking about, was there anything to cause you stress etc.

This record can help you and your health practitioner get to the bottom of your symptoms and start identifying triggers.

If your symptoms continue to cause you distress I wonder if you tried to self manage through them by deep breathing or distraction, calling a friend or someone you trust. It is often through trial and error of different strategies that we find relief. You could also call a support line such as the beyondblue support line on 1300 22 4636.

Another option would be to get a second opinion and see a different GP.

Panic attacks can be very overwhelming and cause many people to end up in the Emergency Department. You are not alone. It is important to get assurance that your symptoms are panic related and not something else. If you are not confident this has occurred, continue to seek advise from a health care provider.

Wishing you the best possible outcome,

Nurse Jenn

[Sueetties]

Hi Nurse Jenn,

I started taking an antidepressant in Aug last year and have since been seeing a psychologist as anxiety and depression knocked my door. I have been doing regular exercises, eating clean, practising thought challenges etc and I have recently completed the Wellbeing course from Mindspot. I found that the course is very helpful and my anxiety and depression symptoms have greatly reduced and I generally feel good.

Two weeks back I went to see my GP and I told her about feeling and also I told her honestly that the psych I have been seeing isn’t helpful at all but she didn’t comment. I did the K10 test which I scored 12. The dr therefore agreed that I could wean the med and she suggested the below weaning plan:

Week 1 reduce to 1/2 dosage; week 2 take only every second day; then cease altogether.

I am in week 3 now but I am still on a 1/4 dosage. So now i do not know if I should continue seeing the current psych or just stop completely. I am worried that after I cease the med and stop the counselling altogether I may fall back to the rabbit hole as I won’t have any supports.

I guess I just want to see from a professional view how to maintain my well being and prevent the symptoms at bay. Thank you.