help please

I have been treated for depression for about 10 years, and probably had it since my early 20`s (I am 45).

I have received antidepressants for the last 10 years and had counselling (which proved helpful for relationship stuff, but didn`t relieve the depression).

The anti depressants worked quite well in the early years. However they have only been partially succesful in the last 4 or so years. For example, I started dosulepin about 4 months ago after the citalopram stooped working. The dosulepin took about 6 weeks to `kick in`, worked for maybe 3-4 weeks, then the depressive symptoms reemerged about 5 weeks ago. I really crashed down about 2 weeks ago and started buproprion.

The crash down this time is the worst ever. I have spent 10 years getting my life sorted, gaining a professional qualification, and going in to business. I really felt extremely suicidal this time, and still have daily thoughts. I have been to my GP and convinced her to send me to a psychiatrist for assesment (local CMHT).

My view is this. I do not want to commit suicide, but the pain is crippling. I believe in life, and am a humanist. I believe I deserve an opportunity to have my illness analysed and the best possible treatment options offered.

I have worked in the medical services and fear that the doctor will make a minor recommendation and send me back to the GP - fob me off in other words.

I would like advice please on how to be taken on by the psychiatrist, and perhaps referred to a specialist in intractable depression. I want to form a friendly relationship with the psychiatrist, but I know from experience that the `squeaky wheel gets the grease` so I am prepared to make noise. I do not have a death wish, but if I am to die then I will go down fighting (ie having explored the treatment options).

Sorry if this is a bit heavy for a post, but I am in a very bad place.

Any advice would be appreciated, particularily from Joel who has had a momentous fight to get some treatment options.

Thank you Linda, I know you think you mean the best, but it is very wrong to try and dissuade me from trying to get treatment, particularily in my fragile state.

We will resume our dialogue about the medical model at some point in the future, but it is not appropriate in a thread where someone is at a very low point.

I have come on here looking for a little moral support, and advice on how to approach the psychiatrist.

A psychiatrist will not offer coming off the drugs as a possible solution. The very nature of the profession today is to treat mental illness with drugs. I've seen shrinks myself and can testify that this is really all they do.
Linda.

Although when I saw a psych the first thing he did was to get me off meds, so this is maybe not true for all of them.
I think all you can do is to explain as clearly as you can how you feel right now and where you are at. I have found sometimes it helps if you make a list of all the points you want to say, or if you have written down something about how you are feeling, as the mind inevitably goes blank once you get into the GP appt and have 7.5 minutes which is not long enough for this type of thing at all.
I hope you are able to get the help and support you need
Take care