Hello, Alison Wells. Do you want to come and have a seat? Hi, I'm Dr Taylor, one of the GPs at this surgery.
What would you like me to call you? Alison will be fine. OK. So what's brought you here today, Alison?
My sister's... I'm just a bit fed up, really. Right.
My sister said I should come. Right, OK. Has this been going on for some time?
Yeah, a few months, really. OK. Do you want to tell me a bit more about what's been going on? I just think things seem to be piling up.
Right. Just... I just don't seem to be coping with things at home. OK.
The kids and things. Right, OK. Would it be OK, Alison, for me to ask you a few more detailed questions about how you've been feeling? OK. Well, if we start with asking you a bit about your mood, how have you been feeling in yourself?
I'd say a bit fed up. Wake up in the morning, everything just seems very black. Right.
Slight. It's just like swimming in treacle really. I just don't... I think by tea time, time the kids get home. I've been having a fairly decent conversation with them.
Right. And can I just check, Alison, when you say things feel very black, do you mean you feel very miserable? Fed up, miserable. Right, OK. And what about sort of feeling tearful?
Has that been happening? I dropped some sugar the other day and I just burst into tears. Right, OK.
Thanks. So is it the slightest thing that would make you feel tearful? Things that perhaps wouldn't ordinarily bother you? Yeah.
My sister's noticed as well. Right, OK. So you've been feeling very low in the episodes of tearfulness.
Yeah. What about other things? What about your energy levels? Are you managing to keep up with things?
I used to do a lot with the kids. We used to go swimming, play, but now I just spend the day on the sofa really. I still have to go to work.
And just remind me, what is it you do for your job? I work in the supermarket. So how have you been managing at work?
I've not been going in as much because I just feel so exhausted. But, I mean, we're just not... The supermarket's been taken over and they've cut the wages.
Right. And I've had problems with the bills. Right.
And it's like catalogues. writing me letters. You know, the kids, they want all these new games and stuff.
It's just, you know... It's just, I think things are really difficult all round. With all this going on, how are you sleeping, Alison? It takes me ages to go to sleep.
I used to read a book and just drop off. But now I just spend my time looking at the clock. It just goes round and round.
off to bed and getting off to sleep, how long is that taking? A couple of hours probably. Right, okay. Once you're actually asleep, are you waking up much during the night? I wake up about, last night I think it was about 4 o'clock.
I wake up. And can you get back to sleep from that time? No, no. And then when you're actually getting out of bed in the morning, are you still feeling tired at that point? Just exhausted.
I feel like my brain's not been switched off. Right. I'm just exhausted the next day.
OK. What about eating? What's your appetite been like while you've been feeling like this?
I used to have quite a weight problem, but the last couple of months, I mean, it's just a bit looser. Right. Right. I just... Do you know how much you've lost?
No, no. The kids come in from school and they make their own stuff and I just don't bother, really. OK, OK, so your appetite's gone down as well. What about things like concentrating in your memory, both when you're, I don't know, watching TV at home or when you're out doing your job? How have those things been?
I've been pretty useless with the kids. I've got the swimming money last week. Right. PE kit.
parents even even right okay well just Start one job and I'd like to... I'm not explaining myself very well. It's like the television. I used to like watching the soaps.
EastEnders or something and now, ten minutes later, I'm just, you know, thinking of something else. OK, OK. And what about things, Alison, that you used to enjoy? Are there things in life that you still enjoy at the moment? Nothing, really.
As I say, a bit useless with the kids. I used to enjoy going out. Right. I used to go out with my friends for pictures and things.
Right. But, of course, now I just can't be bothered. Is it you can't be bothered or you don't feel like it as well?
What's the point really? Right, okay. You know? And I was going to ask, how old are your children now?
I had them a bit later in life. It took a long time for me to have them. Right.
I've got a girl and a boy. One's 11, one's 9. And looking after children takes a lot of time and energy. How are you managing to keep up with that, feeling as low as you do? Well, they're a bit self-sufficient really, the kids are. They're coming from school, getting their own tea.
Right. I should be doing more for them, really, but no, I'm just a bit useless at that at the moment. And what about looking after yourself?
Well, you can see I'm just a mess. Dave used to say that's my boyfriend. I used to, you know, not have much money, but I'd just take a bit of pride in what I was doing, you know? Right, OK.
And my hair and stuff, but I can't... I can't... bothered with that now. There's no point really.
And you mentioned Dave, that's your current partner. How long have you and Dave been together? About a year I met him at work. Right.
And how are things, because often when people feel really down it has a real impact on everything, including their relationships. How are things between you and Dave at the moment? He's not ringing as much.
He used to text. He's going, you know, he's getting fed up with me not wanting to grow. Right, OK. And things. It's a slightly embarrassing thing to ask about, but I guess it's important.
Often when people are really feeling very low, it affects every... and their relationship including things like the sex life. Have you noticed any changes there for you? It's always trying to pressure me a little bit and stuff but I'm really not into that at the moment. You just don't feel like that at the moment?
No. So can I just recap, Alison, and check I've got this right. For the last few months you've been feeling really down, no energy, problems with your sleeping and eating, problems with concentrating, not really enjoying things and actually struggling a bit with the kids and perhaps some difficulties in your relationship with Dave. Have I got that right? Mm.
OK. Can I ask Alison, in the past have there ever been episodes when you felt like this? When my husband left.
I was always crying then for no particular reason. Right. I haven't told anybody this before but I took some tablets.
Right. So how long ago are we talking about? Is this a few years ago?
About four years ago. About four years ago. OK, so you took some tablets. Yeah. Is it all right to tell me a little bit more about that?
You know what it's like? The kids are in bed. Mm-hm.
And you're on your own and I had a few glasses of wine. Right. And I just took these tablets. Right.
OK. Can you remember what you actually took at the time? What sort of tablets there were? I just did the bathroom cabinet. A little paracetamol.
Right, OK. So you took some paracetamol. Can you remember roughly how many you took? It was two strips, about 12. Right, OK. And you'd had a couple of glasses of wine.
Did you take anything else, any other tablets with it? No. OK.
And was this something, Alison, that you'd thought about for a while? Or was it something that was quite a spur-of-the-moment decision that evening? I mean, crying a lot, but... I think just wine. Right, OK.
But, you know... It's a bit of a burden to everybody, really. And was there any other things that you did around the time?
Sometimes when people take tablets, they leave a note or do other kind of final acts, get their affairs in order. Did you do any of those things? No. I just thought I'd take the tablets and go to sleep.
Right, OK. So did you have any thoughts about what taking the tablets would do? Did you...? No.
I just thought I'd go to sleep and not wake up, but I woke up a couple of hours later and I was sick everywhere. God, I was sick. Okay.
So you actually, if I just want to check I get this right, because it's important, you actually thought they would kill you at the time? I just didn't want to. wake up. I'm just a useless mum now and I was then. Right, okay.
So you took the tablets, you were very sick in the night. Did you seek any medical help at the time? No, no.
Okay. then you were okay the following day? Well, yeah, I just felt a bit of a twit, really. Did you feel pleased that you were still alive? Yeah, I think, you know, I realised it had just been silly.
Right, OK. So that was a few years ago, so if we just come back to how you're feeling at the moment, you've talked about feeling very low, have there been times currently when you've thought about either taking an overdose or doing something else to harm yourself in any way? You know at night when you're watching the clock and you know you're on your own, the kids are in bed. It's just everything is so hard and yeah, I suppose, you know, it just feels easy, you know. Right.
And has that just been something you've thought about? Have you actually made any plans, got any tablets in or done anything else? No. No, none.
and I guess it's a difficult question to ask but one we would ask everybody in your situation have things ever been so bad you felt so low that you've not only thought about harming yourself or perhaps killing yourself but you've also wondered whether the best thing might be to take the children with you. Oh, I've never done that with my kids. I love my kids. OK, OK.
No, I wouldn't hurt them. OK. No. And what about the other side of that? Positive things, the sort of things to live for?
Things that you feel good about? Not much at the moment, I suppose. Kids sometimes, you know, they do things that make you think, you know. I don't know what's good about life and things. And are there other things that help at the moment?
I'm thinking about people who can be supportive. My sister, as they say, she said to get down here, and she's always there. She comes down, rings.
Got a couple of friends. They're quite good. Right. And Dave, when he's in the mood, of course. Sure.
But I don't think he's going to be around for much longer. Right. Do you think, or do you feel able to keep yourself safe at the moment from hurting yourself? I think so, yeah.
I know I can come here now. You've been very good today. OK.
Do you think if that was to change so that you didn't feel you were able to keep yourself safe, you'd be able to let anybody know? Well, I know what happened last time, that was nothing, and I know I was silly then. So I know to come here. Right.
OK. Okay Alison, well thanks for going through all that, I can appreciate it must be very painful. It does sound to me like you are suffering from symptoms that strongly suggest that you're actually depressed at the moment. Now I'm not sure how much you know about depression. Not much really.
much but I know I just don't feel right at the moment. Well I guess just briefly depression can cause a number of problems for people and traditionally we think about people feeling very low and very miserable and often you know thinking about hurting themselves but it can also affect all other areas of life in terms of problems with eating and sleeping and the other problems you've noticed is that concentration and perhaps not really managing as well as normal I guess the positive side is that you've done something about it and you've come to talk to me about it today and I think there are almost certainly a range of things we can put in place to help you and treatments that are available so I guess what I'm thinking was it might be worth is just spending a few minutes just thinking about some of those options for you so that we can start to improve things for you. Would that be alright with you? I need to do this, yes.
I think it's sensible, yeah.