"Medication change request not supported"

I went to ED as I was experiencing distressing mania/hypomania symptoms where my cognition was impacted including memory, concentration, disorientation to environment, appetite (loss of) and I was not safe to drive so paid for a taxi to SCGH in the hope of support.

I showed the Triage Nurse the letter my Psychologist had written for this purpose. I had discussed going to ED as an option with my private Psychiatrist and Psychologist, they thought this was a good option for any mania-like symptoms. I had tried some coping strategies on this day but they could not get me ‘balanced’. This all led to the ED visit.

I waited an hour (no ID tag as this was somehow forgotten). I then went to the bathroom and could hear my name being called. I went out and asked a Nurse if I had been called and was told that I hadn't been called yet. I then continued to wait up to the 5 ½ hour mark, at this point I started to feel slightly (not fully) better. I asked the Nurse in the waiting area if I should/could go home. Turns out I was taken out of the system for not being there when called!

I was still eager to see a Psychiatrist given I had waited this long and would possibly experience the same distress the next day, I made it clear I was worried it could happen again. I was not offered any support to prevent this happening again. I feel I should have been able to discuss the factors leading to mania symptoms including stress, caffeine and lack of sleep to then prevent it reoccurring. The on call Psychiatrist told the Nurse they did not want to mess with my medications, even though my Private Psychiatrist only works one day per week (I cannot access Psychiatry support on other days). I was also told I would not be able to see the on-call Psychiatrist that night.

Apparently, in my experience, the only important thing at SCGH is that you are ‘safe’, not whether you are experiencing distressing mania/hypomania symptoms. I know these were related to mania/hypomania as I had already talked about most of them with my Psychologist.

After this visit, I self-adjusted my medications because I was so distressed. I am on an antidepressant (for anxiety) and antipsychotic (for mood stabilization) and decided myself I would stop the antidepressant (which can worsen my mania symptoms) and took an increased dose of the antipsychotic with no medical supervision. I also feel these types of experiences (at ED) worsen my suicidal thoughts, when I went to ED these were not immediate but were still in the background and were made worse by my distress at this experience.

I am hoping something better can be done for the next person with bipolar who needs to attend ED.