I’d been hearing for a while that getting help with mental health could be difficult, but I had no idea how difficult until I really needed help myself…

My Black Dog was back. (image from ‘Black Dog’ by Rachel Howard)
My Black Dog was back. (image from ‘Black Dog’ by Rachel Howard)

For those who’ve been following me for a while you’ll know that I’ve not been the happiest of chaps for some time, something that was really highlighted following the demise of my most recently long term relationship. I went from general malaise into full blown depression, something I’d not had to deal with since I was a teenager. The black dog was back.

The break-up in February sent me into a downward spiral. Instead of looking forward to the future, I started looking in and I didn’t like what I saw. I was a thirty year-old gay HIV positive divorcee living in a friend’s spare room. How attractive.

I stopped eating properly, I stopped looking after myself, I stopped getting out of bed – but it wasn’t until I realised that I’d stopped taking my HIV medication that I realised I wasn’t well. That really freaked me out.

Being fairly clued up on how services are configured in my area I reached out to a local self-referral Mental Health service called ‘Health Minds Birmingham’, provided by Birmingham and Solihull Mental Health NHS Foundation Trust, via their website. A week passed. Another week passed. I called them several times and left messages which I was told they would get back to me about. Another couple of weeks passed. No one called.

I felt so abandoned, so alone. If I’d presented at any of the hospitals with a broken leg, a nasty rash or even a persistent cough I’d have been seen sharpish I’m pretty sure. But a perpetual feeling of depression, anxiety and dark thoughts are something I had to deal with on my own, apparently.

I vented some of my upset around the inaction on twitter where thankfully a nurse at my HIV clinic, Jay, follows me. He signposted me to their in-house counsellor, who after a couple of week’s wait was able to fit me in to her schedule.

She has been great, she’s helped me to see that a lot of my problems have actually been going on for years if not decades, especially some of the issues around self-worth, self-belief and a propensity for self-sabotage – all of which feed my anxiety, depression and possibly even my insomnia. It was suggested at our last meeting that I start on a low dosage anti-depressant, Mirtazapine.

Now, I have nothing against anti-depressants, they are a great tool, but my experience of them when I was younger was far from fun. They made me feel worse, they gave me mood swings and they stopped me having sex. So naturally I was less than eager to jump on that particular ship again, but having just found out I keep self-sabotaging myself I went along with what my counsellor suggested and booked an appointment with my GP.

Booking the appointment was difficult enough, but it was nothing compared to the actual appointment itself, jeez.

It was an early morning appointment, and anyone who’s had depression will able to tell you that mornings are some of the most difficult times of the day. Finding the motivation to lift your head off the pillow, talking yourself out of bed, dragging yourself into the shower. I managed it all, and got to the GP surgery early, I didn’t want to miss the appointment (hello anxiety, nice to see you).

Sat there in the waiting room I was staring out the window, watching the traffic, trying to form the words in my head. How do I tell this person I’ve never met how I’m feeling? How do I help them understand? I don’t want to harm myself anymore, but I just feel sad and anxious, will they take me seriously? The GP (a locum, we don’t have regulars anymore) opened her door and shouted “HAYES”.

I walked in (do I smile? Is that too cheery? I don’t want to be rude. Should I look sad?) and sat down. I was immediately greeted with a grumpy faced GP and the phrase “So what do you want?” in an exasperated tone (hello to you too). My heart sunk. I can’t open up to this person, and they sure as hell don’t want me to open up to them either.

I explained I was seeing an NHS counsellor and that anti-depressants had been mentioned, specifically Mirtazapine. She looked at me for a few moments and asked if I had a letter, I said I did not but gave contact details for the clinic if she needed to check. She looked at me for a few minutes more, tapped away on her computer and handed me a prescription for Mirtazapine. More awkward silence. Apparently this was my cue to leave.

So here I am, at home, with a box of anti-depressants, prescribed by a GP who didn’t want to know or care. I wasn’t informed of any side effects, they weren’t checked whether they were safe to be used alongside my other medications (I’ve checked myself), I wasn’t given any follow up plan, I wasn’t told what to expect whilst taking them. To all intents and purposes a woman I’ve never seen before in my life gave me a box of mystery pills.

Some people are going to (and have already) told me “But GPs aren’t mental health specialists” and “GPs only have five minutes with you”. Yes, I know, I understand that. But you don’t need to be a specialist to have basic knowledge, to have compassion, to give someone who’s anxious and depressed a little information and reassurance.

Every step of this journey trying to take control of my mental health has been difficult and painful. From trying to seek help and being ignored, to being bounced between counsellor and GP, to today’s frankly unpleasant and confusing GP appointment and walking home with a box of mystery pills.

We all deserve help when we need it, we shouldn’t have to be masters at navigating different services commissioned by different trusts for different key populations. If I turned up at one hospital with a head injury I wouldn’t expect to be told “Sorry, we’re not commissioned to provide treatment to your community group, try this other hospital nowhere near you”, then that other hospital ignores me, so I have to find a third hospital I’d never even heard of, who then sends me to my GP anyway.

It’s time the UK got on top of it’s problems dealing with mental health. It is an illness, an injury, just like any other.

People with mental health problems, people like me, deserve better.

Tom Hayes (you can follow Tom on twitter as @PositiveLad)

If you are dealing with depression, or thoughts of self-harm or suicide please speak to someone. The Samaritans are there 24 hours a day, 365 days a year on FreeFone 116 123, or email

Tom Hayes


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