Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Recovery, Scoring and ESA…

with 8 comments

It’s been a strange week really. I seem to have spent the week being confronted with the fact I’m still a lot more ill than I thought I was.

On Wednesday I had an appointment with Dr B. He’s another GP at my local practice and as Dr N is on holiday for two weeks I had to make do with him. He’s okay, but a little brisk. Every time I’ve seen him he’s made me do a PHQ9 form to assess my levels of depression. It’s similar to a BDI I guess, but with fewer questions and less detail. My score was in the twenties (out of 27), putting me in the severely depressed category. I knew I was still depressed but I’d kinda expected it to have moved into the moderately severe category by now. I do feel better than I did back in February. The depression is less absolute, but I can’t deny that I still think of death and suicide every day, I’m still not sleeping and I still feel pretty tired and down.

For curiosity’s sake I did a BDI as well. I ended up doing it twice as I find it so difficult to decide between answers. My pessimistic score (choosing the worse option if I couldn’t decide) was well over 50. My optimistic score (choosing the better option) was about 45. 30+ is classed as severe depression so it’s a pretty similar result to the PHQ9. It’s a vast improvement on the 60+ (out of 63!) I was scoring in February. I racked up one of the highest scores ever seen at The Priory back then, which is pretty scary really. The improvement is not enough though. How can this be recovery if I’m still in the severely ill category?

I don’t know if I am really severely depressed though, even if my scores say I am. I have been depressed for so much of my life I’m not sure if my results are skewed. I expect even when I’m what I’d describe as well, I’d still be scoring a mild depression score at least.

I was talking about this with a medic friend last night. We were talking about the GPs in the village and I mentioned I’d seen Dr B. She asked me what he was like and I basically said he was okay, but he asks me to do the PHQ9 whenever I see him. She said that GPs are obliged to demonstrate they are giving “adequate monitoring” to depression patients and the PHQ9 counts towards this. It’s interesting as I don’t remember ever doing one with Dr N. I guess he prefers to give adequate monitoring with actually asking me how I am, rather than getting me to select ticky boxes.

I mentioned my scores and how I wasn’t sure how accurate they were. She suggested that sometimes the scores can be a little skewed by insight and they often don’t reflect how well someone is functioning, which seems fair enough I guess. She said I’m clearly functioning a lot better than my scores suggest, which I think is true, but I guess that comes with years of practice in hiding things. I function in autopilot, hiding the thoughts, but the thoughts are still there.

To add further doubts to my idea of recovery I got a letter from the ESA decision maker yesterday. They are finally processing my application under the youth rules and the decision maker has sent the sheet explaining how much I will receive. Looking at it, I’m being paid the amount pertaining to the Support Group. I presume this means they have my medical result and not only have I passed, but I am deemed too unwell to even contemplate work and thus have been placed in the Support Group. This is a big surprise. I had worried so much that I wouldn’t even pass the medical, let alone be placed in the Support Group. I haven’t received the letter confirming my medical result yet, so I wouldn’t be surprised if this is wrong, but it shouldn’t be. I will be interested to see what score I actually received. Another set of points telling me how ill I am.

I don’t know how I feel about being in the Support Group though. In a way it is positive. It means I don’t need to do the pointless Pathways to Work interviews and I also get a little more money, which of course is good. It means there is no pressure to try and get back to work before I am ready. I will not be bullied by the DWP to do so.

At the same time though I can’t help but feel disappointed. I feel like I’ve been written off. I am too ill and disabled to even consider working. That’s something I can’t handle and really don’t want to admit. I want to get back to work and I want that to be something achievable in the near future. It makes me feel like this is all pointless. I want to be recovering and this makes me wonder if I really am. I had felt I was making progress, but that progress is clearly not enough. This is all just fuelling the “fuck it, this isn’t worth it” thoughts. I don’t want this.

I’m a little worried too and I almost feel guilty. I wonder whether this is the right decision. I kinda feel like I have cheated the system because I didn’t expect to pass the medical. I know how notorious these medicals are. I know that hardly anyone passes, let alone gets placed in the Support Group. I wonder why I have got through when so many others haven’t? Am I really that bad? I know I can be in denial and I guess in a way these doubts show that, but I am still unsure. It just feels a little wrong.

I wonder if this process is designed to make you feel guilty? There is such a stigma against incapacity benefits, that you feel awful to be claiming them, yet if you are entitled to, it would be stupid not to. There is so much attention paid to people that cheat the system that genuine claimants worry they will be tarred with the same brush. I had no intention of cheating the system and I didn’t do anything to do so. If anything I down played how bad things were. There was no exaggeration, yet I feel like I have cheated. Surely this is wrong? Surely I should just be glad that the right decision has been made? Yet the doctors at Atos have such a bad reputation I even question a positive decision.

8 Responses

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  1. I think for now it’s positive, it means you can concentrate on getting better and like you said, you won’t have to keep attending ‘pathways to work’ thingies. I can understand it feels like being written off, though… X

    Kate

    Monday, 9th November 2009 at 1:52 am

  2. I have no idea how the ESA works since it all came into force after I was already in receipt of IB but I’m in agreement with Kate at least you are secure in getting what you are and not having someone on your back mithering you about attending things to force you back into work when your not 100% ready, that’s one thing I never did like the sound of about ESA from what I’ve heard from others and what I’ve seen on TV.

    Which reminds me I still need to pop into the job centre and tell them I have found a voluntary job, all 2.5 hours once every two weeks!

    Take care of yourself x

    Alison

    Monday, 9th November 2009 at 8:07 pm

  3. Alison & Kate – Thanks girls. It is positive, but I guess I’m just a little shocked. I haven’t really heard of anyone getting into the Support Group before, so for it to be me is a surprise!

    intothesystem

    Monday, 9th November 2009 at 11:22 pm

  4. I’m glad you got ESA without having to appeal.

    DeeDee Ramona

    Tuesday, 10th November 2009 at 6:36 pm

  5. Definitely don’t feel guilty! This sounds like an example of the system working as it should. You say you know you’re not able to work at the moment, and it’s only right that you should be allowed the time and support to recover rather than being pressured or hassled (which only makes depression worse).

    Hope you don’t mind this comment from a stranger who wandered by.

    BoB

    Friday, 13th November 2009 at 5:55 pm

    • Hi BoB,

      Thanks for the comment. I know I shouldn’t feel guilty, but I can’t help it. I guess that goes with the constant media pressure on people claiming incapacity benefits. I had a quick look at your blog and shall continue reading.

      intothesystem

      Friday, 13th November 2009 at 6:48 pm

  6. […] There is limited evidence to suggest that CBT works with Bipolar Disorder and severe depression (and apparently that’s what it is) anyway, but still they persist. Maybe if I just try that little bit harder it will? Maybe […]

    *Sigh*… « Into the system…

    Tuesday, 17th November 2009 at 1:19 pm

    • Hi last year I claimed esa for first time and was put into back to work group. I have just had another assment ( a year later) and have been put into the support group…my conditions have always been the same both years( the form I filled in I put the same things(and I scored 121 points) and for last 13 years…can I now ask them to look at my claim from last year, and suggest they put me in the wrong group , therefore I am entitled to the support group payment for all of last year back pay?

      Wendyjoy

      Tuesday, 27th July 2010 at 8:11 pm


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