How to Deal with Your Psychiatrist

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The following is directed at those who have mental illness and are seeing or preparing to see psychiatrist (the meds doctor, not the talky doctor1.) If you’re not in the category, come along for the ride anyway to see how things work from the perspective of someone who’s had a lot of experience.

The first thing to note, as I did above is there are two types of doctors you may see for mental illness issues. Psychiatrists and therapists (I like to call the latter “talky doctors”, which is funny because they sometimes are not actually doctors.) Focusing on psychiatrists, we’ll call them “meds doctors” because that is unfortunately mostly what they are in the business of. They are there strictly to manage your medications. They often give you about fifteen minutes of time2.

This is not a lot of time. It’s taken me fifteen minutes to write to this point in the article, and only because I use a web service to title capitalize my headlines quickly and accurately3. But with the time issue, you’re just going to have to go in prepared and read to rattle off things quickly. That’s somewhat easy, just do that and bitch about the fifteen minute limit later. Or to me!

Beyond this issue, here is what I’ve gathered in my voyage through medication management, and how to best get the results you need and deserve. Note that by not taking an aggressive approach, no one else in the psychiatry universe is truly on your side. Yes, most doctors want you better. But they are running a business, and want you out the door with a script of some sort ASAP.

 

1. Write a self-assessment and make your doctor read it.

I cannot stress how much this will help both you and the doctor. Do this on your own, in your own words. I have an example of my self-assessment here. I wrote this, on my own. I purposely did not use a template or fill out a doctor’s self-assessment. You can do those things, but it is important to let things flow from your own mind only, unguided.

What did this self-assessment do for me? Well, it got my doctor and me to realize I have OCD, not the generic Generalized Anxiety Disorder (GAD) that every doctor before, and this doctor up until then, pinned on me. It uncovered what is now obviously a Very Big Deal in my life (I’m writing articles on it almost daily! Hey- you’re in one now!)

 

2. Do not accept medication that does not work fairly quickly.

For starters, it is important to note that a lot of medication given for mental illness comes with a disclaimer that it will begin to work within six to eight weeks. Six to eight weeks?! That is a very daunting and frustrating time period. If it doesn’t work, you’re where you started, just with months more suffering in your belt.

Guess what? This figure is bullshit4. Medications start seeing their effectiveness, or more importantly lack of effectiveness in two to three weeks. My doctor ran through a bunch of medications in two week sprints to see if they worked for me. Bless him, he did it right. Other doctors may not. But you are your own advocate! Do not let medication that is not working for you be “your medication” for too long. Insist your doctor change it if it is not working. And often.

I went through about fifteen or so medications until both the self-assessment led us to OCD (which led to an OCD-specific medication that works) as well as a bevy of anti-anxiety medications, most of which did not work, and were tossed after two to three weeks to try something else. Insist on this!

 

3. Do not be afraid to fire your doctor.

Look, not all mental health doctors are great. They are running a business first, all of them. The amount they care beyond that varies. I am very happy with my current doctor, but I have experience with many others that were not do good. This person is the gateway to (at least) medication to solve or lessen major life issues. This is not healing a strained muscle.

Many doctors just go by the book with very generic, almost templated, paths from diagnosis to medication. They are the conveyor belt type. Works well for cars, not so much the mind. And many will not take well to your following numbers 1 and 2 above.

But remember, you’re paying. You are their boss. You can fire them. It sucks, finding a new doctor is hard5. But again, this is your life. If your doctor is not solving your issues with medication, move on. Especially if they insist on sticking with medication that is in the “sugar pill” category for too long.

 

4. and 5. Be your own advocate.

(First, you may know by now I need five items for any list like this)

Getting quirks out of the way, I am combining these into two items because of import. And I fully admit it is a cliché. But it is not followed enough. And I would never get on anyone with mental illness for not being able to be their own advocate. We’re already weakened. We’re already at our limit on energy just making it from waking up to going to bed. But I’m not going to get all “inspirational quotes” about this. This is a hard-line issue for me. Be on your side. Be selfish. Be a prick (well, maybe not out loud.)

DO NOT ACCEPT NOT GETTING BETTER.

 

It will take work on your part. I’m not at all fully better. Hence, I know it will also take a lot of time. And there are no guarantees. This isn’t a self-help article. Shit may fail and often and forever. But you’re going to live day by day anyway, with help (and it is only help) from a doctor. But I will reiterate:

DO NOT ACCEPT NOT GETTING BETTER.

 

1 My lack of belief in them is so unwavering that I don’t think there will be an article on therapists. Or maybe there will be. It’ll be short, that much I know.  [BACK]

2 I’m wordy. Can you imagine what my appointments are like. Go ahead and imagine it! A lot of fast talking2B.

2B We’re not going to get into a debate on our healthcare system in this article and why doctors all over limit patients to fifteen minutes, when we’re talking about their lives.

3 I still don’t know why it capitalizes the word “is.” I thought that would not be capitalized. Huh. Well, I trust the service.

4 Remember, I am not a doctor! Consult your doctor for any medical advice. This phrase and everything related to it is coming from my own doctor. I am not making it up. But again, I am not actually a doctor. Ok, am I clear of practicing medicine without a license? Cool.

5 And don’t get me started on waiting lists.