Thursday, June 23, 2011

why i have a love/hate relationship with psychiatrists

flailing in the wind

so many people
are just not connected
to anything
they just throw their arms up
and blow/go
in the direction of the wind
and it works for some people
i have never had that luxury
my mind
always wanted so badly
to act on the things it conceived/
my emotions/illness
always got in the way
but i fought/
      i fought and still fight
tears/frustrations/warts
and all

i just
long for a time
when
tears don't threaten as often
and the fight is not so hard

but then in my heart
i know
it's a fight
till the bitter end
illness or no illness
-jaa

When I was young (20's), I used to refer to psychiatrists as vermin because I had been so callously treated by them at that time. In time, I realized that regardless of how I was treated, they were all I had to work with.

This entry explores my thoughts and experiences only. I can only comment on what I've been through.

By the way, I'm african-american if you haven't figured that out already. When I was younger, I thought this had something to do with my treatment. Also, in my fiercely psychotic state, I felt that white men should not be messing around with black women's brains. I told my parent's that I wanted a black psychiatrist. They could not find one where we were. The fact is there are only about 2% of psychiatrists in the United States that are african-american. This really got me down at the time.

There's a lot to be said about self-advocacy, when seeking treatment for a mental illness. First of all, God help you if you're too ill and have no one to advocate for you. God help you if you're left to the care of some psychiatrists in this state or any other. You will learn quickly that substandard care (especially in private practices if you have a severe mental illness) goes to the meek. When the treatment is not working, you have to make a lot of noise.

This is because some psychiatrists treat in this way. They will diagnose, prescribe and if it doesn't work for you, they blame you. Their stance is, "I prescribed this, therefore you should be well." I call this "the psychiatrist as God syndrome."

Then there are others, especially in private practice, who herd us through five minutes at a time, regardless of if you have a problem that hasn't been solved. They have to make payments on that Lexus. If you require more than five minutes, you need to go to acute care, take a leave from work or if you complain too many times within the auspices of the five minute framework, you need to be on disability.

I had one psychiatrist that prescribed nothing but Xanax, and kept me coming back every week. I was very ill at the time and neither my parents or I knew that this was not a treatment for schizophrenia, which was my diagnosis at the time. Now I know it only masked the symptoms. My parents had been paying out of their pocket for a long period of time and buying my medicine, I had no insurance. So, I had to get Medicaid. I was swiftly dropped by this psychiatrist.

One psychiatrist prescribed hugging a tree as therapy, she didn't prescribe medication. Needless to say, I wasn't that "crazy"; I didn't go back after that. I knew that I was ill and needed medical care.

There was another female psychiatrist who only exacerbated my symptoms by giving me the wrong dosage of a medication. I only found out because I completely broke down in her office (something I hate to do in front of people) and begged her to send me to the hospital. I was working at the time and knew I was way too ill to function. She sent me to an acute care program and I found out from the doctor there.

Generally, I have found female psychiatrists a little more nurturing. Of course, there are exceptions to every rule.


The lady who first noticed my severe mood swings and prescribed Lithium which gave me a little relief was a nurturer. This lady turned herself inside out trying to solve my problem. She is one on my "good list." I define good as having a set course in trying to treat my illness and a little empathy. "After all," I would tell them, "this is my life we're talking about."

Another on the "good list" was a doctor I was assigned to at a community care clinic. I was 30 at the time and my onset was 20 and still no one could relieve me from my psychotic symptoms. I admire him greatly and am so thankful to him. He had a plan of attack. I felt that he sensed my concern for my life. He started at the beginning and tried every anti-psychotic except clozapine. He sent me to a teaching hospital first to see if they may have been able to help more. Clozapine was a bear to get used to. I vomited and walked around like a zombie for months. But, I tolerated it, I knew it was my last chance.

Another community setting was very helpful. When they could not eliminate my psychotic symptoms (the clozapine only dulled the voices and delusions enough for me to work for awhile), they enrolled me in a research program for Abilify. They are a branch of a medical school and I am still under their wonderful care. This was the last peice of my medication puzzle. In a year, I was free of psychotic symptoms. I was ecstatic. The only voice in my head was mine. I was 45. Yes, my story is a sad one, to me anyway. And these are just a few of my psychiatrist stories.

But, I have found, in dealing with a refractory mental illness, the squeaky wheel gets the oil and you need to change psychiatrists if one is not meeting your needs. I went to so many because I moved around a lot and went through many changes in types of health care payment, in addition to seeking better care.

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