[For what it’s worth, psychiatrists #1-#3 were all disappointing. I liked psychiatrist #4; they would still be my psychiatrist had we not moved to another state.]
I recently had a first visit with psychiatrist #5 (a 90 minute consultation). My husband became a little concerned last month that I might be getting ill (after 20 years of being well) and so we agreed it would be a good idea to check in with a psychiatrist.
The psychiatrist gave me their professional opinion at the end of the consultation that I was not exhibiting symptoms of mental illness (mania or hypomania). I appreciated having that. They suggested I come back 3 weeks later to check in again, just in case, so I made an appointment before I left.
In spite of the helpful professional opinion, I was very disappointed with the psychiatrist in general. They are not the right one for me at all and so I will be cancelling the upcoming appointment. I will need to keep looking if I want an ongoing relationship with a local psychiatrist, but fortunately my husband now thinks there’s no urgent need for that.
I go to medical professionals for expert guidance and I listen respectfully. I also expect them to listen respectfully to me and what works or doesn’t work for me. It is my body, after all and my choice what medication to put into it. I always want to assess the pros and cons of taking medication rather than just saying ‘sure go ahead, prescribe it, I’ll take it”. I don’t like being told what to do; I like to be given information I can use to make up my own mind.
The psychiatrist had a list of questions to ask me which took me most of the session to answer. At that point they’d gathered the following information from me:
- after two acute psychotic manic episodes in 1996 and 2000 I have been off mental health medication by choice and have had no further episodes since then – in other words I have been well for over twenty years now and off medication for over eighteen years
- when my husband recently expressed concern that I was behaving the same way I did just before both of my manic episodes, I was blindsided. As soon as he said it I realized he was right, and I was quite unnerved, thinking “Wow, how could I have not noticed that myself?”
Based on that information the psychiatrist then opined along the following lines:
“Because you’ve been lucky and not had lots of manic episodes, you haven’t had the opportunity other Bipolar people have to learn what your triggers are or the incentive to avoid being manic. So you have poor insight – but fortunately you have a husband who notices when you’re getting symptomatic. It’s good you can trust him for that.
They were right about my husband. In fact I felt sad for him when, in elaborating about his recent concerns, he said, in effect “I watch you like a hawk all the time. Every day. This is the first time I’ve been concerned like this, for two decades.” I was sad for him, that that has to be a part of his life.
As for the rest though, luck!! Poor insight!! Seriously??
I have worked hard since my diagnosis in 1996 to get well and stay well; to understand my triggers and avoid them. I worked hard on this all day, every day for a long time – for many many days, weeks, months, even years. At some point it became such a part of me I didn’t consciously think about it anymore. Maybe I had let my guard down recently; after all I had been well for so long! But actually I think I think it was more that I hadn’t realized a particular thing could be triggering. My list of triggers had been incomplete. Sometimes we don’t know what we don’t know.
In any case, I do not believe I have been well simply due to luck! I strongly believe – but cannot actually prove – that I developed strategies that have worked. The psychiatrist implicitly acknowledged that I have had unusual success in staying well, but I believe they misattributed the cause to luck (!)
As for my insight, who is likely to have better insight? Someone who manages not to avoid manic episodes successfully after two genuine acute psychotic ones, or someone who keeps falling back into mania over and over again? Surely it’s the former, not the latter. It seems to me that the psychiatrist had this totally backwards!
As for my incentive to be well, I knew long before I was ever manic or diagnosed Bipolar, that being Bipolar was not something I ever wanted. A child with a Bipolar parent who regularly has acute manic episodes knows more than they ever wanted to know about the havoc mania wreaks in the life of the manic person and the lives of those they love. I knew Bipolar could be hereditary and hoped I had not inherited it. I never wanted it. I was blindsided when it happened to me in my early 30s because I had thought I was safe; I thought by my mid-20s or so I was well past the age of onset. As soon as I was diagnosed and realized what was happening to me, I had every incentive to be as well as possible from then onwards.
Regarding my recent experience, the psychiatrist accurately picked up on me being blindsided, which might have implied I have poor insight/impaired judgment. However I also shared that 5 days after expressing concern my husband said he was now much less worried. about my mental state. I believe that was because I made every effort to turn the tide once I realized what mental state I was in, and I was successful. For me that is the key takeway here, rather than me being caught by surprise when my husband expressed his concerns to me (which I addressed above).
I felt very invalidated by the psychiatrist’s comments about luck and my poor insight. I didn’t say anything though, because they didn’t give me an opportunity to respond to their comments. They didn’t leave time for a response from me. It didn’t seem to occur to them that I might have something to say that I wanted to them to listen to, that was not on their list of questions.
I’m going to send the psychiatrist a link to this page when I message them that I’m cancelling my appointment. I hope they will read this. I would be interested to hear their response if they have any, as long as I don’t have to pay money to hear it. Even if it’s invalidating, I will still appreciate that by reading this, they did finally take time to listen to me, and on their own dime, as it were.