A long, long time ago. . . (okay, two months, but right now time is relative), I wrote a post about diving into the world of looking for a new psychiatrist (It’s Time To Say Goodbye). I sort of had it in my head that I could write posts about my search here on Canvas. This would be the first, because my moods went off the map and I subsequently slipped off of the radar temporarily.
I’ve had two appointments with one doctor, and one with another. I also have a consult scheduled in January with a third. But before I get much further into to how things are going, I should probably just get my views out here. They’re pretty crucial to understanding my experiences and this post.
To me, psychiatrists have become a necessary evil, at best. That’s not to say I don’t respect them for what they do, because actually I respect them tremendously. But I would really like to be able to respect them in the same way I do soldiers and Red Cross workers in disaster situations. From a distance.
I honestly don’t consider any of my other doctors to be “necessary evils.” Maybe my annual well woman visit to the gynecologist (sorry, boys) comes close, but honestly for me it’s once a year and usually pretty painless. Oh, and the dentist as well, but really, does anyone like going to the dentist?
In any case, mostly my doctors are viewed by me as great resources. When I do have to seek them out it’s to make something that’s gone pear-shaped with my body’s functioning right again, and I’m thrilled and delighted that they are able to perform this service for me. Not so much with psychiatry.
There’s the obvious part, where the malady (maladies) that takes me to a psychiatrist is not something relatively simple. It can’t be diagnosed with an exam and some blood tests or cultures, treated for a couple of weeks with some easy pill, then sent on its way. There’s the part where in psychiatry, so much more depends on your relationship with the doctor and is left almost entirely to their discretion. Yes, there are standard treatment algorithms for manic-depression, but psychiatrists really seem to take them as extremely loose guidelines, with infinite room for interpretation, and there’s no rule that said algorithms even have to be consulted at all.
What I dislike most is the fact that what they’re treating, what they are attempting to examine and test and measure the functioning of is, to me, the most deeply personal and highly sacred part of my body: my brain.
I can think of nothing else more invasive in the world than psychiatry. I have had more than your standard in office visits as far as gynecology (although not so extreme as another Canvas blogger), I had a D & C and lots I won’t detail leading up to it (you’re welcome, boys). I had an endoscopy following a diagnosis of stomach ulcers. I have never had major surgery, so I can’t say for sure, but I think even getting used to an organ transplant would not feel like such an invasion as someone poking and prodding and asking me all about my thoughts and my moods and how they are functioning and basically wanting to cross that final frontier into the land of what I consider to be most private. At least not for me it wouldn’t.
And yes, I know I am seeking out their help, which makes my cooperation pretty much compulsory. Hence the ‘necessary’ preceding the ‘evil.’
But back to the me and the now. Both psychiatrists I have seen thus far in my search have been very nice and very competent. The first one, Dr. M~, I had two consultations with. She was quite helpful and she said she would absolutely be willing to treat me, but that she wasn’t entirely sure what was left for her to try that hadn’t been tried already. She highly encouraged me to look nationally, to places like the National Institute of Health, the Mayo Clinic, Yale, Harvard. . .
Basically she was smart and took what my previous doctor had done over the past five years and, instead of insisting that we repeat it and I go through all of the ridiculous medication and treatment roulette again, she arrived at the same conclusion he had (he had also suggested I look nationally for someone). The one somewhat novel suggestion she did have for me on a local level was that I go see a psychopharmacologist, as he would be very well versed in the intricacies of the specific drugs and their mechanisms of action, more so than the average psychiatrist – a plus for someone with complicated medication and metabolism issues.
The second doctor, Dr. R~, I still have to wait and see (I’m waiting for a call back from his scheduler for when I can see him next, har, har). He was quite nice and very thorough at our first appointment, and Dr. M~ told me he was a good doctor, very well-regarded by his peers. As to how much weight I put on the regard of his peers. . . Well, I guess I won’t get into that just now. But I like him well enough so far.
And then there is the final doctor, Dr. B~, with whom I scheduled first and am waiting the longest. I’m okay with that, I really liked him on the phone and he did his residency with my former psychiatrist, so they are well acquainted.
I’m just so sick of and exhausted from the psychological poking and probing right now. The title of this post came into my head as I was leaving my second appointment this week (my mistake, scheduling them so close together). All I could think was, ‘Stop looking at my brain! Get out of my head and leave it to find some peace of its own!’
Which, of course, is the entire point of the process, isn’t it? I’m looking for someone to help my brain find some measure of balance and peace, and it’s stirring my brain to chaos and frustration.
The irony abounds.
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I hear and very much relate to your story. The irony of havering an illness that forces us to bare the most intimate spaces we have is….i don’t know how to describe it.
And shrinks are, unfortunately, just regular human beings most of the time. No spark of genius among most of them. Too bad there isn’t some sort of code that identifies the ones that might perhaps be too eccentric for the lucky general run of psychiatric clients who just need, to borrow a wonderful phrase from you, “some easy pill.” The special ones would be identified, perhaps, by icons after their names in the provider directory: a pair of eyes designates a visionary; a pointed hat a genius wizard; a magic wand, a worker of miracles. If any of you have the code that unlocks these special icons on the Federal Risk Pool provider list, we would be grateful if you would share it.
In the meantime, my pharmacologically-maxed-out friend, have you already tried rTMS?
Oh, Laura, I love the way your mind works! Wouldn’t it be great to actually have special designations like that? I would even take icons that represent more basic concept: a hug for a doctor who is very touchy-feely, hands covering ears for those who don’t listen and won’t let the patient be a partner in the treatment processes, maybe even a can of Play-Doh for a doctor who is malleable enough to really work with a patient’s individual needs and specific concerns.
As to rTMS, I was evaluated prior to my ECT treatments and found not to be a candidate, I can’t remember why. I’d be very interested in discussing it with you and hearing your experiences, though!
My apologies for the extreme delay. Thanksgiving weekend was hectic, to say the least.
All doctors are a necessary evil. No one wants to get poked and prodded at all. Every year at my annual physical, there is always an enormous amount of blood drawn to test just about everything. That alone is exhausting.
The dentist, well, yay! The cleaning alone is one of the most absolutely unpleasant procedures I’ve ever been through. Have you ever had a deep cleaning? I actually had to have novicaine rubbed on my gums to have that one done. It was still agonizing. The sound of the drill and the smell of decay is just – UGH!
The opthamologist puts those dialating drops in your eyes. It’s usually alright, mostly, although I don’t like my vision to be taken away for any amount of time. Except this one time, where a doctor went nuts with the drops, and I was so light sensitive that I was actually blind for about six hours.
Personally, and I’ll out myself on this one, the OB/gyn is the most invasive thing ever. Not only are those my parts, but I have to have them looked at all of the time. No, most women would disagree because it’s a yearly swipe with a Q-tip and it’s done. For me, it was a painful, invasive battle for four years. There is no psychic trauma worse than having a biopsy done “in there” when you’re 34 weeks pregnant. And when you’re pregnant, they’re looking in there like every 5 minutes anyway!
But, a close second is the evaluation process in psychiatry. I have probably told at least 10 psychiatric health professionals the story of my life. And this isn’t like talking about how your mom has a thyroid condition and your dad has heart disease. This is talking about the absolute worst in yourself. I would call it something akin to going to Catholic confession, except you can lie to the priest and save some face. If you want effective treatment with a proper diagnosis, you can’t lie to the psychiatrist. I know, they aren’t supposed to make judgements. You may think they don’t. But they do. They all do. I’ve had one openly share hers with me. It is absolutely infuriating.
I don’t have a whole lot of dirty secrets and lies. But, my mind is not a playground. It is not play-doh that can be manipulated for someone’s enjoyment and career advancement. I am not a patient, I’m a person. These are my thoughts and emotions. And there’s a real to me as this keyboard, no matter what anyone has to say about it.
I shudder at the thought of what a deep cleaning at the dentist must be like!
I’m still going with the psychiatrist being more invasive than the gyno, but I think we would be comparing apples to oranges, because you have had so much more. . . work done down there, whereas I feel like my experiences with mental health treatments, especially the electroconvulsive therapy, are on par with having a surgery or three. Hell, they anesthetized me 16 times!
And you’re right, even the best doctors make judgments, sometimes especially unfortunate ones, about their patients. They’re merely human (though that doesn’t make them treating you differently because of it alright in any way).