Series

Questions I Bet Your Psychiatrist Never Asked You

During new patient evaluations, psychiatrists generally have a standard set of questions that are asked to help formulate a diagnosis based on diagnostic criteria and to develop a treatment plan.  Every psychiatrist has their own style, but I’ve always been interested in asking patients more open-ended questions if I think it will provide me with a greater understanding of who they are as unique individuals.  Unfortunately, I believe that the art of psychiatry has dwindled down to a checklist which subsequently churns out a diagnosis and treatment plan based on the minimum criteria needed to properly meet billing requirements.  Such a practice may lead to a lack of connection in the therapeutic relationship, therefore, I sought to create a series that explores the unspoken thoughts that a person may have when meeting with a psychiatrist.  If you would like to contribute to future questions in this series, please email me at freudandfashion@gmail.com or add me on Snapchat (freudandfashion).

QUESTION OF THE WEEK:

What do you wish you could tell your doctors when they makes changes to your meds that you don’t agree with?

RESPONSES:

I have definitely been through this experience! I WANT to say that increasing the dose scares me as the side effects I’ve experienced were horrible. I also feel that some (not all) psychiatrists barely ask you any questions about your research on medications. I feel that they don’t want to believe that you are actually capable of being educated on the topic.

Paramedic Nat (Blog: paramedicnatsmentalhealthjourney.wordpress.com, Twitter: @paramedicnat1)

Ever heard the word ‘advocate?’ Did you get your degree for the high status and income, or are you sincere about helping those of us trapped in this system? Why not take a stand against the big pharmacy industry and be true to your patient and what is best for him or her?

Anonymous

Well, to be honest, I don’t think it would be something to say but more to feel. For example, for me, as the side effects were horrible, and as I wasn’t feeling better, she kept upping my dosage.  I wish she would have FELT my side effects.  I described it as best I can, but I’m not sure all docs felt brain zaps.  I wish doctors would listen more to how we feel instead of maybe just push various pills and dosage on us.  Those are pills for our brain, it’s nothing to joke about.  I’m sure it affects us all differently.  But I wished they’d be more open to the fact that for some of us, medications (or SSRIs and such) just aren’t doing any good.

Natalie, Teacher (Twitter: @natricher)

What I absolutely love and appreciate about my psychiatrist is that he lets me choose what I’m comfortable with taking.  I don’t know if other patients are like this, but I know my diagnoses and I do research on different meds.  I haven’t found anything that’s working greatly yet since I do have a lot of different disorders, but knowing that my doctor validates what I’m comfortable with doing makes me feel that much better.  

For example, I really dislike the weight gain side effect that a lot of medications for bipolar disorder have.  I suffered major self-esteem issues in middle school because I put on 50 lbs from lithium and depakote combo.  He knows how hard I worked to get that weight off and feel better about myself, so we only talk about combinations that will make me feel comfortable taking…so that I actually take my medicine.

Alexandra, Advocate

I wish they would have taken the time to explain (simply) what the medication will be doing to my body/brain and why it’s more efficient than what I was previously taking.  

Anonymous

I honestly would tell the doctor my concerns.  I wouldn’t be rude, but I would openly say that I have concerns over it.  My hopes would be that it could open up a two-way conversation regarding my care and I could find out what they have to say (and have them see where I’m coming from).

Tom V, 1st year Medical Student

I wish I could’ve sat down with her and said clearly: “I’m sorry I called you two times today freaking out, but this medicine you gave me just isn’t working right–it’s making me worse.  I’ve never taken any meds before and I’m running scared here and I need someone to understand me and sit with me and talk about my options.  I know we didn’t meet under ideal circumstances and you don’t know me or I don’t know you, but don’t treat me like I’m one of the people who bug you all the time.  Please help me. That’s all I need is some help.”

But, I now have someone who I think is amazing and he talks to me about options and is more of a collaborative force in my health care.  He is in charge of my meds, but he has listened to me and I’m glad to say I haven’t had to take one benzo, not one single one in over 6 months so the fact that a doctor will collaborate makes me very happy, and listens.

Anonymous

 

Photo by Marlon Santos

20 thoughts on “Questions I Bet Your Psychiatrist Never Asked You

  1. Hey Vania! Seriously loving this series. It’s awesome to read about other people’s experiences and wishes as patients, but also comparing those to my own experience being a mental health patient. Then add to that the almost-doctor perspective and the example you’re setting to hopeful future psychiatrists like myself. It’s mindblowing!

    PS: the match is in less than 2 weeks! Not freaking out but freaking out at the same time!

    • Hi! That means so much that you appreciate the series, esp coming from all different viewpoints as mental health consumer and future psychiatrist! My patients often feel so isolated in their experiences, so i’d hope that hearing other people’s experiences could be validating in some way.

      And OMG — match is coming up soooo soon! I wish you the best outcome and that you match at the best program for you!

  2. Because I have been taking medications for MDD, chronic anxiety and panic attacks I have gotten to the point that i educate myself on medications extensively. If I don’t agree I will discuss with my psychiatrist why I don’t agree. We come to a decision together. I find it important to also have a psychiatrist that you have a good and open relationship with. I have left psychiatrists in the past due to the fact that that I felt they did not respect my opinion to the point of dosing one of my medications so high I became suicidal. I now have a psychiatrist that listens to my concerns and we rarely need to make changes to my medication. When we have made changes and I have felt uncomfortable I have been able to get in right away and remedy the situation.
    So, I would have to say in order to be able to speak up about a medication you don’t agree with you need to, educate yourself on your medications, as a well as other medications that used to treat your condition. Have an open relationship with your psychiatrist. If you can’t discuss things opening, feel you are not being heard or respected find one who will. Be proactive in your care always.

    • Hi Cynthia — thank you for sharing! That’s wonderful that you have a psychiatrist who is collaborative and listens to your concerns. I know it can be hard these days esp with such a shortage in psychiatrists and also limits on which docs accept insurance, etc. But being proactive is extremely important, even tho i know it can be hard sometimes. I always praise my patients each time they tell me their preferences and if they don’t agree with the treatment plan because i truly want them to feel they can be open, and also to feel confident they can advocate for their needs with their other docs as well.

  3. I’d love to ask my doc why she won’t listen to me. And then I realize I’m not exactly telling her everything. I know this is a question in a question and answer post, but do you feel that way? That maybe if you lived your truth then you would actually get what you wanted out of your doc?

    • hi, thanks for your comment! it takes time to build a relationship with a psychiatrist, so hopefully you can feel more comfortable telling your psychiatrist your thoughts over time. i can usually tell when my patients are holding back so i try to find ways that can encourage them to tell me their thoughts.

  4. Thank God this hasn’t happened to me in a long time, (my dr. making med change without my agreement) You know I’m grateful for that! 😉

    I appreciate your asking the questions many people think about, yet can’t voice, and for obtaining and sharing the answers to these questions. You’re a visionary!

    We need to get you to open that Santa Cruz practice!!!! (I think that’s the 20th time I’ve written that, LOL!)

    • lol Dyane, I believe this is probably the 10th time you’ve asked about the santa cruz practice actually (haha kidding 😉 And yes that’s wonderful that you have a psychiatrist that you have a great therapeutic relationship with! ANd thanks for your kind thoughts about my blog series…I’m trying to think of the next question to ask!

  5. They treat diabetics for all sorts of “psychiatric” conditions. Then the patient suffers organ damage and eyesight is affected. Finally they discover there is a link between diabetes and psychiatric conditions.

    Idiots! Sorry for being harsh but those idiots misdiagnosed and mistreated patients for long. The real psychiatric disorder is the bigotous beliefs in these “diseases.” The belief is all in the mind. Diabetes is real. Just google the symptoms of Type 2 Diabetes and insulin resistance. It causes symptoms believed to be of “psychiatric” nature.

    • Hi, thanks for the comment. Just to clarify — are u saying that psychiatric conditions are medical in origin, such as diabetes? If so, there is truth in that as the mind and body are not independent of each other as Descartes inferred and unfortunately impacted the way medical sciences were perceived…until recently. I treat many patients with diabetes and often try to motivate them to incorporate lifestyle changes to get their blood sugars under control, lose weight, etc, and at times have been able to lower their psychiatric meds as a result of overall improvement in their wellbeing, though it’s a process and requires commitment on both parts.

  6. Nice question. I ask why have you made this diagnosis and what other diagnosis were you considering and why have you discounted them? Once we are agreed on which diagnosis is most likely, what medication do you favour, why and what are the common and the most dangerous side effects? What are the alternative medications, why have you rejected them, what are the benefits and drawbacks of each in relationship to the medication you are advising? Basically give me all the key information on your reasoning behind your diagnosis and, explain your assumptions and decision making process and review it with me to come to an agreed decision. You are not in my head, if you assume you have enough information to make a decision without me, you need to understand that your perceived expertise in what is happening in my head is a delusion born of your academic study. The b

    • Hi, thanks for providing your response to my posed question! All of the questions you mentioned are definitely factors that should be explained, otherwise one would blindly take a medication and question what they’re even taking it for. there’s also a lot of overlap of symptoms for various diagnoses (ie, someone who is depressed could fall under a diagnosis of bipolar, major depression, ptsd, etc), so anybody deserves to understand the reasoning for a specific diagnosis, esp since one can ask 3 different doctors and they can all potentially give different opinions.

  7. The most likely process to achieve an effective treatment, is for the psychiatrist and the patient to acknowledge that both parties have relevant, and largely mutually exclusive, knowledge and expertise in respect of the patients condition. Only by respecting each others respective knowledge and colluding together can you maximise the chance of achieving both a correct diagnosis and a correct treatment plan.

  8. Pingback: Questions I Bet Your Psychiatrist Never Asked You – Engineer Marine Skipper

  9. I rarely feel I can’t speak up. If I feel my doctor won’t listen to me and work together then I am with the wrong doctor. But I’ve been dealing with this for over 20 years. When I was being jerked around I didn’t have the nerve or knowledge to speak up. And that’s when we need it most I think.

    If a patient has real concerns that aren’t advanced I think they are more likely to not take the medication as prescribed.

    Perhaps you could write a post about the best way to talk to your psychiatrist? or maybe you have, I’m new here. 🙂

    • hi, that’s a great suggestion on a future blogpost! i haven’t written one on how to best approach your psychiatrist…plus the suggestions would possibly apply to advocating for oneself when with any doctor as well! that’s great to hear u’ve found your voice when interacting with doctors…i always tell my patients that i appreciate it when they speak up for themselves & tell me their opinion esp since i want any treatment decisions to be collaborative 🙂

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s