Psychiatrist Advice

[gbf]

Hi all,

I really don't feel comfortable with my psychiatrist. I have been seeing her since earlier this year for acute depression with suicidal ideation/attempt. I have been on multiple medications but none have helped.

I feel that my psychiatrist has made very poor assumptions about me - based on the roughly 5 hours total I have seen her for. When I talk to her, I feel she does not listen to what I have to say, only what she wants to hear, e.g. saying things like "but you're leaving the house, so you can't be feeling that bad", despite me telling her that I am still really struggling with simple effort tasks like showering, eating properly etc. 

My psychiatrist wants me to move out of home, even though I can't trust myself to be alone right now and home is where my support is. When I told her this, she inferred I was incompetent and needed to "do things on my own". I have tried to defend myself so many times but it's like talking to a brick wall, or a bully.

I am scared to see her again. I leave her office feeling so small. As I'm not on the right medication it feels like I'm stuck with her. I worry that if I try and find another psychiatrist I'll be waiting for so long that I'll get worse. But I also worry that she is right, and I'm too depressed to hear it.

I guess my question is, what if she is telling me what I need to hear but I can't hear it because I am depressed? Do I trust myself and stop seeing her, or should I trust her more as the professional?

Thanks.

[Croix]

Dear New Member~

I'd like to welcome you here to the support Forum. I think it is a place if you look around you will find others who have had doubts about their psychiatrist or psychologist.

It can be very frightening to think of what once might do, and in that situation I needed all the support I could get. So I can understand if you want to remain at home and not leave that support behind. Does not sound like incompetence, in fact that is a funny word to use in this situation.

I have never been encouraged to leave support, instead things have only happened when I've felt ready, even though that was worrying enough. Not to feel you are being heard is a horrible feeling, like one does not know what one is talking about. It can make you doubt your own judgment, and the answer to htat I'd expect is talkng to more than one person.

In fact I'm the expert on me and you are the expert on you. As you say, 5 hours is a very short time to start making decisions on major changes for someone else. some clinicians do make assumptions that are not warranted.

Can I suggest rather than just not going beck to this psych instead you get a second opinion. Expensive and time consuming, but not as much as possibly wasting time and money on someone with whom you do not have a good relationship.  If you can't quickly find a psych for that second opinion I'd suggest talking to the GP that referred you and see what they think.

I"m sorry abut your medications, it took me a long time trying different ones out until I found something htat did its job without much in the way of side effects. That made a huge difference.

Do you have a safety plan? I use Lifeline's Beyond Now which is pretty good as it takes no brain power or decision making when feeling overwhelmed. If you want to know how I set mine up to help me just sing out.

Croix

[therising]

The warmest of welcomes to you at this incredibly overwhelming and deeply challenging time in your life.

While someone can offer what seems to be a logical way forward, such as moving out of home, if they're not coming from a place of personal experience then they may not be considering a whole variety of elements beyond what seems logical. Some elements may include

• how to live separately from our support people (family)
• how to live on our own with a deeply depressing lack of dopamine and serotonin
• how to live without people around us who help create distractions from depressing or triggering inner dialogue
• the need to consider how far down into a depression we actually are

and the list goes on. With that last one...

Personally, I've found that life can offer 3 levels of experience. 1)I can be flying high and full of energy, 2)I can be grounded (not high but also not down) and 3)I can be existing within a depression under ground. While being in a depression, the question at times can be 'How far down am I?'. If you picture a depression as a well, 'Am I on the brink of going in? Can I get a basic sense of having gone in while facing the beginnings of some descent? Do I feel half way down? Am I in the absolute depths? Am I at rock bottom?'. Based on my own personal experience, which did not go well at all, never in a million years would I suggest to someone in the depths or at rock bottom 'Go live somewhere else, separate from your much needed support people'. What I would suggest instead would be along the lines of 'How are we going to raise you to a level where you can manage living separately from your support people?'.

Some of the ways of raising can include raising levels of dopamine and serotonin, raising someone to a level of consciousness where they become largely or fully conscious of how their inner dialogue works, raising spirits or connecting with life on a more natural or soulful level etc. In other words, raising someone on a physical level, mental level and natural level. There can be dozens of ways of raising someone. Based on your struggles, I imagine you to be a deeply feeling person. A key question in this case could be 'Can you feel your psychiatrist raising you or can you feel them bringing you down?'. If the answer is 'down', then Croix's suggestion of returning to your GP for another referral sounds like the way to go. You want to be getting a feel for the kind of psychiatrist or psychologist who's going to raise you. You deserve to be raised. Btw, if you feel like you're talking to a brick wall, another way of looking at a brick wall is as 'a barrier' (getting in the way of significant progress). When it comes to certain things, you may have better instincts than your current psychiatrist. It can be such a challenge, learning to trust what we feel 🙂

[ABC01]

Hello,

After reading your post, I can see that you may be feeling incompatible with your psychiatrist. I can assure you that not everyone gets along with every professional we met along our journey. I have had an experience twice with psychiatrists that I felt dismissed me or went ahead with their own plans, instead of asking me first.

Is there an option for you to search for a new Psychiatrist and stay with your current one until you can get a new appointment? Financially I understand this could be tricky. But also understand that they are in demand and there can be waitlists. So that way, you still have help but then can leave if you feel better with the new professional.

I believe tact or bedside manner could be an issue. Some people mean good but deliver poorly. And though this may not be helpful for you and professionally they shouldn't let this get in the way, they could be having a bad or overwhelming day themselves and not delivered something correctly. Or we could have possibly interpreted something strangely. I have been guilty of that. Please know I am not saying you are or have interpreted something incorrectly.

The other week my psychiatrist told me they had no answers for me on a particular thing I am going through. I left the session feeling like "If they had no answers for me, then how am I going to find them?! They have been professionally trained!" After some reflection and coming down from that panic I realised they did have answers for me. Medication and a specific therapy I am doing, having been referred by them, to outside the clinic. But it took me a little bit to see that.

But in my experience, Psychologists are much kinder as they do psychosocial therapy and psychiatrists are more business like dealing with diagnosis's, medications and trying to balance/stabilize their patients.

5 weeks isn't a long time. There may need to be more time together to know each other better. It took me nearly 5 months to find the right balance and combo of medications to where I wasn't experiencing any side effects.

I too have been told it may be better if I left home, but financially I can't. And also I don't want to be alone either. therising made some good comments about that.

You should trust yourself. However, if you want help,you may have to trust your mental health professionals to a degree. You also have to try to comply to a degree too. But you should always feel comfortable and everything in your post was valid. You should also be able to speak up and it is okay to disagree with something said to you. If it is reasonable and rational, nobody can argue with you on that.

I hope you find your answers,

ABC01

[Eagle Ray]

Dear Guest,

If you consistently feel small after seeing your psychiatrist I feel that isn’t a good sign. Sometimes we do feel worse after a therapy session because it’s brought up difficult and challenging emotions. But it isn’t a good sign if you actually feel belittled and it keeps happening. I think getting a second opinion is quite wise.

Before I found my current very good psychologist I had several experiences of average to very bad therapy. Your description reminded me of one therapist I saw who would ask me questions and then belittle my answer whatever it was. It felt like he was a football coach putting me through some kind psychological resilience test. I eventually ended up in tears and unable to speak and made a conscious decision after a few sessions not to go back.

Basically a good therapist can truly be present with you and meet you where you’re at. They don’t judge you but seek to understand your experience and work with you towards better outcomes. Generally they don’t give you specific prescriptive advice such as you should leave home, but help you to find ways to better support yourself and grow so that you are in a better place overall.

After several not good experiences I learned to trust my instincts with therapists and knew I only wanted to work with someone I felt emotionally safe with. I have found that emotional safety and knowing they are truly present with you is what makes all the difference. To me you sound like an intuitive person with insight about your own situation. Just because the other person is a professional it does not mean they know you better than you know yourself. You really don’t want to be seeing someone you are feeling scared of. Sometimes you can raise such issues with a therapist and go through a process of rupture and repair and then some therapy relationships can go really well from there. But that requires the therapist taking responsibility for any projections and unhelpful judgements on their part, and that doesn’t always happen.

I’ve learned to listen to my body in relation to all human relationships and if I feel ill at ease I pay attention now instead of overriding it. If something feels off or a bad fit I’m learning it usually is. Whereas if I feel at ease and safe in the presence of another it’s a really good sign. So my sense is to listen in to yourself as to what feels right.

Take good care,

Eagle Ray 

[gbf]

Hi Croix,

Thank you for your response, it was so helpful to be reminded that I am really the only "expert" on me. I have booked to see my GP to get an appointment with a different psychiatrist, just to see what they say as you recommended. I am glad you are on the right medication now, I hope eventually I will find a good one too.

I do use Beyond Now, it's been a life saver in many situations - particularly because it's so easy to use when I'm overwhelmed.

- gbf

[gbf]

Hi therising,

Thank you for your reply. I like your idea of the three levels of life experience - that we can live alongside with depression, some times without and sometimes deep in it. I think my psychiatrist's intention was to raise me to a level where I could live out of home, but the way in which she kept bringing it up as the most critical thing to do right now was really unnecessary and unhelpful. As overwhelmed as I feel it's a good lesson to listen to myself and my intuition.

I have booked an appointment with my GP to find a second opinion as Croix has kindly suggested.

[Croix]

Dear GBF~

I'm pleased to hear you are taking charge, seeing if you can get a second opinion, and remember they are opinions and have to match you, not some general formula. Even the  best opinions have to be based upon knowledge, and that may only come - with  expereince - after a fair while of interaction with you, certainly more than a few hours.

I belive any good clinician will ask you each time how the treatment is going, and be concerned if you feel belittled and the therapy unhelpful. It is their chance to be flexible and adapt - one size does not always fit all.

Croix