Finding the Right Psychiatrist

I’ve been doing it wrong. I thought I would go see a psychiatrist, and ze would know all about the different medications available and listen to me and figure out what would best help me. I found an organization covered by my insurance and started working with the person they assigned to me. I put random chemicals in my body, who knows what they’ve been doing. It’s so hard to tell whether they’re helping or hurting that I want to rip out my brain!

Wakana’s been ridiculously concerned about me. She asked me to sign a contract saying that if I’m thinking about hurting myself I won’t act on it without talking to her first. She’s basically given me permission to call her any time of day or night. That’s … wow. Frelling huge!

She also expressed an interest in working with Psychiatrist B. I gave her his number (well, the number at the organization that assigned him to me) and when I went to see him on Wednesday I gave him her number. On Friday I asked Wakana if she’d gotten his call.

“We spoke, actually. I thought he was being very arrogant and he wouldn’t talk to me about how you’re doing. He didn’t seem to take your suicidal and self-harm ideation seriously.” (Actually, he interrupted me in the middle of telling him about these sensitive topics to take a phone call from the org.’s billing dept.) “He kept saying it’s a clinic. People just go there for medication. He’s only there two days a week. If anything comes up he tells patients to go to the emergency room.”

Being hit with this reality really hurt. I just want the meds to work their magic and the pain to go away. But my problem isn’t a headache, it’s an extremely complex combination of maladaptive thought and behavioral patterns, disabling physical and emotional symptoms, unbearably stressful situations, and atypical brain chemistry. The medication might be helping the brain chemistry part, or it might not, or it might even be making things worse. I have literally no way of knowing, because how I feel and function on a given day depends on so many other factors that it’s impossible to isolate the effect of the meds (in research-ese: “There are too many confounding variables”). The American Psychiatric Association wasted their time making a new version of the DSM that the National Institute of Mental Health withdrew their support from and has devised no tests that would enable a healthcare provider to objectively observe and measure the effect these psychotropic substances are having on my brain!

That infuriates and terrifies me but now I’m kind of dependent on them. I don’t know. Maybe I could stop taking them and walk away. Maybe whatever effect that had on my brain would end up resulting in my death. I have no idea.

I need to find someone who will take every word I say to zir as seriously as Wakana does, if not even moreso. Someone who knows everything there is to know about every medication and how it interacts with every other. Someone who can juggle what information is available from scientific research with experience treating diverse clients; someone who is willing to try new or atypical approaches and will be responsive to my every symptom and concern throughout the process. I don’t care if you’ve been practicing psychiatry since before Freud was born, this is my body and the only brain I have. I need it to last me a good 70 more years or so. The depression is taking enough of a toll without the meds I’m taking to try and treat the depression fucking things up even more. I’m taking a huge risk; I can’t hit “undo” or “restart.” There is no option to save first, then exit without saving if something goes wrong, reload and try again. There’s just my life. I need whomever I work with to respect that and take it seriously.

Wakana doesn’t seem to think Psychiatrist B is capable of doing that. I was extremely angry with him when he interrupted me in the middle of trying to tell him about the symptoms I couldn’t bring up at our last meeting. It was very hard for me to organize and express my thoughts about what I’ve been experiencing – something that doesn’t lend itself to words to begin with, and that tends to be hindered when I don’t feel emotionally supported by the person I’m trying to share this information with (“lack of rapport”). I don’t know what to make of my body randomly twitching in response to certain sounds, especially if I’m tired or anxious or angry. I never experienced that until the first time I took a SSRI. It’s not like this is an experience people typically talk about; I can’t poll my neighbors or classmates or Facebook friends about “What makes you twitch as though Gimli has his axe embedded in your spine?” Don’t blow me off and tell me “it’s the depression.” If you’re going to say something like that, at least explain what you mean.

I need a psychiatrist who respects that I’m trusting zir with with more than my life. Someone who respects that I’m trusting zir with my Self. My thoughts, emotions, conscious experiences, self-perception, how I interpret and respond to everyone and everything around me. It’s all been affected, and for all I know I’d be a lot better off if I’d never started taking medication.

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