My post about my first appointment with my (psycho) psychiatrist made a couple of waves in the mental health blogging world. Phil from Furious Seasons did a huge post on it, and told me it was one of the “worst stories I’ve ever heard,” which, coming from a dude who blogs exclusively on mental health injustices, is pretty bad. Liz Spikol from The Trouble with Spikol also picked it up, with the title, “This is why people don’t trust doctors,” calling the experience “bizarre” and stating, “I have heard of similar experiences, but only with cults.”

It was nice to have others recognize how horrible this situation was. Unfortunately, it didn’t really change my situation.

After that first appointment, I vowed I would never go back to psycho psychiatrist again. I went to my family doctor and told her what happened, (she was horrified and said, “Maybe she was hypomanic that day!”) and she agreed to refer me to another psychiatrist.

The problem is this is a small city with a limited number of psychiatrists, and the majority of them work in the same clinic downtown. I made sure that she referred me to a psychiatrist who had a private clinic so there wouldn’t be any problems.

A few weeks later, I got a call back from my doctor’s office saying that the psychiatrist’s office had rejected my referral, stating that it’s his policy not to accept any patients who have already been seen by another psychiatrist in the city.

My doctor tried to refer me to another psychiatrist, again in a private clinic, and his office also rejected my referral, based on a “conflict of interest” because I had already seen another psychiatrist.

[And may I also mention that before I even went to psycho psychiatrist, I tried to get in with my mom’s psychiatrist, and he also refused to see me because he felt it was a “conflict of interest” to see two members of the same family.]

So, not only is it really difficult to get in with a psychiatrist in the first place, once you get in, you’re stuck with her no matter what, because everyone else will refuse to see you because they don’t want to get involved in any drama that may be going on between other psychiatrists and their patients.

Aaaaaaaaaaghhhh!

I didn’t feel like I had much of a choice, because I strongly felt I needed a psychiatrist to monitor me because of my family history. Unless I wanted to try and get referred to a psychiatrist in one of the neighbouring cities, wait another six months to get in with him/her and then take time off work to drive a few hours to my appointments, I was stuck.

So, I did what any semi-sane person would do: I went back.

But I went back armed with six months of mood charts, a list of supplements and drugs I’m taking and a very guarded attitude.

It was six months after the first appointment. And the weirdest thing happened.

She was nice.

She smiled, she laughed, she was friendly and helpful.

It was like she had switched personalities since the last time I saw her. This was the woman my doctor had described when she first referred me to a psychiatrist. This is the woman I wish I had had during my first psych appointment when I was scared and vulnerable.

Maybe she has some kind of personality disorder?

I think I’ve also learned how to deal with her. One of the first things I did was hand her a piece of paper with all my supplements and drugs listed, along with the doses. She exclaimed, “Oh, I wish all my patients did this. This is so helpful!”

I then said things like, “I took your advice and started taking fish oil supplements, and I noticed a real difference.”

“I took your advice and went off the Wellbutrin, and I’m really glad I did because I don’t think it was a good drug for me. I feel much better now just on the Celexa, as you suggested.”

“I took your advice and kept a daily mood log, and I’ve brought a graph of all my moods for the past six months here with me for you to look at.”

She was really pleased. “You’re doing everything right! You’re doing so well!”

Of course I was: I had followed all her advice and made sure she knew it.

We looked at my mood graph together and she agreed that there was no hypomania there. I reminded her that the only time in my life that I’ve ever felt hypomanic was when the Effexor made me wonky and again with a high dose of Wellbutrin.

She hasn’t deviated from the initial diagnosis as far as I can tell, but she was much better to deal with this time, and didn’t push any additional drugs on me. She just said we’d monitor it and only respond if something changes. She didn’t try to get me to go off the Celexa either.

So, while the situation isn’t ideal, I think I can work with this woman, particularly if I only have to see her once every six months.

I don’t think I can ever fully trust her, though, because I will never forget the things she said/did during the first appointment and the horrible way she made me feel.

The main problem with this psychiatrist, as far as I can tell, is that she needs to be the authority figure. She doesn’t know what to do with an educated, intelligent women who has done her research and who knows her mind/body/mood well.

During my first appointment, my psychiatrist was very defensive and aggressive, and it seemed as though she was threatened by me asserting myself and not agreeing with everything she said. If I had to guess, it was that dynamic that led to the weird behaviour/accusations on her part.

I was able to diffuse that dynamic by appeasing her in the second appointment, but I did notice that anytime I spoke too much, inserted my opinion, or let my guard down and tried to crack a joke, she would cut me off and dismiss me.

So, it’s all about walking that fine line with her. Acting the part of the patient and choosing my battles in order to get the care that I need in the very weird system we’ve got going on here.

My next appointment is in December. Hopefully, I’ll get her nice personality again. Wish me luck.