Know When to Fire ’em: Should You Change Psychiatrists?

“You are a loner!”

My psychiatrist practically shouted that sentence. It was my second week in a private psychiatric hospital in Greensboro, NC, in 1987. I admitted myself on the recommendation of Dr. Garrett, after I’d called him to say I thought I was causing the snowstorms.

“You are not causing the snowstorms,” he’d said on the phone that night. “You have a chemical imbalance in your brain.”

Do psychiatrists actually think that means anything to someone experiencing her first psychotic episode? (“Oh, gee, I guess that must be it. Thanks for your time, doc.”)

Dr. Garrett went on to make three serious mistakes and several lesser ones. Besides the inaccurate assessment that I was a loner (would YOU try to be buddies with people you thought wanted you to kill yourself?), he:

  • Ordered the dexamethasone suppression test for me, which had been discarded by most shrinks as being ineffective.
  • Started me on Stelazine, which had absolutely intolerable side effects, rather than putting me on one of the milder antipsychotics that had recently been introduced (Trilafon was available in 1987).
  • Diagnosed me as paranoid schizophrenic after observing me for only a few days.

Wrong, wrong, and wrong.

These events started a spiral that led me to go off my meds, quit a job I loved, move 1200 miles away, and pick up the psychotic episode where I’d left off. It would be months before a new doctor put me on Trilafon, which quieted my symptoms with minimal side effects.

I should not have gone off my meds. I should have told Dr. Garrett I couldn’t live like that, and asked for a med adjustment. He had increased my dose from 10 to 40 milligrams (the max dose) in about three weeks, rather than giving a lower dose the time it needed to work.

He asked me once if I thought he, too, was trying to convey dark messages to me through hidden meanings in language. Oddly, I didn’t, and I told him that.

“Well, maybe I’m the voice of health,” he replied, beaming.

If you’re seeing a psychiatrist or getting psych meds from your family physician, is he or she the “voice of health” to you? In retrospect, I should have gotten a second opinion from a different doctor after my horrific experience in the hospital.

I’m not advocating doctor-shopping. Psychiatry is so imprecise, and mental illness is so hard to diagnose and treat. I honestly believe most professionals are doing their level best to treats their clients. And they do know many things that we don’t.

But please don’t settle where your emotional well-being is concerned. Aim for the best mental health you can achieve. Psych meds have improved so much since the 80’s, and sometimes the docs need to get creative if you’re not responding to standard solutions.

Or maybe someone else needs to evaluate your symptoms, see you and your history through fresh eyes. You wouldn’t keep going to the same mechanic if your vehicle wasn’t running smoothly when you picked it up. Give your doc a chance to make adjustments that could help, but learn from the mistake I made 30 years ago. Know when you need to move on.



On Smiling Dogs and Life Disruptions

I’m what’s called a “bi–phasic sleeper.” I take a long nap after dinner, then get up and attend to the dogs and cats, scan the news, check out Facebook, and watch a streaming TV show. Then I go back to bed for a couple hours before I get up for the day.

I usually feel OK during that in-between period. My psych meds keep me from being too high or too low, and I’m usually content living a simple life. But last night, I was feeling bad about my life. You know how it goes. I haven’t accomplished enough professionally. I don’t read enough “important” books, and I’m not involved in my community. I have failings as a friend. I spend my TV time watching bad medical dramas (along with some good cable shows), and I didn’t tell my parents how much I really, really liked them before they died.

I was browsing Facebook (usually a bad idea at a time like that; people only show the highlight reels of their lives, and it’s too easy to feel unworthy when the inevitable comparisons bubble up), when I came across a video my sister had posted on my timeline. It featured a goofy-looking yellow mutt who sported a variety of smiles. Different smiles meant different things. His smile had gotten him adopted by a loving human.

It cheered me up to watch it, so I watched it again. Those few moments reminded me of other videos of dogs simply enjoying life, living in the moment and not second-guessing their life choices or their value to the universe. They’re happy enough just existing.

Why can’t I be more like that?,¬†I thought to myself. Of course, I can’t. I have responsibilities. I have to do things I don’t enjoy. I’m a human.

I’m where I am in this life–in part–because mental illness disrupted my life when I was 30. A psychotic episode, and another 12 years later. Mercifully short periods of severe depression caused by medication that suppressed my brain’s dopamine too much, and years of being “OK” mentally, but not overly happy until I found the right med cocktail years ago.

Most of the time, I like my life. I’m married to my best friend. I have work. I have great, lifelong friends. I have a home and two dogs and two cats and always enough food to eat.

So when I go through those periods where I feel like¬†my life could have been better, I eventually come around to remembering that I’m a survivor of mental illness. It’s not really an issue in my life anymore. I take my pills and I see my psych NP every three months. It wasn’t always like that; my illness caused humiliation, confusion, frustration, emotional pain, and some really bad life choices.

I’ll try to remember that smiling dog the next time I go into a brief blue funk. He may have had a rough life before he was adopted, but he’s able to put that behind him and grin at the simple joy of being alive and the possibility of good things on the horizon.

Should I stop watching bad medical dramas and read “deep” books instead? Nah. Should I work on being a better friend? Yes, of course, always. Should I try to get more involved in my community, find ways to give back and just meet new people? Definitely.

I should also–and you should too, especially if you’re battling the symptoms of depression or psychosis or anxiety–remember what a challenge mental illness can be, how it can disrupt your life and change its course. No one but you will ever really know what you’re going through now or have experienced in the past. But do take all of it into account when you’re being hard on yourself, and ease up. You wouldn’t have chosen it, but you can survive it.