Why I Choose Not to See a Psychiatrist
Despite having a severe mental illness
When depression first entered my life more than ten years ago, I’d already been working as a mental health nurse for two years, and I’d been a pharmacist prior to that. When it comes to the treatment of my illness, I’ve always known my stuff, and that has posed some challenges when I’ve had to deal with healthcare providers who weren’t willing to recognize that.
My depression has never been easy to manage, and that’s been a strong motivating factor for me to keep up with my own continuing education. I’ve been hospitalized multiple times, and required multi-drug combinations and electroconvulsive therapy (ECT) to get better. In recent years, my illness has become treatment resistant; even with the drug cocktail that has worked best for me, my symptoms are never fully controlled and I have ongoing functional impairment.
The relapse that started this whole treatment resistant adventure happened three years ago. The trigger was workplace bullying. More specifically, it was discovering that my bullying former manager was trying to destroy my career, and having considerable success at it. The chances of me getting another nursing job were looking very slim.
At that point I’d been seeing the same psychiatrist for 3–4 years. When I first went to see him after I found out all this was happening, I was experiencing significant psychomotor retardation. That meant I was moving at a snail’s pace and having a hard time putting slow, complete sentences together. I was ill enough that I probably should have been hospitalized. My psychiatrist’s response? “I think you need therapy to learn better coping skills.” Jaw. Drop. That complete breach of trust meant that was the last time I ever saw him.
I tried going to talk to my brand new GP (general practitioner). When I told her why I wasn’t going to see my psychiatrist again, her response was, “Don’t you think you do need better coping skills?” Another one bites the dust.
I was so disheartened at that point that I wasn’t willing to try another doctor. I tapered myself off my medications, since I was out of refills. Unsurprisingly, my depression got even worse.
Eventually I started going to a medical clinic I hadn’t been to before. At first I lied, saying the only problem was with my sleep, or lack thereof. It was at that clinic that I found my current GP, and he was a game-changer.
He acknowledges that I know at least as much about my meds as he does, and that means the world to me. He’s very pragmatic, and doesn’t ask trite “shrinky” questions. He takes me seriously, and he always wants to know what I think should be done.
While it may seem obvious that someone with treatment resistant, sometimes very severe depression should be seeing a psychiatrist, I have no desire to do that. I have the knowledge base to know what my options are. My doctor gives me an objective opinion and together we come up with a plan of action. He knows that sometimes I will make necessary dosage changes first and tell him later, and he’s okay with that.
For anyone who has been through negative experiences of psychiatric treatment, both in hospital and in the community, trust is in essential ingredient in any therapeutic relationship. I’ve had my fair share of negative experiences, and trust is not readily given.
That’s why I am happy to continue to see my GP who has less specialized knowledge in psychiatry than I do; trust and the accompanying respect are game-changers. I have lied many times to treatment providers over the entire course of my illness, but finally I’ve found someone that I feel no need to lie to.
Could a psychiatrist come up with some new treatment ideas that I wouldn’t have thought of? Maybe. But the therapeutic relationship with my GP is rock-solid, so I’m not going anywhere.