The onus is on you. Psychiatrists these days have severe constraints on their time. If you don’t badger them, they won’t ask that vital extra question. Remember, psychiatrists are only as good as what you tell them. This is no time to be shy. Here’s a brief list of what I consider to be your rights as a patient:
1. Your psychiatrist has a duty to listen. If you feel this is not happening, find one who does.
2. The American Psychiatric Association, in its 2000 Bipolar Treatment Guidelines, stipulates that the goal of treatment is to achieve remission. The APA goes on to say that this means having virtually no symptoms and functioning fully. Basically, your psychiatrist writing you off is not an option, no matter how bad things may be going for you at the time.
3. You should not have to settle for dulled cognition and a diminished capacity to enjoy life as the price of reduced mood symptoms. Many side effects of major medication tend to go away as your body adjusts to the meds, and you should allow for this. But you should not have to put up with meds that make you feel worse. You can discuss the side effects of bipolar meds on our message boards.
4. You have the right to give your psychiatrist the third degree concerning every medication he or she may prescribe. If you are not satisfied with the answers, you have the right to refuse to take that particular medication or medications.
5. Less may be more. It's overkill is justifiable for a crisis, but is not the right strategy for long-term recovery. There may be valid reasons for remaining on many meds in high doses, but the onus should be on your psychiatrist to provide satisfactory explanations.
6. You’re entitled to timely responses from your psychiatrist. Phone messages should be returned at first opportunity, and your psychiatrist should be available in a crisis.
If you have just been diagnosed, you are probably in a crisis, or are just emerging from one. For the time being, your psychiatrist will be the lead partner. But once you start moving into the recovery phase, you need to show some initiative. Only an equal partnership will get the job done.
