Question of the Week: Doctors - The Good, the Bad and the Ugly

First of all, I want to say that living in New York City and having a Manhattan doctor doesn't mean you're going to get best practices treatment.  I saw a psychiatrist-let's call him Doctor A. for obvious reasons-that I quit in the summer of 2003 after seeing him for five years.  At the time, the Stelazine was working yet he kept asking me if I wanted to switch to an atypical.  "Everybody's doing it" was the reason he gave, as if it was the latest craze, like Hula Hoops.  At the end of every session before I rose to leave, his last words were "Do you want to switch meds?" or "Are you in a relationship?"  I thought it creepy that he inferred having a boyfriend was the only measure of my success.  He also did something that was odd: he sat in a chair with metal tubular arms and lifted his left leg over the arm of the chair during the session.

 

I had begun seeing him because Dr. Santiago, the doctor I saw for 11 years, had died of a heart attack.  Dr. Santiago, my first doctor, was happy-go-lucky and more of a friend than a professional.  He set me up on a date with one of his other patients.  He was the one who told me from the very beginning that I would be able to live on my own and find full-time work.  He instituted the three-month drug holiday that failed.

 

In July 2003, I started seeing Dr. Altman who is a true professional.  I wrote in my SZ magazine spring 2009 Living Life column that he has the confidence to wear a hot pink shirt and this impresses me.  He also is confident in his decisions and has knowledge of the latest treatments.  I've been seeing him for six years and will continue to do so.  Yet I must pay for him out of my own pocket because he doesn't take insurance.

 

My first therapist was also my ally.  I saw him privately for six years.  In the beginning, my mother paid for the sessions and when I began working, the health insurance paid for some of it.  T. is my current therapist and he is the most empathetic person I know.  I use him as a sounding board and for feedback.  I've been seeing him for over three years.

 

One gripe I have about psychiatrists: when they put you on medication, they don't tell you what the side effects are and what you should look for in case something unusual happens.  On the good side, you can get this information from your local reputable pharmacist.  The other day my neighborhood Rx guy printed out for me info on Geodon and the names of the drugs that you shouldn't take when you're taking this atypical.  He allayed my fear that the Geodon caused my sugar to hover around 113 by saying it wasn't likely the Geodon caused that and I was in no way nearing diabetes.

 

Right now I'll sign off and wait for you and others to post comments before returning.

 

Christina

I have been lucky because I have been with the same psychiatrist since I was first diagnosed in 1983. I firmly feel he is the best psychiatrist in my area and I feel he has been good to me as a patient. I can remember one Christmas night when I was having a rough time and I called him and he called back pretty quick. I only see him now every 4 months but know I can call if I need to talk to him.

My first pdoc, I will call him Dr.D. He was a brash, cold man. He would look over the top of his glasses. The 1st session he asked why I was in the hospital. I told him I had a "nervous breakdown." He asked to explain that. He had me on alot meds, to this day I'm not sure what I was taking. I learned from that to always ask what med I'm taking.

 

The next doctor, Dr.G, was at the state hospital (BPC). She was good. She listened and was geniunely interested in helping me. She retired and was replaced by Dr.M.

 

I saw Dr.M until I was released from BPC. She was good, so I thought. I saw her when I starting going to the BPC Day Center. She told me that I would be in the hospital at least once a year. I had numerous hospitalizations at that point. I was angry when she said that. I stayed hospital free for 3 years to prove her wrong.

 

Dr.T came next. I was taking Prolixin (the dancing med) at the time. He asked me why I moved my legs back and forth. I said it was a side effect. He laughed and said "no, Prolixin won't do that."  After being taken off the dancing stopped.

 

DR.S is the one who got me to get sober. He was a nice pdoc.

 

Dr.U is my current pdoc. I've been seeing him for 20+ years. Whenever I needed to be admitted he would see to it that I did. He is the pdoc who suggested I get ECT's. DR.S also is in the ECT room.

 

Up until about three years ago I thought DR.U was a good one. I see him every two weeks for my Risperadol Consta shot. Its less than a 5 minute appointment. There has been times his cell phone will ring and he will talk to the cellphone longer than me.

 

His wife is his office help. She's a mean cold woman. I dread seeing her and having to deal with her.

 

He is only good for the meds. He told me last year that he doesn't want to counsel me.

 

I don't have any questions to ask. I wouldn't get the the answer anyway. I do not trust my pdoc. I have been his patient for 20+ years because he is the only one that will take my insuranace. He was shocked when I started to see a therapist. When I ended up in the hospital he said "what good is she?" I stopped seeing her. He often curses and sticks up his middle finger. He calls me David G, which pisses me off. I stopped correcting him years ago.

 

I get more support from Margaret and the online sites then I ever will from him.

 

I can't stop seeing him because of insuranace. I tolerate him. I haven't much of a choice. As long as I get my meds and ECT's I will be fine.

 

Dave

When I was 15 and dx as sz reaction, I did not know then how good those docs were for they were actually telling me that stress would trigger onset of sz. The stressful trigger came while i was in the Marine Corps and was charged with a crime I did not do and being punished for it. I broke and hallucinations and delusions swamped me. The doctors they took me to did not dx me or treat me but was just concerned with getting me out of the Corps. My doctors today have been nothing but truthful and honest and my psychiatrist and psychologist are both professors. I am told the truth about my condition schizoaffective disorder and my prognosis. I pay for a mental health counselor who is also very good to and for me. i must guard against and be aware of triggers or potential triggers. After many trials with meds, I have a cocktail that kinda works. I may not totally ever recover but I do have a bit better outlook.

I just want to start off by saying thank you to Chris.  She sends me emails to nudge me to participate here and it really helps.  

 

I was diagnosed in the fall of 1998 by the only psychiatrist I have ever known after I checked myself into a local hospital psyche ward for just an overnight stay.  He was originally from India and sometimes I have trouble understanding him.  He dresses nicely, is always polite and before I got insurance he was very generous about giving me many samples of anti-psychotic medications and Prozac.  He has set opinions about what drugs to prescribe (he doesn't like Seroquel or Geodon) and will not prescribe any anti-anxiety drugs because they are so addictive.  When I was suicidal, he didn't seem to take it that seriously, but did keep increasing my anti-psychotic medications until I was stable again.  It was a rather long and drawn out process though.  I see him every three months for about 5-10 minutes.  He always asks me how I'm doing and then he just writes the prescriptions.  I've been seeing him for eleven years, but I don't know him particularly well, though I did see his son play soccer for my friend who is the high school soccer coach and sometimes I would see him and his family at the games.  His son is going to Boston University now and wants to become a doctor.  I live in a very rural part of New York and there are not many psychiatrists.  This doctor works in about three different towns and also at a prison I believe.  I don't know how he manages in the winter when the roads are bad.  I feel pretty neutral about him, but he's all I've ever known and the medications he's prescribed have been helping me for which I am grateful.  

 

I started seeing my therapist in the fall of 1998 also and I have been very fortunate in finding her.  She is located right in my town, so I don't have far to go to see her.  Her primary job is as a psychology professor at the university.  She teaches in the Master's degree program and is well thought of.  Her husband is also a psychology professor.  My brother knows him because they are both music lovers. She is in her early 50s, a few years older than me, happily married with no children (though she gives therapy to children as well as adults).  Except for two years when she took time off (and I saw no one) I have seen her for about 9 years.  I now see her once every other week, but in the beginning I saw her every week.  I consider her a friend, though I never intrude upon her privacy.  We both live in the same town, so I see her from time to time out and about, but I just say hi or wave and leave her alone.  She is smart, sensitive, with a good sense of humor.  Like me, she leans towards Buddhism which is unusual around here where most people are Christians.  She also grew up in New York City, as I did.  So we have a few basic things in common, a common outlook.  And we both love music.  During the first three years of my illness, when I was only occasionally taking the anti-psychotic medications, she was very patient with me and kept urging me to take the meds.  She has always treated me with kindness and respect.  She is a very good listener with a keen memory and she is not judgmental.  I don't tell her everything, but I tell her a lot.  When I am in the midst of some psychotic symptoms, I have often imagined what she would say to me, something earthy and practical and supportive and it has relieved my symptoms.  She is a good, responsible, hard working person and I can't really think of anything bad to say about her.  I feel grateful to her.  She has seen me in all different states and she has believed in my recovery.  The only thing I would say is that I wish it was she who was the psychiatrist as well as the psychologist because she knows pretty much what I need when I have any setbacks.

 

That's it.  I have never been in a hospital setting, except for that one overnight stay, in part, thanks to my therapist and psychiatrist.  And also thanks to my own resilience.  I have always strived to be very honest with my doctors and that has helped me immeasurably.  The only thing I have lacked is a mental health support group to go to and/or a club house.  I am still very isolated from people and know no one offline who suffers from mental illness.  This is my main regret.  

 

 

 

Hi Christina,

 

 I have alot to say psychiatrists and therapists.  It is my belief that psychiatrists are very likely to overmedicate.  I never understood how they can prescribe medications.

I am, have always  been, and continue to be so, confused regarding this fact. Since we are all unique, doesnt it make sense that everybody's body is different and will react differently to medications.?  How does the psychiatrist know how your body will react based on individual differences?  One medication will, I belive, react differently for every individual.  The psychiatrist has no idea how a medication is working for you and your body.  They have the book knowledge but how about EXPERIENCE having a mental illness.  It is said that experience is the best teacher.  Also, it is my belief that texts can only teach you general facts, and , therefore, I feel psychiatrists generalize alot.  Also,another question I have thought about alot regards the subject of how long-term usage of a drug affects the body.  I feel that it is quite possible for drugs to build up in the muscles.  How does long-term usage of drugs affect the brain?   Based on the brief concerns that I have, I believe that psychiatrists are not as godly oriented as we believe.  I belief that it is the individual with mental illness who knows his body best.   I realize that not all consumrs will be well versed with language to discuss this with them.  Still, when you or I discuss this with them they don't really listen.  They tend to think of only psych meds, and this is only something they have knowledge in, but I still say, it is the consumer who knows more about his body and how various psych meds will react. Also, can you tell me why psychiatrists are so gungho about prescribing psych med versus vitamins, amino acids such as melatonin.  Why do they or therapists never mention other forms of therapy such as art, music etc.?  I am really beginning to question mental health services.  Also, I believe that the best therapists are individuals who have been consumers themselves.  Yes, I agree that all consumers experiences will be different, but this would allow them to empathize more with patients, also, they could share like-experiences which would  include universality- making the client feel as if he is not the only one having such experiences.  This, I am sure, is why self help groups are so valuable.  Also, this is why consumers need to tell their stories.  I have written a manuscript which has taken me over thirty-five years to write.  But where do I turn to from here, regarding how I can use it to educate the public and others?  I want to advocate and help others so much and I would like to use this manuscript when doing so.  Can you give me any ideas???

 

Sincerely,

Marya Pyrek