5 Reasons to Fire Your Psychiatrist

Patient Expert

Psychiatrists are essential partners in our quest for recovery from depression. I consider a good psychiatrist the most important component in recovery. Fortunately, there are many good, committed psychiatrists out there. Is yours one of them? Or do any of the problems below apply to your doctor?

Your doctor:

1. Does not respect you.

We sometimes forget, when depression has beaten down or smothered our self-esteem, that we do deserve respect from our doctor. Meaning, your doctor should listen to you (really listen, not just pretend to), treat you like the intelligent person that you are instead of a child and take your wishes into consideration.

2. Is not committed to your full recovery from depression.

Your doctor should not be satisfied until you honestly tell her, "I'm back to normal. I feel normal sadness once in a while, but no depression symptoms." If she tries to persuade you that feeling better than when you were severely depressed is enough, even though you're not back to normal, she does not have the commitment necessary for your successful recovery.

3. Dismisses your concern about antidepressant side effects.

Some psychiatrists dismiss patient concerns about weight gain, sexual dysfunction and other side effects that have a profound effect on quality of life. Their reasoning is that if the depression is partially or wholly alleviated, the patient should be happy or grateful. This is, to put it bluntly, bunk. It may not be easy to find an antidepressant that will treat your depression successfully without major side effects, but it's possible, and that should be your doctor's goal.

4. Doesn't keep up with new developments in psychiatry.

I had a psychiatrist who, although not a psychopharmacologist (a doctor who specializes in psychiatric and psychotropic drugs), was fascinated with the medication side of psychiatry, so he was more knowledgeable about the specifics of antidepressant treatment than other psychiatrists I've had. No one is saying that your psychiatrist needs to devote all his free time to reading medical journals, but if he wasn't interested in the topic, why did he become a psychiatrist?

5. Is not interested in finding the best treatment for you.

This means that your doctor shouldn't recommend that a new antidepressant just because it's new, for instance. If it's better than the one you're on as far as effectiveness or fewer side effects, great. But if the only attraction is that it's cutting edge, your doctor should not be willing to put you through the potentially painful transition. You are not a guinea pig.

As a final note, don't assume that if you're getting care from a clinic instead of seeing a private psychiatrist, that you don't deserve good care and/or can't get it. When I was first diagnosed with depression, my insurance wouldn't cover my treatment for eighteen months because they considered it a "pre-existing condition." My family doctor had noted on a prior visit for something totally unrelated to depression that I seemed to be under stress.

I was able to afford to pay for my treatment myself because I went to a local mental health clinic that operated on a sliding scale (you pay what you can afford). Psychiatrists were at the clinic on a six month rotation, and in the time I was there I had three different doctors. Two were great; one was not. But my therapist and the doctor who ran the clinic were caring and competent. So, don't assume that you need to settle for second best at a clinic.