* TRIGGER WARNING * This story contains discussions around suicide and self harm. If this story is triggering please contact LIFELINE at 13 11 14.
The 'relationship' between a psychiatrist and their patient is often not spoken about. Like many other relationships some can be rewarding and joyous. But like many others they can also be strenuous and disappointing. A Nasty Woman Club contributor has bravely decided to speak about her medical 'relationship' with her psychiatrist. Our contributor was diagnosed with bipolar at age 21 and for over two decades she's been seeing her psychiatrist to help her with her mental health..
This story is about the importance of listening to your gut instinct. And understanding that it is okay to change doctors, therapists, psychiatrists and other medical professionals if you wish to hear a second opinion about circumstances surrounding your mental and physical health. If you are not happy with your medical relationship - do not be afraid to speak up and inform your loved ones.
Dear Mr. Psychiatrist,
You came into my life at a very vulnerable time. Just weeks before I turned 30 years old I had just recently started dating a guy seven years my junior after ending a relationship with a guy 21 years my senior. I was just recovering from a breast reduction operation and most significantly I met you in a psychiatric hospital after being referred by the Crisis Assessment Team after a luckily unsuccessful suicide attempt. It had been a long time between admissions to a psychiatric hospital, This was my first into a private one. I remember our first meeting very clearly. My paperwork from the C.A.T. team had a female doctor’s name written on it as a contact but you turned out to be male so that was my first surprise. And unlike other psychiatrists I had met in the past you smiled a lot and talked a lot (a trait I later learned to hate, the talking not the smiling!).
It was in that first session I decided I wanted you to be my psychiatrist. I hadn’t had a regular one for nearly a decade. You agreed to be my psychiatrist and so our long ‘relationship’ began.
I was in hospital for about four weeks and you saw me every day so we quickly got to know each other and I started regularly seeing you as an outpatient. I was very happy with how things were back then. I put my faith in you as a doctor that what you said was best for my mental health (in hindsight not a good idea!). I was put on a medication regime that allowed me eventually to go back into my full time career. My relationship was somewhat up and down but you were there to pick up the pieces, offering sage advice.
As the years went by, things got tougher. There were more ups and downs. More depressions and many more manic episodes and hospitalisations. We got second opinions and changed medications but my thirties were a very difficult time for my mental health. Credit to you though, you stuck by me. You were always trying something new. You went to conferences around the world and came back invigorated with what the new treatment protocols were and were wanting to try them with me if they were appropriate. Despite this, my thirties is just a haze of mental illness chaos. My relationship suffered and my career suffered. My partner and I broke up and got back together many times because he struggled dealing with my mental illness and I no longer could work full time.
But you always gave me hope. When I would come out of hospital and struggle with dealing with life and routine again you would give me hints and tips, recommend reading, outpatient courses for me. I had much hope for living with my illness then and you were giving it to me. New doctors to consult with, new meds to try. It was almost like there was a cure. I was even managing to hold down paid employment (unlike how things would end up after 20 years, with me on a disability pension).
At age 34 I got married to the same person. Yet again you were our hero. We eloped and I got completely manic. We were in Tasmania and it got completely out of control. We rang you and you were there for us. Guiding us so we could have our memorable five star honeymoon despite me being so sick. Every few days I would report in and you would listen to my mad ramblings, I was having visual and auditory hallucinations at the time and we adjusted my medications accordingly. We made it home and soon after I was hospitalised.
At this time I remember clearly how I felt about you. I thought of you almost as some kind of a God. You were so knowledgeable. Even when I was an inpatient the nurses and other patients would speak so highly of you and tell me I was lucky to have you as my doctor. Sometimes if a family member wasn’t happy with my treatment and suggested I get a second opinion, I wouldn’t hear of it. There could be no psychiatrist better than you. I was under your spell. Even when things were stable I would trek across the city fighting traffic to see you every few weeks because you told me to.
As the years went by more life changing things occurred, my marriage ended after 18 months. The divorce was a hard one to get over, and yet again I thought how wise you were because when I told you he’d left you were the only one who saw it coming. In my mid-forties I got breast cancer twice and you visited me in hospital when I was recovering from surgery. We had been seeing each other for about 15 years by now.
After my first breast cancer I got severely depressed and self-harmed. I was admitted to the hospital and you told me I should have ECT (Electroconvulsive therapy). I was very against this. Terrified about it in fact. In the end I went ahead and trusted you. I got better quite quickly and went home and back on medications.
As the years went by my manic episodes disappeared but the depressive episodes became more frequent and seemed to last longer. I expressed this to you and you told me that this was how bipolar worked. The older I got the more episodes I would have. Well, not very encouraging news to tell a depressed person. By now I was in my forties. My depressive periods were coming in thick and fast, sometimes with no trigger at all. So quickly that sometimes it would be from one session to the next. When I would express this to you, you would glibly say, "well what do you expect, that’s the illness?"
By now all that would happen in regards to treatment is that I would hear the same refrain, "you’ve been on all the medications, there is nothing new." I was up from one mood stabiliser to three, and on more than double the recommended doses of anti-depressants. You put me on anti-psychotics that were specifically not meant for people with diabetes. When I told you this (after my sugars went sky-high) you said, "oh good, I know that for next time!" You would recommend I go into hospital but I didn’t see the point. My hope by now in the second decade of being treated by you was gone. My illness was now in control of me and according to you it was only going to get worse.
I started suggesting to you that I wanted to get a second opinion but you brought up excuses, "it was too expensive for me, there were no other treatments." Only ECT and TMS, both needing inpatient care which I was averse to.
In 2018 after having some layover time at Sydney airport coming back from a holiday I started to journal my thoughts in a letter to you about how I wasn’t happy with how my treatment was going. I never sent it. I shared these thoughts with my family and some close friends. They all agreed with me that after 22 years it was a good idea to move on.
One of my biggest concerns was that after all that time there is a lot of water under the bridge and you really don’t want to have to start again with someone else. My brother reassured me that when starting again with someone else, they really didn’t have to know all that stuff. They only needed to know some of it.
The next 18 months were really tough, as my heart and mind had already left but I needed to find a new psychiatrist and I needed to tell you that I wanted to find someone else but having previously discussed it with you I knew that it wasn’t going to go down well.
We had started having some tough sessions where we weren’t communicating well. At the beginning of 2020 I had made the decision that I had to leave. I was in a severe depression and you as you had done so so many times before, recommended ECT for treatment. You knew I didn’t want this! This had been your go-to now for the last few years. You were done with trying meds. You said there were no more new ones so ECT was the only way. I told you I would only consent to ECT when my life was in danger (I had ECT one other time in 2017 after I had bowel cancer). Every week you were making a deal with me to make it sweeter. I could come in as an inpatient for just one week instead of the usual four, yada yada. Anything so you could get those electrodes attached to my brain. I said to you, "are you telling me that if I get depressed four times a year you expect me to have ECT each time and that is not going to damage my brain permanently?" You got quite uppity and said was I a mere mortal going to go against all the scientific research that had been done.
I was getting more and more depressed and then one day I brought up again, the issue of getting a second opinion and told you that I had brought up the issue with my GP. Mr Smiley was gone. You blew a gasket. I couldn’t believe it. Three times in that session you said, “so you want a better psychiatrist," and each time I replied, "no, I want a different one."
You should have told me that was fine. Well you didn’t! You went off on a rant which I have mostly blocked out and told me you were referring me back to my GP and you wouldn’t be seeing me again. Our relationship after 24 years, more than half my adult life was over, just like that, in a fit of pique. By the time we got to reception you had changed your mind and said I could make an appointment to see you the following week with a decision about the ECT. Well that wasn’t going to happen.
COVID hit and we had a few more telehealth appointments and I got better without ECT. I found a new psychiatrist and wrote you a polite letter.
Mr. Psychiatrist you did help me a lot in the early years. In the later years however, you turned me into a victim of my own illness. You did the worst thing you could do as a psychiatrist. You took away my hope. You led me to believe the illness was in control of me. You took away my autonomy over my illness. You talked about you, and your other patients. YOU DID NOT LISTEN TO ME! You did not hear me!
After barely two months with my new psychiatrist I am on half of the medication I was on. I have hope. I am in control of the illness. It is not in control of me. My friends and family have told me there is a different energy about me. I have more positivity and confidence. I am me again.
I have HOPE now.