While I am eternally grateful for psychiatrists and the medications that treats my bipolar disorder, I have run into problems with certain doctors who think they know what is best for me. So I have come up with a personal mantra to remind myself who is in charge here:
Doctor, you are the expert on medications.
However, I am the expert on me.
I have yet to say this but I am keeping that in mind. I get my mental health care through the state right now and they often switch doctors on me. For the most part, despite frequent changes, I have gotten better service through them than I have in the private sector. Where I live I have little choice because there are only three doctors who take Medicare plans and they are all terrible.
Now of course I advocate co-operating with your doctor, especially when you are first diagnosed. At that point it is likely that he does know more than you do about your symptoms and how to treat them. You may be at a point where you are so sick that you can’t think clearly anyway.
I do believe however, that it is unhealthy to develop a long-term dependence on the psychiatrist’s opinions because he is only human. He makes mistakes too. From my work as a peer mentor in the mental health field and from my own experience it seems to me that the people who have developed co-operative partnerships with their psychiatrists actually do better in the long-term than those who are more passive.
It is important to learn as much as you can about your illness and how it is treated, otherwise you may get the wrong treatment altogether. Keep in mind also that in many ways the doctor is making an educated guess as to what is wrong with you and what your treatment options are. This is because many symptoms of a particular mental illness can actually overlap with another diagnosis. For instance a person with major depression could actually have undiagnosed bipolar disorder. Someone with a mood disorder can also have some periodic schizophrenic symptoms (breaks with reality). Someone with schizophrenia can have mood symptoms also (schizo-affective disorder). Quite a few people have co-current issues with anxiety. Doctors base their diagnosis on what the patient tells them, so it is important to be as open as possible.
So I believe it is paramount for me to understand my symptoms, how they are treated, and how these treatments affect both my body and my mind.
Most doctors I have seen respond positively to my input. However there are some old-school psychiatrists out there who actually have the audacity to tell me that I can’t possibly know myself, my own symptoms, and my own reactions to my medications. They treat me, well, like I’m crazy.
The worst example I have is a doctor who told me that I couldn’t possibly be feeling what I was feeling because it wasn’t in the textbook. Not only was he wrong, but you can find those symptoms on any reputable website on the internet. I was having a mixed-episode, rapid-cycling between feeling high and euphoric and feeling depressed. When I came in to see him I was crying. So in his mind I must have been confusing being anxious with hypo-mania.
Granted I haven’t experienced mania that often, but I have experienced anxiety. Both anxiety and mania have racing thoughts and hyperactive behavior as symptoms, but the feeling is quite different. I don’t experience euphoria and hypersexuality when I am anxious.
His solution was to prescribe a tranquilizer. I declined, because I am a recovering addict.
I left, completely frustrated and crying. Because I knew exactly what I needed. I wasn’t a newbie or an idiot. I had years of experience dealing with my illness, listening to other people’s accounts when I worked as a mental health peer mentor, and doing a lot of research on my own. I needed a mood stabilizer medication. That is the standard treatment. I don’t care what his outdated textbook says.
This is why it is so important to know your symptoms and what your treatment options are. Because you are the expert on yourself, not the doctor.