Tuesday, May 19, 2009

The Treatment Team

Another aspect of treatment for mental illnesses like bipolar disorder, is a good treatment team. In a perfect world someone with mental illness would have a supportive family and friend base, a good general practitioner, a nutritionist, a therapist, a psychiatrist, and a naturopath. All the books say so.
However, in the real world most of us cannot afford to have all of the above practitioners, we may have frightened many family members and friends away, and our insurance companies would just say "Naturopath?" laugh, and hang up on us. Finding "good" practitioners is also about as easy as finding the long lost friends who bolted when they learned your diagnosis. They changed their phone number.
I have had some really messed up experiences with practitioners: the hypnotherapist who lied to me to get me out of her office but had the nerve to hug me on my way out, the male psychiatrist who picked at his scabby face and head with his bitten-down nail nubbins, while twitching slightly and staring at my breasts, the stoned female psychiatrist who kept drifting off in mid sentence (having double dipped one too many times into the sample closet), and the psychoanalytical psychotherapist who I wasted 4 years with; he encouraged me to stay off meds and use marijuana, and ignored threats of suicide, all while encouraging me to wallow in the past, and that I was never wrong, even while manic and semi-delusional.
Yup, I've had some real gems on my team.
My current psychiatrist (or pdoc as we refer to them in cyberspace), forgot to write the prescription for the main drug we discussed yesterday. He also refused to take me off a drug that is making me physically unhealthy, encouraged me to try an over the counter weight loss supplement, told me to use my benzodiazepene for sleep (a no-no, especially for someone with addiction), and after informing me that I might need a sleep aid the rest of my life, due to side effects from the aforementioned ill-making med, told me to cut my sleeping pills in half...all while getting paid $150 for spending 15 minutes with me.
My general practitioner looks concerned and clueless and says "They sure have you on a lot of stuff." Poor guy. He also tries to give me meds and advice to counteract the devastating effects that psych meds and my mood disorder have had on my body. Most general docs do not treat a complex illness like bipolar, letting "the experts" treat it. I feel he may do better than them at this point.
My therapist is pretty great. She does Dialectical Behavior Therapy which teaches skills for emotion regulation, social skills, mindfulness, and coping mechanisms. The point of DBT is to relearn emotional intelligences which have morphed due to mood disorders or past trauma. It was created for people with borderline personality disorder, but can be useful for other psychiatric maladies as well. I can rarely afford to see her though, even though it is a $25 copay, I am spending all of my money on meds and seeing the semi-incompetent pdoc every two weeks.
In my dream world scenario I'd have a naturopath, a nutritionist, an acupuncturist, etc. If only I had the cash for a complete team of professionals to repair my head.
I do have several supportive family members, especially my indomitable husband, and a friend or so. It is hard to let myself rely on them due to massive amounts of guilt. They are few, but they have been integral to surviving my imperfect world.


  1. Yeah, you've had some psychiatric "docs" with some severe psychiatric issues, that's for sure. I have read some of the pie-in-the-sky treatment plans that some books endorse. One actually wants you to find 10 people who will take your health on as their personal responsibility. I don't know 10 people who would accept the responsibility of just e-mailing me every day. Most people barely take their own health seriously, so how can we find people to truly be invested in improving our health? I just don't know. The professionals usually aren't very professional. I know the general doc of whom you speak. He tries very hard to understand and learn more about maladies with which he isn't entirely familiar. I think he is a good choice because he cares and he tries, and that counts for a lot in a world of uncaring people who really don't try to help.

  2. I've had my share of whackos docs too. There was my spaced out existential therapist who had know idea what was going on in my life, and told me that he didn't care if I got better. And my psychiatrist who misdiagnosed me, and gave me copious amounts of antidepressants and anti psychotics, when I really needed mood stabilizers instead. I think that set me back a year or too, I actually got worse than when I went in. I like my therapist and my doc now though. My therapist does DBT with me also, and my shrink has a "less is more" approach to medicine, which is good. Regular health care is so messed up right now, and sometimes I think that people just don't care about mental health care. sigh...

  3. If you have fallen in the grip of overweight and obesity and are eager to trigger off weight loss, you should opt for dieting and physical exercises in the first place. However, when dieting and physical exercises fail to yield results, get hold of diet pills such as Phentermine, Adipex etc but only after getting a doctor’s prescription for the same.