How Years of Having a Caring Psychiatrist Made It Hard for Me to See the Danger
If you experience suicidal thoughts, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741741.
I’ve been blessed with the most incredible psychiatrists for the last 15 years. After 10 years with my first one, he moved away and, despite my overwhelming belief that no one could be as phenomenal as him, he referred me to another psychiatrist who turned out (after patiently allowing me to give him a chance) to be absolutely invaluable and determined to help me.
My depression is labeled “treatment-resistant” and the severity of it has left me in a private psychiatric hospital three times for my “immediate suicide risk.” Technically I admitted myself voluntarily but in truth, I only did it because my psychiatrist told me to. I trust him with my life, and that trust has undoubtedly saved my life several times. The problems arose with the fact that, while in a psychiatric hospital, you are often under the temporary care of the hospital’s psychiatrist. They may keep in close contact with your regular doctor and consult with them before making any changes to your medication, but they don’t have to. Sometimes they will simply take the diagnoses and medications you have, and do as they please. Technically they do what they “deem best,” but it can also be more like what they “feel like doing.” Unfortunately, the resident psychiatrist at this facility seemed to be doing the latter — and it could have killed me.
I was in the hospital for two weeks. Because the resident psychiatrist had tried a few medication changes with me during my stay, but hadn’t had success, he threatened to send me to the “state hospital” if I didn’t improve in the next few days. For liability reasons, the hospital won’t discharge someone who is a risk to themselves even if that person admitted themselves voluntarily. In my experience, the state hospital is not a nice place. It is scary, and often a “last stop” for people with severe mental illness — and many times people spend nearly a lifetime there. So I did the only thing I could think to do: I told him I felt better. I knew I would be discharged if I just told him I felt better — so I did. It wasn’t true, but I had to do it.
I was unbelievably relieved to return to my personal psychiatrist less than a week later. As he read over the report from the hospital, he noticed something: The hospital psychiatrist had not listed my diagnoses as “refractory major depressive disorder” (which would have been on my intake paperwork), but instead as “bipolar disorder.” When my psychiatrist told me that, I looked at him shocked. It couldn’t possibly be true after all these years… could it? I knew the diagnostic criteria for bipolar disorder, and I knew I didn’t meet it at all. Over the years my psychiatrists would routinely screen out possible misdiagnosis by asking me questions that would indicate a disorder other than depression. In 15 years, it had never changed.
For a brief moment after he said those words, I panicked; I didn’t know what to think. But without hesitation, my psychiatrist looked up at me and said: “Well that’s not right.” Two things quickly dawned on me. The first was that my psychiatrist had just shown enough confidence in all the work we had done together to contradict another professional. He was taking a risk by doing so. In the event I did take my own life, he could be held accountable for “misdiagnosis” by contradicting another doctor’s assessment, even if it was the other doctor who was completely off the mark. He was not being arrogant or dismissive of the hospital psychiatrist’s evaluation — he was simply being confident in his. Then something else dawned on me: Maybe I wasn’t improving in the hospital because I was being treated for the wrong thing.
My psychiatrist and I were able to get me to a stable point, but I couldn’t help but wonder how the hospital’s doctor got it so wrong. The thing is, I never really felt like he was listening to me. I never really felt like he cared, at all. But I ignored those feelings and believed that surely he was doing his job and trying to help me. By the time he threatened to send me to the state hospital, I realized he could not have cared less about helping me. He had put someone who was actively suicidal in a position where they had to lie about how well they were doing, and he didn’t even bother to worry about it.
He had to know that being actively suicidal one day and “perfectly fine” the next day was not possible. He had to know, but clearly, he didn’t care. He had always been kind and personable when we talked, but it’s as if he was just treating another name on a file. He wasn’t interested in really listening to what I was saying and evaluating the issue in depth. I don’t doubt that he feels overworked and underpaid, but he holds people’s lives in his hands and he has to be invested in helping them.
Still, part of me felt personally responsible. Years of excellent care made it hard for me to see the alternative. I was naïve to the reality that many, if not most people struggling with their mental health do not have the kind of doctors whose heart and soul go into their job. I was oblivious to the fact that I had something rare – something truly invaluable. And I realized how dangerous it could be to have a doctor who doesn’t have the kind of investment in their patient’s wellbeing that my doctors have had in me. That lack of genuine care could truly end someone’s life.
Photo by Molnár Bálint on Unsplash