Jump to content


Click here to find a mentally interesting date at No Longer Lonely Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud



Some Crazymeds mugs to help you wash down your meds. Get mugged for at Straitjacket T-shirts for more. 11oz mugs are $13. 15oz mugs are $14.
Mentally Interesting mug
Mentally Interesting
Medicated For Your Protection mug
Medicated For Your Protection
Team Bipolar mug
Team Bipolar
Brain Cooties Aren
Brain Cooties Aren't Contagious
Photo

A Word Of Advice To My Fellow Nutjobs.


  • Please log in to reply
13 replies to this topic

#1 jessica

jessica

    DIY Trepanist

  • Members
  • Pip
  • 74 posts
  • Diagnoses:recurrent depression, schizoid personality, cynicism about labels
  • Current Meds:lamotrigine, thyroxine, omeprazole
  • Location:People's Republic of Cambridge, United States

Posted 25 August 2007 - 07:21 PM

Because there is no rant section yet.

Rant.

If you're mentally ill and being treated well by your doctor, praise your doctor, and more importantly, praise him or her to his supervisor or director. The good doctors are few and far between and the directors rarely know one from another. Not only will your recommendation carry weight with employment / promotion / sacking decisions, it also will make a huge difference in letters of recommendation and peer reviews of their work if their hard work is known and rewarded. This work is thankless, and it's made in part thankless by the fact that lacking patient feedback, they have to go on some fairly arbitrary criteria.

If you're mentally ill and being treated unfairly by your doctor, say something. Say something and say it now. Half the time, the doctor has no idea because you're bottling it up, half the time, the doctor is burned out. Broach it with your physician. Then broach it with your physician's supervisor. If need be, change doctors and tell the doctor who referred you to the old doctor why.

If you're mentally ill and being neglected by your own doctor, e.g. calls routinely not returned, no advocacy or visit taking place if you're hospitalised for your condition, billing issues being used to disrupt treatment or a medication regimen (prescriptions being held hostage because "insurance hasn't paid yet" is not unheard of, sadly), having therapy interrupted routinely for lengthy telephone consultations, raise hell. This is inappropriate patient care. Tell your doctor you're disappointed, but if you've been around long enough to notice the pattern, but you will be seeking treatment elsewhere. Tell his or her supervisor why, as well. Be sure to tell the doctor who referred you exactly why you're leaving this person, at length, and your concern that this person will take on new patients with the same attitude. Tell the insurer who's been paying for your treatment why you are discontinuing treatment with this person and you would appreciate their assistance in finding a new doctor immediately. Inform the professional groups that the doctor is a member of (state medical societies, APA, & c.) as well as the state medical board.

Please recognise that while you may raise a bit of hell, you cannot expect miracles. However, enough people saying these things will lead this person to have fewer and fewer referrals, fewer and fewer defences from their colleagues, and less and less patience from the people who do affect them, namely the people who employ them, advocate for them, defend them, send patients to them or consider whether this person should be given leadership positions in organisations.

Assuming you may not have a great relationship with your primary doctor or may not even have one, good places to ask for treatment include a local medical school or nursing school's site for mental health rotations and clinics that work closely with the local hospital (if you've not been hospitalised, telephone their psychiatric ward anyway and ask where they refer patients for post-discharge care). If these fail, you should get in touch with your state's medical society and medical board, and a psychiatrists' society should they have one, and ask for referrals to practitioners in your area.

Interview any new doctor carefully, with the following list of questions:
  • "What is your philosophy on treating someone in crisis?"
  • "What is your philosophy on treating someone who is having some interruption of their ability to cope but is not suicidal?"
  • "What is your philosophy on treating someone who doesn't want to be medicated or is frightened of medication?"
  • "How do you approach a patient who is well-informed on treatments but suggests an approach you disagree with?"
  • "What influences your choice of medications?"
  • "How should a patient contact you outside of treatment hours? What sort of events warrant being contacted outside of appointment times? How is paging handled? When can I expect a return telephone call?"
Feel free to add your own questions. But you should have a feel for the doctor's treatment personality.

In exchange for all these rights, there are a lot of responsibilities.

Describe your symptoms honestly. Don't try to self-diagnose, and for gods' sake don't leave things out. Try keeping a mood diary. Ask your friends and family what they've noticed. Spouses, parents, siblings and children are particularly good bets. You need not traumatise them, but ask them honest questions and tell them to be honest, because you need to tell a doctor how you're doing. Do you seem ill? Out of sorts? Distractible? Irritable? Withdrawn? If they don't feel comfortable saying this to you (not uncommon), ask if you can have their impressions in a short paragraph or two in an envelope they seal and you give to your doctor. Unless you're totally nutters at the moment of intake, you will be presenting as far differently than you do when you're not being interviewed. You weren't put through intake because of how you behaved in the waiting room. You were put through intake because this is something you asked for based on the day you called and asked for the interview.

In describing symptoms honestly, this means everything. *Everything.* "Do you believe in magic?" Well, yes, if you do, say yes. Saying yes to one of these questions doesn't make you schizophrenic anymore than admitting self-injury makes you have borderline personality disorder. You have what you have. And being labelled either (correctly, that is) means you'll get better treatment focussed on your problems. Admit if you smoke pot. Admit if you take cocaine. Admit if you drink. Admit if you hear voices. Admit, admit, admit. As computer geeks say, Garbage In, Garbage Out. You can't feed these people non-information and lies and expect them to come out with a useful answer. Whatever symptoms you have, you are just as crazy as you are if you hide them, but if you hide them, you're wasting your own time. Stop worrying about stigma and start worrying about getting better.

Be honest about your own medication compliance. If you weren't med compliant, say why. "I didn't feel like taking it" is a valid reason in this case — it indicates depression, for one thing, lack of confidence in the treatment for another, and possibly intolerable side effects for a third. Your doctor needs to know what you can take and how and why and what warrants discontinuation and what should be pushed a little harder, and this is *your* brain all these chemical reactions are happening in and you are allowed to choose what goes into it. You also need to remember that *you* didn't go to medical school and your doctor did, so be very open minded.

On the third hand, you also need to remember that you are supposed to be a partner in your own care. Investigate medications you're prescribed. If they don't seem to add up, say something. Have your pharmacist check for interactions. Do your best to be compliant with all medications prescribed — mobile phone alarms, pill cases, patterns and routine (meds right next to toothbrush) will all make it easier to give the medication a fair try.

Honesty with yourself is key. Honesty with the person trying to fix your problems is key. Taking an active interest in your own mental health is key. Learning to advocate for yourself and your needs is part of recovering your mental health.

A lifelong medication and treatment régimen doesn't mean that you're hopeless. Hardly. Most diabetics, renal patients, bone marrow transplant patients, etc. go on to live healthy and full lives. Yes, there are a few pains in the ass in their lives and there were intense times where everything was dropped in favor of getting better. Just because your illness is in the brain does not mean that you should accept less — either fighting for medical care for what is a medical condition, or deciding you'll never survive in the world because of it and giving up.*

Never give up. Be honest with yourself, your family, your doctors. Be an informed patient. Work with people you trust. Be willing to take chances — on being a psychiatric resident's first case, on a new medication, on a change in lifestyle.

* Note that in no way am I impugning applying for disability benefits. If you're disabled for 40 hours of work per week, that's that. But assuming you'll be completely incapacited and you'll never be able to do anything in life at all, such as run a website, a knitting circle, or bake cookies and sell them, and things will never get better, that's a defeatist attitude, and you'll never kick this thing's ass into shape should you continue thinking like that.
  • 1

Dx: agoraphobia w/ panic disorder (300.21 / F40.0), recurrent depressive disorder, current episode severe w/o psychotic symptoms (296.3 / F33.2), generalised anxiety disorder (300.02 / F41.1), non-organic insomnia (307.42 / F51.0), schizoid personality disorder (301.2 / F60.1), Asperger's syndrome (299.8 / F84.5), post-traumatic stress disorder (309.81 / F43.1)
Rx: lamotrigine
Previous Rx: alprazolam, amitryptyline, amphetamine salts, buspirone, bupropion, clonidine, diazepam, diphenhydramine, duloxetine, escitalopram, eszopiclone, fluvoxamine, lamotrigine, lorazepam, olanzapine, prazosin, propranolol, quetiapine, ramelteon, sodium oxybate, trazodone, zaleplon, zolpidem, zopiclone




Enable Crazymeds to keep ranting about being crazy and taking meds. Donate some spare electronic currency you have floating around The Cloud


Stick to your treatment plan with buttons and magnets. 2.25″ $4 & 3.5″ $4.50 at Straitjacket T-shirts Some designs available in packs of 10 and 100
Pile of Pills buttons at Straitjacket T-shirts
Pile of Pills
Vaccines
Vaccines Cause Immunity
Medicated For Your Protection magnets at Straitjacket T-shirts
Medicated For Your Protection
Mentally Interesting buttons at Straitjacket T-shirts
Mentally Interesting

#2 Stacia

Stacia

    Would-be Neurologist

  • Members
  • PipPipPip
  • 753 posts
  • Diagnoses:Bipolar I, ADD
  • Current Meds:Lamictal, Latuda, Lithium, Klonopin, Adderall

Posted 25 August 2007 - 07:36 PM

Applause.
  • 0

#3 dymphna

dymphna

    Ready for the MCAT

  • Citizen Medical Expert
  • PipPipPipPip
  • 4,488 posts
  • Diagnoses:Suck-Ass Epilepsy, Perma-Migraine, Endocrine Hell, Associated Mood Crap
  • Current Meds:LTG 600, TPA 500, CLZ 1.5-2, Dostinex 0.5, Zoloft 0.25-.5
  • Location:A Mac Computer

Posted 25 August 2007 - 08:04 PM

Describe your symptoms honestly. Don't try to self-diagnose, and for gods' sake don't leave things out. Try keeping a mood diary. Ask your friends and family what they've noticed. Spouses, parents, siblings and children are particularly good bets. You need not traumatise them, but ask them honest questions and tell them to be honest, because you need to tell a doctor how you're doing. Do you seem ill? Out of sorts? Distractible? Irritable? Withdrawn? If they don't feel comfortable saying this to you (not uncommon), ask if you can have their impressions in a short paragraph or two in an envelope they seal and you give to your doctor. Unless you're totally nutters at the moment of intake, you will be presenting as far differently than you do when you're not being interviewed. You weren't put through intake because of how you behaved in the waiting room. You were put through intake because this is something you asked for based on the day you called and asked for the interview.

In describing symptoms honestly, this means everything. *Everything.* "Do you believe in magic?" Well, yes, if you do, say yes. Saying yes to one of these questions doesn't make you schizophrenic anymore than admitting self-injury makes you have borderline personality disorder. You have what you have. And being labelled either (correctly, that is) means you'll get better treatment focussed on your problems. Admit if you smoke pot. Admit if you take cocaine. Admit if you drink. Admit if you hear voices. Admit, admit, admit. As computer geeks say, Garbage In, Garbage Out. You can't feed these people non-information and lies and expect them to come out with a useful answer. Whatever symptoms you have, you are just as crazy as you are if you hide them, but if you hide them, you're wasting your own time. Stop worrying about stigma and start worrying about getting better.


Very well written post.

I would like to add one small caveat: Most of you here do A LOT of reading and researching about your condition. While this is to your benefit in the long term, it can trip you up rather significantly in the short term (i.e. an intake interview).

Always be careful to separate what is you, and what is something you read, somewhere. Just because something here (that you know the name of), or in a journal article sounded like what you feel you are experiencing does not mean that it IS what you are experiencing. Additionally, just because you know of a condition does not mean it is applicable to you. It sounds simple, here, as I write it, but some of those questions can really make a well-read person wonder.

Leave the finessing of distinctions to the professionals.


dymphna
  • 0

Yes, my name really is Dymphna.

 

I'm not a doctor, nurse, pharmacist, or therapist.

I can find you an answer and I won't blow smoke up your ass.

 

St. Dymphna is the Patron for brain maladies.

 

I'm the Enforcer.

 

eqnmrt.jpg

 


#4 StrungOutOnLife

StrungOutOnLife

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 235 posts
  • Diagnoses:Bipolar ?, Asperger syndrome, OCD, ADHD

Posted 29 August 2007 - 06:05 PM

I don't want this getting buried under a bunch of crap.
  • 0
Lamictal 350mg/day, Adderall 15mg/day, spironolactone 25mg/day, loxapine 15mg/day, metformin 500mg bid, Vitamin D 3,000 IU/day, Tri-Sprintec

#5 NOS

NOS

    DIY Trepanist

  • Members
  • Pip
  • 126 posts
  • Diagnoses:Bipolar NOS, lots of other things, NOS
  • Current Meds:Klonopin, Adderall and some other stuff
  • Location:Oregon

Posted 06 September 2007 - 09:00 AM

Absolutely very good advice! Glad someone took the time to write it. Thanks.
-L
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#6 In_Remission_aurelius

In_Remission_aurelius
  • Guests

Posted 23 December 2007 - 03:08 PM

This is really helpful, thank you. I'm going for an intake interview with my new doctor next week. I'm preparing a small writeup of pertinent information and symptoms so I don't forget anything.

Great post, very well written.

#7 StrungOutOnLife

StrungOutOnLife

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 235 posts
  • Diagnoses:Bipolar ?, Asperger syndrome, OCD, ADHD

Posted 09 January 2008 - 10:22 AM

In describing symptoms honestly, this means everything. *Everything.* "Do you believe in magic?" Well, yes, if you do, say yes. Saying yes to one of these questions doesn't make you schizophrenic anymore than admitting self-injury makes you have borderline personality disorder. You have what you have. And being labelled either (correctly, that is) means you'll get better treatment focussed on your problems. Admit if you smoke pot. Admit if you take cocaine. Admit if you drink. Admit if you hear voices. Admit, admit, admit. As computer geeks say, Garbage In, Garbage Out. You can't feed these people non-information and lies and expect them to come out with a useful answer. Whatever symptoms you have, you are just as crazy as you are if you hide them, but if you hide them, you're wasting your own time. Stop worrying about stigma and start worrying about getting better.


This is a very good observation. Giving the wrong or holding back information can actually makes things a helluva lot worse because you'll be misdx'd and treated for the wrong symptoms.

This bit me on the ass once a few years ago. I never told the Tdoc about a psychotic episode for a number of reasons. First, I didn't want to admit I was totally nutz. Second, it involved religious overtones and I thought they could be true and I didn't want anyone judging my spirituality. I finally revealed these things to my Tdoc and I was put on the heavy stuff. My Pdoc was hesitant to jump right in but he did after a second break.

Good writeup BTW-

Jook

My weird shit involved arguments from ignorance. I found myself concocting them all over the place. I remember reading fda.gov and realizing that I could not disprove the assertion that it was being run by alternative medicine proponents/practicioners from my computer chair that instant. I was pretty sure that it was not possible, but since I didn't know precisely how it worked, it was thus very possible. I also questioned the reality of the rats we were dissecting in biology class; I wondered if they weren't fake. I had a letter in my hand explaining that the school district had eaten through its pre-Joan Finney budget surpluses and kids in my class who didn't want to dissect real animals and I was thinking that maybe the rats were fake and maybe it was part of an antiscience conspiracy. I remember the letter and the kids because I reminded myself of both of those things which didn't make my head shut because arguments from ignorance are annoying that way.

I also had embarrassing racist/perverted intrusive thoughts. At first, they only happened with black people. Then I realized during Blazing Saddles that I was thinking any of that stuff with the coolies building the railroad. Bad idea!

I also had great difficulty remembering the way the world worked. Talking about my problems didn't just unburden me temporarily; it made my brain kind of sort of work. I always felt better after eating with friends outdoors and while walking home from school. When I got home/got back to class, it was back to my own personal hell.

My mood looked like an acid base titration curve: down a little ways gradually, followed by a big plunge.

It didn't fit my rigid definition of mental illness symptomatology, so I didn't tell the doctor, who I wish had been suspicious of a 15-year-old reporting depression, especially rapid-onset depression. I long for the day when age of onset and rapidity of onset are mentioned in the DSM.
  • 0
Lamictal 350mg/day, Adderall 15mg/day, spironolactone 25mg/day, loxapine 15mg/day, metformin 500mg bid, Vitamin D 3,000 IU/day, Tri-Sprintec

#8 panic!

panic!

    DIY Trepanist

  • Members
  • Pip
  • 95 posts
  • Diagnoses:Panic Disorder, GAD, Bipolar NOS, MDD
  • Current Meds:Wellbutrin Lamictal Clonazepam Lexapro
  • Location:lost in thought

Posted 24 June 2008 - 10:21 AM

Wow, great thread!
I've been known to suppress things that i didn't think were relevant to treatment.
Which was an excuse to not reveal things that I thought of as embarrassing, or differing in opinion with my doc, because I needed my doc to LIKE me.
It seems silly in retrospect, my percieved need to be liked by a medical professional (or anyone for that matter) held me back from more effective treatment.
Live and learn.
  • 0

#9 jennex

jennex

    DIY Trepanist

  • Members
  • Pip
  • 101 posts
  • Diagnoses:bi-polar
  • Current Meds:Lamictal, Effexor, Seroquel, Clonzepam, Wellbutrin
  • Location:MD, USA

Posted 24 June 2008 - 12:29 PM

This is a great thread. It's not uncommon to feel intimidated by professionals. Some are pretty aggressive.
It's important to be your own best advocate (It's also empowering)

Thanks Jessica
  • 0

#10 lostanddelirious

lostanddelirious

    Would-be Neurologist

  • Members
  • PipPipPip
  • 911 posts
  • Diagnoses:PTSD, Mood Disorder NOS, Epilepsy
  • Location:Not Wyoming

Posted 25 June 2008 - 09:56 AM

yup there are some things i definitely keep to myself cuz its really weird, like the time i had a dream when i was 10 that a spider bit me and turned me into a spider. For entire year i thought i was going to be turned into a spider on the date i had the dream.
i was obsessed! i dont bring it up because i am note sure it is relevant. maybe i should. hmmm?

btw, that was a great post.
  • 0
Current rx: Lamictal-500mg, Keppra-1500mg, Lithium-1200mg, Risperdal-1mg, Ativan-prn, Risperdal-prn, Geodon-20mg

Past rx: Tegretol, Dilantin, Depakote (15 yrs.), Zoloft, Abilify (3 trials), Celexa, Geodon, Topamax, Seroquel, Cogentin

#11 Jamie

Jamie

    DIY Trepanist

  • Members
  • Pip
  • 22 posts
  • Diagnoses:Bipolar Disorder I, OCD
  • Current Meds:Celexa 40mg, Depakote 1875mg, Klonopin 2mg, Seroquel 200mg
  • Location:Davis, California

Posted 13 February 2009 - 06:15 PM

Jessica,

Your post deserves a standing ovation. Thank you for writing such an eloquent, urgent piece about the vital importance of communication. I was never particularly open with my psychiatrists, psychologists, and therapists until I began working with my current doctor. A toxic combination of shame, fear, and embarrassment clouded my judgment and prevented me from sharing important information with my caregivers. I didn't feel comfortable discussing certain events in my life, the extent of my psychosis, or the moments during which such trauma and insanity became inextricably linked. (In fact, the psychiatrist who treated me from 2000 until 2005 didn't upgrade my diagnosis from bipolar II to bipolar I until he looked through my file in preparation for switching doctors.) As a result, I intellectualize my feelings and present my concerns during each therapy session like a medical examiner discussing the results of an autopsy. My shrink and I jokingly refer to this behavior as "emotional forensics". She is the first therapist to whom I can pour my heart out without feeling guilty, and this professional relationship would not have been possible without awareness of the issues you mentioned in your post.

~ Jamie
  • 0
"In the depth of winter I finally learned that there was in me an invincible summer." -- Albert Camus

#12 mickmax

mickmax

    DIY Trepanist

  • Members
  • Pip
  • 177 posts
  • Diagnoses:clinical depression, GAD
  • Location:Between Oz and Dark side of the Moon

Posted 13 February 2009 - 07:12 PM

Awesome awesome post!!
  • 0
Deby

current meds: Trileptal 300mg, Topomax 300mg, amilitryptiline 10mg, welbutrin 300mg, klonopin .5 prn

#13 cherries

cherries

    DIY Trepanist

  • Members
  • Pip
  • 122 posts
  • Diagnoses:some flavor of craziness

Posted 07 June 2009 - 07:48 PM

I know the rant is good and in a perfect world I would say, yes to all you said to do.
But in the world I live in if I tell my docs half the stuff you suggested, they would write me off completely. No one wants hard patients anymore. They will just dump you to the county and where I live you don't want that.
  • 0
"Well, I take this medicine as prescribed
It don't matter if I get a little tired
I'll sleep when I'm dead"

Warren Zevon

#14 cgrace

cgrace

    DIY Trepanist

  • Members
  • Pip
  • 32 posts
  • Diagnoses:Mood Disorder NOS, ADHD
  • Current Meds:Cymbalta 60 mg, Vyvanse 70 mg, Lamictal 200 mg, Geodon 240 mg
  • Location:Baltimore, MD

Posted 08 June 2009 - 05:23 PM

Always be careful to separate what is you, and what is something you read, somewhere. Just because something here (that you know the name of), or in a journal article sounded like what you feel you are experiencing does not mean that it IS what you are experiencing. Additionally, just because you know of a condition does not mean it is applicable to you. It sounds simple, here, as I write it, but some of those questions can really make a well-read person wonder.

Leave the finessing of distinctions to the professionals.


dymphna

I agree with this, a lot. I'm here to learn what I can about medication and learn what others are dealing with. But I've seen a few people (in my personal life) get mixed up with stuff they read... i've done it too.
  • 0
i'llliveonthemoononeday.


0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users


Shirts to swipe from Crazymeds' Clothes Line See more ways to let my meds express your feelings at Straitjacket T-shirts. Shirts, hoodies & more, $15-$51.
Batshit Crazy shirt
Batshit Crazy
Mentally Interesting shirt
Mentally Interesting
Medicated For Your Protection shirt
Medicated For Your Protection
Breakfast of Champions shirt
Breakfast of Champions
Bipolar Is NOT Contagious shirts at Straitjacket T-shirts
Bipolar Is NOT Contagious
Also available for other brain cooties.


Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud




Keep up with Crazymeds and and/or my slow descent into irreparable madness boring life. Pick your preferred social media target(s):
Follow Jerod Poore on Facebook
Wear my StraitjacketBatshit Crazy Blog
Crazymeds | Promote Your Page Too
Play Dress-Up with your Imaginary FriendsCrazymeds: The Blog