New psychiatrist just as I’m feeling better

[Reallyreallyreally]

I had an evaluation with a new psychiatrist today. I was really nervous because she has horrible yelp reviews but I'd already made the appointment and couldn't find the list I got her from. The thing that stuck out most were the reviews that said she was cold and uncaring and condescending. It turns out she just isn't very expressive. She seems very flat on the surface, but I think she's actually nice, just very reserved.

They have a policy of up to three assessment appointments before deciding on a medication regimen but at the end of just the first one she already agrees that my current meds are good. I seriously downplayed the suicide stuff, but overall was up front. She was trying to ask me questions to redetermine whether I'm bipolar or not and thank god I've been at this long enough to be able to make a solid case for why even though I can appear to be this way on the surface I'm just really affected by things like my environment, diet, etc.

I have mixed emotions about both her and my therapist asking for each other's names. I know they can't talk to each other without a release, but of course if I get too suicidal "that goes out the window," as my therapist puts it. I feel like I'm never going to be suicidal again but I always feel like this when I get out from under it.

Do you guys experience this as well, where you'll be really suicidal, depressed, anxious for a while and it feels absolute, as if you'll be this way forever and always have been, but then when those weeks or months or whatever pass the feeling better also feels absolute, as if it is was always has been and will be? Intellectually the truth is there as data but the experience of it feels this way. Maybe I actually am a little bipolar??

 

[the_inbetween]

Yes. I suspect I have borderline personality disorder and/or cyclothymia.

 

[Reallyreallyreally]

Yes. I suspect I have borderline personality disorder and/or cyclothymia.

Those can occur together but are quite different. Self diagnosis generally isn't a good idea. If you feel this is the case and want to address it a professional could be helpful here. Borderline can be difficult to treat but cyclothymia is a super mild case of bipolar and can be completely managed through medication, plus I imagine the stress of having borderline probably exacerbates any propensity toward depression or anxiety.

 

[the_inbetween]

Those can occur together but are quite different. Self diagnosis generally isn't a good idea. If you feel this is the case and want to address it a professional could be helpful here. Borderline can be difficult to treat but cyclothymia is a super mild case of bipolar and can be completely managed through medication, plus I imagine the stress of having borderline probably exacerbates any propensity toward depression or anxiety.

Thanks. I will have to address it with a psych professional if I wish to deal with it.

 

[JustLosingMyself]

Hmmm...
I'm "encouraged" by my employer to attend the psychiatric services.
I've reached the point where I just don't say much of anything to the consultant in front of me.
In the last consultation he managed to insult me, lie to me and take me for a fool in 1 sentence.
Capital waste of time all round.

 

[Reallyreallyreally]

Hmmm...
I'm "encouraged" by my employer to attend the psychiatric services.
I've reached the point where I just don't say much of anything to the consultant in front of me.
In the last consultation he managed to insult me, lie to me and take me for a fool in 1 sentence.
Capital waste of time all round.

What a douche. Some people really are in the wrong job. Are you at risk of being fired if you don't attend? If so, can you choose your own mental health care outside of work as long as you're attending?

Are you in the United States? if so, your job is legally protected under t he Americans with Disabilities Act (ADA), as long as you're seeking treatment for any mental illness or other disability that does not place undue hardship on the company, and as long as there are over a certain number of employees. I think the magic number is 60 but double check that. That may be a state law rather than federal. It doesn't mean you won't get discriminated against but discussing it with HR will often scare them into backing off for fear of a lawsuit.

Apologies if we've already had this conversation. If I'm tired or a little bit dissociated I'll forget all the details of pretty much every conversation I have.

 

[JustLosingMyself]

What a douche. Some people really are in the wrong job. Are you at risk of being fired if you don't attend? If so, can you choose your own mental health care outside of work as long as you're attending?

Are you in the United States? if so, your job is legally protected under t he Americans with Disabilities Act (ADA), as long as you're seeking treatment for any mental illness or other disability that does not place undue hardship on the company, and as long as there are over a certain number of employees. I think the magic number is 60 but double check that. That may be a state law rather than federal. It doesn't mean you won't get discriminated against but discussing it with HR will often scare them into backing off for fear of a lawsuit.

Apologies if we've already had this conversation. If I'm tired or a little bit dissociated I'll forget all the details of pretty much every conversation I have.

I'm in Europe. The employment legislation protects my job to a certain extent, but not the illness benefits that are at the employer's discretion.
In both cases I need to be seen to take "reasonable medical advice". As long as I'm not queried about the drugs I refuse to take I hope I'll be ok
Txs though

 

[Reallyreallyreally]

I'm in Europe. The employment legislation protects my job to a certain extent, but not the illness benefits that are at the employer's discretion.
In both cases I need to be seen to take "reasonable medical advice". As long as I'm not queried about the drugs I refuse to take I hope I'll be ok
Txs though

It can be like that here for people applying for disability. They have to go through a lengthy process of taking whatever meds the doc decides for them during the very long application process and hope their complaints of side effects are listened to.

 

[LittleJem]

I think I'm in a similar situation in that I don't know if I'm Bipolar or not - if I am it's Bipolar II - the depressive version. I don't personally think I get mania, my family does - but that's because I have self-medicated with cannabis edibles, LSD etc - so I am high on something, but this is not mania. I don't personally have any patches which are different to my standard suicidal depression.

Often, I read yesterday, people can be misdiagnosed for up to 15 years. It is better to know if it's Bipolar, as the treatment is different, but it can take a long time to confirm a diagnosis. I did see a professional (private) psych for a first appointment, as I wanted a diagnosis, and he also didn't think I was Bipolar (though I took the reasons my family thought so...) but I still keep it as an option.

I don't know what medication you are on, but I've recently heard Modafinil plus anti-depressants can help them work more effectively, and I think someone told me that is safe for Bipolar. I'll look that up later (I'm moving house today) and add a link to any info I have.

It sounds to me like your psychiatrist and therapist want to care for and look after you. It is still up to you how much you tell them.

When I am happy I don't think about suicide - I am only happy when I have a working medication or drug or supplement.

When I am suicidal, I thikn about it constantly.

When I am in the middle and the depression is coming back, I start to feel fear of it coming back. Then it comes back!

 

[Reallyreallyreally]

I think I'm in a similar situation in that I don't know if I'm Bipolar or not - if I am it's Bipolar II - the depressive version. I don't personally think I get mania, my family does - but that's because I have self-medicated with cannabis edibles, LSD etc - so I am high on something, but this is not mania. I don't personally have any patches which are different to my standard suicidal depression.

Often, I read yesterday, people can be misdiagnosed for up to 15 years. It is better to know if it's Bipolar, as the treatment is different, but it can take a long time to confirm a diagnosis. I did see a professional (private) psych for a first appointment, as I wanted a diagnosis, and he also didn't think I was Bipolar (though I took the reasons my family thought so...) but I still keep it as an option.

I don't know what medication you are on, but I've recently heard Modafinil plus anti-depressants can help them work more effectively, and I think someone told me that is safe for Bipolar. I'll look that up later (I'm moving house today) and add a link to any info I have.

It sounds to me like your psychiatrist and therapist want to care for and look after you. It is still up to you how much you tell them.

When I am happy I don't think about suicide - I am only happy when I have a working medication or drug or supplement.

When I am suicidal, I thikn about it constantly.

When I am in the middle and the depression is coming back, I start to feel fear of it coming back. Then it comes back!

I have a less common approach to treatment. I take lamictal but I also use dietary means, specifically a really simple whole food ketogenic diet. They each work pretty well on their own to stabilize me but I mostly do really well when I do both, consistently. I landed in here on a long stretch of baked goods.

And yes, I agree they both want to provide good care. I feel really fortunate. I tell them what I can. Some of it I just can't, but my therapist at least knows the gist of the things I can't say and that's enough. Her take on when I can't tell her something is that I'm not ready *yet*. The psychiatrist I think will be really cool too. I'll see her again too. First impressions are not reliable generally.

 

[LittleJem]

I have a less common approach to treatment. I take lamictal but I also use dietary means, specifically a really simple whole food ketogenic diet. They each work pretty well on their own to stabilize me but I mostly do really well when I do both, consistently. I landed in here on a long stretch of baked goods.

And yes, I agree they both want to provide good care. I feel really fortunate. I tell them what I can. Some of it I just can't, but my therapist at least knows the gist of the things I can't say and that's enough. Her take on when I can't tell her something is that I'm not ready *yet*. The psychiatrist I think will be really cool too. I'll see her again too. First impressions are not reliable generally.

That sounds like great care. Kudos to you on generally avoiding baked goods. I'm veggie/vegan ish but I do like bread! A lot!! At least you know what works, all power to you

 

[Reallyreallyreally]

That sounds like great care. Kudos to you on generally avoiding baked goods. I'm veggie/vegan ish but I do like bread! A lot!! At least you know what works, all power to you

I like bread too. Even before keto I had to stop buying it except for special treats because when I'm eating it and have access to it all I will eat is bread with slabs of butter for days as I watch my other food go bad. I never got addicted to any drugs but caffeine and cigarettes despite years of enthusiastic dabbling with all kinds of things that should have hooked me hard, but food, specifically carbs for sure make that grade. It takes a very short time on carbs for me to start getting and staying irritable, anxious, unkind to people because I resent them so much, obsessively suicidal. I'll ruminate about everything that will potentially cause my life to unravel in short order. One day off keto and my mood dips. So I stay on it when I can. My therapist absolutely wants me to stay on it. She wants me alive.

On the subject, keto is known to mitigate not just physical health, but many symptoms of mental illness: mood disorders, attention deficits, even psychosis. The general lack of knowledge about it in mainstream medicine, the refusal for the most part to find studies for it for any purpose but epilepsy (not always true but the studies are very few and far between), and the continued pandering to big pharma is literally killing people. It's catching on but very slowly. How many of us would have no need for this site if the information were widely available, understood by doctors beyond fear mongering misinformation? Of course some would still be here but of course the pushback is great because the pharmaceutical industry would take such a massive hit that their CEOs would have to become millionaires rather than billionaires. So many people have so much trouble finding medications that truly help them long term and which don't have life altering side effects. How many instances of one medication to treat the illness, another to treat side effects, another to treat the side effects of that, or medications that have to be changed because people have built such a tolerance that they can no longer raise the dose high enough to continue getting the full benefits, when maybe the dose could have been much lower the whole time did big pharma and the sugar industry not have the medical industry by the financial balls? The reality is disgusting, and it truly does make it hard to find adequate mental health care. If I were low income like I used to be I would absolutely have killed myself by now.

Fuck. I sound like a religious proselytizer. Can I introduce you to my lord and savior Keto? It's true though.

 

[UpandDownPrincess]

I once had a psychiatrist who took a long time to diagnose anyone with bipolar. She told me that for people who are long and/or often depressed, getting reset to normal can feel like flying, just because they're not used to it. That is what your first post reminded me of, that just getting out of the depressed state can feel like a huge upswing.

 

[Reallyreallyreally]

I once had a psychiatrist who took a long time to diagnose anyone with bipolar. She told me that for people who are long and/or often depressed, getting reset to normal can feel like flying, just because they're not used to it. That is what your first post reminded me of, that just getting out of the depressed state can feel like a huge upswing.

Yes, definitely. I think it's a conclusion they jump to because it streamlines people in the direction of meds. Next in line!