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My psychiatrist has just shafted me!

Tawny

Tawny

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Thanks tawny. Its a Saturday so my surgery is closed atm but I will give them next week. Of course wellness is a priority. Unfortunately, without a diagnosis there can be no treatment. They won't just prescribe bipolar drugs for someone who hasn't been diagnosed. Hopefully my GP will be able to help me get a referral to a different team, but there is only so much they can do. Unfortunately, they cannot prescribe this kind of psychiatric medication by themselves, even though I'm sure if I spoke to them they would be more sympathetic to me.
Lots of people without bipolar take mood stabilisers. Many people with severe depression take Lithium because it also is very good as an antidepressant.

I understand diagnosis is important. It must be very confusing for you because a diagnosis is like turning on the light. It is very bad what has happened to you but i am sure this will be rectified next year.

In the meantime, speak to your GP on Monday and express this concern, that you will relapse without this medication. I think if you explain that you have not met this silly psychiatrist (don't say sill :) then the GP will probably understand and be equally stunned. They will probably not let you know they feel that way though.

Tread carefully and it'll all work out
 
manicmonday

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I'd request copies of your medical notes so you can see what the original doctor's reasoning was and what they've recorded about you since that made them change your mind. Then I'd speak to the GP about getting a second opinion. If you can afford it it would probably be quickest to go private, thinking about your medication.

I also second contacting PALS as they are the best people to explain what your options are.
 
Tawny

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I think you should do this the easiest and most stress free way possible. Try the GP first and see what they can do. Don't criticise anyone, just ask for help. Keep it all nice and calm and not emotionally dysregulated :)

That is what i would do

Another way might be better for you
 
T

timing

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NIMH has alot of information on it's website. I can't understand why she would diagnose you with a childhood disorder. Something is really wrong here. GP maybe the best route from here. I have had some questionable docs over the years but this is ridiculous.
If there are any crisis lines where you are I would call them and look for options. Don't give up, your concern is legitimate.
 
Ghost_Owl

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The cynic in me thinks this is an attempt to off roll you as the NHS is on its knees. I had a similar attempt from a new psychiatrist who took over from my old one. It was like they had made up their mind before I even entered the room. Almost like they have targets to meet and top down pressures... Same reason why CPN's are becoming like mystical unicorns so rare they may only soon be imaginary. They dismissed my support workers observations of mania entirely. Someone who has known me now for four years and is formally paid to look after me in those times of illness alongside others. I don't like having my life being dismissed by some one who has only known me for forty minutes.

So next time I saw them I made them justify their complete dismissal of my entire known existence that like you has been witnessed by close loved ones. I first asked them if they drive? They said yes. I said no they don't I have never seen them drive. They did not like this but it underscored my point of their failure of logic last time.

My manias, have damaged my father's finances, something I will likely not manage to pay back. So to say I was a little bitter as was my support worker for being ignored, would be an understatement. In that confrontation I asked them to specify how I lived upto these new descriptors ignoring those that have overlap with Bipolar. They did not like this as we went through each trait. But I started to push them, to back up why they wanted to withdraw the Bipolar diagnosis or to name what unstable relationships I have? What their evidence was? I doubt they read much of my file... They just faltered in the end. My Support worker went at them as well with examples. I almost felt sorry for them by the end.

I am just going to be depressingly honest. The vague diagnosis means support can be withdrawn. As personality issues cannot technically be treated, just managed. It means they can justify putting you on cheaper medications and sign post you to Mindfulness workshops that have a five month waiting list. That ticks the boxes. This is the sad state of the NHS currently as it has been undermined and gutted. I don't doubt this Psychiatrist is under top down pressure to get their caseload down. I made some attempts to put up with them, but I did not feel I was being listened to in the end. I put across in writing that I felt that rapport had broken down between us and was not conducive of a therapeutic exchange.

If you feel you have lost trust in this Psychiatrist you should put that in writing. Get them to justify how you meet the criteria not including overlap. Hear them out but you know yourself better than they do. Because Psychiatry is reliant on self report and witnesses to behaviour. If you have loved ones witness you in those states maybe get them involved to write to the trust. If they ignore that they don't have anything to go on, as unlike a disease there is no definitive test just groupings of symptoms. So the onus is on them to prove why they have arrived at that conclusion. You can get second opinions and you have a right to change psychiatrist.

In the end I wrote to change psychiatrist on the basis the therapeutic relationship has broken down. (These are the magic words.) If they block that as they may do. Escalate it by getting other agencies involved. Mind sometimes have advocates as do other charities. Citizens advice if you can get ahold of any one in an equally gutted organisation. Always create a written trail as this can be turned in liability later if needs be. If you have concerns about medication regime changes write that to them as well. Note your concerns. I have found Pals to be entirely useless but maybe you will fare better with them. Sometimes its luck of the draw. Same goes for psychiatrists. Sometimes you have to fight for yourself even when you have no energy to do so.

This is the cache of relevant information, as some people are funny about opening pdfs, which is understandable.

Medical Consultant Change Request Procedure

Not a fan of the guardian but this is what I mean by off rolling. We all deserve better you included.

 
N

Nukelavee

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Ghost is entirely right. Get this all in writing from the doctor. Force him to explicitly explain his logic and conclusions.
 
Lone_wanderer

Lone_wanderer

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NHS shrinks tend to be a mixed bag, had some excellent ones and some downright useless ones, my old one when I lived in the city even gave me his work mobile number so I could contact him directly if need be. I liked my last one now I'm under county services but he left me psychotic for most of the summer because he couldn't be arsed to change my meds back.
 
HLon99

HLon99

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The cynic in me thinks this is an attempt to off roll you as the NHS is on its knees. I had a similar attempt from a new psychiatrist who took over from my old one. It was like they had made up their mind before I even entered the room. Almost like they have targets to meet and top down pressures... Same reason why CPN's are becoming like mystical unicorns so rare they may only soon be imaginary. They dismissed my support workers observations of mania entirely. Someone who has known me now for four years and is formally paid to look after me in those times of illness alongside others. I don't like having my life being dismissed by some one who has only known me for forty minutes.

So next time I saw them I made them justify their complete dismissal of my entire known existence that like you has been witnessed by close loved ones. I first asked them if they drive? They said yes. I said no they don't I have never seen them drive. They did not like this but it underscored my point of their failure of logic last time.

My manias, have damaged my father's finances, something I will likely not manage to pay back. So to say I was a little bitter as was my support worker for being ignored, would be an understatement. In that confrontation I asked them to specify how I lived upto these new descriptors ignoring those that have overlap with Bipolar. They did not like this as we went through each trait. But I started to push them, to back up why they wanted to withdraw the Bipolar diagnosis or to name what unstable relationships I have? What their evidence was? I doubt they read much of my file... They just faltered in the end. My Support worker went at them as well with examples. I almost felt sorry for them by the end.

I am just going to be depressingly honest. The vague diagnosis means support can be withdrawn. As personality issues cannot technically be treated, just managed. It means they can justify putting you on cheaper medications and sign post you to Mindfulness workshops that have a five month waiting list. That ticks the boxes. This is the sad state of the NHS currently as it has been undermined and gutted. I don't doubt this Psychiatrist is under top down pressure to get their caseload down. I made some attempts to put up with them, but I did not feel I was being listened to in the end. I put across in writing that I felt that rapport had broken down between us and was not conducive of a therapeutic exchange.

If you feel you have lost trust in this Psychiatrist you should put that in writing. Get them to justify how you meet the criteria not including overlap. Hear them out but you know yourself better than they do. Because Psychiatry is reliant on self report and witnesses to behaviour. If you have loved ones witness you in those states maybe get them involved to write to the trust. If they ignore that they don't have anything to go on, as unlike a disease there is no definitive test just groupings of symptoms. So the onus is on them to prove why they have arrived at that conclusion. You can get second opinions and you have a right to change psychiatrist.

In the end I wrote to change psychiatrist on the basis the therapeutic relationship has broken down. (These are the magic words.) If they block that as they may do. Escalate it by getting other agencies involved. Mind sometimes have advocates as do other charities. Citizens advice if you can get ahold of any one in an equally gutted organisation. Always create a written trail as this can be turned in liability later if needs be. If you have concerns about medication regime changes write that to them as well. Note your concerns. I have found Pals to be entirely useless but maybe you will fare better with them. Sometimes its luck of the draw. Same goes for psychiatrists. Sometimes you have to fight for yourself even when you have no energy to do so.

This is the cache of relevant information, as some people are funny about opening pdfs, which is understandable.

Medical Consultant Change Request Procedure

Not a fan of the guardian but this is what I mean by off rolling. We all deserve better you included.

Thank you ghostowl for sharing your experience. Your insights are very useful and I will definitely be following up on that. I totally agree, Its a sorry state of affairs and a classic case of the lunatics running the asylum. For some of these doctors, their oaths and principles mean nothing to them. All they see is statistics and budget cuts. They don't even take a second to consider the very real consequences that their decisions have on people's lives.

One question I have concerning changing psychiatrists. Is this still possible to do once they have discharged you to the GP?
 
On Fire

On Fire

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Another poster, in a different thread, described mental health care as a crap shoot.
 
Ghost_Owl

Ghost_Owl

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Thank you ghostowl for sharing your experience. Your insights are very useful and I will definitely be following up on that. I totally agree, Its a sorry state of affairs and a classic case of the lunatics running the asylum. For some of these doctors, their oaths and principles mean nothing to them. All they see is statistics and budget cuts. They don't even take a second to consider the very real consequences that their decisions have on people's lives.

One question I have concerning changing psychiatrists. Is this still possible to do once they have discharged you to the GP?
It is not the doctors who set policy. It is management who never come out of their ivory towers onto the front line. Where to them the best run hospitals would be empty of patients but they still draw a salary. We are just numbers to them driven by disgusting target culture that often misses the point. Morale is low on the front line they know the NHS is being decimated and its core principles undermined. Many are just doing the best they can with an intentionally starved service. My last decent psychiatrist said as much, it was why she retired early. I really miss her, she gave me some of the best years of my life. Sounds like you had a good one too.

That is a tough one if you have been discharged, but don't go quietly into the night. Strong suggestion is to talk to your GP. Show up with a letter of your concerns. Your fears regarding medication, loss of mental stability. Reference the failure to communicate effectively in discharging you. That a lot is unresolved and little explained. Reference your concerns about relapse and enquire with the GP what your rights are in this situation? Above all make a paper trail that gets entered into notes. Keep copies of what you write. Your GP may be annoyed, like many, at becoming the dumping ground for mentally ill people they are not trained enough to deal with and are overstretched in other areas as it is. They know what is happening they just won't obviously state it to a client.

Maybe you will have a sympathetic one who will reverse the pressure back on the discharging psychiatrist and try and refer you back. Unfortunately as I said you got to fight to get what you need. Pretty demented when you think about it, as the most ill are the least able to fight how are they doing I wonder. I always try and fight sideways by getting other things involved. Be it my father who does not want to have to rescue me from a manic trip to Turkey. Or even my own therapist. What ever it takes. We all deserve dignity. It should not feel like such a damn fight for help. But sadly it is.
 
K

keith74

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The important thing here is your medication and what is going to happen when you run out. Have you spoken to your GP?
Not sure how it works in the UK but here in Canada I know that the GP can still write prescriptions for existing medication. My wife's GP has done that when she needs to refill her meds. What the GP can't do is prescribe new meds or change the existing prescription in any way. That needs to come from her psychiatrist.
 
jajingna

jajingna

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I once just told the family doc, first time I met him, that I was depressed and had taken zoloft in the past. No problem. Got the prescription. (in Canada)
 
Tawny

Tawny

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Not sure how it works in the UK but here in Canada I know that the GP can still write prescriptions for existing medication. My wife's GP has done that when she needs to refill her meds. What the GP can't do is prescribe new meds or change the existing prescription in any way. That needs to come from her psychiatrist.
A GP here cannot give mood stabilisers or antipsychotics without instruction from a psychiatrist. If the psychiatrist says don't give the medication, i don't think the gp can do it.

The GP can though contact someone or use their judgement when it comes to a patient facing having to go cold turkey because it is not safe. The GP is going to have to do something because this is not acceptable is it. The GP won't be able to keep giving the medication.

It is complicated. I am keen to know what the gp says.
 

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