October 24, 2007

Second Opinions In Psychiatry

Recently, I've run into a string of fellow bipolars who are winding up on four and five medications at a time. Two mood stabilizers plus two antipsychotics plus an anti-depressant or two plus a benzo or maybe some Lunesta. I've even run into people on three antipsychotics when they've not had a genuine psychotic episode in their lives. It's like docs have lost their minds--someone is supposed to live and thrive on these things long-term how exactly?

I usually suggest to these folks--at least when they complain of getting poor results--that they ought to really get a second opinion from a different doctor, preferably one working independently of doc A. It may or may not help you, but it likely won't worsen your situation--and you could just end up on fewer meds and doing much better. This seems to work for depressives and people with anxiety as well. Not so clear what kind of results schizophrenics might see.

The sad thing is that anytime I've made the suggestion I've been met with blank stares. Yes, people, you really can go to a different doctor--and you can do it without your current doctor's permission.

Just an idea.

Posted by Philip Dawdy at October 24, 2007 12:03 AM
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Comments

well, maybe the problem is we are taught to believe our doctors are god.
come on people, if you buy a car you take a couple out for a test drive. doctors are fallible just like anyone else. if you were told you had cancer and they needed to remove an organ you would get a second opinion. why not when it comes to your brain?

if i have learned anything from this blog it's to question the doctor about everything script, every notation in their book that they write about you. for your shrink, your gp, even your dentist! the only way to get well is to be informed and know what drugs and what you need to do to get your body well.

Posted by: susan at October 23, 2007 11:54 PM

The dangerous thing in psychiatry is this - questioning your doctor is a symptom of purported mental illness and can get you in trouble when not done carefully. Questioning your diagnosis or disagreeing with your psychiatrist in any way can be seen as lack of insight which thanks to TAC is now synonymous with lunatic homicidal murderers.

Posted by: Sally at October 24, 2007 05:22 AM

I wish going to a second doctor who might really give you a different opinion was easy but unfortunately it probably would just be a question of tweaking a drug here or there or changing a dosage. Likewise I think it's bloody hard to find a doctor who would seriously help with withdrawal. Remember these guys actually know less about psych drugs than most of us here on this blog. Unfortunately if you want to get the truth and get help probably your main resource is the internet. There are a few docs out there who know but you can probably count them on the fingers of two hands. Your bipolar friends on cocktails are in big trouble. If they were independent thinkers they wouldn't have gotten to that point. You really are on your own if you want to question the current paradigms and reject them. That's the sad truth and we have an epidemic of psych drug harm in the making -- it's already here but when the generation of kids who are being raised on psych drugs become adults we really will be in a fix unless some of them figure it out and raise a call to arms.

Posted by: Sara at October 24, 2007 08:26 AM

pdocs are loathe to say anything against a treating psychiatrist. I went to see doctors for consultative purposes and the only thing they ever did was recommend additional meds. I was already on a ton of shit. It's a code among them...they won't say bad things about colleagues. I'm ditching psychiatry. Good luck to those of you looking for a second opinion---there may be a few doctors out there willing to express a different opinion.

One way to get an honest opinion would be to say you are leaving your current doctor. Then the doctor will feel like you are his/hers. Then they are more likely to freely discuss changes. And recommend their favorite cocktail which may be better or worse than your current doctor.

Posted by: Gianna at October 24, 2007 08:38 AM

As we all know, being exceedingly generous, psychiatry is the field of medicine with the least objective, least reliable method of diagnosis, and the least effective treatments for ailments psychiatrists themselves tell you are incurable, and yet, it's the only area of medicine that I know of where "patients" are discouraged, if not outright forbidden from getting second opinions. Why it's enough to drive you cr....oh not that.

Posted by: Sally at October 24, 2007 10:32 AM

Once a person is on the medications (especially multiple), it nicely complicates the persons life.
Distracting them from their problems.

Are the (bad) symptoms a side effect of the drug, underdosage/overdosage or mental illness?

A second opinion from organization who think the mind/human condition can be helped/fixed with the (only their) correct chemicals? There are other chemicals like alcohol and (illegal) marijuana, some use successfully in moderation to coap.

Posted by: mark p.s. at October 24, 2007 10:33 AM

I'm wondering if it's possible to consult a second doctor without a crib sheet from the first. I've given up on the medical system entirely so I won't be able to find out. There was a bit of an uproar when "walk-in clinics" opened in British Columbia. The thinking was that patients wouldn't get "continuity of care." I guess my question is: What about breaking continuity of bad care? A fresh start.

In August, I was taken to a new hospital and initially wasn't admitted. Only the third try (with the police in attendance) succeeded. But when I showed up at my home town hospital, their door was wide open. Always is, for me at least.

As crappy as the whole experience was, I was actually happier with the new hospital's protocol. They did tie me down to a bed and inject me with Loxapine but then let me go a few hours later (guess my neurochemistry rebalanced with the antipsychotic -- those shrinks are heroes!)

It's interesting to ponder whether a second opinion is ever truly a second opinion (unless it's blind).

Posted by: Francesca Allan at October 24, 2007 05:05 PM

Francesca, One of the problems with the psych world is that if a pshrink "misdiagnoses" a patient, it's just atrributed to the patient "lying" and hiding symptoms. TAC has a creepy piece on the homeless and how some of "them" hide the fact from the public that they are mentally ill until night time when they "talk to the voices in their heads." Their site really says this. So the idea is that once you are diagnosed with SMI, if another doctor doesn't validate the diagnosis, it's not because the diagnostic system is total bs, it's because the lunatic is lying or goddess forbid, hiding their craziness. Once again I am reminded of the Puritan witch test, if she drowns she's not a witch, if she doesn't drown she is so we have to draw and quarter her or something.

Posted by: Sally at October 24, 2007 07:44 PM

It occurs to me that if you live in the US there may be one way to get a free second opinion on whether you are mentally ill, one so helpful, I might try it myself. Here it is: Apply for social security disability and say you are mentally ill. They will likely order records from preious shrinks and have a psychological expert review these records to see if what is in the records supports a diagnosis of bipolar disorder or schizophrenia or whatever. These psych experts are renowed for never finding a psych diagnosis valid in my experience. I'm wondering if anyone else out there has similar experiences.

Posted by: Sally at October 25, 2007 08:38 AM

I think you'd have to pretty damn smart to (a) live on the street, and (b) hide your mental illness, at the same time. If the Nazis at the Treatment Advocacy Center are suggesting that these crazy people are no burden except for talking to themselves at night, how does that tie in with unmedicated loonies being as dangerous as someone with untreated active tuberculosis sitting in a crowded theatre and shouting fire? (or some such shit-for-brained analogy by the esteemed E. Fuller Torrey)

Posted by: Francesca Allan at October 25, 2007 04:12 PM

Francesca,

Torrey would probably explain to you that intelligence is often a symptom of mental illness - another thing that makes those subhumans so dangerous.

The next paragraph is what they say about homelessness from TAC's purported homelessness fact sheet. I was going to post the link but I kept getting nauseous...sounds like they're describing Zombies:

"Many other homeless people hide from the eyes of most citizens. They shuffle quietly through the streets by day, talking to their voices only when they think nobody is looking, and they live in shelters or abandoned buildings at night. Some shelters become known as havens for these ill wanderers and take on the appearance of a hospital psychiatric ward. Others who are psychiatrically ill live in the woods on the outskirts of cities, under bridges, and even in the tunnels that carry subway trains beneath cities."

Posted by: Sally at October 26, 2007 09:07 AM

I don't think a second opinion is going to mean much if the psychiatrist has given you an Axis 2 diagnosis. You're pretty much screwed at that point. And if you have been under a psych's care for a few years you can pretty much count on having an axis 2 diagnosis. I will never share my previous psych hx with any other physician. Partly because my psychiatrist was a jackass, and partly because he has a fairly serious Axis 2 diagnosis of his own. Under his care, I was a hopeless, chronic patient. Away from his care, I got better. I am glad to leave my past (and him) behind. I had forgotten what it was like to be treated as an adult. I kind of like it.

Posted by: Lisa at October 29, 2007 09:02 AM

This is such a relief. I can't believe I've found people, other than my husband and a few close (non-diagnosed) friends who see the psychiatric industry for the fraud that it is. I can't tell you what a relief it is.

I recently saw a friend's husband, a logger, whilst visiting at their home. I hadn't seen him in a really long time, since before I gave up the psych docs entirely. Here's what he said to his wife after I left: "Sherry looks really good. She must be out of therapy." So simple a logger can see it.

I was overmedicated about 7 or 8 years ago with benzodiazapimes (spelled wrong) by a private psychiatrist. These drugs are notorious for causing loosening of inhibitions--not that I was told about that. I was unable to get any psychotherapy because the mental health center refused to see me because I was "too high functioning" while the private people refused me because I "needed too many services" (this was when I thought there *was* such a thing as help from that profession). As a result of being in a double blind situation and the lack of inhibition caused by the drugs, I made a very serious suicide attempt.

The ER doc decided I was lying and sent me home, where I almost died in bed next to my husband. He and the mental health worker were making jokes about me in the hallway, in ear shot of my distraught husband!

I was drugged out of my gourd on the benzos and unable to walk the next day. Got sent home again by the same ER doc. Then tried to hang myself in the woodshed--all the while wondering why I was doing this (It's the benzos, stupid). My neighbour called the police, who were much smarter than the ER docs and told my husband to take me to another hospital. There they tested me (finally) and my blood level was two points below lethal. This was two and a half days after the overdose.

I spent three weeks in that hospital with a doc I THOUGHT was a good guy. I made the mistake of trusting him until I read his discharge summary recently. It is a pack of lies designed to protect the original prescribing pdoc from the consequences of his overprescribing.

Now I find I cannot risk going to the local ER if I have a physical problem. They read my record and immediately treat me like crap and stop treating anything physical. A friend of mine recently went to this ER. The minute they found out she had a psych diagnosis they stopped treating her, made her march down a hallway in her bare feet to a seclusion room. She was there because of fainting spells brought on by a bad reaction to blood pressure medication. She was actually in danger of having a stroke. During the forced march down the hallway she passed out. All the good people in the white coats literally turned their backs on her. They put her in a room with a uniformed guard at the door and ignored her for three or four hours. She ended up in the back seat of a cruiser in handcuffs, transported to the state hospital where she was immediately released because she didn't belong there. The next time she became ill her physician's assistant was able to beg a local doc to admit her to the hospital directly, bypassing the obviously dangerous-to-anyone-with-a-psych-diagnosis ER.

I live in a very rural area and am getting to the age where ER care becomes more important to one's peace of mind. It is a considerable stressor in my life to know that my life will be in danger if I end up in the ER I'm most likely to be taken to. There is no way anyone can provide good medical treatment to someone they hold in contempt and it's clear that's what happens once they find out you have a psych diagnosis.

Ironically, I found out about six months ago that my long held suspicion that I have hypothyroidism (pooh-poohed for years by the docs) is quite true. The disthymia I've had for almost 30 years lifted within weeks of getting onto thyroid meds. I still have a lot of PTSD symptoms but can live with them.

But I now have this Mental Patient tee shirt and a shopping bag full of (mis)diagnoses to go with it, including "histrionic personality disorder". I asked the pdoc about it. He literally got out his DSM and started reading it aloud, then said "oh, this doesn't fit you at ALL". BUT he didn't change it on the computerized records so now I'm stuck with it.

Since the advent of computerized records (oh, excuse me--continuity of "care") I wonder what I can do to make a fresh start in the US. I'm actually thinking of moving to another country (where I have citizenship) mainly so I can "forget" to bring any medical records.

Sorry to go on so and, since this is an older blog entry I have no idea if anyone will ever read this. As I said initially, it's a huge relief to know that I and my small circle of close friends and family are not alone. Thank you for being here.

Posted by: Sherry at November 12, 2007 05:41 AM

I too have issues with psychiatry, good blog, i read it all. Move to australia, although I say, its the same damm thing, these doctors cannot be trusted, they are undiagnosed themselves i believe. Dont ever trust a doctor again.
email me

Posted by: Jones at April 8, 2008 08:43 PM

Sherry, I want to talk to you, email me at gbfd77@msn.com You sound normal, remember there are people reading this blog who like to through psychiatry down peoples throats, you can trust me, Its a fraud!!!!!!!!!! Contact me

Posted by: Jones at April 8, 2008 08:46 PM

Jones, once I told forensic psychologist I was working with that before we could go any further I would need to see the results of his mmpi and Rorschach since these were the tests he makes a living administering and testifying about and it would seem scientific for me to know his results. He explained that the tests aren't valid on mental health professionals because they know how to administer them so you are correct not only are they undiagnosed, because of their profession they think themselves immune from the diagnostic process. As I suggested to this guy, it seems the opposite should be true, that in fact every patient one of these guys sees should have access to their mmpi test results. Oh well.

Posted by: Sally at April 9, 2008 01:17 AM

Sherry, same thing just happened to me when I recently had severe pneumonia, both lungs/ surrounding my heart as well. Unable to breathe went back to the doctor/[floor above an ER]I was off the charts unable to get oxygen [on their monitor, the red flag level] I was wheeled directly via a nurse with demand from doctor I receive immediate oxygen. They read my chart; first tried to give me xanax; I couldn't breathe and fingers were turning blue. LONG story short; I had to lay there being a model patient, no complaining, left alone for 2 hours when a lab tech came in and read my oxygen level and heard my gravel chest breating, and said, "wow you need oxygen". I finally got it; the worst part was I heard a nurse say, "oh on xanax? that's the first thing they will give her!" I had full blown pneumonia!! I never saw the ER doctor for 3 hours. It was horrible; and being that I've been in ER's with my daughter who was psychotic and they shoved her into a locked ER room for 12 hours in urinated clothing, I can safely say, anyone with a history of psych in their charts [mine says bipolar, because when I had chest pains and they asked me what meds I was on their faces fell off when I said Lamictal...what for? uh, mood disorder", I said. Well, if you don't divulge the meds you are on things can go awry, so I was leary of speaking, and look what happened. End of the event, doctor says "you have a very bad double pneumonia"-- I told him we already knew that 3 hours ago, I was sent downstairs for oxygen and didnt get it for 3 hours. Shit.I complained a week later to the original doctor and she was shocked I was treated that way--welcome to the real disconnected world of medical vs. psychiatric care.Psych care has no dignity at all. I've seen it all and the treatment of psych patients is horrific. My daughter was severely dehydrated last summer, and the admitting medical hospital dumped her to the curb, literally at 11pm at night, when they said, "no psych patient on the medical floor".
It's fucked.

Posted by: Stephany at April 9, 2008 02:22 AM
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