Mentality

  

I saw my psychiatrist yesterday afternoon. The new one for the second time as they do this rotation so there’s never a consistent one. The first one was a bright eyed Malaysian lady, who dressed comfortably, who kept meticulous notes and seemed to want to spend hours with me, going over every symptom, every mood, carefully tweaking medications. yes, I found it arduous. She was then moving to the intake department at the hospital and was excited about that experience. 

The second was an Austrian guy, a former director of a hospital in Austria. He used to sit at a desk when he spoke to me and didn’t write anything when he spoke but liked me to know he was familiar with his notes. I used to discuss pharmaceuticals and side effects with him which meant he’d had to refer to books or his computer. Sometimes he’d like to go on tangents about how he personally liked to treat people, ie, not using a mainframe model etc, but I thought that naive once he got used to the NZ system. And I wasn’t there to hear him blather on about his ethics.

And now this psychiatrist. I didn’t like the fact her heaters were at boiling point and her office was like a sauna, but since getting her full name I’ve looked her up and seen she’s from Arizona, so I can understand her need to acclimatise! I didn’t give her much last time, I couldn’t be bothered. Just told her what drugs I needed and she obliged with the prescription. Thank you American doctors! 

This time I went for the same and mentioned in passing the disassociating and extra stress. She wanted me to elaborate, I kept it simple and light and her eyes darted towards the clock above my head. Not simple and short enough evidently! She went on to say some people say their better self comes into play when they’re under a lot of stress. For an awful moment I thought she might start talking about God, but only because she’s American 😄 

My better self? Not sure where she was going with that, but she ended with telling me to take more diazapam. I wanted to say, you do know it’s illegal to drive and use this medication right? Especially as one example id given involved driving.

She smiled with an ok and turned to finish and then remembered something else, oh, any urges of suicude or homicide? That standard question. Which I’m always tempted to answer with a joke but I just know won’t be taken well. So I answered with a flat, no, as before. And then the customary, ok now, you take care now, have a nice day.

Ah, the world of mental health. 

Fortunately I’m one of the lucky ones. I know what medications work for me, I’m read up on pharmaceuticals and I can advocate for myself. I see the majority of these people as prescription pads and when the really good ones come along, it happens rarely, but it can happen, I get to hear about other medications and trials and further research and contraindications.

This psychiatrist looked more miserable then when I last saw her. It may be the cold weather, or just a bad day, or maybe the reality that in NZ, mental healthcare is predominantly an underfunded state care provider. Her patients will be predominantly lower end income because no one wants to admit to having mental health issues – I would prefer private but there’s only 4 or 5 private psychiatrists in Wellington and there’s either a long waiting  list or I don’t like them. So the money and heat and real difference would be back in Arizona. Because here, if people can be drugged and managed – why change the status quo? That’s the mentality we see.

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4 thoughts on “Mentality

  1. Glad you can advocate for yourself. For what it’s worth, be careful of benzos with dissociation. Benzos are good for anxiety, panic….but they can make dissociation worse.

    I suspect the US is much like here in Canada – the system funds psychiatrists to manage patients with medication, basically. Insurance likes the medical model, because they think it’s cheaper to medicate than to do therapy.

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    1. That’s good to know, thank you. I rarely use them actually. But if I went by her advice I’d use them more, but I didn’t know they might make disassociation worse. You’d think she might mention that in passing

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  2. Like Ellen, i am so very glad you know what works for you, do the research and advocate for yourself. This is just another thing that shows how smart you are.

    As for mentel healthcare in the US, it is very medicalized. Insurance likes the medical model, or things like CBT, that are quick fixes– they like to deal with symtoms only. There has been some shift in insurance allowing better and more prolonged mentel healthcare, but it all depends on which insurance you have and (i think) how your therapist/doctor writes their case notes to the insurance company. With my daughter’s autism, we have dealt with a lot with insurance. Some things are all about which code the dr. uses for diagnisis/treatment, and the wording. The new company that is handling all autism insurance claims for our health imsurance is extremely picky and we have had to be very careful with how things are worded. For example, Kat has goals/objectives in her ABA therapy that deal directly with her anxiety and managing feelings. This new company tried to argue that Kat doesn’t need to see Bea for therapy because ABA is handling it. They also always suggest medication– for my 5 year old, who does not need meds! Its insane. So far we have managed ro get what we want, but who knows how long that will last. On the other hand, insurance has allowed me to see Bea for over a year, twice a week, 90 minute sessions. So…thats how insurance in the states is.

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