Open Letter to a Psychiatrist


I got a copy of the Discharge Summary the psychiatrist, who I met once for an hour while at the mental health ward submitted to my doctor and I got a bit pissed off by what she said. I felt it needed addressing. This is the letter I am sending her:


Dear [Psychiatrist]

Re: Discharge Summary submitted for [me] dated 2/10/2013

I am in receipt of a copy of the discharge summary you submitted to Dr xx, copy enclosed for ease of reference, and part of its contents has me puzzled.

During my admission, you spoke to me once, for about an hour, at my last ward review when my section was lifted, yet apparently this was enough for you to make judgement on my condition, that you refer to as Bipolar Effective Disorder and also declare a lack of faith on how I intend to remedy this condition, ie quit alcohol for the foreseeable future, if not ever, and stabilise my mood without resorting to medication whilst dealing with issues which affect me.

I came across this behaviour before from a fellow psychiatrist in Canada, who, he too felt speaking to me for an hour, while I was heavily sedated the day after I was admitted, was enough to declare I was bipolar and needed heavy medication, and I have decided now was the time to put a few things straight.

First of all, I am puzzled how you can make such a judgement having spoken to me for only an hour. You know nothing about me, my past and what brought me there, yet you are happy to diagnose me. And for the record what happened to me on 27 August (by the way, you got the admission date wrong on your document, as well as the spelling of my first name in the summary) was a little more than a “brief manic episode”, speak to the Police Officers who brought me in and you might realise this.

And yes indeed, in Canada I have suffered two similar episodes, which I told this hospital about, but again you don’t know any of the circumstances. No-one can really understand what happened to bring me to those unless they have lived under my skin and know what has been going on in my life for the last 30 years.

I will try and explain a few things to you in the hope you might learn something your text books clearly didn’t explain to you.

You mentioned in the summary that I have “an understanding that one of the factors that sometimes contributes to relapse is that I stop drinking”.

First of all these episodes are not “relapses” they occur when I stop repressing my deep feelings by quitting alcohol.

You might have noticed in your line of business, or simply by looking around people in every day life, most people these days have various ways of repressing their feelings. Why? My bet is because they don’t know how to deal with the truth, which is they are not satisfied with their lives.

Some drink a little too often and a little too much, some play computer games for hours, some go to the gym or do a sportive activity to excess, some take drugs/smoke pot, some watch TV for hours on end, or work long hours, whatever is available to forget their lot.

I decided twice in my life to stop escaping myself. Simple. I don’t call that a relapse but an awakening.

The first time was semi-successful except I started to suffer from depression because my life was pretty shitty after my husband left me to pick up with my best friend, in a foreign country where we had just moved to and I found myself being forced to move back to the UK with two suitcases, an empty house and a little saving to start my life from scratch.

This was tough, I can assure you, and when the depression lifted, with a little help from light medication, I started drinking again, because that was the only way I knew how to cope with stress and also it gave me confidence to “fit in” again in the normal world – have you noticed how much alcohol is part of society these days? Pretty scary I’d say.

I soon realised I had started using alcohol to mask unhappy feelings again, this happened when I started dating the wrong chap, and I decided to quit for the second time.

The wave of repressed feelings hit me in the face like a ton of bricks. This time though, I decided to ride the wave.

It felt good actually, and I got over excited, started lots of worthy community projects whilst still processing 30 years of repressed emotions and I got burnt out. I started to sleep less and less due to the excitement, and started to behave in a manic behaviour. I actually spoke to my doctor about this a couple of weeks before the incident which brought me in. What happened that day cannot be easily explained and in fact, I don’t think scientific knowledge can explain it, but this isn’t something I am willing to discuss with you as I have little faith about your ability to understand such behaviour.

Which brings me to the point I wanted to clarify. You “somehow doubt” that I know what I am doing. Which is to manage my drinking sensibly whilst dealing with emotions I need to deal with – you cited issues with my mother but it runs much deeper than this – and not to use mood stabilising medication. You even suggest I should take medication long term, if I remember correctly at the ward review, you mentioned something about “for life”.

You met me for only an hour – and yes granted, you may have had feedback from the other professionals I spoke to, namely my primary Nurse and the Psychologist that I requested to see during my stay – yet you feel you know me enough to pass such judgements. Worst of all that I should be on medication for life!

I just do not understand why Psychiatrists’ answer to everything seems to be medication. I got exactly the same from the psychiatrist I had the displeasure to deal with in Canada.

Is that what they teach you at school? Meds are the answer? I was really hoping they’d teach you a bit about human spyche, enough that you’d learn it takes time to get to know a complete stranger to be able to fully grasp what might have gone wrong with them emotionally to then put them on the right track.

And no, that doesn’t mean which meds will numb them enough to function again in society. It means helping them process their feelings properly, feelings which usually range from fear, shame, guilt and anger, depending on what has happened to them to get them there (most likely some kind of abuse when they were younger).

Really not rocket science this, but apparently judging by what I observed during my stay at the ward, you professionals don’t seem to have a clue.

Patients there were really left to their own devices. I got the support I needed because I asked for it. Oh yes, it was there, but it seemed you guys concentrated on finding the right meds, rather than really getting to the nitty gritty of speaking to the patients on a regular basis to find out exactly what was in their heads, what happened to them to make them mis-function and how they may be able to deal with it, what support is available etc.

I believe mental health wards are the best place for people with mental health issues, however, they need help once in there. Yes granted, medication can help regulate inappropriate behaviour, but talking is what is needed more of.

I met a fellow patient today at Tesco [girl]. A lovely girl, I was very fond of her whilst at the ward. I recognised only too well the signs of over medication when I saw her. My face lit up as I went to say hi and hug her – she just looked at me spaced out. I managed to have a normal conversation with her, but I knew this wasn’t the real [girl].

Is this really what you are trying to achieve? I sure hope not.

Anyway, I needed to say my piece, for what it’s worth. I might or might not have a stay at the mental health ward again in the future, but it really doesn’t worry me. I know it’s not the end of the world, and sometimes, a place like this is the best place to be to process emotions, because, apparently there you are left completely alone to deal with your lot, and there’s plenty of fun activities to join in when the mood takes you. A great place to holiday I have decided. Shame about the stigma attached to it.

Please feel free to comment, clarify your thinking should you wish to.

Yours sincerely