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

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Mental Health – The Stigma from all Angles

I touched on the Stigma attached to mental health in a previous post, and something I experienced recently made me realise that ridding of the Stigma is a mammoth task.

A few days ago, I went to visit a friend I made when I stayed at a Mental Health ward recently – see post Psychosis – he had left before me and unfortunately, as I suspected, returned a few days after I left. I say as suspected due to my view on how patients are cared for in a Mental Health place, see post My Take on Mental Health.

As I was sat with him and a few other patients friends in the smoking yard, this woman came out shouting and screaming, went to sit on the ground some way apart from anybody else and started ranting to “herself”.

She obviously grabbed my attention and as I listened to her ranting, I realised she was in a similar position as I was when I had my psychosis. She was talking to someone (I suspect God) and was very angry, shouting that she couldn’t understand why this was happening to her, that she was an honest person and had never lied.

I looked back at the guys and said “poor woman”. Their answer? “Don’t mind her, she is loopy, she is a right pain in the arse, last night she kept us up til 5:30 am with all her screaming and ranting, she has no respect for anyone”. Shocked, I tried to explain to them that she probably couldn’t help when her ranting would happen and didn’t do this to be a pain. They wouldn’t have it. They being people with mental health issues!

So I gave up trying to convince them and went to speak to her. I sat on the floor in front of her and asked her how she was. Instantly, her behaviour changed. She started to talk about herself, her life, her passion for guitar, a little support group she got involved starting up which is now a registered charity and many other topics that blew my mind away.

All it took was for someone to listen. But no-one at the Mental Health ward, staff or patients, had bothered before. This really re-affirms my thinking that professionals have no clue and the Stigma starts with patients.

Today, I had another example of this via Facebook. Time To Change posted a little story of how Asda had removed a fancy dress costume from their shelves after they realised their mistake. The costume was “Mental Health Patient”. One of the comments was from a girl who said “How appealing, I will never shop there again”. There the Stigma just there. “Why not” I commented under her post, “They’ve made a mistake, acknowledged it and removed the item, I think they should be commended myself”.

When I started thinking about the Stigma, I emailed a few people who knew me at the time of my first stay in a Mental Health Institution in Canada and who were aware of where I was. I asked them how they felt. Of the 10 or so people I emailed I received answers only from four.

Here are the answers of those people who kindly agreed to reply:

“I can tell you what I felt although it probably won’t be too typical, because my best friend growing up was diagnosed with a mental health issue and on more than one occasion has been sectioned.  I felt profound sadness, helplessness, I wouldn’t know how to help or reach you. I didn’t really feel going in to care would help you, apart from stopping you be a danger to yourself.  I didn’t think it would ‘cure’ you, just remove you from society so you weren’t an embarrassment and a worry to others.  These feelings are just as you asked maybe not justified but they were my true feelings rightly or wrong”

“you had a broken heart, you were not crazy ever.
You were dehydrated, and under nourished and the mind becomes confused, happens to everyone. You could not grasp the reality of what was happening with those closest to you. A broken heart is not a broken mind. Your answers are inside you not from us. Walk in nature and spend enough time alone with no distractions to find.”
 
Mental health issues and seeking the help of professionals is a positive approach to taking care of your mental health.  Our mental health is so important – it is important to us all. (Perhaps even more important than our physical health and the protector of our physical health). We must all be vigilant about our mental health at all times.  Yes, our society can put a stigma on being in a mental hospital but we are so lucky to have hospitals that care for the mind and spirit.

I hope you are feeling better.  It is a process and must be cared for daily.  You have nothing to be ashamed of”

When I first heard you were going into care, I was afraid for you, my friend and what you were going through. I knew you would eventually “straighten out”, but felt bad that you were having such a bad time.

I was sure that being in care was probably a good thing, as I didn’t want you to hurt yourself (or others, although I wasn’t too afraid of that happening). When we are experiencing great grief, we don’t always think very clearly and can take actions we might regret later.
 
I feel like I may be “smarter than the average bear” about mental illness and acceptance of others who need help from counselors/psychiatrists as I suffered depression for years and had a break down in my late 20’s.
But I also felt a need to distance myself from you after you wouldn’t listen to reason about getting more sleep. Lack of sleep is one of the most toxic things one can do to kill brain cells and it makes one unreasonable. 

So, although it pained me to do it, I did withdraw from you (as you pointed out to me), knowing that you wanted to be “fixed” and no one could fix you until you had faced the demons/issues in your life that you had indeed been running from for too long.

As much as you were looking for someone to make you happy and feel better than, (or group or activity), you needed to take that down time and depression and just deal with it. I’m certain it made you stronger and and that’s a large part of why your happier today.”

 
Food for thought don’t you think?
 
Shame, fear and hopelessness seem to be emotions that go with Mental Health issue.
 
I will clarify that these days, I don’t feel ashamed of what has happened to me, and going into a Mental Health place was the best thing for me at the times. The only fear I feel is the reactions others may have towards me when I return to work, as I have been away for a month now and my immediate colleagues now know where I have been, others won’t know and really, short of sending an email to everyone (which I will not do), I am not sure how I am going to deal with this situation. 
 
With regards the hopelessness, this is the main issue for me. How do I break this barrier down, which keeps people away from you when you need them most.
 
Educating people is the answer, I know it. Because people who have never gone through it will never understand what Mental Health issues are about. I heard recently someone talking about a friend of mine who has been labelled as suffering from multiple disorder that “he isn’t helping himself”.  I have suffered from depression once in my life, and believe you me, we know damn well what we should be doing, however, we are unable to function properly.
 
And one more thing – why is it ok for some people to suffer from Bipolar (or manic depression as some prefer to call it) and not for others, example:
 
Stephen Fry – respected
Britney Spears – poopooed
 
Empathy is the key word here, not sympathy, however as most people have never experienced Mental Illness directly, most are unable to give empathy. So it’s sympathy if it touches someone they like and lack of it if it is something they don’t.
 
As I said at the beginning, mammoth task changing this Stigma. Still, I have hope 🙂

The Stigma with Mental Illness – Bipolar

Since pledging on the Time To Change website, I have been thinking about how my experience with Mental Health can help others.

I have a lot to say on the subject but I would like my contribution to be helpful, so I am working on the best way to do this. I have some ideas that are forming, but it is a slow process. I want to do it right.

A couple of days ago, I received an email from someone who was upset with me. I had broken off our relationship as I felt it was the right thing to do. I had known from the beginning we were not right for each other, however I had realised we could learn a lot from each other so I continued seeing him. (I had written a post about it on this blog but sadly I deleted it a couple of days ago as I felt maybe it was too personal (for him) for me to share openly.

On Sunday I realised that we would be better off as friends and told him so. This didn’t go down well and he got rather angry with me (which happens).

I had told him very little about my experience with Mental Health, only that after my husband and I split up, “they” tried to diagnose me as Bipolar (it took a psychiatrist one hour chatting with me to decide I was Bipolar) but that’s a story for another post.

Yesterday, I received an email from that chap, listing the symptoms that go with the manic stage of Bipolar, blaming the decision I had taken to finish with him on this illness.

I was rather angry at first, it felt like a slap in my face “see, you are crazy, you are not thinking straight, that’s why you dumped me, you’ll regret it”. More so that his sister apparently has been diagnosed with Bipolar and he seems to have very little understanding of the problem, and even less empathy.

However, I have had signs of being manic recently so I decided to look at each point and see where I was on the Manic scale.

This is my findings (which I emailed back to him):

The manic phase of bipolar disorder may include:
  • feeling very happy, elated or overjoyed – yes, but for good reasons, my life has turned around, I am no longer reliant on drugs and alcohol or guys to be happy.
  • talking very quickly – sometimes yes, when I get excited – who doesn’t?
  • feeling full of energy – yes, probably due to too many teas in the morning though and the fact that my life is quite fun these days, no mopping about in bed for hours on end (reminds you of someone?). Most days though I feel quite tired towards the end of the day, pretty normal behaviour really. Also, apparently stopping alcohol does that to you (gives you extra energy)
  • feeling self-important – no. Proud of myself for achieving what I have at the moment for sure (quitting drinking, successful launch of the social and other groups) but nothing wrong with that. But self-important no. I even had a debate with someone on FB who suggested I should “go down to their level” when approaching my neighbours about the noise issue. Told him I talked to everyone the same, apart from to kids when I might be softer.
  • feeling full of great new ideas and having important plans – I do have good ideas and all seem to go down well so far, nothing “disorder-y” about that. Important plans are only important to me. For my own reason (ie figuring out where I went wrong in life and bettering myself). If they happen to matter to others, great. I am certainly not pushing my ideas/plans on anyone, I am just doing my thing and if people like it, then great, if they don’t then it doesn’t matter. My blog for instance, I haven’t told many of my friends about it.
  • being easily distracted – not really, in fact when I concentrate on something, I tell people to wait before speaking to me so as not to be distracted. My boss actually laughed at me today because I was concentrating on something at work and hadn’t noticed he was sitting there waiting to talk to me.
  • being easily irritated or agitated – no more than usual. Probably a lot less actually. Certainly not anxious at all these days (used to be a very anxious person)
  • being delusional, having hallucinations and disturbed or illogical thinking – categorically no. (I suffered from that when I was sleep deprived before so I know what that’s like)
  • not feeling like sleeping – I do sleep, maybe not long enough but I certainly like my sleep, plus I nap when I need to as well, so I have no problems shutting down my brain when needed.
  • not eating – I eat plenty 🙂
  • doing things that often have disastrous consequences, such as spending large sums of money on expensive and sometimes unaffordable items – no disastrous consequences from my actions – in fact, very positive ones, made peace (properly) with my husband, getting on better with my friends, making new nice ones, and work is getting better all the time. Money wise, hmmm let me think what my latest expensive, unaffordable item was….nope can’t think of any. Even managed to go round a whole car boot sale and not bought anything.
  • making decisions or saying things that are out of character and that others see as being risky or harmful – all the people in my life are telling me they like this new “positive paz”, my mum in particular is very happy to hear how I am doing (and she would know if I was out of character)

——————————————-

If I am really Bipolar, I sure hope I will be able to see as clearly why I feel the symptoms that go with depression when that stage hits.

As an addendum, I am closely watching this seemingly manic phase, in particular the over excitement bit. This is what I do to make sure my overthinking doesn’t affect my life too much:

  • Go on long walks with my friend’s dog. sometimes my friend joins us too.
  • Meet up with people regularly, nothing beats interaction with people to level you (and they can tell me if I get too excited)
  • Having a routine to make sure “normal” stuff gets done, such as tidying up, clearing up the dishes straight after eating, food shop so I don’t run out of food.
  • Listen to chillout music
  • Switched to decaf tea
  • Spend time with my cats (cats have an amazing calming influence)
  • And most importantly, I make sure I make my bed every morning 😉

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