Saturday, December 20, 2008

It's Okay, I'm Just Neurotic!

Why the hell do I need to see a psychiatrist? I don't. When I booked the appointment, it was because I was tired of the throw this against the wall and see what sticks kind of approach. I was hoping that maybe someone who dispensed anxiety meds might have some sort of experience with drug combinations or dosages or something. Perhaps all I needed was a little bit of this and a dash of that. And maybe, he could even offer counselling. However, I think I already realized that I was willing to walk the unmedicated route for a little while cause I was feeling much more motivated about my life. Watching one of my dearest friends in the world die in front of me gave me a certain perspective on life. I've seen my Buddhist friends look head on into BIG FUCKING ILLNESSES and glow with such high life conditions. I'm not looking for any big illness wake up lessons. No thanks. I'm full thank you. So I went to my specialist appointment and he asked me a bunch of questions and I answered.

I told him that I had recently come off of Effexor because the side effects were outweighing the benefits. I had reached a big question mark, not quite clear of the withdrawal, but given my grief issues, I was certain to be a little emotional. Yes, it did its thing, my mood improved and I got a lot of stuff done. That's always a good thing. Getting out of bed is always a good thing. Pretending you have life under control when really you don't is not a plan. It's a disguise. But I don't see why I have to put with intense itching, dead taste buds (wait, that was a good thing cause skinny tastes good), no libido, crazy ass dreams that make you wake up in DREAD and the threat of burning up on a spin bike. He made a comment that perhaps some of the side effects were psychological. Oh. No. He Did. Ent.

I smiled sweetly. I told him what difference did that make? If one feels the drug is giving you a nasty side effect, it's still real to the person affected. He conceded quite graciously on that point. Or maybe my smile looked homicidal, I don't know.

And then he gave me his professional opinion. He told me I probably could use some psychotherapy cause I had some "life issues" but that I wasn't suffering from severe depression and I didn't need medication. If I had indicated that I just wanted to try something else, he would have gone with that. (That was something he could "fix". ) I asked him if he could refer me to any low cost or free therapists. He told me he didn't know anyone and the last psych at the clinic that did that had retired. So. Ah. I'm good to go.

I told him that it's always nice to have a symptom addressed and treated but it rarely addresses the total health and wellness of a patient and I impressed upon him that it would be really nice if one could really do further research to offer assistance and reassurance to those who might not know how to proceed next if one might find themselves in a situation similar to mine. Not suicidal, just "neurotic". Was that polite?

Yeah, I guess you could say I have some issues with medical professionals. Given that I have more than just a casual acquaintance with the medical system for a pretty healthy individual (mainly for hoo haw malfunctioning and maybe that's why I'm bitter/cranky/sensitive). I feel like I can say with confidence that GENERALLY SPEAKING western medicine is only focused on the eliminating the symptom or treating a disease. Not preventing a disease, or getting to the real cause of a symptom. Don't get me wrong, I love pills. They don't call me the pharmacist for nothing. I won't tolerate discomfort if I can take a pill for it. But did you ever notice that when someone really hears and acknowledges what you have to say (even if it's only in 5 minutes) you actually FEEL better? Especially with your spouse. Even if it's just "all in your head". What's wrong with seeing a doctor and feeling less "stressed" coming out then when you went in? Did you know that some people's blood pressure actually goes up a bit just from simply seeing a white lab coat? Do you know the real reason why some cancer patients just turn away from the medical establishment. It's not that they don't want to live. It's not that they don't want treatment. It's because sometimes the treatment feels WORSE than the disease. So. Don't. Even.

That's my rant and thanks for listening. I feel better already.

I thanked the doc for his time and on my way out I formulated an action plan for myself. I felt grateful that at least he saw me as perfectly capable of handling my own mental health. That's a positive. I really can't afford to spend several hundred dollars a month to see my old shrink, sweet as she is, but I do have a program through my actor benefits that will allow 6 visits without any money down. Of course, you spend a couple sessions bringing the counsellor up to speed and then wrapping up, but hey, I might just be able to find a good "coach". Maybe I'll drag up a new skeleton out of the closet. I actually know what most of my "issues" are and how they came about, I'm actually good with that - it's just the how do I change that thing that is no longer working for me - that's the sticky part.

So here's my plan, stick with the chanting, exercise and treating myself well, I've got some amazing creative work to look forward to (yes!!!!) and acknowledge that crying about my friend and my dog is grief and it's okay to feel sad. I will continue to write action plans and post up positive notes and Buddhist encouragement on my bathroom mirror and tell people to back off when they get on my last nerve. I will own up to bad behaviour and apologize where needed (cause I hate apologizing cause I'm HARDLY EVER WRONG) and I will work on demonstrating the love, understanding and compassion that I so desire. I am also a bit cranky and will firmly but lovingly place my foot up the ass of the person who gets on my last nerve.

Good plan.


OHN said...

Sounds like a pretty good plan to me.

I decided long ago that I need to tell my health professionals what they need to do. Well, not all of them, but the little voice in my head always has me asking "exactly what percentage in the class were you? bottom 10%? that explains a lot".

Nobody can tell you what you are really feeling. They can only treat the symptoms if we are eloquent enough to explain it for them to understand.

Obviously YOU and I are but what about all the others??:)

Guera! said...

This was such a delightful post to read for me. Delightful is not the word but I never know what "the word" is when I am leaving comments here. I wish I could so rapidly form an opinion and express it as you did with the doctor. I need a couple of days to think and then it's too late. But what you said to and asked him was so true. I hope he chewed on that for a while and spends some time thinking about it. It's also true that Western Medicine wants to treat symptoms of specific diseases and focusing on the whole wellness of a person is so out of their realm. I need to lose 40 pounds. If just ONE doctor told me to lose weight I would do it. I can't stick to numerous diets that I have tried. If just ONE of the many doctors I have seen just this year alone either for endometriosis or infertility or both would tell me to change my diet and lose weight I would do it. When weight and diet is linked undeniably to so many conditions and just general well being why has not a single doctor told me to lose weight? The approach of many doctors is frustrating...especially when we know our bodies better than they do.
I hope you don't have shove your foot up anyone's ass but I have no doubt you will do it if necessary!
Sounds like you are well in control.

loribeth said...

Good plan indeed! LOL -- I'm hardly ever wrong either. ; )

Pamela T. said...

I've come to accept that we're all a bit neurotic in our own special way. Just acknowledging that helped me get beyond some of my "issues." You've also had a huge amount of sadness and grief instigators in your life, which take quite a bit of time to recover from so don't be too hard on yourself for not being "cured" yet. Keep writing, too! It's been a great way for me to get to the heart of a bunch of confusing emotions. You're a strong, beautiful, delightfully talented and generous woman. Don't ever forget that.

Wordgirl said...

grrr Doctors!

As you know I have some issues surrounding Western medicine (not that it doesn't keep me flocking back to them -- ever the good patient)... think much of my desire has been the hope I would find the rare Western doctor that would integrate some vision of holistic health...

I had one doctor once -- a young woman around my age -- who was so, and I mean SOOO dismissive of headaches I was having, visibly frustrated and writing it off to my history of anxiety -- that I left that office feeling so small, wretched, diminished. Ooof. I cringe to think of it.

The best doctor I ever had -- a psychologist -- was a Buddhist -- and I fear he's one of a kind -- I may never find his like again -- but I learned so much from him.

I also think this is why I go to my homeopath -- even though I'm not certain that the remedies are 'helping' me -- but I just love her and I feel better when I see her. I leave feeling a million times different than I do when I see that internal medicine doc...and what's the harm in that (harm to the pocketbook that's for sure.)

I love your plan...for me if I eat well, exercise and write it goes a long way to equalizing things...and funny thing? I'm never wrong either!




Deathstar said...

Did you ever notice how much it costs to see a naturopath or go to one of those fancy pants wellness centres? They spend hours talking to you and testing you with all sorts of blah di blah - you feel thoroughly pampered and catered to. You feel like your concerns are respected and validated. They talk about your diet, your exercise, they address every ache with suggestions of natural health product a,b,c. But you feel like you're in charge of your health and rarely does any of the treatments cause you constipation or hives.

Some of the stuff works and some of it is unnecessary and are not based on any medical tests, but they prosper because they make people feel better and offer people an alternative to standard treatments that don't work without causing other problems.

Anonymous said...

Arrgh!! My eyes are burning from reading this! It is so clear that with the disparate expectations people have from physicians, we will always be vilified!

So you want someone to just listen to you and validate you? Yeah OK. We will manage to do that in a 10 minute appointment between the uncontrolled diabetics and hypertensives (who get truly pissed at you if you mention any lifestyle changes like diet or exercise, by the way) and all those whose medical issues really need to be addressed. Yeah, that'll happen (and your insurer will be willing to pay for the time I spend "just listening.")

But yes, you can go to your naturopathic tea and sympathy dispensing placebo docs and hope to hell they don't miss a real cause of your headaches like a brain tumor as they perform Reiki healing! And yes, they charge a fortune (without insurance pick up) for that lovely listening and hand patting.

I spent 100% of my life (no vacations, no relationships) devoted to the health and well being of my teen patients, but no matter how much I did, how hard I worked and how much I partnered with the family in helping my patients in the most holistic (though based in allopathic medicine) fashion I could muster, there were always those who wanted a quick fix (pill) when I felt something different was needed and those who preferred cupping and magnetic therapy when a simple pill would do.

It is a sad state of affairs when 50% of primary care physicians would leave medicine if they could think of something else to do. And it isn't about the money or prestige. It's about the erosion in appointment time, in relationships with patients, and in trust that medicine in 2008 has become. Since everyone can get their MD from Google University, the doctor is no longer seen as someone who is there to help you. Instead s/he is just the idiot with the title licensed to provide the care, though the patient knows best what the diagnosis is and what should be done about it.

But let me stop my rant. You guys think docs are cheeseballs. Got it. Well I will say that this cheeseball said from the very beginning that a) primary care doctors should not be prescribing medications for mood disorders unless they are working in conjunction with a therapist/psychologist and b) you should be evaluated by a mental health professional to determine a diagnosis and whether medication is a viable treatment option for this diagnosis.

Though you eventually got around to doing what I suggested you do first, the specialist's evaluation proved to be the most important one...and the one that should have been sought in the first place.

Good luck with your plan.