I waited a year for what turned out to be one 45min appointment with the most arrogant person I’ve ever met. He started peppering me with questions as soon as I sat down. My head was spinning and I had no time to think! He seemed to fixate on one thing I said early on, and didn’t give me a chance to tell my story or what my concerns were. Before I knew it, I left with a prescription for some pill. I have no idea what it is or what it’s supposed to do, and nobody has said anything to me about a diagnosis. What if it doesn’t work, or I have questions later? Do I have to wait another year? Would talking to some kind of therapist also help me? And who?
My wife finally convinced me to go see my family doctor as my mood had been low, and I was having trouble concentrating at work. He seemed annoyed, like he didn’t really want to hear it. You know what he told me? He said I should “just suck it up” and be glad I’m not sick with something real like cancer. He suggested I go talk to someone at my church because that’s what they’re there for. When I pushed he said he’d send me to a psychiatrist, but he didn’t know any that were taking patients. He said if I found one who would take me, he’d send in a referral. I walked out of that ten minute appointment even more confused than before.
I saw a psychiatrist for ten years who diagnosed me with bipolar and put me on what I now know is a third-line medication, because she didn’t think women should be on anything that might cause weight gain. My new psychiatrist took a detailed history and reviewed all my records. She told me what the first doctor thought was “hypomania” was nothing of the sort, and I never had bipolar. For ten years, I’d been taking a useless medication for something I never had! I’m off it now and feel better. I decided not to have kids because the medication I thought I needed to be on (but actually didn’t) sometimes causes birth defects.
These three anecdotes are based on real patient experiences, though are not direct quotes.
Compared with most physical illness, our system sucks at handling mental illness.
Increasingly treat only the most seriously mentally ill, and there aren’t nearly enough of them to do that well. If you’re “high functioning,” good luck seeing one at all, especially for more than a single short consult.
They can’t properly treat mental illness in the same short visits they’d use for physical illnesses, meaning they often get the diagnosis wrong, miss many underlying causes, and don’t identify the most likely treatments.
While they can often help, mental health meds are complicated and time-consuming to manage. There’s more trial and error involved, effects are hard to measure, and proper use requires a longer-term perspective.
Often effective, it’s out of reach for most people due to cost or availability, and finding the right therapist who can treat your actual illness is almost impossible without becoming a mental health expert yourself.