Unexpected Stigma

I have been very lucky with the care I’ve received from medical professionals in the past few years since my diagnosis of bipolar and psychosis. The two psychiatrists who’ve been charged with my care have been understanding and respectful. All good news. That is, until this week. I have a new psychiatrist. My first appointment with him at the end of last year was fractured and awkward. I thought that maybe we just needed to get to know each other, and build a rapport.

The appointment this week was even worse. I’m not in an amazing place at the moment. I feel stressed out and my moods feel all over the place. One moment I feel suicidal, the next I’m full of a tense energy that makes me irritable and lash out. I’d hardly slept the night before and had spent the morning before my appointment contemplating taking all my meds at once with bottle of whiskey.

My Mum took me to my appointment. Before we left we talked about how I’d been feeling. She was calm and compassionate towards me, and didn’t judge. Mum encouraged me to be completely honest with my psychiatrist and not to hide anything from him.

I walked into my psychiatrists office. He didn’t stand up to greet me, he didn’t smile, barely looking up from his computer screen. I laid it all out for him. Through tears and scattered sobs I explained how stressed I was, and how I didn’t know what to do about it. Without looking up from his screen and as he typed he passed me a box of tissues. No eye contact. No words of encouragement. No empathy. I was shocked. We sat in silence, the only noise the clacking of the keys on his keyboard.

Eventually he spoke. Matter of factly he said,

“Are you taking your medication and is it still working for you?”

I replied that they were working, but that it wasn’t the point. He made some agreeing noises. I told him about my ongoing problems with food and that I’d managed to break the binge/purge cycle of bulimia, but I was still struggling. He asked if I’d ever been referred to the eating disorders team and I said no. He left it at that. I was in too much of a vulnerable place to press him further and ask if he was going to refer me.

Then I thought ‘sod it’ I’m going to be honest about how he’s making me feel. I told him how appointments like this often put me on edge and I dreaded them. These appointments made me deal with difficult feelings and I was finding it especially tough today. Instead of providing some supportive words he simply told me I wouldn’t have to come to the hospital anymore. He was going to discharge me back to my GP. I was still crying, now my body was shaking with the tension and fear I was experiencing. None of this seemed to bother him.

I often see people celebrating being discharged from their psychiatrist or mental health team. I’m not one of them. I’m not ready for this change. I again sat in shock opposite him as he started to explain how long I should be on my meds for and the process of tapering off them. Tapering off! The second part of 2018 I’d only been truly stable for the first time in my adult life and he was talking about taking that away, already. Like I said, I was feeling vulnerable and didn’t have the capacity to challenge what he was doing.

I knew what he was doing was wrong. I knew this was stigma I was facing, but I was shocked it was coming from a psychiatrist. He wasn’t treating me with respect, as an equal. He was making decisions for me without discussion, without asking my opinion. I’m an expert on my own mental health, I live with it everyday, so I should be involved in significant changes to my care.

I’ve had time to reflect and I’m going to make an official complaint about him through the hospital. I’m also going to meet with my GP to discuss my moods and the stress I’m feeling. This isn’t ok, and isn’t the behaviour I’d expect from a medical professional.