Bipolar Treatment: What Happens When Your Doctor Gives Up?
As a seriously ill person, I can honestly say that I have given up. Many times. I have lain on my floor praying that someone would kill me. I have taken too many pills hoping that I would die. And yes, I have even cut into myself hoping that I would bleed out.
We give up. After years of trying. Years of bipolar medication. Years of side-effects. Years of therapy. Years of doctors. Years of hospitals. We give up. We’re done.
But what happens if in one of these moments your doctor gives up too?
A Doctor Gives Up
When I first started treatment and doctors kept flipping diagnoses from unipolar to bipolar depression and back again, I saw a doctor at my university. He was an older doctor, well-acquainted with treatment resistant bipolar disorder. We tried every type of drug to lift my depression. When it didn’t work, he sent me to a specialist for a consult.
Unfortunately, the specialist didn’t have much to suggest. Because I experienced such severe side effects from medications, I could almost never get on a therapeutic dose of anything. And no one saw a way around it. So one day, in the spring of 2000, my doctor just gave up. I came into his office and he told me that it would be our last visit. Done.
A Second Doctor Gives Up
Recently I moved from one country to another and had to get a new psychiatrist. I was in a pretty bad state, as all the recent stress had made me suicidal. After months of waiting, I finally got in to see someone at our mood disorder clinic. The doctor took a history, said she couldn’t help me, I would not be a patient there, and that I should go off my medications because obviously the side-effects were harming me. She did not refer me to anyone and seemingly didn’t care what happened to me.
What Happens When a Doctor Gives Up?
I hate to put it that bluntly but that’s what happens. When the one person in the world who is supposed to help you throws you to the lions, there is very little to stop you from dying. I would think that “health care professionals” would understand that and take action to prevent it, but they don’t seem to. I don’t know why.
What NOT To Do If You’re Doctor Gives Up
If you’re like me, you’re going to want to throw yourself in front of a car. Don’t do that. You’re going to want to hurt yourself. Don’t do that. You’re going to want to stop taking your medication. Don’t do that.
As much as giving up is a part of what we do as treatment resistant patients, doctors are victims of the same type of desperation. They don’t want to see you, their failure, day after day, when they can’t think of any way to help you.
It Is Unacceptable for a Doctor to Just “Give Up”
The fact is that no matter how many treatments you have tried, there are always more. There are almost innumerable combinations of medications available. Yes, I understand, it’s like looking for a needle in a stack of needles, but it’s still true: there are always more drugs. There is vagus nerve stimulation (VNS), there is repetitive transcranial magnetic stimulation (rTMS), there is electroconvulsive therapy (ECT), there so on. Giving up is bull.
What TO Do If Your Doctor Gives Up
Get a referral. To someone new. To someone different. Just because your existing doctor can’t think of anything, it doesn’t mean that no doctor can. This is your doctor’s failure, not yours. It sounds like the end of the road, but it isn’t. It’s just the end of the road for one doctor.
Get enough meds. It’s going to take time to get a new doctor, so make sure you have enough meds. Do not go off your medication – even if an idiotic doctor tells you to. Never go off meds without a doctor’s direct supervision.
Get help from others. Even if you understand it isn’t your fault, a doctor giving up on you is going to sting. It’ll probably upset you no matter what you do, so try to get yourself into a safe place with safe people who can help you get that new doctor and take care of you while you’re down.
This is Not Your Fault
You didn’t do anything wrong. You didn’t fail. A doctor's abandonment is their failure, not yours. It hurts, it sucks and it’s hard, but there is life after patient dismissal.
Tracy, N. (2010, July 15). Bipolar Treatment: What Happens When Your Doctor Gives Up?, HealthyPlace. Retrieved on 2019, August 22 from https://www.healthyplace.com/blogs/breakingbipolar/2010/07/bipolar-treatment-what-happens-when-your-doctor-gives-up
Author: Natasha Tracy
One of my pills tasted so terrible, was odd shaped and hard to swallow, and seemed to have no positive effects so I gradually starting weaning myself off of it. A couple weeks later I told my doctor who said that was fine. I told him I had been medicated for most of my life and since I'm in a better position environmentally that I would like to try going off some of the others. He advised me how to taper off of them and said if I needed anything to call him.
Not too long after the appointment I had serious withdrawal symptoms. I was awake for days and felt like my skin was crawling. I called his office and he just said to deal with it. My boyfriend was pretty upset with his response so he wrote him a letter.
At today's appointment I expected things to get cleared up. Unfortunately, my doctor said that he didn't want to see me again. I was shocked and confused. He said I was non-compliant (I only ever made the one change in the 7 months I saw him) and that he bet I had problems with all my doctors because I liked drama. I told him he had me all wrong... my past docs always said they were sad to see me go when I moved and I'm not the type to create drama. He said he didn't believe me. I said, "I don't know if anyone else takes my insurance; can't we work this out?" His response was wishing me good luck finding another doctor.
I know this is long, but I have never walked out a doctor's office crying as hard as I did today. I feel completely misjudged, rejected, and confused. If the people who are supposed to feel compassion and help us turn us away... then what?
It's great that writing it out makes you feel better, I can relate.
I do understand long-term lack of happiness, hopelessness, demotivation and lack of joy.
ECT is brutal. Save that one until you're absolutely desperate, in my opinion. Did you look at this article?
Maybe there's something in there that might help.
He's a great doctor, but even he can't help me. Although I'm not suicidal anymore, I remain in a constant state of dysthymia and none of the drugs no longer work. I also live in a very toxic home environment with a very mentally ill 13 year old son. My son has been recommended to the highest experts, and he is so complex and so challenging that even they are stumped. What a pair we make.
Although I feel I still need regular monitoring due to the fact that I'm not well and on medication, I'm tired of going to my doctor to say the same old, same old. No, I'm no longer suicidal, I'm off medical leave and working again, but still depressed, and this is as good as it gets. There are no more options for my doctor, except I would like to have ECT which he refuses to do because he feels my depression is environmental. And he's right.
So this is the end of my road - no, I can still function, but no longer feel joy or optimism, am unmotivated, hopeless. I don't need to go to the doctor to keep repeating that. If I again became suicidal I would medicate the heck out of myself until the extreme emotion passed - I would not take myself to hospital unless I really felt I couldn't control any impulses - I've never been to that state yet.
And I keep trying to remind myself that things change in the space of a few hours, moods improve, (distraction from my thoughts help), nothing is ever what it seems, and it's the depression creating lies influencing my perception. They are all thoughts, they are not truths and they are not facts, just extreme emotions, thoughts and feelings assaulted on me by this evil force we call depression.
If we could only take these emotions which are killing us and bury them in the garbage where they belong, and instead have emotions of joy, peace, happiness, optimism and contentment.
These depressing thoughts are all lies.
I feel better already.
Sounds like that woman wasn't really "firing" you as much as she was firing herself from everyone. But insane, yes.
I found your entry interesting do I've added a Trackback to it on my weblog :)...
I believe there are many reasons to dismiss a psychiatrist, and the one you've mentioned sounds like a good one to me. Sometimes one answer can tell you all you need to know about a person. A friend of mine once dated a guy who refused not to drink and drive. I told her, if he does that, then he's not responsible, he doesn't care about others, and he's not good enough for her. One thing told me all I needed to know.
As for experimentation, yes, I do it all the time. Unfortunately, many of us are left with only that option. I would suggest against it, if possible, but reasonably, most bipolars are going to end up doing it at one time or another. And I do think it's reasonable to be fearful, but I think it's also reasonable to understand its necessity. Ah, for a perfect world where such things didn't happen...
Wonderful topic you’ve addressed only it’s one of a rare few that I probably cannot relate to.
Through the decades we’ve dismissed a number of my spouse’s physicians simply because they were static in their thinking and unsuccessful in treatment and unwilling to consider thinking outside the box or as I refer to them as there are doctors, good doctors and better doctors. Then there is also the fact that when they hang their shingles out to practice it doesn’t state whether they graduated first or last in their class.
Your topic did remind me though of the shortest consultation my spouse and I had with a psychiatrist or any physician for that matter. Joyce was in need of a local psychiatrist to attend to her VNS which at the time was not yet approved by the FDA. A friend recommended her psychiatrist. After 45 minutes of filling out his questionnaires we finally sat down in his office. Before he had the opportunity to speak I asked him if he was familiar with VNS Therapy for Depression and/or the manufacturer. He stated he was vaguely familiar. I told him I would get him trained and equipped with the necessary instrumentation if he would attend to Joyce.
His reply was he was too busy to learn something new. I immediately requested Joyce to please get up and we left his office. Our consultation was less than 3 minutes. Once in the car I told Joyce in a million years I’d never recommend any patient to him or anyone like him. To not want to be up-to-date on any current and/or forthcoming therapies is to my mind negligence and the fact that he was a psychiatrist and lacked the intelligence to at least state at that moment he was swamped but would investigate later on is indicative of the fact that these are only people with their own frailties and without my even discussing those physicians we’ve encountered who thought they were deities and whom we also dismissed quickly. Since I prefer to be positive in my thoughts and sharing I will give that particular physician credit for at least being honest and forthright.
I found your remark about retrying Lamictal (Lamotrigine) and/or previously tried medications both interesting and informative and that which represents another treatment option to consider. I would also add rethinking the use of medications in terms of experimenting and adjusting times of day in conjunction with titrating slowly the use of older or newer medications.
The only other thought at the moment which I’d like to add and one which has worked reasonably well for us is not to be fearful of experimentation providing one has a cooperative, knowledgeable and attentive psychiatrist which obviously is 180 degrees opposite this very topic and where we have been fortunate.
There's absolutely no reason any psych should treat anyone that way. Thank goodness you found someone better.
Yeah, I got the Depatoke rash too. Here's a bit of advice from the dermatologist who saw me when I got that rash: just because you got the rash once, doesn't mean you'll get it if you try the med again. (I was very surprised to hear that) You can try a VERY slow taper onto the drug and see what happens.
I only mention this because if it was a wonder drug for you, it might be worth a second try. Something to discuss with your doctor, of course.
Oh, and as for your wife, three cheers for her. :)
I haven't had a doctor give up on me per se, but I did have one from 86-88 who emotionaly abused me. I was a teen at a state ran psych center for kids. She would constantly berate me, call me a liar, and even once told me my girlfriends miscarriage was my fault. They diagnosed me as major depression and after I got out of the hospitals I was on my own. I did well for 10 years, but I never believed the diagnosis. In 99 I found a great psych thanks to my wife, and she got me on paxil. Still thinking of depression, the meds worked well for 6 months, then they sent me into a manic (technically hypo) yanked me off the paxil (before they acknowledged withdrawl effects) got sick for a few days and she got me on depakote. Depokote was a miracle drug for me, best i ever felt. after a month though I developed a rash, the black box warning rash. thus endeth depakote ( I can't take lamictal for the same reason). I've been on a roller coaster of meds and moods ever since. But I've been lucky to have some good psychs since that one evil one which I still have some ptsd from. Sorry this is so long, some of this needed to come out.
PS Love the blogs, I seriously identify with them. I wish you the best.
PSS My wonderful wife Cat said if I got a Bad psych she'd beat them up :)