Wednesday, May 27, 2009

What Psychiatrists Need to Know: A Patient's Perspective © Megan Snider

"Writing is a form of therapy; sometimes I wonder how all those, who do not write, compose, or paint can manage to escape the madness, the melancholia, the panic fear, which is inherent in a human condition”
--Graham Greene

Initially this blog stemmed from an experience I had with my last session of "treatment".

I had a strong desire to document the absolute frustration I feel with the mental facilities--especially in Alabama.

I know if I were back home (Iowa), I would be receiving better care.

I know that Georgia also has much better school systems and mental health organizations and programs than compared to Alabama. When I began to post, I wanted to mention some things my therapist had said to me that I found rather upsetting.

Keeping in mind that this therapist and facility is the only place I have and can afford, I think I will keep remarks to myself. Instead, I am going to compose a small, easy-to-read list of rules that every therapist should somehow be made to submit to.

1.) Patients are not case studies-- They are people.

2.) Most patients can't afford the prescription plans you decree. Patients should not be treated with money and marketing in mind. Stop under-rating and over-rating drugs. If the generic version is just as good then offer it-- don't pick another medicine out of your hat when they can't pay for one.

3.) Warn your patient of side-effects of all drugs.

4.) Talk to your patient, not to yourself for the sake of hearing your own voice.

5.) Don't assume your patient is an idiot about his or her disorder. He or she LIVES with the disorder; you can only read about it. That must be nice.

6.) Stop neglecting patients by making them guineia pigs. Prescribe the proper counter-acting drugs with drugs that may cause side effects. I had
tardive dyskinesia (click for link) for three hours on Saturday. It hurts like Hell. It spreads, too. In my case it was in this progression: lips, mouth, thumbs, hands (claw posture), eyes, tongue/mouth, jaw, back, and upper torso. Take note of the fixated grimacing and grinding of teeth section in this link provided. Now imagine that for three hours.

7.) Don't make promises-- especially huge promises or downright lies

8.) Realize that you don't know what your patient experiences and you never will.

9.) Mental illness does not equate to loss of I.Q.

10.) Stop buying into the drug hypes and pushing the new, mostly scantly-documented new drugs like they will be a cure. Prescribe just what works-- not what's popular.

11.) You may or may not be smarter than your patient. Deal with it.

12.) Give patients regular appointment times and see them often-- even the poor ones.

13.) Realize your patients came to you for help, not a life-time membership in the "new scary/great drug participation plan". Give them help and follow up on them.

14.) Let your patient talk-- not you-- AND LISTEN.

15.) Make sure you don't have trouble with overlapping diagnostic criteria.

16.) Mental illness is not a small problem; it is pain every day you live with it.

17.) Don't say to your patients, "I hope you get better." Try to actually make them better.

Sign here: _______________________ Date:________

© Megan Snider


  1. Yes. In an ideal world...

    There are "Patient Bill of Rights" posted in every hospital room here in NY that essentially say the same things. Maybe there, too, I can't remember. (My family all live in Alabama.) As such, it's fair to demand those things of your providers.

    Alabama's health insurance situation is deplorable with nearly 1/3 of their residents without coverage. I've been in that situation before and know that it pays to learn as much as you can about every aspect of:
    ~ the health care system in general - from state insurance plans (vitually non-existent in AL) to local clinics
    ~ medications (brands and generics, benefits and side effects)
    ~ alternate prescription coverage (try, a discount prescription drug plan - $4.50/month)
    ~ treatment needs and EVERY option for getting them

    There've been times when looking after my son's health issues was a full time job, but I've learned so much - the most important thing being that in this impersonal world, self-advocation is the key to survival.

    Keep writing and speak out when and wherever you can.

    Love your posts, and thank you for sharing, Megan. Hope you are having a good week.

  2. Yeah, I don't know if it's this state or what. I'm beginning to think every option is just about as horrible as the next.

    I love hearing from you and I know my parents and I have trouble talking about this problem of mental illness. I'm not sure what they want me to do and they're not sure why I do what I do.

    I began writing this about a month ago as a draft. My experience Saturday led me to finish it.

    I wrote this because I was so disturbed by what happened-- I still am-- and because it was basically allowed to happen because the proper precautionary prescriptions were not provided.

    I do not have access to my therapist again until November. What would have happened if I would have died?

    That's not proper care. For a long time I held on to the belief that there was some cure. Some medicines make some symptoms dimimish, but they never go away.

    My father baically told me today what you said: You have to be your own advocate--but he was meaning that I should stay positive.

    I think it is hard for them to understand that my thinking is contorted by fear and hopelessness. And that when I say negative things, I'm not feeling sorry for myself; I believe the horrible, sad, and desperate things I say.

    As for speaking out about mental illness, I am, I do, and I will continue to do so. I just hope people will stop putting their hands over their ears.