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Beyond Blue

One of my many book ideas: “The Psychiatric Guide to Annapolis: An Atlas of Shrinks in the Sailing Capital of the World.”

Do you like it?

My research was quite painful. Having a medical file with almost all of the head doctors in the area (or is it the same file, in which case I never ever want to read it), I could divulge the skinny on each one…like which diagnosis each psychiatrist favors (some docs bookmark the DSM-IV–the latest edition of the “Diagnostic and Statistical Manual of Mental Disorders”–to a certain page), and which are his favorite drugs (i.e., which pharmaceutical rep is the cutest).

I’m sounding bitter, like I hate all psychiatrists, and that is so not true. The physicians who evaluated me at Johns Hopkins saved my life; I’m forever indebted to Dr. Smith, my current psychiatrist, for leading me to good health. But I do think that a depressive has to be VERY careful in selecting a doctor. Because she has to trust her psychiatrist with her life, and together as a team (patient and doctor) they have to tackle some really challenging stuff. Dr. Smith was my seventh doctor (not that I was counting), and she was (as Goldilocks would say) “just right.”

Here’s a summary of the first six:

Doctor One: “You’re a writer? Could you help me put together a book proposal?” (Actually, I think I offered–which is even sicker.)

Doctor Two: “You’re clearly ADHD, but your biggest problem is sleep deprivation. Go home, take this Ambien (even though you told me you are a recovering alcoholic and shouldn’t take anything addictive), get some sleep, and check back with me in a few weeks.” (Later I learned he specializes in geriatric psychiatry. No wonder he thought I had ADHD–compared to his other patients I had David’s energy after devouring his entire Easter basket.)

Doctor Three: “I’m in love with Lilly’s schizophrenia drug Zyprexa (or maybe Lilly’s rep), so I’m going to keep on prescribing it in higher and higher dosages until it starts working–even though you’re clearly getting worse, and you aren’t schizophrenic. I am so excited by all these new atypical antipsychotics! I can’t wait to try them out on all my patients so that I can share the success stories (forget about the zombies) in my speaking gigs around the country, as a psychiatrist using cutting edge drugs. And for anxiety, pop an Ativan every half hour if you want (they’re not really addictive), and a Valium or two at night. That way you won’t feel a thing. You may think you need antidepressants, but I’m so afraid of your getting hypomanic (and having a creative thought) that I’d like to keep you suicidal for now.”

Doctor Four: “You have low self-esteem and you had a poor relationship with your dad, so I think you have borderline personality disorder.”

Doctor Five: “What do you think you are–depressed, bipolar, OCD? What would you like to take (and how much)? I’d love to be able to sort all this out, but the insurance folks only allow 2.5 minutes for each patient, so you’re going to have to do a bit of the diagnosis and treatment. Let’s just try out some meds, and see what happens. Okay?”

Doctor Six: “I know you’re suicidal and all that, but let’s wean you off all your meds and try some hypnotic regression (using candlelight), because your condition is undoubtedly a result of childhood issues you haven’t yet addressed in therapy.”

Moral of the story: FIND THE RIGHT DOCTOR! Keep on looking until you find a good fit. Pay attention to your gut if something says “This guy isn’t committed to getting me better.” Remember, you’re on a team–so you should be shooting for the same goal. Be picky and high-maintenance and demanding and annoying. Because finding a good doctor is the difference between life and death.

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