Brainstorming why I’m scared to see a psychiatrist

[barefoot]

@Abstract suggested in another thread that I might like to brainstorm why I’m scared of seeing a pdoc so I thought I’d start another thread.

ETA: The other thread is here for anyone interested: Any ideas for a replacement for diazepam?

A bit of background from the other thread:
I’ve been taking diazepam for incidents of acute anxiety for the last few years. I take them very infrequently. It helps, I’m not addicted, it’s an effective back up option that I can use and that works when I occasionally find myself needing a bit of help to down regulate when all else has failed. My GP doesn’t want to prescribe them to me anymore, even though he says I clearly don’t have any dependency issues. I’m going to try a new GP to see whether she would be happy to continue to prescribe diazepam in the same way I’ve been having it the past few years, but I wanted to be prepared with some other ideas in case she is unwilling.
A couple of members here and the doctor at the sleep clinic I’m going to suggested that I see a psychiatrist who would be best placed to suggest medication which is best suited to me.

For some reason, the thought of going to see a psychiatrist is very anxiety-making. I’ve been pondering why since it came up in my other thread and think it mainly comes down to these things:

- the thought of diagnoses/labels being formally in “a system” is very anxiety-making. I don’t know why. I don’t know what I think is going to happen if a diagnosis is suddenly in my medical records. There is a sense of that being able to be used against me/to harm me in some way now that’s a stupid thought.
- I feel like I might not have any power...because it feels like a psychiatrist would be very powerful and that I could end up being powerless. I find it hard to trust medical people. I feel quite a lot of fear around them because of some old doctor stuff when I was a kid. Still working on that! I’m also terrible at advocating for myself re medical stuff. The thought that keeps coming up as I ponder this fear/resistance to seeing a psych is that a non-psych doctor could be abusive and that abuse would be over my body...my physical self. Which is horrible. A psych doctor though could potentially have my mind, which somehow feels even worse. Having written that down, I don’t think this bullet point contains rational thoughts. But it feels like I wouldn’t have power over/about my mind. I don’t think that probably makes any sense but it feels very dangerous/frightening to me.
- I’d be worried about getting a dx that is “worse” than what I already think is “wrong” with me.
- On the other hand, I also worry that they will think there’s nothing wrong with me. That they think I am wasting their time.
- I do think I’ll be wasting their time and that I’m not in a bad enough state to warrant seeing them. Twenty-something diazepam last me six months. So, I am not in urgent need of help. So, I don’t really know what I’d be doing there.
- I don’t want to end up on medication that I don’t need. I don’t want or need to take something every day. I just want something I can take as and when, for times when I feel much worse. I worry that I will end up
- I’m not very good at advocating for myself with doctors etc. I tend to get a bit overwhelmed, freeze etc and then just end up going along with things. I don’t want - or think I need - to be taking medication regularly eg daily. I worry that I will somehow misrepresent myself and I’ll end up with loads of medication that I don’t really want to take.

Having written this out and read it back to myself, I can see a lot of worry and anxiety in what I’ve written and, intellectually, I can understand that a lot of these are stupid. But the fear and the danger feels very real.

Anyone want to help me unpick this stuff?
Or help me to think differently about it?

I know I’m being stupid.

 

[Teasel]

Not stupid at all :-)

I had enormous resistance to seeing a psychiatrist too as I grew up with a mother who was treated by them my whole life and I didn't think they helped her.

Anyway I finally took the plunge a few years back. I went for asseament by a psychiatrist, it took a couple hours, there was a patient liason person there too.

The psychiatrist was extraordinarily rational, cold even though not unkind. I did freeze in the session and wasn't able to speak up for myself. I was diagnosed as borderline personality disorder, which I don't relate to. I was offered a drug I did not want to take but she was fine with me not wanting to take it.

After some time I asked for a second opinion, in the second assessment, again the psychiatrist was cold, again I froze, again was diagnosed as borderline.

Luckily, when referred for treatment for borderline, the ppl who deal with personality disorders told me they dont think I'm borderline but c-PTSD.

I was devastated by the experience to be honest. But looking back now, I'm really pleased I did it as I am now beginning treatment for PTSD and so far it's excellent.

I think the pain I felt through the whole process, was at least partly down to value judgements I have from childhood - fears of psychiatrists 'cause of what I saw my Mum go through. And of course reality is nowadays the mental health services of the NHS dont have the resources to section people left right and centre.

And also a lot of the pain I think was because I didn't quite know that I'm not powerless. Like in my life generally, not just with the psychiatrist- I still felt powerless to counter what others say. Still felt others get to define reality. And of course I don't have to let anyone else define reality for me now at all.

I guess I want to say after all that, that they can't insist you take any drug & you can ask for a second opinion.

The patient liaison person in the assessment with me, explained they would contact me by phone later if I wanted to bring up any concerns. So that helps with the problem of freezing - is a way to be able to say what you need to say later, when you're not frozen.

I'm rambling a bit sorry.

I think it's a good idea to pick this apart and brainstorm on it :)

 

[barefoot]

@berlinda - pretty much everything you’ve said here makes me feel even more frightened of it!

I get that, ultimately, seeing the first psychiatrist set you on a path to now getting the C-PTSD diagnosis and, more important, treatment, which you are now finding so helpful (that’s awesome, btw!)

But the thought of cold assessments, freezing in fear and then getting misdiagnosed just sounds so....dangerous. Dangerous is the word that just keeps popping into my mind when I think about this stuff.

I think the idea of me accidentally misrepresenting myself and then getting a “worse” diagnosis (because I’ve got anxious and then frozen) or no diagnosis at all (because I’ve presented as fine and high functioning) feels like a very big risk. And knowing that’s what actually happened to you - twice - spooks me even more!

If you don’t mind me asking: what happened to the Borderline diagnosis? Did a psychiatrist then retract it? Or is that still sitting in your records?

 

[FauxLiz]

@barefoot I don't remember if you are in the US but with so many crackdowns by the FDA in this country many GP's are shying away from prescribing anything that is considered a psychiatric medication. Part of this is that there are so many on the market now with different uses, diagnoses associated etc but because many are also scheduled controlled substances and GP's don't want to get in hot water for prescribing meds that are out of their "expertise". Honestly, by the time I was first referred to a Psychiatrist I had been on so many different meds through my GP it was helpful to have the P-doc to work with. These are the meds that they deal with every day and both have been willing to listen to my concerns regarding meds and whether I will take them or not. If I out right say I won't take it my P-docs have worked with me to find something else that works or lets me go it on as I am with regular monitoring. I hope this helps.

 

[barefoot]

Thanks for sharing @FauxLiz
I’m in the UK. I think what you say applies here too though. Especially the off label uses for things where GPs don’t have the specialist knowledge and therefore don’t feel comfortable. Or their hands are tied. Or it just costs more.
Good to hear that your experiences with a pdoc have been positive.

 

[barefoot]

How often do people see their pdoc?

@berlinda - did you get a referral from your GP or go private?

 

[Teasel]

I'm sorry that what I've said makes you feel worse about this @barefoot This is only my experience though, hopefully others can relate their experiences too.

But the thought of cold assessments, freezing in fear and then getting misdiagnosed just sounds so....dangerous. Dangerous is the word that just keeps popping into my mind when I think about this stuff.

Condensed into this very short paragraph it sounds dangerous yes. And actually it was devastating at the time. But I stress that this short paragraph isn't the whole story. The freezing in fear is something I've done with almost everyone I've ever known at some point or other, and with people in every kind of profession. Because I have PTSD and freeze in fear at the drop of a hat.

And if that first assessment was something set in stone, and which would stick with me for life, and if treatments for that diagnosis could be forced upon me, and I could have no say in the matter, then yes, it would be dangerous.

But none of those things are true.

I think it is extremely common for those of us with PTSD due to abuse, and c-PTSD, to be diagnosed with other conditions as c-PTSD seems only to be recognised as an option in this country relatively recently. But I also think things are improving all the time and it is absolutely possible to get the right diagnosis if you persist, and speak up when it feels like the diagnosis doesn't fit. And even if you do freeze in an assessment, you can speak up to your dr at a later point.

If you don’t mind me asking: what happened to the Borderline diagnosis? Did a psychiatrist then retract it? Or is that still sitting in your records?

I shall look into whether it is still in my records. Didn't occur to me it might be as I was told clearly that it's the wrong diagnosis.

When I was diagnosed as borderline, I was offered mood stabilisers, lamotrigine I believe it was. (I declined, because my experience of SSRI's was horrific and I didn't want to risk feeling that bad again). I explained how horrific the symptoms were for me to the psychiatrist, and they accepted my decision not to take them no problem. She said it sounded like I might be very sensitive to drugs.

I was also referred for psychological treatment.

When I went for the assessment for psychological treatment - (by a psychiatrist, a psychologist and a nurse who work with people with personality disorders) I said that I didn't think I had borderline, they asked why, I said I don't relate to the symptoms.

They asked me plenty of other questions and told me they are sure I don't have borderline, that they thought I had c-PTSD, and they referred me to the PTSD stream of mental health services.

I think the thing about abuse in childhood and the way you are often truly powerless about that when you're a kid stuck with me all through my life. The feeling that I'm powerless, that others get to define reality.

And strangely I think it took the culmination of years of abuse and bad therapy and misdiagnosis and being turned away from help for domestic violence and not being believed by friends or family cause he seems such a nice guy - for me to turn around and say No! f*ck the lot of you!

Which has been just about the best life lesson I've ever learned. To know I have a voice and can use it. That others making pronouncements about me in any walk of life is never the end of the story, it's the beginning of a conversation that I get to take part in, or I can discount what they say and walk away from if they don't see or respect me.

I'm rambling again, sorry barefoot.

 

[Teasel]

@berlinda - did you get a referral from your GP or go private?

Referral by GP

 

[whiteraven]

the thought of diagnoses/labels being formally in “a system” is very anxiety-making. I don’t know why. I don’t know what I think is going to happen if a diagnosis is suddenly in my medical records. There is a sense of that being able to be used against me/to harm me in some way now that’s a stupid thought.

I have all sorts of scary diagnoses in my medical records - I'm 57 and have NEVER had an issue with someone going in and taking something off my records and using it against me. The only issue I've ever had was when I was on medical leave and the doctor provided my diagnosis to my employer. I had expressly said they couldn't, so this is against the law. What I learned from that is to be very specific about things I'm worried about, including a separate letter in my chart, if necessary.

I feel like I might not have any power...because it feels like a psychiatrist would be very powerful and that I could end up being powerless. I find it hard to trust medical people.

I totally get this. I think we tend to put doctors on a pedestal. I have started thinking of them as "body mechanics" - they have had training in medicine, but that's not much different (in my opinion) than an auto mechanic who has been certified in his field. They "treat" your car so that it doesn't break down on you.

YOU are the one with the power in the relationship with your doctor. You aren't required to accept their recommendation for treatment, you aren't required to take meds, etc.... The one area where we sometimes feel out of control with psychiatrists is their ability to hospitalize if we are a harm to ourselves or others. I rather like to turn this around though and remember that I am the one who is making the choice/decision, but sharing my feelings with my doctor and anything s/he does in response is/should always be in my best interest.

I’d be worried about getting a dx that is “worse” than what I already think is “wrong” with me.

Yep. Been here, too. And actually, it's happened to me twice. I got a neurological diagnosis I wasn't expecting and I was diagnosed with DID (oh, and cPTSD). Shit. But getting the new and correct diagnoses helped me get the right treatment and I am far better off now that I did.

On the other hand, I also worry that they will think there’s nothing wrong with me. That they think I am wasting their time.

I had a psychiatrist who didn't believe I had DID (because he didn't believe in it). How could I, though, be wasting his time if he's getting paid (and very, very well) for the time I spend there?

I don’t want to end up on medication that I don’t need.

You are completely in control of what you accept to take.

I’m not very good at advocating for myself with doctors etc

Do you have someone who knows about you that can go with you?

 

[EveHarrington]

I’ve seen many docs over the years. I have one wrong diagnosis that I need to dispute. It was slapped on me when I wasn’t even cognizant! For the most part, docs are willing to work with you and won’t just label you withought getting a thorough picture of your history and symptoms.

 

[LuckiLee]

That's a great "con" list can you come up with a "pro" list now, @barefoot? ;) Good luck!

 

[frogthroat]

- I don’t want to end up on medication that I don’t need. I don’t want or need to take something every day. I just want something I can take as and when, for times when I feel much worse. I worry that I will end up
- I’m not very good at advocating for myself with doctors etc. I tend to get a bit overwhelmed, freeze etc and then just end up going along with things. I don’t want - or think I need - to be taking medication regularly eg daily. I worry that I will somehow misrepresent myself and I’ll end up with loads of medication that I don’t really want to take.

I have an appointment in a month and I'm making a list of questions I have and what I don't want a medication to do to me. This makes me feel much more in control of the situation. I'm not thrilled about attending either.
Maybe you could write questions down about what other resources are available if the pdoc won't describe your meds. Maybe there's another medication that will work just as well and you would be able to take it just as infrequently.