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I have an appointment with my psychiatrist on tuesday. I've been really messed up. Something needs to change with my medication, I think, and I know he won't or can't increase my lamictal. I have been suicidal and hysterical on and off, but it comes in waves, and the rest of the time I'm "okay". I need him to understand how badly I feel, but I can't afford to have him send me to the hospital. My insurance just dropped me. And I still have nightmares about the place. Should I bring up the 'suicidal' aspect? How do I convey the severity of this to him? If I tell him I've been suicidal recently, but am not right now, is he likely to refer me anyway? Please, some of you with experience, help me out. I really don't think I'm going to kill myself, but I am in so much pain.. edit: thank you all so much for your kind words. i went today and was met with complete indifference. his idea of treating me was telling me to get a job (I am applying/appealing for disability). He told me it was unrealistic to want to feel better. I dropped him like an anchor. I will be finding a new psychiatrist who will listen to me. You gave me the courage to dump his ***. Thank you.
gloomysunday gloomysunday 18-21, F 10 Answers Oct 4, 2010

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wow, that's a terrible situation, you said that you didn't think you might kill yourself, but you didn't seem entirely sure. you obviously have a solid grasp on your illness, and are highly articulate. i would focus on getting your doctor to increase your medication through a methodical analysis of your symptoms. you certainly seem capable. try not to be respond 'emotionally' to your doctor if he/she disagrees. approach your prognosis like another professional would, arguing the management of your case for yourself. use 'we' instead of 'i'. as in 'we should consider raising this dose' etc. if he/she disagrees, allude to possible impending decline in your mental health without admitting to suicidality. don't admit to nightmares about hospitalisation. approach the situation as if you are assisting in your management with the doctor, rather than adopting passivity. if it doesn't work, tell your doctor that you require a referral for a second opinion, which any decent professional would support, especially in mental health. good luck, thinking of you, i have a few years under my belt too, hope it gets better for you

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Thank you. After putting up with him dismissing me and my concerns throughout most of the appointment, I told him I would be finding a new psychiatrist. He was like a robot. I should have gotten rid of him months ago!!!

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Is there a reason you don't feel you will kill yourself? Perhaps if you explained this to him. And I definitely agree about the therapy if you are not seeing one already do it. Therapy didn't work for me because I am too guarded and have trouble opening up but the fact that you are willing to tell your psychiatrist how you feel shows a willingness to get help. But I do believe medications help I know my life would be out of control if I didn't have them.

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I hadn't thought of that. I will remember it. That gave me a lot of comfort. :) Explain why you don't feel you're a real threat to yourself... gee, what a novel idea. I can't believe that never occurred to me, lol!

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If your psychiatrist has half a brain, he shouldn't commit you because you did feel that way, days ago. The only reason he would commit you when you see him is if you were to tell him that you were intending on going home after your appointment with him to kill yourself - at which point he is obliged to place you under suicide watch as part of his duty of care. If he can't (or won't as you said) increase your medication, then I would be questioning that first and foremost. If your medication isn't working, quite simply, it needs to be changed. Sometimes it takes several attempts to find the one that will work best for you.<br />
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I disagree with people who do not believe that medication is helpful, and that alternatives like exercise should be pursued first - it's rubbish. I have had depression, and was on a medium level dosage of the anti-depressant Zoloft, which for the most part helped me. As things change in our lives, so do our needs, and medication is no exception. The psychiatrist should be conducting regular eviews of your circumstances and medication levels, and if he is not, maybe it would serve you well to see another psychiatrist.<br />
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Whatever you decide, please don't withold information from your medical professionals, they're actions are made in your best interests. If financial circumstances are a concern for you in the course of your treatment, then voice those concerns. I found my GP and psychiatrist very helpful in these respects.

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Thank you. That was very helpful. I will be finding a new psychiatrist. This one.... ugh. I'm so angry at the way he treated me. No more!

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Hi gloomysunday <br />
I think you put it very well in your question. So say:<br />
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"I feel bad but I do not want you to hit the panic button and send me to a mental hospital."<br />
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I think that is very clear. It states you are seriously concerned but have not lost it. Then talk openly and clearly.<br />
very best wishes<br />
:)

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This was also very helpful for me. I hadn't thought of outright phrasing it like that when I talked to someone. Thank you very much. I'll remember.

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He wont, trust me, I know I don't know you but he will not think you are crazy and if he did do something like that, it's not cause your crazy it's cause he's a bad lazy psychiatrist.

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You know, he really is. But for the opposite reason... Absolutely no reaction to me telling him how very depressed I was. He wouldn't even consider changing my medication. He just told me to get a job and exercise. Well, I have a hobby that brings in a small amount of money that I work on when I am able, but I'm not able to handle much more than that. I'd like to be able to exercise more, but my physical problems limit me right now. I'm trying baby steps. In the meantime you jackass, I have a mental illness that needs controlling, you know? I just wanted to punch him in the face.

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Gloomysunday; how did it all go with your new Psych?<br />
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I’ve just found myself in a similar position with my psychiatrist . I tried to tell him I was still not able to get up before 12 and do more than go to the gym and I don't feel like the medicine he had me on was working properly. He said “forget about the medicine, what are your plans for the future?”. I said “I don’t think you understand I can’t function properly without my medication and at the moment I can’t plan to do any more than one basic thing a day”, he cut me off he said he has cancer patients who did more than me. he threatened to stop prescribing me ANY of my meds if I don’t tell him what I plan on doing in the future.

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Gloomysunday; Wow! A lot of Words of Wisdom there for you! I agree with many of them. I also have too much experience in Mental Hospitals. On a factual level, with no insurance they are going to give admission a second thought. I was receiving excellent care with fantastic insurance and could stay as long as I needed, which for me meant I could go to the hospital whenever I felt out of control. As soon as I was Medicaid (said with a sarcastic groan)...my problems didn't seem very serious to any doctor!! I need to ask..are you drinking at all on your meds?? With the potential side-effect of suicidal ideations, alcohol doubles these effects. I feel for you and wish I had answers!! From my loads of experience and listening to others, most shrinks are controlled by insurance or the a lack of, and money does the talking. With 100% coverage I stayed for two months! With Medicaid, 5 days, and left with them knowing I felt suicidal. Does anyone know what Pres. Obama's new insurance package says about mental hospitals? With medical hospitals, doctors are under the threat of non-payment if a person comes back with a recurring illness. There have been times when I WANTED to be hospitalized but they wouldn't accept me because of Medicaid!! I know one thing for certain..don't do anything drastic to get him to listen...you never know how he'll respond and you don't want to go to a State facility!! THOSE are nightmarish.

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Try be honest with your psychitrist. Remember psychiatrists are people too. They aren't all robots...or satan. Explain your situation and he will do his best to understand you. It is his job to do the best for you! <br />
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If you think your meds are wrong you need to get him to do something about it quick before things get too far out of hand. It may be that if you do something early enough then you wont need to be hospitalised.

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This one certainly is a robot... I put up with him way too long. I tried to explain, I really did. But he'd barely let me finish a sentence, let alone accept what I was trying to communicate to him.

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I am very against medication that controls your behavior. We don't even know exactly how it works. But we do know that much of it, especially SSRIs, can have devastating consequences that, in my opinion, make in not worth the risk.<br />
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With that said, I suggest you see a therapist. I think they could do a lot more to help than a psychiatrist. There is no magic pill that will instantly solve all your problems, but you can definitely make a lot of progress by talking to someone about it and just getting it out.

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Without my medication, I am invariably a terrible mess. It would be great if I didn't need it, but I know what I am like when I do not take medication for my disorder, and it's a dangerous state to be in.

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