So, I have a PA doing the work of a psychiatrist through American TelePsychiatry. He's a former prison guard and Naval medical officer. His name is P. I am a former inmate in the same state that he once worked (he was at a different camp than I was). I came to him yesterday after breaking up with my gf and told him I wanted to be put in a permanent twilight state to just sleep away the rest of my days. The conversation went, to the best of my recollection, like this:

Me: Remember what I said about psychotropics being off the table? Scratch that. I want whatever combination I need to be put into a stuporific state. I want to have only the bare minimal cognition necessary to function but without any conscious thought.

P: Okay...

Me: I want to do the thorazine shuffle. No risperidone. Can I get thorazine?

P: What about Halidol?

Me: Is it strong? Is there anything stronger? You know I'm going to look it up, right? *gets phone*

P: It's pretty strong. It comes in a variety of dosages.

Me: What about seroquel? I took that once.

P: What was the dosage?

Me: I don't know. I got it from some guy in jail, and slept eighteen hours. What's it go up to?

P: I have patients on eight hundred and a thousand milligrams a day. I don't know how they do it.

Me: Let's start at three hundred. That ought to make it so I can't feel. Just like in prison when they would medicate the problem inmates so they would end up doing the Thorazine shuffle.

P: Is that what they did...? *gets irritated look on his face*

Me: Damn right. Any chance of giving me something that will induce permanent brain damage if I OD? Like permanent catatonia?

P: Are you planning on OD'ing with something I prescribe?

Me: *laughs* Not that I'd tell you. Besides, you'd be doing society a favor. I'm one of the undesirables, anyway, right? No one will care what I do with it.

P: I can start you on twenty five miligrams of seroquel twice daily.

Me: No three hundred?

P: We can go up to that. We'll follow up in two weeks.

That's ultimately what we ended up deciding on so I can just live to wake up, take a pill and go back to sleep. What bothers me is one, he showed little desire to follow up on whether I was going to self-harm in some fashion or not. Two, he still has not gone through my eval test that he gave me to determine my mental status, so he doesn't even know what he's treating me for. Three, he was quick to go along with what I wanted (Halidol and Seroquel are anti-psychotics, not anti-depressants), especially after I made the crack about his previous profession (problem inmates being the ones they medicated); and four, that sh*tty look, which he had on his face the entire time as though he agreed with me about being a cast-off and was weighing the risk.

As a result of his not going over the eval, I have yet to see the actual psychiatrist. I asked for a referral to a psychologist, but because I am on medicaid, there's no psychologists around here who take my insurance.

I am already extremely paranoid about psychologists and psychiatrists in general after being their guinea pig for 13 years in a state pen from my teenage years until I was 33 (a couple years longer if you include jail and court). I had one threaten to essentially play with my file and massage it so that they would try to keep me locked up for life. There's no coming back from hearing that and trusting psychs. I have no choice, now, because the one I did trust in there and whom I spoke to sporadically since release, but as she's not in private practice, I cannot see her. I trust psychiastrists even less because I've been on every anti-depressant most people can name: Pamelor, meliril, indoril, lithium, remeron, paxil, prozac, lexapro, wellbutrin, celexa, venlafaxine, zoloft, amitryptiline, kolonipin, buspar, xanax, and probably a few others I'm missing.

And now, I'm suddenly feeling that very familiar paranoia about this guy, too. Am I crazy in thinking he may have crossed a line or two, ethically? I mean, yeah, I asked for it, but now that I'm thinking a little more clearly, yeah, sleep-walking through life is probably going to be a bore, but doesn't he have a duty to ensure I'm not making bad decisions clouded by emotion?