[emptyspace]

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Does anyone ever feel like their pdoc is flying by the seat of their pants?
That it's all one big experiment.

Or do you think they actually make a plan for your treatment?

[CopperStar]

I think it's a bit of both. Assuming a good pdoc, and not one of the bad ones.

All they have to go on is the patient's testimony, more often than not, our subjective reporting, to the best of our ability to even articulate some things. So I think in the beginning, all a good pdoc can do is try to make their best guess and try something. However over time, I would expect a pdoc to refine their approach strategically as they learn more and more about the patient.

I can only speak about my own pdoc. I have always felt pretty confident that he has a plan in mind, probably because he tells me what his plan is, why he is making the decisions he is making, what his plan B is if this doesn't quite work as he believes it will. And when he's guessing, he tells me that too because there have absolutely been a few times when he was quite willing to admit what he was about to try was not his usual plan.

[Chickenkicker]

This disorder is such in 2015 that only a little bit is known about it. Hell, scientists don't even know how many of our medications even work. A lot of it is simply 'pin the tail on the donkey'. I had an azzhole egotistical psych that bombed me just to see what stuck. It wasn't an 'educated' guess, it was throwing darts at a target painted on the side of a barn. It did't work. I lost 9mos in a severe fog: couldn't drive for that period of time, lost 40lbs, anxiety through the roof and I spent my days circling my dining room table with my fingers in my hair cursing. I was terribly scared. My wife was scared. My friends were scared. At one point I asked him if I were dying.

But he wouldn't listen...he knew it all. At that point I fired him. I found a female psych that didn't have the ego associated with a penis. She brought me down to functionality again, then we started back up -slowly- to see what worked. 4yrs later I'm still on the same successful med combo, and with my therapists help, have been stable..

The entire process of bipolar treatment is all a guessing game. Its impossible to figure out how a particular psych will treat you until you're invested in them for awhile. There are no reliable report cards anywhere to reference their style. The diploma they proudly display on the wall tells you nothing about them except their taste in frames.

'Professionals' misdiagnosed me for 30yrs after I started reaching out for help in 1982. Psychs are representative of the general population too: there are lazy ones, indifferent ones, ones just looking for a paycheck, dirty ones that take Big Pharma money to push meds, ones that believe in tough love, kind ones and ones that believe the individual is a valuable resource in their own treatment, and should be listened to.

Its distasteful. At the time you need a 'professional' to help you during a dysfunctional and terrifying period of your life, you still have to have your wits about you and have your guard up to protect yourself from them doing something stupid...and sometimes very harmful.

[SillyKitty]

Originally Posted by CopperStar

I think it's a bit of both. Assuming a good pdoc, and not one of the bad ones.

All they have to go on is the patient's testimony, more often than not, our subjective reporting, to the best of our ability to even articulate some things. So I think in the beginning, all a good pdoc can do is try to make their best guess and try something. However over time, I would expect a pdoc to refine their approach strategically as they learn more and more about the patient.

That's why I love my pdoc. He's not afraid to say, "Maybe I should/ shouldn't have messed with the dosage." Or, "You've been misdiagnosed. The papers from inpatient say you're depressed, but you're clearly not."

I once entered an appointment and after a few minutes the doctor said, "wow, you seem to be doing much better this week. Looks like the medication is working!". I wasn't on medication...

I think it totally depends on the quality of person who is treating you, but i am ALWAYS skeptical.

[Ripose]

Psychiatrists are psychopathic, narcissistic, ignorant and have no redeeming social qualities whatsoever.
They base their diagnosis on what is possibly the worst medical book in history (the DSM V).
They base their diagnosis on a 10-15 minute visit in which they get everything wrong about a person and then prescribe medication based their faulty assumptions.
They have no idea what psychiatric drugs will do in the long term, yet they leave people on them for years while at the same time denying there are any side effects like dying 20-30 years early.
They are not concerned with your health in the slightest, only about how much money they make off you.

They are the scum of society.

[Crazy Hitch]

Yes look I think my old pdoc was such a phoney and a ********ter indeed

I do think some of them exist out there ...

Fortunately my current one is great!

[Nammu]

Originally Posted by Ripose

Psychiatrists are psychopathic, narcissistic, ignorant and have no redeeming social qualities whatsoever.
They base their diagnosis on what is possibly the worst medical book in history (the DSM V).
They base their diagnosis on a 10-15 minute visit in which they get everything wrong about a person and then prescribe medication based their faulty assumptions.
They have no idea what psychiatric drugs will do in the long term, yet they leave people on them for years while at the same time denying there are any side effects like dying 20-30 years early.
They are not concerned with your health in the slightest, only about how much money they make off you.

They are the scum of society.

For the most part that was my experience. I had a good one for a short time decades ago then she moved. I have a pretty good one right now. His listening skills are first rate and he's not shoveling meds down my throat.

[Fuzzybear]

This, unfortunately, is far too often true.

Originally Posted by Ripose

Psychiatrists are psychopathic, narcissistic, ignorant and have no redeeming social qualities whatsoever.
They base their diagnosis on what is possibly the worst medical book in history (the DSM V).
They base their diagnosis on a 10-15 minute visit in which they get everything wrong about a person and then prescribe medication based their faulty assumptions.
They have no idea what psychiatric drugs will do in the long term, yet they leave people on them for years while at the same time denying there are any side effects like dying 20-30 years early.
They are not concerned with your health in the slightest, only about how much money they make off you.

They are the scum of society.

[Capriciousness]

Oh yes. There are all kinds out there. All kinds. I finally found a good one but he is the tenth I have tried. I had to keep firing them for their egregious behavior.

more here
https://bipolarfirst.wordpress.com/2...olar-disorder/

[Woolly Bugger]

I have had nothing but good psychiatrists who worked slowly and carefully to find the best balance of medication for me. I've been through four doctors in twenty years of treatment. The last one is the best, and I feel lucky to have him. He's been treating me for nine years. Right now, he wants to replace my daily dosage of Abilify with Latuda. It's certainly experimental, but he is confident it will reduce my anxiety. I have faith in him.

[BipolaRNurse]

Originally Posted by CopperStar

I think it's a bit of both. Assuming a good pdoc, and not one of the bad ones.

All they have to go on is the patient's testimony, more often than not, our subjective reporting, to the best of our ability to even articulate some things. So I think in the beginning, all a good pdoc can do is try to make their best guess and try something. However over time, I would expect a pdoc to refine their approach strategically as they learn more and more about the patient.

This. ^^

I've been very fortunate to have a pdoc like that. He was my first and he is the standard by which I will judge any future psychiatrist, assuming I won't be able to keep him forever. I've been in his care for over 3 years and the "plan" changes constantly as circumstances (and mood episodes) do. We finally got to a good place as far as medications are concerned and his attitude is "if it ain't broke, don't fix it". I trust him implicitly and wish everyone had a doctor like him.