[tecomsin]

I don't know if I have mentioned this before but my pdoc also has bipolar disorder. He has been out of hospital the whole time I have been seeing him (many years) and is supervised by another psychiatrist in order to be able to treat patients.

I tried years ago to get another pdoc but where I live in Canada you have to give up your psychiatrist before any other pdoc will take you. So even though he doesn't know much about the newer meds (he's in his 60s and I think stopped staying up to date a long time ago), I've kept seeing him. He also has 45 minute appointments so you have a chance to talk about things. Usually he just sits there and takes notes but today he spent the whole time talking about cutting away the bad part of ourselves with a meat cleaver. He was saying that our psychotic selves are psychopaths because of our fathers and that is one thing we have in common.

I really didn't have a chance to get a word in edgewise. He said he is on the verge of a manic episode and it helped me see how I must appear to others when I am starting to go manic. Anyway I will see him again as usual in a few weeks.

Isn't this a weird story?

[fern46]

Very weird. The meat cleaver part cracked me up and scared me a little at the same time. I suppose it is good to see a doctor that can really relate to what you're going through, but it strikes me as odd he kept your appointment knowing he was on the verge of mania. Its hard to get what you need if you can't get a word in.

[tecomsin]

Hi Fern,

Yeah he repeated the part about cutting off the bad part of myself, the one with negative thoughts and anger about myself, with a meatcleaver twice. Who thinks about meatcleavers? It isn't an image that resonates with me in any positive way.

He also said he was seeing a new patient after me and that is why he cut off our meeting a few minutes early. He said he had been fooling everyone these past years that he was well when he really wasn't. I felt like he was not respecting the fact that he gets paid to provide a service for me (by the government) rather than the other way round.

[fern46]

I agree that doesn't sound very respectful at all. I wonder if he will feel the same about his words when he comes down from this episode. I imagine he might feel a bit embarrassed and maybe worried he will be reported for inappropriate behavior. I know I said all kinds of ridiculous stuff when I was manic. I'm glad I wasn't out in public for the worst of it. He really should stay home for a few days and get himself under control.

[~Christina]

Wow just wow.....

The meat cleaver comment ? I think I would have ended the appt at that point, just for my own sanity.

Sure BP’ers can work in the field. Is there a way for you to let his supervisor know what happened ? If so I’d definitely do it.

The guy needs time to help himself not other people while clearly in a manic state.

Sorry this happened to you

[franz kafka]

Woah, awkward. I guess it's a good thing that he isn't trying to mess with you meds while in that state of mind.

[tecomsin]

Christina,

I don't know the name of the psychiatrist he reports to. i could report him to the College of Physicians and Surgeons, but my name would go on that and he would get a copy and probably refuse to see me after that. Maybe it is simplest just to try to get another psychiatrist but the last time I did that my referral was refused because I already had one.

He said he was concerned that he hadn't really helped me all of these years because we didn't connect as people that he hid his feelings and his true self but he was confiding in me because he knew he could trust me. I am just repeating what he said.

Fern, you are right. I think he will feel a bit embarrassed when he comes down. He might get reported by another one of his patients.

[~Christina]

Tricky situation to be in

I hope you can figure out what will be best for YOU

tecomsin, is there a receptionist or the like, you can ask to pass on your concerns? I know this sounds rough, but really your psychiatrist may need help. Mania can be disturbing to anyone. To people with mental illness it could be dangerous. He could be more harm than good to one or more of his other patients.

[tecomsin]

@christina and @BirdDancer, I'm also inclined to just focus on what is best for me rather than try to solve other people's problems. I have a lot of difficulties as it is and just want to make less problems in my life rather than more.

The weird thing is one of my friends suggested to me that I have allowed my son to feel free and safe to dump on me and this is what I wanted to discuss today with my pdoc. Instead we talked about my pdoc's problems. I tried to butt in a few times but he was really on a rant today. I've never seen him like this before. He usually has not much to say unless you ask him a direct question.

What I feel bad about mostly is that the government paid him a significant amount of money to tell me about his problems.

[Guiness187055]

ummm wow just wow....

[tecomsin]

Originally Posted by franz kafka

Woah, awkward. I guess it's a good thing that he isn't trying to mess with you meds while in that state of mind.

He never makes suggestions about meds, so if he did that it would be a symptom.

I asked about Rexulti about a year ago when I found out about it on PC and then he opened up his drawer and gave me free samples and said he had never prescribed it before or given out any samples.

I mentioned today that I am back on a small dose of Olanzapine at night to sleep, which he usually writes down, but today it just bounced right off him.

He was telling me that because of my heavy, down and slow mood I should be obese but since I wasn't obese there must be something else going on too.

[TheSeaCat]

My last T who will be moving soon is Bipolar and he was a wonderful T; he really knew his stuff, but he knew when he was dealing with something and knew to call of seeing patients. I couldn't imagine going through all of that.

I am so very sorry tecomsin that you had to deal with that. I agree I would try and find another psych bronto.

[tecomsin]

Having slept on it, I'm thinking maybe i have been too negative. The truth is that I have been stuck in therapy with him for years, not getting better although he did help me improve my relationship with my son particularly during the teenage years, but the last few years I have been stuck in a rut.

He started out saying he felt some regret at not being able to help me because of all the walls he had put around himself, how all these years he hadn't really shared much about what was going on and how he hid his symptoms from the province (by that he means his psychiatrist) and his wife.

So I don't think there were bad intentions. I think he is hypomanic and wanting to get unstuck in his relationships including with me.

I have been seeing him for 10 years and am not inclined to give him up after 1 weird session. Maybe the weirdness will help me get unstuck too.

[tecomsin]

Well I am going to think carefully about what I will do or not do in my next session with him. I see him every 3 weeks and kept it at that. For a variety of reasons it makes my life simpler to be under the constant care of a psychiatrist and his office is conveniently close, he gives 45 minute appointments, and is almost always on time. Plus if I hear about a medication he will look it up and generally prescribe it.

But if he is acting agitated, talking a lot and seems distracted I will ask him I think point blank if he thinks he is manic and see what he says. Then i might ask him if he thinks he should be treating patients while he's manic. I'd prefer to deal with this face to face with him seeing that I've been a patient for 10 years and he has always been loyal to me even though I was once even in serious legal trouble.

So what do you think of this plan?

[~Christina]

Sounds like a great plan !

[fern46]

I think the success of that plan depends on what kind of mania he has if you confront him. He might not take it well if he is agitated or if he's feeling God like. He could even be violent if he's suffering from psychosis or a mixed episode.

It shouldn't be your place to call him out if he is treating patients in a compromised state, but I think you're a good person for considering his feelings and being willing to work with him. You're honoring what seems like a friendship that you've built over the years. I hope it works out that he is back to his normal self the next time you see him so that you don't have to risk rocking the boat. I'm sure you'll be able to feel it out and stay safe no matter what happens. Definitely keep us posted.

[tecomsin]

Thanks @~Christina. I appreciate your good judgment. Still I have almost 3 weeks to think this over and @fern46 raises the point that it depends, really, on how far gone he is when I see him next. Hopefully he has climbed down from the manic phase, but I have to be prepared if he has not. What if he is in a state where you can't readily communicate with him. I'm going to read up on the list of symptoms of mania...

Well according to the DSM 5 one criteria for mania is "Excessive involvement in activities that have a high potential for painful consequences."

He said that he trusted to share how he was feeling with me and was in his view tearing down the barriers he had placed in order to form a better therapeutic relationship. I had a creepy feeling that felt like i was being 'groomed' with the compliment I am special and he can share how he is feeling with me while at the same time hiding it from his psychiatrist and his wife. I am just repeating what I remember him saying. He said at one point that he was psychopathic, or his psychosis was psychopathic. He was sharing a view he has that my negative thoughts about myself are not really me but part of my psychosis, how I was raised in the absence of caring emotions. The only real emotion I remember from my childhood is anger. My parents were proud of my accomplishments but this always felt to me to be a separate thing. I was loved for what I did rather than who I was. I remember being beaten by them both. When I was young, my mother also beat me. Then they would laugh and say that "I wanted to be a victim". I was 10 years old.

[fern46]

I'm so sorry to hear about the abuse. That's heartbreaking and no child should suffer that way. I'm not saying your proc is wrong about the psychosis, but he shouldn't be relating it to his own. You are your own case and it seems like he is projecting.

Grooming... That's a little scary, but it does sound like he's using you as a sounding board for thoughts and feelings he cannot share with his doctor or wife.

[Fuzzybear]

I’m sending hugs

[tecomsin]

Thanks @Fuzzybear for your hugs. I have a few acutely painful memories from my childhood but already before the memories I have of abuse I have memories of being all alone to play by myself. I was 3 or 4 and playing with a plastic golf club and ball by myself in Scotland before we moved to the States.

@fern46 Yes grooming is a scary term. I think this is how I was raised too. I was groomed to be abused. I grew up and entered into abusive relationships with men. Not all were abusive though.

I think you are write that he may very well be projecting. He was talking about how we were both professionals (I'm on disability now) with psychosis. He was telling me how he would be in the depths of depression sometimes and want to tell his patients who were also depressed that they had no idea how bad it could be. He was basically saying that he suffered much more so than many of his patients. It was all about his suffering, his isolation and how he also grew up in an emotionally deprived environment.

For many years as a child I thought I was adopted because my sister was treated so much better than I and the three of them seemed to form a group that I was left out of.

I just feel the need to get this out of my system. Thanks for reading.

[fern46]

You're welcome. I'm grateful we have this safe space to share. Getting it out can make all the difference. It is so hard to feel left out of a group and it is really painful when it is your own family you feel alienated from. I spent time as a child feeling like an outsider and it is tough. My family wasn't abusive, but I always felt different.

It is sad to me that he would discount the pain his patients are going through because he has the same disorder. I am sure he has suffered, but he should realize that sharing that with you may make you want to keep your feelings to yourself next time. Who knows what he says about you to his other patients. He is there to listen to you, not dump all of his inner thoughts on you and take advantage because you are a kind person willing to listen.

Huge hugs to you. I hope you can find someone new to see soon who can give you the focus and attention you deserve. Also, it would be nice for you to see someone up to date on all meds so they can suggest what might work based on expertise. It seems like you've been doing that part of your doc's job for a while now.

[tecomsin]

Thanks for your messages @fern46. I'm not at the moment looking for a new pdoc. Last time I tried to get another one the referral from my gp (which is what you need in Canada to see a specialist) was declined by the new pdoc because I already have a pdoc.

So I would have to give up my pdoc in order to attempt to get a new one and really there is no reason to believe the new one would be any better than the one i currently have.

If I feel i really must drop him then I would probably go to my gp and tell her I need a new psychiatrist and will no longer see my current one. She will likely ask me why and I guess i will just state the truth more or less like what i have written here. But i am not ready to cross that bridge yet.

Yes it is true I have taken on the role of researching my own medicines and am not getting expert advise on what maybe the best regimen would be.

It just isn't so easy to get a new pdoc when you cannot self refer. In Canada if you want to see a specialist all referrals go through your gp and the specialist can just say no.

Thank you for sharing you were also an outsider as a child. I think this experience has unduly coloured my entire life with a sense of alienation and helplessness to do anything about that feeling.

[fern46]

It is unfortunate the process to see a specialist is so complicated in Canada. I wish that wasn't a factor you had to consider.

Happy to share. Looking back on it, my actions were mostly to blame for me being an outsider. I think you just got a raw deal. It still hurts either way. Hopefully you've found your way into groups that accept you fully over the years. It is hard to go it alone all the time.

[tecomsin]

It is also a slow process. It was months before I was able to find out I had been declined the last time I tried to get a new pdoc. Basically the system operates on the principal of exhaustion to make people go away. I once asked for a specific ENT specialist and after more than a year was sent to see another one who took a ct scan of my nose and left me to my own devices.

I'm pretty much on my own. I have two friends and my son plus I go to an Emotions Anonymous meeting every week. I isolate a lot and have been alienated many people during my psychotic manias. But I was already quite alone in the world before my first breakdown in my mid 40s. I am grateful for my friends and my son for sticking with me. I text with my sister almost everyday but we are not close in many ways. She is always right.

One of the rare constants in my life has been my pdoc. Even though he is not great he has been a steady force until recently.