Thursday, May 2, 2013

What can a bipolar patient do if his psychiatrist becomes fixated on a certain course of treatment?

Good medical care needs broader thinking

Treating bipolar disorder can be tricky.  The same illness in the same patient can manifest itself in surprising ways at unpredictable times.  So we realize the importance of vigilance and adaptability.  The same vigilance and adaptability are also required of the psychiatrist.  Sometimes a scenario can develop when, a psychiatrist becomes fixated on a certain course of treatment.  Generally it may have proven successful for other bipolar patients, but it may not be helpful to you.  What is more, it could be counter-productive or even harmful.  An example would be, prescribing a certain medication.  The patient comes back with the report of feeling some disconcerting side-effects.  However those specific side-effects are either minority cases, or not substantiated by medical literature.  So the psychiatrist promptly disregards the feedback, and asks the patient to give it more time.  The psychiatrist insists on using this medication.  He is fixated on the idea, it will give good results.  He may be right, or maybe he needed to investigate further about the cause.  What can a bipolar patient do in such a situation to help himself, and also assist his psychiatrist in providing good medical care?

Good medical treatment is the right and responsibility of every bipolar patient

We could shift the entire responsibility on the psychiatrist and only focus on our rights, but would that be right?  No.  We must share the responsibility.  We as patients have a role to ensure that we are getting the best medical care possible.  Those patients who take an active interest in their own treatment of bipolar disorder stand the best chance of getting good medical care.  These are some things we can do, if we see that our psychiatrist has become narrow-minded and fixated on a certain course of treatment:

  1. Take the support of family, and perhaps even friends: A psychiatrist might dismiss the observations of a bipolar patient simply because he sees the patient as mentally ill.  He might also feel, that a patient is not competent enough to challenge the views and knowledge of someone who is a medically trained professional.  Sadly, arrogance and prejudice have become all too common, in all medical fields.  Family and friends could substantiate our observations, and might be able to have a more objective conversation with the psychiatrist.  In the mind of the psychiatrist, he might knowingly or unknowingly give more weight to the same thing when coming from the mouth of a person who does not have a mental illness, such as our loved ones.
  2. Keep a mood-chart: Do you realize how useful a mood-chart can be in quickly identifying the root of a new or emerging problem?  It can also help us to identify if a problem started at a certain point in time, but went unaddressed and thus became a more serious problem.  A mood-chart is especially useful in tracking the effect of any new medication.  It will provide the evidence needed to back our claim, if a certain medication is hurting us.
  3. Personal research and talking to others: People with similar experiences are a valuable resource.  Knowing that others have faced similar issues helps us gain comfort.  Learning what they did and how they dealt with the issue could give us fresh ideas.  A support group can thus be helpful.  Many times it is people like us who make discoveries, and later it may or may not become part of established medical literature.  And where do you think medical literature gets information for regular updates, if not from the feedback that we patients give?
  4. Looking for a new psychiatrist:  This is the worst case scenario.  We don't want to change a psychiatrist on a whim.  If we have been going to the same psychiatrist for a long time, he is now familiar with us as a person and our medical background.  Changing a psychiatrist is not easy.  However, sometimes even such a difficult decision has to be made in the interest of getting good medical care.  Before making such a decision, we must carefully weigh the pros and cons.  Consulting with loved ones would be the prudent thing to do.
I hope, these four suggestions would prove practical and helpful to you.  If you have encountered a situation when, the psychiatrist became fixated on a certain course of treatment, how did you handle the situation?  Perhaps, you can share something that can help another reader.

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