Confusing the Psychiatrists

Well, I just returned from my second psych evaluation. I never blogged about the first, I don't think? I can't remember. Well if I did (or did not) here's a brief review.

Of course with my "doctor anxiety" I was nervous as hell. Add to the fact that I hadn't had a full consult in about seven or eight years. I had no idea what to expect. It went alright, however. The psychiatrist at this "institution" had a gentle demeanor and a soft voice and we actually ran over the allotted time. I felt okay with it and he allowed me to ask as many questions as I needed.

Alright, I thought, this whole evaluation thing isn't so bad. Granted, it was difficult to pack your entire life's woes and psychological/neurological history into such a brief time span. I didn't cover everything in perhaps as much depth as I wanted with this man. The reason being, this consult was a "one off" and I did not expect any further appointments or follow ups with him. And again, I was nervous, unprepared and it was difficult. However, we went through Medication History, Family History/Trauma, Bipolar Disorder, Self Injurious Behaviour, Hospitalizations, ADD and a little bit about Aspergers.

After it all, he said he would "try and put something cohesive together" for my GP. I had to laugh a bit at that one.

Today was a bit different, however. I was mistaken about a lot of things. First, my appointment duration. I was told an hour, I only received 30 minutes. Also, I was under the impression I would be seeing this psychiatrist on an ongoing basis. Nope. But more on that later. Also, this man was not as...well, he certainly had a different "demeanor" than the first psychiatrist I saw.

It was a good thing I was a bit more prepared for this appointment. 30 minutes! We very briefly touched on all of the above mentioned in the first appointment. He asked some fairly simple and straightforward questions and I answered them. I gave him my prepared "dossier" and he flipped through some of the pages. Basically some self-prepared notes about ADD and Aspergers and some highlighted notes from referenced materials etc...

He asked if he could keep all of it. I told him the copies were his.

He basically told me about a counselling group (i.e group therapy) for women who are trauma survivors and how I could take advantage of that. He also told me that I would not benefit from ongoing psychiatric treatment from a psychiatrist due to my problems with functioning and other issues. I have no idea what this means. I don't know if this is an allusion to the fact that I have Aspergers or not. He said that seeing a psychiatrist would only exacerbate my problems. He said that I already have a therapist, see a neurologist and have a GP so that is good enough. Well, then why offer me group therapy? During all of this I simply stated that people with Aspergers do not usually do well in therapy. He agreed.

I still remain confused.

I did manage to get out of him his med recommendations. He had five. Ooh, decisions, decisions! He also casually mentioned one of them, Risperdal, would be helpful with both Bipolar and Aspergers. I told him that yes, I knew this. I also had to remind him of another med that would probably be helpful. He agreed and wrote it down. I so often wonder what doctors think of me when I stroll into their offices and spout such things.

So at that point, time was pretty much up. I felt unfulfilled. I asked him what he thought of the ADD and Aspergers. He said it was hard to tell due to "other issues" and the trauma I had been through. Alright. I understand all about truama and it does not preclude neurological disorders. I also argued high comorbidity rates (and even had that reference material with me.) I asked him if he planned on reading what I had brought him. He said that yes, he would. As I was putting on my coat, I asked again, "So it wasn't all in vain, then?" He said that no, it wasn't.

Yes, I can be terribly blunt.

Now I understand that clinicians can not provide diagnoses on the spot and I did give him a fair amount of documentation to review but a little more feedback would have been helpful.

Shoot, I can't stream the song I wanted for my new MP3 so you'll just have to go with my second choice. "One In Ten Words" by The Spoons. Canadian Band and the poppy little song is from my youth...it makes me laugh about communication.