Own Your Care

Today’s post is a little late because I’ve just come back from Urgent Care to get my back checked out. I overextended in the gym and have torn some lower back muscles. The pain is pretty severe, the doctor is thinking it’s very deep tissue, and let me know what I need to do to continue recovery.

But the events leading up to Urgent Care inspired this post on how important it is to own your care, both physical and mental.

The thing is, you’re going into the office of a person who (usually) doesn’t know you very well other then the check ups or issues you come in for on a haphazard basis, and even if they do know you well they don’t know you so well that they are aware of your body more than you are. The same goes for psychiatrists.

An important thing I’ve learned to remember in both my physical and mental health care is that no one, regardless of Ivy League education or multiple specialties/degrees, knows my body better than me. No one.

For example, I’m considering getting a PRN (as needed) medication for my anxiety, as my panic has been off the Richter scale lately. It would be something I took maybe once a month, or even less, as I tend to work very hard on balancing my panic when it comes on. (I’m careful not to say I “control” my panic, because I’m not going to run around in circles and play Panic’s power-struggle game).

Since I’ve got to find a new psychiatrist for this, I filled out an intake form which asked me what my primary concerns were and if I had any other information about medication or suicidal tendencies. I wrote something along the lines of: “SSRI’s and SNRI’s do not work for anxiety for me; I do not want them. I don’t need anymore antipsychotics, they make me dead. I am coming in for a PRN for anxiety, and nothing more. I have been happily off medication for a year and three months.”

I stated that twice.

The reason being when the psychiatrist sees my history of psychosis and mood swings and depression and says “weeeeeeeell, how would you feel if we also try a little–”

I can then say “Weeeeeeeeell, why don’t we try reading my intake form where I state exactly what I’m here for?”

Because the fact of the matter is that yes, I still struggle, often daily. But I know myself. I know my limits. And I know that getting back on meds would wreck more havoc on my body. No psychiatrist can know that. All they know is what they read in a textbook.

Conversely, if you are content with taking poorly-researched medications, and you feel they improve your well-being, it doesn’t cause any side effects and hasn’t yet ruined your physical health and a doctor tries to tell you “this med isn’t very good, I’d like to try another,” your response should be something along the lines of “well this doctor isn’t very good, I’d like to try another.”

Not to be a smart ass. Not to insert your dominance. But to make sure you’re being heard and that you’re in control of your health. A lot of people like to say “doctor’s work for you”, but I don’t use that phrase because that initiates yet another power-dynamic with you on top. That’s not the goal here. The goal is fair collaboration.

Having an advocate accompany you to your psychiatrist appointments can be helpful as well, preferably someone who is very clear on what your concerns and wants are, and someone who has been through similar situations. Not only will you walk in the office with confidence, but if you’re someone like me who wasn’t always present or aware of what was going on and so assertiveness took a backseat, you have someone to fall back on who you know will do you justice. Doctor’s can be intimidating with their degrees and “factual” knowledge and they’ll blurt things at you that make you feel lesser, not always out of intention but just because that’s how they show you they “know what they’re talking about”.

This doesn’t mean be afraid of new things or ideas. If something isn’t working for you, speak about what’s not working specifically. Don’t say “I just don’t like it,” because that gives them more of a reason to convince you you’re just not giving it enough chance. If you feel coming off medication is something you’d like to try, find the doctor that will support your decisions. Don’t let anyone tell you that you can’t, because you’ll start believing it. Yes, you can come off medication, even with severe psychosis. If you’ve been on them for years, 10+ as many are, you’ll be needing to come down 50x slower. Even as small as .025mg at a time. Doctor’s words, not mine. Also, researcher’s words, not mine.

In the world of psychiatry, we must be wary of manipulative words. Whether they mean to be manipulative or not. When our brains are fragile we are at our most vulnerable.

And so take this post with you to your next psychiatrist appointment if you’d like, if you feel you haven’t been heard or respected and you’d like some strong words from an internet stranger to back you up. Hell, have your advocate read it and them snap their fingers in the “Z” formation afterward. Your doctor’s response will tell you all you need to know about that doctor.