I had a pretty amazing appointment with my new psychiatrist this morning. It was an hour long intake, and it was pretty much just enough time to talk about the major things. I walked away believing that this is going to be a good relationship. He seems intelligent, knowledgeable in his field, and willing to get down to the heart of what is going on. He read me like a book, which was a strange feeling yet comfortable at the same time.
I wanted to get right into it with him. We had an hour and I wanted it to count. I explained that I am fairly knowledgeable, I do my research on mental illness, I have been in the mental health system for the last sixteen years. He confirmed that I am intelligent, and that I know what I’m talking about when it comes to this stuff.
He started by asking me why I left my nurse practitioner, and I was nervous to answer this question but I wanted to be honest about it. If he knew what my NP did wrong, then perhaps he wouldn’t do the same shit. When I told him about the major things that she did and said that made me quite uncomfortable, he said he was sorry that I had those experiences with her. He said he understood why the sum of all of those things made me uncomfortable. He was fairly incredulous when I told him about the first time that she asked me if I was thinking about returning to work. At that appointment I had just finished telling her how depressed I was and about the suicidal thinking, and at the end she popped the question. Like…no. I’m not thinking at all about going back to work, I’m thinking about trying to survive thank you. I’m glad that he understands, and it doesn’t seem like he’s going to push me in that regard. I am pretty grateful for that. I felt more at ease after telling him those things and having him validate me.
I explained to him that I am looking to get diagnosed, finally. I know it doesn’t really matter, in general, what we call my cluster of symptoms…but it matters to me. He seemed to get that, and he heard me. He said he doesn’t normally diagnose people in the first session, but it seems like I’m ready to “jump in with both feet”. I said that’s exactly what I’m ready for.
I told him that I have trauma and that I would like it acknowledged. I said that I have had several therapists in the past who have said I definitely have complex trauma, but that no doctor had acknowledged it. I told him about a few of my experiences, very briefly, and he confirmed that yes, I definitely have PTSD. Again, feeling validated, I relaxed a little more.
I talked with him about the various symptoms that I experience, and he listened carefully, nodded, and took notes. He asked me several very specific and pointed questions about the symptoms I was describing. We started by talking about the anxiety, since we had talked about PTSD. I told him about my fears, paranoia, panic attacks, and all of that. He asked me how I feel about going to stores, markets, etc, it was like he knew that that was where I was going next. Again, reading me like a book. It was refreshing that he seemed to understand where I am coming from. He said it seems like I have social anxiety with agoraphobia. Sounds about right.
He saw my history and noticed I had been diagnosed with various things such as Schizoaffective Disorder. He said he didn’t agree with that, and that’s fine with me. He gave me a long explanation about it, and honestly I cannot recall all of it and it would be too much to write at once. In short, it seemed right to me and it seemed like he really knew what he was talking about.
The way he spoke to me was refreshing. He got right to the point, right to the heart of the matters. He asked me questions using clinical terms that he knew that I know the meanings of. He gave me very interesting information on the way that the brain works with the body, sleep, and even the meaning/translation of the word “agoraphobia”. He asked me about my nightmares. He said that he was sure I am having them but I hadn’t told him about them yet. So we talked a little at length about that. He told me about how the brain and body work together when we sleep, and how sleeping and dreaming help our brains process through our memories and daily lives. He said it’s no wonder I’m exhausted all the time. Another tidbit of validation.
He said that since I spoke of mood swings that he wanted to ask me “the Bipolar questions”, as he put it. He asked me about my history with upswings, and determined that I’ve never had full blown mania, which I knew. I’ve had several periods of hypomania. So he determined Bipolar 2 is a more accurate description than Bipolar 1 – which he said I have most likely been diagnosed with, and indeed, I had. I again agree with his assessment.
Toward the last part of our time together, he said, “ok, we’ve talked about the trauma, the anxiety/panic, and the mood…so what about the personality?”. I was interested to hear what he had to say. I had been diagnosed with Borderline Personality Disorder by my previous provider, and turns out that my new doctor thinks it fits well also. He gave me some fascinating bits of information about BPD, too, and listed off symptoms and asked me to tell him if those ring true for me. I said yes to most of the symptoms he listed.
I told him I’m working on DBT with my therapist and that it really helps. My doctor is glad about that and says to keep working on it. It’s the cornerstone treatment for BPD, he says. He also says I should continue to work on my trauma, and consider EMDR in the future.
Overall it was a pretty awesome appointment. The best I’ve had with a psychiatrist, I think. I didn’t expect to walk away with a diagnosis after the first session, let alone a small handful of them, but he listened to me. He heard me. He verbally said that he heard what I want, that I wanted a name for things that I’m dealing with. We jumped in with both feet, and I feel a lot more at peace. He is also very interested in collaborating with my therapist about my care and he wants to get her perspectives as well so that I feel secure in my care team. I’m looking forward to this relationship.
He is tweaking a couple of my medications, but for the better in my opinion. So we’ll see how that all goes as well.
Aside from that stuff, my life is going alright. My husband is off work at some point today. It was supposed to be 4:00 this afternoon, but things got a little messed up at work. He’s quite irritated about it, and I don’t blame him. We’re both glad that he has the next two days off. We have things that we need to do and want to do. The last couple of weeks, on his days off, we’ve been super lazy and not doing a whole hell of a lot. I think we both would like this week to be different. Sometimes we just need days to chill and just be together, and I can appreciate that. So he’ll be getting home…at some point. I look forward to seeing him and telling him about my appointment today.
Hope you all have a great day.