I Think My Husband's Psychiatrist Has An Endorsement Contract

The BBQ Pit
1

Note: This is not a rant against all psychiatrists–just a rant against one in particular.

My husband and I are both clinically depressed. We see different psychiatrists for our medications. I’m taking Celexa, and it’s working quite well for me.

My husband has been taking Paxil. After the first six weeks, there was no noticeable improvement, so he told the doctor about it. The doctor increased the dosage, and added another med. The combination left my husband in a perpetually zombie-like state. So, the doctor stopped the second medication, but left the Paxil at the raised dosage.

The depression that my husband suffers from causes him to not want to do much of anything, including actually keep his doctor’s appointments. This doesn’t help matters at all. But today, I made an appointment for him, and we went together. I was going to give the doctor my take, in the hopes that he’d see that in my husband’s case, the Paxil is completely ineffective. I also brought a book about depression with me, because I found something in it about atypical depression that related directly to my husband (depressives often cannot correctly relate their own symptoms to the doctor, and this can often result in ineffective or incorrect treatment). I thought that since I am being successfully treated myself, and I live with my husband and his illness, the doctor would welcome any input from me.

I was wrong.

I wasn’t given the opportunity to tell him how miserable things are right now. I nearly had to force him to read the part of the book that described precisely how my husband is. I told him flat-out that the Paxil wasn’t working, and my husband told the doctor that he wasn’t happy with it.

The doctor raised the dosage. Again.

[begin rant]

What part of “it isn’t working” didn’t you understand? Yes, my husband is a physically large man. But the Paxil already makes him sleepy–now you’re putting him on enough to turn him back into a zombie. We’ve got toddlers at home, pal, and my husband is a stay-at-home father. Chronic sleepiness is not an option. And how DARE you blow me off like that! You’re just a doctor–I’m his God-damned wife, and I live with this shit every fucking day. If ANYONE has a clue, it’s me. You want to know how he feels? Don’t ask him–he doesn’t know. Depression does that. He feels like shit, and that’s all he knows. He has no idea how it’s affecting me, and he’s so self-absorbed by it that he doesn’t recognize the damage that it’s doing. That’s why I came in with him today–something I should have done a long time ago.

And when we left, and you thanked me for coming, I hope you know it was all I could do to keep from saying “Fuck you very much.” Instead, after the door shut, I turned to my husband and said “I’m sorry I didn’t come in here sooner. And tomorrow morning, we’ll be finding you a new doctor.”

I will tell the new doctor about you. Of course, I should have told you about you, but I think I was too much in shock. But tomorrow, I will begin my campaign. I know lots of folks who see psychiatrists, and lots more who either want to, or deeperately need to. I will do my best to keep them away from you. Of course, I won’t be ending your career. But maybe I can point one more person toward proper treatment, and away from your sorry ass.

2

aww sweetie, I’m so sorry you’re both dealing with this. This well and truely sucks. I won’t bore you with my entries into the sucky counselor/psychologist list, but you are (as you know) absolutely doing the right thing by changing doctors pronto. I hope that you can get to a good one quickly. Wish I knew of some there - (I do have a friend who works in Flint, she might know competent folks there -if you wish, I’ll try and get in touch with her).

3

They aren’t exactly endorsement contracts, but yes, there are certainly a number of perfectly legal mechanisms by which doctors benefit from prescribing a given medicine and unfortunately some bad doctors out there.

I wish you lots of luck with finding a new doctor for your husband.

-Doug

4

Oy.

My husband and I also thought it would be helpful for him to share his thoughts with my (ex-)shrink.

At the next session:

Shrink: I was very glad to meet your husband last week.
Green Bean(expecting shrink to say that she thought he was the sweetest, lovingest, most adorable, most caring guy to have ever graced her doorstep): Yeah?
Shrink: He’s completely clueless.
GB: Huh?
Shrink: And after meeting him, I see that you have serious problems in your relationship.

:confused:

Good-bye Shrinky-dink!

Sorry to hear the shrink was such a schmucko, Cristi. New Shrink + New Pill = Happy Hubby. Good luck.

5

There are??? Why the hell wasn’t I informed? Dammit, why the hell have I spent all these years prescribing what I thought would be the best medicine for my patients, when I could have been getting legal kickbacks? Quick, what are the mechanisms? My kid’s going off to college soon!!

No, really, all I ever get from drug companies are pens. Once I got a laser pointer, but it didn’t work. And I did get a clock for my wall. And some Hershey’s kisses. But they never even asked me if I prescribed their meds before they gave me that stuff. I always hear about the drug company gravy train, but I can never find the station.

Re the OP; if the doctor can’t or won’t address your concerns, get another doctor. Of course, you’re already doing that. Good luck.

Qadgop, MD

6

Oh, I know that doctors get free stuff. Like pens and note cubes and cool posters of brains & things. My husband commented on the fact that the doctor had a coffee mug on his desk with the Paxil logo. But then I asked him if he’d noticed the really cool brain poster on the wall–with a Carbatrol logo on it (interesting, because I take Carbatrol as well–but for epilepsy, not depression).

This particular guy, though, just seems really gone on Paxil. Now, having taken seizure control meds for nigh on to 20 years now, I do understand that sometimes, you do have to tweak the levels. This is normal, and perfectly right to do. But, I was talking to my mom tonight (she’s a social worker), and she asked me if the doctor had ever done a level check on my husband. That stopped me in my tracks. No, he hasn’t. My husband has never had a blood test to see if the levels are correct, and to my knowledge, he’s never ordered one. He’s just upping the levels with wild abandon.

A few weeks ago, I went to my own psychiatrist, because I didn’t think the Celexa was as effective as it had been, and I thought it might need some adjusting. You know what MY shrink did? He whipped out his calendar, and opened my file. He counted the days between my calls for refills…and lo and behold, it wasn’t the drugs. It was me. I’d been missing days. Duh. I got myself one of those seven-day pill containers from the drugstore, started counting them out, haven’t missed any since then, and gee whiz, I do feel better. My husband’s doctor did not ask him if he’d been taking them right. Just upped it without question.

Grrrrrr! The more I think about it, the stupider that doctor gets.

[sub]pssst…hey Qadgop…got any note cubes? I really like note cubes…*

7

By chance, are you and your husband patients of Dr. Nick Riviera?

8

Oh, man, that sucks. Would your husband feel comfortable seeing your doctor? He sounds like he’s got his stuff together.

{{{{Christi & Tim}}}}}}}}}}

9

Well, you see doctor, medical degree or not, you are not properly equiped to benefit from this. You see, Dr. Qadgop, I really hate to point this out, but well, sir, ummm… It’s really not a flaw but…

There’s this thing called Ethics and you seem to have a wonderfully abundent supply of them.

I believe less than 1% of doctors receive the benefits I was referring to (drug company sponsored travel, conferences at no cost to the doctors, etc.) and those are only the people who the drug company considers likely to benefit them in a bigger way than simply prescribing their product to that doctor’s patients.

-Doug

10

Aw hell! 1st diabetes, then heart disease, now I’ve got Ethics? Can I get disability for that?

thanks, dublos

11

a) Doctors in general (if I may be permitted a generalization or two) do NOT appreciate informed patients who do independent research and come into the office with clear ideas of their own as to what the doctor ought to prescribe or do. They want awe-struck obedient unquestioning ignorami for the most part.

b) The opinion of spouses, parents, children, siblings, neighbors, or other people who are not the patient tend to be given even less weight than those of the patient.

c) Psychiatrists tend to be worse by a double handful of quantum leaps about this than other doctors.

12

A) Well, I surely don’t enjoy a patient coming in and telling me they have to have drug they just saw on TV, 'cuz they know it’s better for them, or it wouldn’t be on tv. But a patient who’s really done their homework is a godsend in getting them to engage in caring for themselves, and when that happens, 90% of my work is done. Most of my and my colleagues frustration seems to be for the patients who just want to be given a pill to make them better, so they don’t have to change their habits.

B) One significant other in the room with the patient at a time please, unless we’re doing a family conference.

C) Many psychiatrists are different.

13

Went to a new psychiatrist today. Actually, it’s my psychiatrist, but my husband has seen him in the past, before I ever did, and stopped going (bad move, I know).

Anyway, this doctor did give me the courtesy of seeing me alone briefly. I had written a list that contained a lot of my husband’s symptoms, because at this point, my husband just can’t explain it all himself. I also expressed my displeasure with the other doctor, and told him why. He said okay, then called in my husband, and I went back out in to the waiting room.

My husband came out a short while later, and told me that this doctor…wants him to go back to the other one. My doctor apparently gave my husband a bit of a verbal spanking for not keeping up with his appointments, and also told him to just follow the other doctor’s orders.

I feel totally betrayed.

I have an appointment myself tomorrow, with a psychologist. She has treated us both, and is familiar with our cases, separately and together. I am going to ask her advice. My husband doesn’t want to see the old doctor anymore, and I agree with that decision. But I also want to be heard. I don’t want to cause a bad relationship between my husband and whatever doctor he sees, but dammit, this is my husband we’re talking about here. We’ve got our problems, but the depression on both our parts is a major contributing factor. If we can get his under control, coping with other issues will be a bit easier.

Fuck. How do I assert myself here? I feel that I must. I don’t want to lose my temper with the doctor, because that won’t help at all. But my husband’s depression isn’t just affecting him–it’s affecting me, and our kids. What do I do when the doctor won’t listen? He’s already waved me off once. No doubt he’ll do it again.

Fuck. Fuck, fuck, fuck.

14

Wow. That just seems like such a betrayal. Sucks. Seriously. ((((Christi & Tim))))))))

15

Jeez, Cristi, this bites.

Perhaps after getting another viewpoint from the psychologist, you can discuss it again with your psychiatrist. You’re well within your rights to ask why he made that decision about your husband, and to tell him how much you feel betrayed. I’ve always felt that medical treatment is a partnership; your body, their advice. If you’re trying your best to follow that advice, and it isn’t working, then listening and fine tuning is the next logical step.

It is amazing that your psychiatrist wouldn’t understand that you were fed up with your husband’s doc and looking for a second opinion rather than a “How dare you question your meds ?” judgement. How could he not realize that would endanger your trust in him as well???

Ask him all the questions you have; that’s his job and duty.

And Quadgop: I’ve noticed it on these boards often; but you are an admirable credit to your profession. Keep on!

16

Persephone: I can’t help but wonder if there isn’t something going on in this picture that you don’t know about. One psychiatrist acting oddly (your husband’s in this case) is surely not exceptional. Two is certainly possible, but when the 2nd one is your pshrink, in whom you have had trust, the possibility that there is more happening than you know must be considered. I have been put in uncomfortable situations before by patients who brought in family members to talk about their situations, but only after they’d told me specifically they wanted certain information withheld about their circumstances. It often left family members unsatisfied and puzzled about what was being done and why, but it did respect the patient’s confidentiality, if not (IMHO) their best interests. Again, I’m not saying this is happening in your case, but you might want to ask yourself if it is possible.

elelle: Thanks, I try. Some days I don’t succeed as well as others.

17

Well, I spoke to the psychologist yesterday, after I calmed a bit. She backed up psychiatrist number two, the one who’d said for my husband to go back to psych one.

She said that it’s not good for my husband to switch psychiatrists as many times as he has, in such a short pace of time (psych one, the one we don’t like, is actually the third my husband has seen in about 3 years–but there was one he only saw once, and he made my husband feel like and absolute worthless POS on just the one visit).

So, with psych two and the psychologist speaking in stereo, we’ve decided to give psych one another try. But I am going to stress to my husband that even though he’s depressed, he has a right to speak his mind about his treatment, and try to get on the same page as the doctor. It’s important to us both that we know why the doctor makes the decisions he does, rather than just saying “do this, because I said.” Doctors owe it to their patients to provide an explanation of why, but patients also owe it to themselves to ask in the first place, and not just accept without question.