Bipolar 2 From Inside and Out

Posts tagged ‘psychiatrists’

On the Couch From the Couch

(Actually, from my desk chair, but you get the idea.)

This week I tried teletherapy, one of the workarounds that psychiatric patients have turned to in order to promote their own mental health, especially during the pandemic.

I know there are various online companies that specialize in teletherapy, or other health conditions plus psychiatric ones. Among these are Talkspace, Betterhealth, and Brightside, plus meditation and mindfulness apps such as Insight Timer. I wrote about the phenomenon back in January (https://bipolarme.blog/2021/01/10/distance-psychotherapy-is-it-for-you/).

In that post, I said that I hadn’t needed to try teletherapy yet, though I did mention having had telephone sessions with Dr. B., my psychotherapist. These were set up when I was unable to make it to my sessions, whether for transportation or psychological reasons. They helped but were not ideal, of course, because we couldn’t see each other’s faces and body language. Now, of course, with the proliferation of tablets, smartphones, and apps like Zoom, that’s no longer a hindrance,

Lately, I’ve been feeling a need to go back into therapy and by default I had to use teletherapy, as Dr. B. still isn’t seeing clients in person. (I had done Zoom calls for various other purposes, so I knew the drill.) We set up a Webex appointment and I thought about what topics to bring up, since I hadn’t seen her in so long.

I still don’t know all the advantages and disadvantages of commercial teletherapy, but I wasn’t tempted to try it.

First of all, I hate breaking in a new psychiatrist/therapist under any circumstances, as I had to do when my regular psychiatrist retired and moved. At this point, even the Reader’s Digest version of my life – or even just my mental health journey – would take several sessions. And I don’t trust therapy that starts without knowing my diagnosis, my medications (including the ones I’ve tried that didn’t work), what triggers me, at least a summary of my major depressive episodes, what therapy I’ve had so far, what I learned from it, my family and childhood and relationships, and more.

Not to say that a person couldn’t help me at all with my current situation (possible onset of a major depressive episode) without the backstory, but all that history informs what I’m going through now and why. Going through it would take several tele-sessions before we ever got to my current problem.

So, Dr. B. agreed to see me promptly and I appreciated it greatly. I was able to skip all the history and just get to the meat of my problems. She was able to remind me of some of the things that have helped me in the past and suggest some new things as well. And we set up another appointment for next week. One of the things she recommended was that I check with the psychiatrist who prescribes my meds, as I’ve been having some trouble with sleep. (Fortunately, my next appointment with Dr. G. was within the week. I see him only four times a year for maintenance.)

I had my appointment with Dr. G. He refilled all my meds, but had little to suggest about any of my other problems. He heartily agreed with my decision to go back to seeing Dr. B. He told me that one of my meds which I thought I might switch from nighttime to daytime was the kind that built up to a certain level in the bloodstream and it didn’t matter when I took it. And he suggested I make an appointment with my primary care physician regarding a matter that seemed not to be psychiatric in nature. (I agreed, and will do that as soon as the holiday weekend is over.)

So, where does this leave me? In touch with three doctors who know me and know my conditions. Set up with regular appointments to keep an eye – and an ear – on my symptoms. Reassured that my meds are functioning as they should, even if my brain isn’t.

All in all, I don’t feel better, but I feel better about it, if you know what I mean.

The Quest for a Psychiatrist

I have been seeing Dr. R. for eight years. He helped me through my major meltdown and skillfully, gradually mixed the cocktail of medications that would get me and keep me functioning at an acceptable, livable level. He got me through my near-brush with ECT (although he also suggested it).

Dr. R. is moving to another state. He sent all his clients a letter listing half a dozen or so local psychiatrists he could recommend, though he didn’t know if they were accepting new patients or what insurance plans they took. This week was my last appointment with him.

I looked at the inch-thick file he was holding. “I was really messed up back then,” I said.

“Yep,” he replied.

I left with a hearty handshake, good luck wishes, a paper stating my diagnosis (bipolar disorder, anxiety disorder – I guess there was no insurance code for bipolar 2) and six months of refills on my prescriptions. That’s how long I have to find a new psychiatrist.

So where will my inch-thick file end up next? That’s a good question.

I’ve written before about finding a psychotherapist (http://wp.me/p4e9Hv-1m), but oh, I hate the process of finding and breaking in a new shrink.

At least this time I probably won’t have to go through the whole Reader’s Digest Condensed Version of my screwed-up life, since what I really need at this point is someone who will prescribe and monitor my meds, though it will also be nice to have someone standing by in case of another major meltdown, should I have one.

My first avenue of exploration is whether my primary care physician will prescribe my psychotropics, so I can continue with just a psychotherapist. Dr. R. says that most GPs would shy away from the somewhat lengthy list of meds, but every time I see Dr. S. I update him on what meds I am taking, and I always mention the psychotropics, which have mostly been the same for years.

I have an appointment to see Dr. S. next month and sent a query about the prescription issue (his office has a robust online presence), so with luck, I may have a solution before Halloween.

My next step would be to start with the list that Dr. R. provided. Only one of the offices is at all close to me and I’ll likely start there. Does the doctor accept new patients? Does the practice take my insurance? What’s the charge if they don’t?

I’ll also need to contact my insurance provider for a list of local psychiatrists who do take that insurance, but with that I’ll be flying blind. Dr. R.’s recommendations are people he knows, and knows are good.

I hope they’re as good as Dr. R.

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