Went to the new psychiatrist today, Dr. C. She’s nice, but she’s definitely NOT a med person. Yes, she has a medical degree. Yes, she’s a physician specializing in psychiatry. She’d probably be a better therapist than psychiatrist. I think that’s what she really likes anyway, based on some of the things she told me today. She said she’d wondered why she didn’t just become a physician’s assistant instead of going to med school and then having to do a residency.
Okay…
We were talking about my desire to go to medical school and to become a psychiatrist. She was saying that there are other ways I can do therapy. That’s what she normally does - therapy supplemented by medication.
I have a therapist. A therapist I’m very fond of, actually. I need someone who does medication management. Not that a psychiatrist doesn’t need to know her patients, but she needs to take a more scientific, medical approach to treating mental illness - that’s kind of the point. Yes, psychiatrists can do therapy (though they’re not necessarily taught *how* in medical school), but they are MDs so they can prescribe medication. If they’re not interested in medication management, they should’ve gotten PhDs or MSWs and chosen a career as a therapist, not a psychiatrist. Psychiatrists who aren’t good at medication management (most of them) are doing a disservice to patients who rely on them for mental health treatment.
I told Dr. C that I like psychiatry because I *like* the medication aspect of it. It is fascinating to me. I know for a fact that psych medication works, and I’m amazed that it works as well as it does considering how little science knows about the brain. I want to know more. I want to learn more. I want to be able to help people with mental illness through medicine, not just psychotherapy.
So, I’ve been reminded of why I don’t like most psychiatrists. Most psychiatrists, it seems, aren’t much more up-to-date on the latest in psychotropic medications than most general practitioners. It’s very frustrating.
Anyway, I decided to page my former/current/long-time psychiatrist, Dr. L. He called me and, um, did exactly what I thought he would do - he bumped my fluvoxamine (Luvox) dose a bit. I’ve been on a pretty low dose for a while, but fluvox has been a good drug for me (minus the initial weight gain), and bumping the dose back up a bit makes sense. I had thought about just doing it myself, but figured I’d better check with the good doctor first. As much as I hate the fact that Dr. L moved his entire practice to Charlotte, the fact is he’s brilliant at medication management. He knows the drugs and the brain inside and out. And he knows me and my history.
Dr. C wrote me a script for clonazepam (Klonopin), a benzodiazepine. I’ve only ever taken one benzo - Ativan - that did me no good at all. I told Dr. L what Dr. C had prescribed, and, as I suspected he would, he said he’s not a fan of clonazepam, that it’s one of his least-favorite drugs. It’s one of Dr. C’s most favorite drugs. Hmmm…
Anyway - for the time being, I’m going to keep letting Dr. L manage my meds while I look for someone else local who knows something (please!!!!!!!) about psychopharmacology, particularly for patients with complicated medication histories and treatment-resistant mental illness. Like me. I don’t have much confidence that I’ll find someone who is actually on my insurance, but hopefully I can find someone. Someone competent.
Someone who knows that bupropion ER is the generic for Wellbutrin SR, which Dr. C wasn’t aware of, apparently. Jeesh.
Reminds me of the psychiatrist who treated me the time I was hospitalized, Dr. N. He tried to tell me that one of my meds, Lamictal, wasn’t yet approved for treating mood disorders, nor was it a good first choice for a mood stabilizer.
It had been approved for treating bipolar about 2 weeks before I went into the hospital. The day I was released, when I met with Dr. N for the last time, he told me that he had just gotten the letter saying it was now approved for treating bipolar. I said, “Yeah, two weeks ago.” At least he admitted that I was right.