How to get the right therapy when doctor won't listen?

Hi

I'll keep this brief, as I have a tendency to ramble. I've felt for many years I'm borderline and increasingly avoidant in many of my behaviours, but when I've mustered up the courage to mention it to a doctor, they either poo-poo the idea (because they don't like people coming in with self-diagnoses) or they start asking questions that quite clearly suggest they're trying to label me bipolar. This can be - as most recently - a doctor who has never met me and spends all of 3min on assessment. The recent frustration has been very triggering for me and I've been having flashes of childhood memories (I repressed most of my childhood) and today it hit me that my mother exhibited all the signs of being borderline, too.

Anyhoo, I've been referred to the same counselling service as I wasted 6mos at last year, who specialise in CBT and anxiety and depression, and I felt I was railroaded into dealing in logical ways with the anxious behaviours I sometimes exhibit, when that's only scratching the surface. I'm also very right-brained and just don't think CBT is for me. I have a tendency to play a part and so I played the part of a patient a therapist successfully treated for GAD (anxiety) because I didn't want her to feel bad that she'd made no difference whatsoever. I need to know WHY I choose a certain behaviour, WHY I'm triggered etc, not learn new behaviours and just shove the issues under a rug.

I'm 34 in a few months, never been in a relationship (outside of being the third wheel, due initially to being stupid and naive and later to not caring), raging through the roof IQ, childhood musical prodigy, adult dropout, recovered anorexic, who is unlikely to have children if I can't be in a loving relationship, unable to hold down a job - I've only ever created my own work, but as a musician this is becoming increasingly more impossible to do, so I'm dealing with a ton of debt, bleh. Also, the only relationship I really have is with my mother who is far too busy to even answer the phone now she has a life. I have conflicting feelings of being protective of her and hating her for the things she did to emotionally scar me. Just this hour, I remembered how she used to take me with her to the guy's house she was having an affair with so I could mind his kids...I can't see how that was in any way appropriate for a 12yr old. When I've blown up in the past, she's refused to take responsibility and crumbled in tears, and of course, gets everyone's sympathy in the family. How dare her ungrateful daughter throw it back in her face blah blah blah. And that's just a minor infraction. My brothers didn't turn out as messed up as me, fortunately for them! I try to 'suck it up' mostly, but when experiences bust your psyche, it's hard to hide from.

Yes, I said I have a tendency to ramble What I want to know is, do I go to these counsellors again, who are set on labelling me depressive, anxious, bipolar, whatever, when I know what the problem is? Just because a doctor has a certificate, it doesn't make them an expert on me in less than 5min and I don't see how agreeing to treatment for something else can help? I hope I put this in the right place!

Thanks for reading x

Hmm. You're totally right that doctors hate people that come in with self-diagnoses. They often get "offended" because they are the ones that got years of schooling & we've just read the DSM on the internet. (Or if you get lucky & can get ahold of the physical book, like me. ) But the truth is, we KNOW what we feel, so a lot of the time (not always) we know whats wrong with us. We can just feel it when we read the criteria.

My first psychiatrist hated the fact that I walked in & told him that I thought I was Bipolar. He despised it & did all he could to "prove" that I wasn't. (He turned out to be a complete idiot) My current psychiatrist actually heard me out. He first diagnosed me with mood disorder NOS. But I complained saying it was invalidated & I've been invalidated for the severity of my mental illness for years. So - he said, & I quote - "Make your case." He let me sit there & persuade, the best to my ability - that I had manic-depression.

He ended up agreeing with my proof. & Now we have a proper game plan as to how to treat it.

The thing is, you need a doctor like that. That will HEAR YOU OUT. So that you can get the proper treatment which is usually an anti-depressant/mood stabilizer & DBT. Plus - like me, you probably want some validation of your suffering/disorder, am I right?

When I went in to see my latest psychologist, who I have now been with for 12 months, I wrote out all of my history for him on paper. Mainly because I have seen so many so-called "experts", many of whom have dismissed my thoughts and fears and made my "illness" much worse and I've become tired of re-telling a painful story so many times. When I went to see him, I'd actually already done a bit of reading on BPD. In my list of stuff I gave him, I didn't say "I think I have BPD", I told him about the diagnoses I have been given in the past- depression (diagnosed with that 10 years ago) and went through the other problems I've had- panic attacks, self harm, etc., etc. So he had my history there. I wrote out a separate sheet of info with the stuff that goes on in my head now- a lot of the BPD stuff. I didn't present it as BPD, but as "I have all these things going on and I don't understand why I do this"- what's wrong with me?

He wouldn't play into my "I want a diagnosis" bit, but we went through a lot of stuff, and when I was finally diagnosed by a psychiatrist a few months back, he actually pulled out his notes from my first session with him, where he had written in his notes that he suspected that I had a personality disorder, and told me that he would totally agree with the psychiatrist's diagnosis- so he'd already worked it, but he wasn't letting on to it- he was treating my issues as being more important than the label. I can understand why he's done that, but personally, I wanted some sort of justification of the what and why of what's going on in my head, and knowing I have BPD does that.

As scary as it is (and it is something I now absolutely hate doing)- don't be afraid to ask for another opinion, or find a doctor you're more comfortable with. Some of them just have no idea- I had one that just wanted to endlessly stumble through SSRI medications as the only answer for my depression- refusing to acknowledge that I am allergic to SSRI medications when every single one made me violently ill, and that I could possibly have anything other than just plain depression. The validation of your disorder is important, as EarlGreyDregs said.

I do much the same as lilyfairy - go in with a written history, a list of what others have diagnosed me with, and a list of symptoms I have that trouble me. I knew years before being officially diagnosed with BDP that I had it (along with almost every other mental illness I have - PTSD is the only one I missed). But, like you and others have said, it hurts many doctor's egos to have a patient walk in and actually say what they have.

You could try DBT - there are a fair few places online that do DBT sessions for free, either with pre-made lessons that you work through at your own pace, or with a group doing one lesson a week. The other benefit of the free online ones - you don't need a referral.

Like others have said, you don't have to settle for what one doctor or counselor says. You can find another, or ask for a referral for a second opinion.

If ever someone in your life, whether that be a family member, a friend, a partner, or a doctor, chooses not to listen to what you believe your problem(s) to be, then they do not have your best interest at heart. Just like other types of professionals, doctors make money doing what they do. As i am sure alot of them truly wish to help, they all have their best interest at heart. In a country like Canada where our health care is paid by the insane amount of taxes we pay, doctors are paid per patient, per visit, and per prescription. So some doctors, like some other professionals, think about their own gain before that of their patient. Why is this? Because regardless of their title they are still human. They are still subject to being selfish, and minding their own best interest. They are still subject to making mistakes, and still subject to being blinded by their own wants and needs. Sometimes they are blinded by what it means to be a doctor and have more to do with upholding their title than bending a bit to get to the real problem.

With that said, there are still copious amounts of psychiatrists who aren't so horny to jump to the prescription pad first. Ones who actually listen to you, and want to know your brain personally, not just to see how you fit into the DSM. I was asked, on a few occassions, if i were planning or studying to be a doctor myself by a doctor i highly respect.This leads me to believe that only a doctor who listens to you and your suspicions is the right one to have on the case. There haven't been many doctors i have met in my journey to understand myself that have actually made a good impression on me. To be honest, alot of them are in the wrong business. But like any friend, or lover, the good ones are hard to find. If you are dedicated to finding the right one, they will someday arrive. It's recognizing the true people we need during the confusion, ( not just doctors), that is the real challenge.

It's like they say, follow your guts. If you feel you need to be looked at from a particular perspective, and your doctor fights you on it, then finding another opinion should be encouraged. Either way you will have more than one hole to look through into your own brain. Finding another opinion is sometimes the smart thing to do. You are not just a science project, and it is possible to have insight into one's self even while continuing to use the same brain you are trying to treat. It may be a paradox, a catch 22, but it is possible. I mean, i have to think this way. DBT isn't even offered anywhere near the city i live in. If i didnt think this way, then i'd really be lost.

Thank you all for your input, you've given me a lot to think about. I don't even know where to start, in terms of writing up a history; my life has been very chaotic, especially as a musician. I was thinking I might just start with the pattern of self-sabotage I have with dropping out of things in the last minute: jobs, uni, college, school, orchestras, etcetera, which has been a pattern since childhood. I watch people I went to school with earning huge money - C students who doggedly applied themselves, and I'm earning less than I did as a teenager, because I quit everything. That's caused me a lot of debt and court appearances - well, non-appearances, 'cause I rarely open mail and have a memory like a sieve. If I don't figure this issue out alone, I'll end up in jail soon. I think if I get started with that, it won't seem such an insurmountable task to deal with.

miss_communication wrote:Thank you all for your input, you've given me a lot to think about. I don't even know where to start, in terms of writing up a history; my life has been very chaotic, especially as a musician. I was thinking I might just start with the pattern of self-sabotage I have with dropping out of things in the last minute: jobs, uni, college, school, orchestras, etcetera, which has been a pattern since childhood. I watch people I went to school with earning huge money - C students who doggedly applied themselves, and I'm earning less than I did as a teenager, because I quit everything. That's caused me a lot of debt and court appearances - well, non-appearances, 'cause I rarely open mail and have a memory like a sieve. If I don't figure this issue out alone, I'll end up in jail soon. I think if I get started with that, it won't seem such an insurmountable task to deal with.

I thought i coined the term "self sabotage"? I mean, I think i said it hours ago, or perhaps yesterday. And i wish i could say that i finally got together with the people i have been meaning to jam with over the past few months. I'll contribute that to anxiety... Alot of the thingz i had hoped to accomplish or could even see in the distance, haven't happened yet. I want to sing in a ( or should i say many) bands. I want to write a book. I have been learning to tattoo for the last three years and have been doing okay. But bizz ain't much when you work out of yure home. Oh yeah, that's and everyone thinks im right-out-of-er.....sometimes i feel some of my actions could have rendered me in jail. I had a peace bond court date i did attend but that waz because the girl accusing me of threatening her iz a few degrees more twisted than myself. The universe took one big dump on me at the end of the winter, and honestly at the moment ive been pretty sick over the last few weex.

miss_communication wrote: I watch people I went to school with earning huge money - C students who doggedly applied themselves, and I'm earning less than I did as a teenager, because I quit everything. That's caused me a lot of debt and court appearances - well, non-appearances, 'cause I rarely open mail and have a memory like a sieve. If I don't figure this issue out alone, I'll end up in jail soon. I think if I get started with that, it won't seem such an insurmountable task to deal with.

It sucks aye. I see mates of mine in uni now, just doing the bare minimum to scrape by, taking whatever courses they're not even interested in just so they can get a decent job and be paid well. And meanwhile I dropped out of uni because it was too stressful for me.
I know I'm worth something, and have skills that can help the economy, it's just I can't apply myself fully. Half of myself always wants to get away from whatever I'm doing and just die. The other half has terribad social anxiety and won't let me interact with people without being overly self critical. So I can barely ever put my concentration fully into something that I want to achieve. There's always parts of me sabotaging my efforts to do well, telling me I'll never amount to anything. I don't want to be gloomily pessimistic but the more I listen to it, the more I begin to think it's true.
But hell... I dunno.

It took me eight years, 10 different therapists, 4 different psychiatrists, and 13 different medications (none of which worked, of course, and some that made me worse) before I found a therapist and a psychiatrist who were willing to listen to me and thought that what I have to say about my treatment and diagnosis is actually important. They literally saved my life.

I know that probably doesn't sound encouraging, but please let it be of some encouragement - it means that there ARE doctors out there who want to help people like us. It means they exist, and it may take going through bad ones to find them, but once you find them, they are worth their weight in gold.

Hi, guys.

Again, thank you for sharing your experiences. I had the sleep from hell last night and have been walking round like a zombie today. My brain chatter never switches off but last night it was so loud, I was literally holding my head in bed, willing it to just stop. Eventually fell asleep and must have had terrible quality sleep, because I woke feeling like death. I have a telephone interview with the therapist tomorrow, one: I HATE telephones, and two: I've been thinking about things to write down that I want to talk about and it's been releasing more memories, at a rate I can't deal with - like having several stereos on at once, all tuned to different stations.

I'm not feeling positive about the counselling; they don't offer DBT and I don't open up - I tell the truth but remain detached from it, that's one thing the last therapist said, that I don't exhibit appropriate feelings, but I know I do it to remain in control, otherwise I would be a heap of limbs on the floor of the office. But I'm going to go and see them, if only so they report back to the doctor that I need different treatment. I don't relish addressing anything if it's just going to make me feel worse - which it does - but it's a necessary evil if I want to find the right therapist and make headway. Bleh.