What Was That?

Sitting in a waiting room full of crying and chattering children wasn’t bad. It felt a little weird to be the only adult patient waiting for an appointment – Was there some mistake? Did I accidentally arrange to see a pediatric psychiatrist? – but I’ve sat in plenty of loud and irritating spaces before. After countless bus rides and mall trips, a room full of loud kids is really no big deal.

After calling me back, they explained that the psychiatrist I saw last time was running late, so I’d be seeing someone new. I hadn’t exactly bonded with the first psychiatrist, so that was no big deal either. The nurse pointed me towards a room in the back.

There was a big, formal desk with a small table pushed beside it. One man – the psychiatrist – sat behind the desk. Another man in scrubs – a nurse, I guess? – sat at the table. The psychiatrist pointed me towards one of two chairs arranged before the men.

That’s where things began to feel a little ominous. It felt like I had been called in to some committee. It felt like I was in trouble.

The man in scrubs had a laptop open on his table. My file was apparently pulled up. Both men read off the screen and asked me questions.

“Your primary diagnosis is social anxiety?”

My primary diagnosis is technically avoidant personality disorder, but I’m used to that being ignored. It may just be an insurance thing – some insurance policies won’t cover treatment for personality disorders. They’re considered too resistant to treatment, not worth the effort. It may also be that most psychiatrists aren’t really versed in AvPD. It’s not borderline PD or antisocial PD, which tend to be the two that people have heard of. Or it may just be another example of psychiatrists ignoring their patients’ input. I’m not self-diagnosed, but I don’t have any paperwork or anything proving my diagnosis.

Seeing new therapists or psychiatrists is always surreal. They tend to rattle off this list of incredibly intimate questions. Some of them are better than others at pretending to be interested in your responses. Most of them are just getting through their work day.

“What were your symptoms like before [medication]?”

I couldn’t answer. I just shrugged. I was completely unprepared to describe the sensation of living in a plastic tube, of having bare wires sending shocks through my chest. Not to these strangers behind a desk and a table.

Eventually we decided not to change my medication. The psychiatrist wanted to – they always do, in my experience. Seeing a psychiatrist means walking through a door and immediately having pills thrown at you. In my experience. I explained that my dosage was increased just a few weeks ago, and I didn’t want to increase it again so soon. They accepted that.

The entire appointment lasted about five minutes. I took time off work and drove half an hour to get there. I would love to give up on the whole thing, but the medications do actually work for me and this is the only way to get them.

Doctors and researchers tend to be baffled by low compliance rates among the mentally ill. Don’t we want to get better? Is it really that hard to show up for appointments and take medication regularly? There are lots of theories about compliance – maybe we’re mistrustful, maybe we fall for the anti-mental-illness stigma, maybe we just like being crazy.

Any theory that doesn’t look at the actual experience of seeking treatment – the discomfort and the weirdness, and the boredom and the inconvenience – is a theory that is seriously lacking.

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