I need advice on how to proceed with my psychiatrist

Ok, quick intro. I was diagnosed with ADD two years ago, when I was 16. I had been seeing a psychologist since I was 13 to help me deal with my anxiety and other issues. I had initially went to get tested for dyslexia and GAD, but through all that found out that I did have a reading disability, but it wasn’t dyslexia, GAD, and ADD. ADD wasn’t even on my radar until I started getting tested, and I was somewhat shocked when I got the results. Fast forward to October 2019, I started seeing a psychiatrist at the recommendation of my therapist. We had gotten to a point in my schooling where I was having so many problems in school that it was starting to affect my grades and sleep. Ok, now on to the main issue.

So trying to find a good psychiatrist is always hard, I mean, really, any doctor in general. My older sister had some bad experiences with psychiatrists, but in general her body doesn’t respond to most medications well. So while looking for one, my mom realized that a cousin of my uncle’s is a psychiatrist. While I never met her before hand, my mom knew her from some family parties in college. She is incredibly smart and her dad was a very well-known doctor. We knew she had a very good head on her shoulders and is very in to taking holistic approaches before trying medication. She is an incredibly nice person.

I was super nervous a my first appointment, and started panicking while she asked my mom and I questions. I didn’t really realize it then, but something about her tone bothered me. She’s very logical, which I like, but also somewhat dismissive. I liked how she thought more than just about meds, but at the same time she was making it sound like what I was going through is normal for teens and my lack of motivation is something I just have to get over.

Eventually she put me on a low dose of Zoloft, which did seem to help my anxiety a lot. She wanted to start there and see if my focus issues were more anxiety based, which is fair. A lot of what I talked to her about seemed to be greatly affected by my anxiety. I started taking that in January, slowly increasing the dose when needed. During the last 9 months the appointments have been more medication based, which is fine since I have my psychologist to talk to for the more emotional side of things. None of this really bothered I just started college 3 weeks ago, and I have been having a really hard time keeping organized, getting the drive to do anything, and just generally enjoying anything.

I had my monthly appointment with her today and I asked about trying a stimulant. I explained to her how many issues I’ve been having with school recently, and she just said it was due to me trying to handle to transition to college. I understand what she was talking about, but all the things I was explaining to her were common topics on How to ADHD that I know are different from neurotypical people. I know that what I’m going through isn’t “normal” and is affected by my ADD. I’ve been losing a lot, which I think I’ve just been noticing more and hasn’t necessarily gotten worse since starting school. I’ve been forgetting to turn in my assignments, which has never happened before, but I was homeschooled my entire life, so I never really had to turn things in. Like, I did the assignments, I just forgot to turn them in. I’ve always had issues starting things, but after getting watching How to ADHD, I’ve realized it not just me being lazy or unmotivated.

She kept saying that it’s common for new college students to have these issues, but I don’t think she understands the ADHD brain as well as I hoped she did. She tells me that part of growing up and being an adult is doing things we don’t want to, when we don’t want to. I get that, but this is different. I’m just frustrated because at this point with all the distance learning and uncertainty in the world, I would have liked to have more answers or help with managing my ADD than I have. I feel like a year should have been enough time to progress more than it has. I keep trying to do what she says, but it just doesn’t seem right to me. I kept thinking that I was just lazy, or over-dramatic, or dumb, or all this was my fault for not explaining my issues to her well enough. But after my appointment today, I feel like I need to change my doctor. This just isn’t working and I feel so unheard.

Looking back, I realized how uncomfortable I was around her. I nearly cried during my appointment today from how frustrated and stressed I was. I rarely cry.

What should I do? If she were any other doctor, I would just leave. It’s not as simple though since she’s technically family and there’s a good chance I would see her at a family gathering sometime in the future. I have no idea how to face her. My mom said she would be in the appointment with me if I wanted and she’d help me prep before hand. I just have no idea how to go about this.

Sorry for the super long post. I’ve just had a day.

2 Likes

If you explained your concerns and say what it is you need from her . . . and see how she responds . . . maybe . . . just maybe she will understand . . . and maybe . . . maybe . . . be able to adjust how she works with you. It might be worth a shot.

BUT! Regardless of her response . . . It is your right to change psychiatrists. Sounds like you know yourself well and should be able to listen to and trust your own advice.

Any medical professional should be capable of hearing the wishes of a client . . . And respect and support them (and not take it personally)!

Best of luck to you . . .

2 Likes

As @Brooklyn said… Have a chat with her about your concers, that you don’t feel that she is fully grasping your situation, and you’d like to get another opinion, or even better, a more ADD focussed approach from her.

There’s always the old “You came here for my help, and now you don’t like what you’re hearing and want to go to somebody else to only hear what you want to hear?” argument.

But you know your own mind (even if you don’t hold a doctorate). And if your course of treatment doesn’t feel right, that is definitely worth exploring further.

Arrogance can be a huge impediment to progress. When people assume they know the answer better than you do, they will be closed to hearing your arguments.

And the prickly egos of family can be upset for decades by something like this, so I understand your caution.

Just mention your concerns, and ask her to please consider other options. Or refer you to someone who has experience with ADHD.

My experience, and that of many others who have posted here, is that the trivialisation of ADHD, and ignorance of it amongst professionals who should know better is pretty endemic around the world.

Good luck!

1 Like

If you feel comfortable enough, I might try to address your feelings with her directly. You could also ask her more about why she is resistant to the idea of an ADHD diagnosis or medication, and see if she can give you reasons or examples of what she thinks your behaviors or challenges are. That may open the door for you to provide examples and evidence to support your case.

Some providers may also be willing to try non-stimulants before stimulants. If you’re willing to give that a try you could mention it. A non-stimulant could be beneficial, but if you try it and it is not, at least you have the evidence to show for it.

Worst case scenario you could seek a second opinion from another provider or change to a new psychiatrist. That’s not always the easiest, and it can be hard to find providers that are sympathetic to ADHD.

I don’t know that there’s an easy answer for this situation. I guess my personal thought would be to see if the provider would try a non-stimulant first, and also see if they would be willing to entertain more discussion or testing (i.e. rating scales or interviews) to assess further for the ADHD. In the end, some providers are just bull-headed and won’t listen to the idea because of their own anxiety or bias. Whatever happens, I’m sorry you experienced what you did, and wish you good luck moving forward!

2 Likes

Hi Elizabeth,

You’re not visiting a psychiatrist for their health; you’re visiting a psychiatrist for yours. If you pay them (private health care), you’re especially not obliged to accommodate them; if you’re in public health care, sometimes you need to navigate this more carefully. But in any case, there are good fits and bad fits, and bad fits don’t mean that either party is to blame. Psychiatrists are aware of this; it’s not all on the patient’s shoulders.

But that may sound like a platitude. Fundamentally, we all deserve to get help from someone that we feel understand ADHD. From what you say, this psychiatrist isn’t very attuned to it. She may be great for other things, but not for ADHD. That’s okay - for both of you - as long as you can get help that will be effective for you. She’ll find other clients - don’t worry about her.

I think that times of stress do tend to exacerbate symptoms, so please don’t blame yourself. I’m a professor, and both students and professors are stressed out right now, in light of Covid. If it helps to hear it, there are professors out there (like me) that have mental disabilities and other challenges, too. It might help to find them.

Some suggestions (take or leave):

  1. Cancel your next appointment with the psychiatrist who makes you uncomfortable, but send her an email a couple of weeks on and say that you appreciated her time and help and are looking into alternative coping strategies. It may make meetings at family gatherings easier, and yet it lets you both move on.
  2. I don’t know how accommodations work at your university, but they’re absolutely legit. If there’s an accessibility unit there, talk to them and see if you can hand in those assignments late. They’ll ask for paperwork, so make sure you have some - either from the psychiatrist who makes you uncomfortable (get this before you cancel your next appointment) or elsewhere.

Good luck!

2 Likes

Is this ethical? I thought doctors weren’t supposed to treat family…

I think the others are right to say you should switch, but I understand you’re in a frustratingly unique situation… If you want to keep trying with her, my suggestion would be to make an outline you can show her. Something that clearly breaks it down. So you might want to say:

  • this is hard for me
  • I want to try stimulants because they are a common medication for my diagnosis
  • you’re saying no, why?
  • ( if she is open to non stimulants, are you ok w/ trying them? )

You can also make a chart of how ADHD effects you and what you’re hoping medication will do. If she sees you have a realistic and educated view on meds, she might be more willing to prescribe them

Other points to mention might be:

  • I feel that you’re being dismissive
  • I have not heard you offer any other solutions
  • you have said that is normal, that’s not helpful
  • I do not feel like I have made enough progress given how long it’s been

I would also ask yourself a couple of questions:

  • do you trust her to make the right decisions about your health?
  • how will she react to your mom being there?
  • what happens to the medication you’re already taking if you leave her?
  • what might happen if you leave her and see her at a family reunion?
  • do you have another doctor in mind?
  • if you do leave, will you tell her over the phone? Via email?
  • does leaving her have an effect on paperwork you might need for accommodations?

And by the way, just because everyone struggles w/ starting college, that doesn’t mean you’re any less deserving of help. I would avoid arguing about whether or not everyone goes through this because normal or not, she should be helping you. That’s her job
I hope you figure this out, we’re with you :blush:

1 Like