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So I want a new psychiatrist and my friend who is also BP referred me to his. My psychiatrist is no help whatsoever. It's like a factory at his office - he goes through so many people so quickly - you can ALWAYS get an appointment with him. I called and told his office I was feeling way funky (no sleep, crazy ideas, etc.) and they gave me sleeping pills. Well the new Dr. can't see me until February. In the meantime I'm swinging between being very happy/weird and very unhappy/angry. I'm no longer depressed but I'm ansy, can't concentrate and just all around feel strange. What should I do in the meantime? Something has got to give - I mean I know changing meds can do this but I need something to change so I can get work done. I get so weird feeling that I just want to run around and scream!

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Uhm, no. If he sees people like he is a factory then you need to find another pdoc.

It's not your responsibility to figure what meds work for you. Sure, you are the one who has to deal with the meds, so of course it's good if s/he's open to suggestions, but in the end it's the pdoc's job to fix your meds.

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Boy, that really sucks. My advice is go to the pdoc that's been recommended. Your friend wouldn't steer you that way if the pdoc sucked. Like, y'know, yours seems to.

Can't tell you what to do in the meantime except for, like, hang on, exercise and all that jazz, whatever seems to work. A month to 6+ weeks is fairly normal to get in to a new pdoc. It's a tough wait, but may well be worth it. Good luck!

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  • 2 weeks later...

So I sent to the "bad" pdoc because I can't get into the new one until February and I need a prescription for my Lamictal. I told him that I can't sleep, can't concentrate, my mind races and that I become unusually angry for the stupidest reasons or no reason at all. He upped my Lamictal to 150mgs and told me that my mood swings were caused by the unusually warm weather and that the increase dosage in the Lamictal should help. He then sent me on my way and told me to see him 3 months (which of course I'm not going to do because I will be with the new doctor). Well I'm so angry and desperate right now - I've slept like 12 hours over the last 4 days - that I just want to run up and down the hall at work screaming. I do what I'm supposed to do - take my meds and tell the pdoc how I'm feeling. Yet I get no better - yeah the depression is gone but now I'm left with this absolute craziness and my friends don't know how to deal with me. At this point I don't care they can all go to hell. I'm going to call the new pdoc and see if I can get in any sooner because I can't deal with this much longer.

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So I sent to the "bad" pdoc because I can't get into the new one until February and I need a prescription for my Lamictal. I told him that I can't sleep, can't concentrate, my mind races and that I become unusually angry for the stupidest reasons or no reason at all. He upped my Lamictal to 150mgs and told me that my mood swings were caused by the unusually warm weather and that the increase dosage in the Lamictal should help. He then sent me on my way and told me to see him 3 months (which of course I'm not going to do because I will be with the new doctor). Well I'm so angry and desperate right now - I've slept like 12 hours over the last 4 days - that I just want to run up and down the hall at work screaming. I do what I'm supposed to do - take my meds and tell the pdoc how I'm feeling. Yet I get no better - yeah the depression is gone but now I'm left with this absolute craziness and my friends don't know how to deal with me. At this point I don't care they can all go to hell. I'm going to call the new pdoc and see if I can get in any sooner because I can't deal with this much longer.

Well for starters i would have them up your meds WAY up!!!... cause as posted before the low dosages you are takin are like said way low ...a good thing to think of in the low dose sometimes your body isnt even feeling the effects of the med at that low of a dose .. if they bump it up heafty then you will feel the love...!!!

As for the enviroment you are talkin about with your current doc .. that really doesnt sound like a good place to be emotionaly and physically and its no wonder why your a nervous wreck cause all your thinkin about is your doc sucks my meds aint workin i am goin crazy .. its time for a change !!!

With the new doctor your talkin about goin to i would call there office and be like i know i have a appointment a few down the road but this is a crises and a emergency and i really need to be seen ...and maybe they can slide ya in cause people do cancel every know and then ... cause from what your talkin you need the help NOW!@ not down the road . .

--But also what you should do is put down what your goin through in a daily journal so that ya can take it with ya when ya go see the new doc.. plus it might help take ya mind of how ya feel cause ya can put all ya energy into the journal

---hope this works out for ya keeps us posted !!!

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Mine does. I deliberately don't look at my watch during pdoc/tdoc sessions, but most of the last year she has been spending between 20 -30 minutes and sometimes as long as 45 minutes with me.

She had been running a solo practice and was always jammed up. When she got a partner her schedule was a lot less pressured and she said she wants it this way. Still, even when she ran a tighter pace, she would take extra time if I was falling apart. I've waited for other patients and I don't begrudge it. I'd rather know my pdoc actually gives a damn then keep arbitrary appointment times.

a.m.

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Your mood was messed up because of the weather??? What a cop out! I mean, weather can have some effect on your mood, but if you're truly having some sort of clinical episode what the F does the weather have to do with it!!! Good thing you're getting a new doc...

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Does anyone here have a pdoc that sees them for significantly longer than 15mins (not counting the initial diagnostic)?

Yeah, 30 minutes minimum. Longer if necessary. And he makes time in the evenings for emergencies. Not to mention, when I was in the hospital and had cold-turkeyed off my meds, he came into see me--once between the rehearsal and performance of an opera he was in!

So it seems I may be spoiled...at any rate, my belief is that a pdoc should spend a minimum of 30 minutes in a session. Hell in my sessions, half the time is spent talking about...whatever. And, while it may seem like jack is getting done, it's really a good way to suss out wjhat's up with me--after all, I can't remember or may not know what my current "issues" are. The pdoc can note manic or depressive signs grom what you talk about and how.

15 minutes...is NOT enough.

And oh yeah, he has a model of the Starship Enterprise in his office. Yeah, I like the guy.

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My guy does hourly sessions. He's out of network for most insurence though. That's really the issue. A lot of insurence plans won't pay for longer than 15-20 mins. Depending on your out of network co-pays, that may be the best way to go. There are quite a few psychiatrists who think that it's unethical to give out meds after only seeing someone for for a few minutes and would rather loose buisness than cave on that. These are the good ones. You bite the bullet and pay whatever insurence won't cover out of pocket.

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Guest Guest_SuperVepr_*

I have been to 3 so far and they have all been the "15 minutes and out" type. I hate the cattle mentality of those places but it seems that most are like that. It seems all I ever get is the "here try this" pep talk followed closely by the quick escort to the billing person accompanied by the obligatory "call me if you need to" ;)

Either there aren't enough docs or there are too many crazy people or both.

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Here's an interesting tidbit from the website of The National Association for the Dually Diagnosed:

Medicare sets the standard for medical care in the U.S. It defines procedures (such as defining what constitutes an individual psychotherapy session). Medicare treats mental health disorders differently than any other medical conditions. For example, for a psychotherapy visit, the patient must pay a 50 % co-pay. This is not the case for other forms of medical care.

Medicare outpatient psychiatric visits are also different that any other medical specialty. For outpatient psychiatric care, Medicare has special psychotherapeutic care codes, and these are the codes used by all health insurance companies. Under Medicare, a psychiatrist bills an outpatient psychopharmacology appointment as a 15-minute visit, no matter how complex the patient is or how long the visit lasts. As a result, the 15-minute psychopharm visit has become the industry standard and it is not sufficient for the complex patient.

;)

Don't know what other insurance companies require, but Medicare has certainly set the precedence.

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Most of the psychiatrists I've seen, I usually had hour-long appointments with them, or 50 minutes, or whatever. I live in Canada, though. It can be very hard to get to see a pdoc here in the first place, and usually you don't get to see them nearly as often as you'd like, but at least the appointments are long enough. That's my experience, anyway.

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Canada is great! I would love free healthcare. I would rather see my pdoc less but when I do see him see him for a longer period to time. At least I would feel like he would get a better idea of what is going on. Especially with how much I have to pay to see him. I do not get my money's worth that's for sure!

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Most of the psychiatrists I've seen, I usually had hour-long appointments with them, or 50 minutes, or whatever. I live in Canada, though. It can be very hard to get to see a pdoc here in the first place, and usually you don't get to see them nearly as often as you'd like, but at least the appointments are long enough. That's my experience, anyway.

Say what? I'm in Canada. Pdoc # 1 was 5 mins, pdoc # 2 (the good one) is about 20 mins. Hang on to yours!!!

I'm just happy they're free.

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Anne - I know what you mean about the weather thing. I just stared at him and my jaw dropped. If anything warmer weather would make me feel better! The funny thing is I saw another person I know there (I didn't know he was a BPer!) and he said the guy hands him drugs like it was candy. The man doesn't want to give me anything. I had to call his office and say that I cannot function anymore at work (which is true) and that something must be done or I was going to flip to even get 5mgs of Abilify. It's not like I'm asking for Valium or something like that. I just wanted something to calm me down and enable my mind to focus. Hopefully the pittance of Abilify he gave me will help. He upped the Lamictal too but I think that may be causing my problem - every time it's upped I go to the funny places.

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My p-doc is the 15 minutes and out kind, but he always reads the notes from my last t-doc session and he always gives me bunches of Lexapro. So far the short visits haven't been a problem for me. My t-doc spends a full 60 minute hour with me, sometimes a little longer. I have a $20 co-pay for both docs.

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Most of the psychiatrists I've seen, I usually had hour-long appointments with them, or 50 minutes, or whatever. I live in Canada, though. It can be very hard to get to see a pdoc here in the first place, and usually you don't get to see them nearly as often as you'd like, but at least the appointments are long enough. That's my experience, anyway.

Say what? I'm in Canada. Pdoc # 1 was 5 mins, pdoc # 2 (the good one) is about 20 mins. Hang on to yours!!!

I'm just happy they're free.

Unfortunately I can't hang onto mine, as I have moved (still in Canada, though) and don't currently have a pdoc. I went to see one in September who worked at the hospital, and unfortunately he was an asshole and I am scared of asking to see anyone else at the hospital. So I finally found a GP, who is monitoring my meds, and I will also get to see a tdoc soon, too.

Oh, and one of the shrinks who I used to have long appointments with? The donwside is that he was always running late. Hours late. Once I had to wait until five hours after my scheduled appointment time to see him. The others all were pretty much on time.

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