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Fired by my psychiatrist...while depressed!

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So, I just got discharged from partial hospitalization yesterday by my "former" psychiatrist who led me to believe we were still in a patient-doctor relationship.  He mentioned how we'd approach transitioning me off of a medicine and other future plans during our daily check-in.  Then I get pulled out of group to do my discharge paperwork and am told that my psychiatrist will no longer be my outpatient psychiatrist by my case manager. Mind you, I'm in partial hospitalization because I have severe depression (I have bipolar disorder)! 


The best part, actually there's 2. The lesson for the day was on anger types (passive, aggressive, passive-aggressive, and assertive)...um, the psychiatrist not being up front with me and leaving "the dirty work" to the case manager was incredibly passive-aggressive! And the case manager told me that the doctor had pulled her aside multiple times to re-iterate that he no longer wants to see me as an outpatient. She then proceeds to tell me that with my insurance, I'm going to have an incredibly difficult time finding a new psychiatrist. I'm in shock at that point.  I only asked to be discharged because the program truly wasn't helping.  They didn't offer much group therapy and it was a dual program so most of the programming was about drugs and alcohol and then there were periods in the day where they took the drug adicts and alcoholics to meetings for hours and had me sitting and doing nothing. I'm feeling a little better (I can get out of bed; I'm a bit less tearful.) since I went to the program, but being dumped through word of mouth was a kick in the stomach. 


My case manager contacted the doctor one last time on my behalf because of how severe my depression is and that I really do want to work with him (I know that's messed up since he dumped me; but I am scared. I've been with this doctor for 3 years and he's helped me through some pretty rough times. Plus, the case manage made it seem as though my insurance would not be accepted anywhere close by). He said he was okay with taking me back as a patient at that point. I left the hospital hysterical. I was told that I need to work with the team that wants to help me. That I have too much of a negative perspective and negative thoughts (which I admit...I've never denied that I'm depressed and that I want to feel better).  It was suggested that somehow I was supposed to know to bring my therapist in to a psychiatrist appointment. Then when I brought up that there were hardly any groups that dealt with the real core issues that we all have in common (depression, low self esteem, anxiety, etc), so I felt like this was a waste of my time, I was told that I'd only get from the program what I put into it. I shut down emotionally and cried. I just gave up. I cried. Then I was told I couldn't leave the hospital in my condition. I had to pull it together enough so the staff felt I was "safe" to leave.  The next morning is when I asked to be discharged by my doctor and he said ok.  I was even confused about why I was even in the day program.  I asked during our appointment yesterday, because I've been feeling misunderstood and he told me because I shutdown in my appointment and got very upset. At the appointment wehen I calmed down my doctor was talking to my husband about that the options were for me to go inpatient or partial hospitalization.


I'm begining to think that I'm alone in my struggle with managing my bipolar disorder...or at least it's so taxing and out of control that even the doctor doesn't want to manage my case anymore.  That's another thing my case manager said--that the doctor feels like he isn't helping me because I feel like I'm not being understood. I trust my doctor--I've taken all of the medicines he's prescribed, done all dose changes, come to all of the appointments, etc--and the case manager confirmed that the doctor said that was all true too. So I now have him as a psychiatrist again, but my husband (my poor husband and daughter) and I are trying to find a new one. Perhaps I do need a new doctor. My week of "treatment" has caused a lot of stress and while I'm no longer bedridden, I feel worse about myself. I feel like I've done something wrong even in how I've been ill this episode. I can't even be a good bipolar patient.


Am I crazy!? I know this is long, but I needed to get it out to other mentally interesting people.  I tried talking to my mom, but she only triggered me by saying that the doctor firing me was a "wake up call" that I needed to do better.  She also did the infamous, "feel better for your child" and "your life isn't that bad" song and dance.  I know she meant well, but doesn't she think I'd be enjoying life if I could? Does she really think I choose to be miserable? I am in so much pain emotionally that sometimes it's hard to speak. I can't even express how much anguish I'm in and to have people say such harsh things in response to my illness makes me want to isolate myself even more because they just don't understand--and I can't be angry with them for their ignorance. Or can I?

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Is this your first pdoc, the one who made the initial Dx?


(And for what it's worth, I think it's far more likely that he's a bad pdoc than that you are a "bad bipolar patient." Please don't put that label on yourself, you sound like you are working very hard to get better, and BP is a bitch of a foe to fight)

Edited by goldfish
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I am flabbergasted by how many bad pdocs there are. As I have other medical issues, I have four other doctors (for slightly different things, like diabetes, gp, eyes, etc). None of them are "bad" and ones I have had previously aren't either. Yet so many pdocs I have had have been awful. I wonder if it's because psychiatry is, in some ways, a less "precise" practice, because lots of the symptoms are subjective and it's harder to know the chemistry of the brain then to say, take a blood sugar and see that it's high. But still, so many pdocs I've had have not believed side effects I've said I've had, have been somewhat rude, etc. So, I highly doubt it was you that was bad, and if it weren't a bad situation I'd almost laugh at the doctor being passive aggressive while teaching others not to be lol.

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I am so sorry you had this experience. I wish I could fill this entire page with stories of bad doctors and if I had the time I would.

This is my advice and it is free so you probably get what you pay for but here goes. Contact your insurance company and make them give you a list of every doctor in their system. Get on the phone all day and find an appointment. Find a therapist the same way. Go to your primary doctor and make sure he/ she is aware of problem

Although you do not have drug and alcohol problems I would still go to meetings. I found incredible support there and it did not allow me to sink in the whole of depression and isolate.

I know you are hurt and mad and I would be too. You can feel all of it when you need to but I think you need to jump into action. When you set the appointments do not commit the whole story to the clerk or you will be labeled as high maintenance. When you are asked why simply answer I am depressed

Keep going and remember no one is going to take care of you like you can

Also if things get out of hand GO TO ER

Be well


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I know this isn't related but have you tried ECT for depression? It is supposed to work wonders on people who are resistant to medications for depression, as long as you don't mind slight short-term memory loss. The people who had it done in the hospital called it miraculous. Your family doesn't sound supportive and your doctor obviously has his own issues and is an apathetic prick.


Here is a great video: http://www.mayoclinic.com/health/electroconvulsive-therapy/MM00606


"Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of a number of mental health conditions. It may be an effective treatment in someone who is suicidal, for instance, or end an episode of severe mania. ECT is used to treat:" 



Edited by Forbidden91
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What people have said here is right - this is not you, this is him. What this doctor did is nothing but unprofessional and damaging. The only thing I can say is long-term he did you a favor. You do NOT want to stay with a pdoc like this - even if he is willing to "take you back" (sonofabitch). You need and deserve someone who is looking out for your welfare and is careful and professional. This is just not that person. It's a shitty time to find that out though. I'm sure you're feeling really bad about this, but try not to take it on yourself. This has nothing to do with you.

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Forbidden91: This isn't where you should suggest treatments. Only a doctor, that they have worked with for a while, should. Laptopdancer was venting about being fired by a pdoc.

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man i Really feel you there. Things aren't going well with my pdoc, and more than one person has told me I should switch, including the dr at an e.r. when I was in crisis and my pdoc wouldn't call the ER back. I made an appt with another doc. He spent 5 mins talking to me asked what meds worked for me and what meds i wanted. Nothing so far has worked at 100% and I feel my current pdoc doesn't communicate with me. I'm on Lexapro, was on lamictial, but got pulled because of a rash. Latuda is supposed to replace Lamictal? I Just don't understand. I tried to ask at my appt but there was no explanation offered. I just don't know what to do!


I want help,  I need help, Why is this so hard? 


The new pdoc basicially said well if none of these meds have worked for you, how am i supposed to help you, tell me what you want and I can get it for you. My response was simply I don't know what I need. You're the specialist. I need help. Can you help me? 





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