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emma123
New Contributor

Frustrated with psychiatrist care

Just joined to get some support from other people who are dealing with similar situations. Bit of background: my husband has paranoid disorder (paranoid ideas, people are following us in our home etc. But no halucinations). He has been on medication (antipsychotic +SSRI) and has maintained his job, never needed to take a day off, never been hospitalised. As a carer I am very proud of this, because it has not been easy. I've put a massive effort into supporting him, making sure he gets the best medical care (I have an MD degree myself, and I think this helps).

 

Now onto the problem: as most people with paranoid disorder, his paranoid ideas are very real to him. Hence he doesn't think he needs the treatment. I've managed to convince him to take it to "deal with the stress of what he's going through". For the past 3 years, he did not have any symptoms, but I still booked him in to see his psychiatrist once a year (in Oct last year). He told the psychiatrist he would like to go off medication. The doctor told him to go off his SSRI by reducing to half for two weeks and then stop taking it. No follow up appointment was scheduled.

 

In Dec, my husband had some stressful event at work, after which he became very anxious, distressed and paranoid. I called his doctor's office to book an appointment. The only available appointment is in May. I. tried to send him an email and let him know symptoms have relapsed, but I was told he does not provide advice by email. I am angry and disappointed. This is a highly experienced doctor. He knew that going off the SSRI means risk of anxiety and anxiety leads to paranoid ideas. He also knew that if symptoms relapse my husband would not book in  an appointment (it's paranoid disorder, not back pain!).

 

Why did he take him off the SSRI completely instead of reducing to half dose and checking in with a follow-up? Why did he not at the very list schedule a follow-up appointment to see how my husband is doing off the SSRI? I used to accompany my husband to his appointments , but I don't. want to look controlling. But now I have the huge burden of convincing him to take his SSRI again, I don't have a psychiatrist appointment until May, and my husband is starting work again after the Xmas break in a few days. He might be ok, but he might not ...

 

Thank you for reading my long rant. I'm hoping to find a good psychiatrist  who actually cares if they put the patient at risk of relapse. Also, my heart goes out to everyone who needs to deal with these difficult conditions, and navigate medical care. This is not ok and really has to change. Psychiatrists should be accountable for patient relapses in the same way that a surgeon would be for the outcomes of surgery. 

3 REPLIES 3

Re: Frustrated with psychiatrist care

I'm hearing your concerns @emma123 ,

 

I'm sorry it has come to this stage, especially considering he was so well.

 

As for the SSRI, perhaps the psychiatrist asked him to reduce it because from what I know, it is an antidepressant, not antipsychotic.

 

For me, the doctor said I could come off my SSRI, but I chose to stay on it because I saw how well I was doing on it. Instead, I've chosen to reduce it VERY slowly...over a period of years because I can't afford to go back to my depressive state. 

 

The stress of your husband is probably exacerbating the paranoia. 

 

Are you able to go on the waitlist for anyone who cancels their appointment?

 

From experience, reducing meds should be a VERY slow process so it gives time for the body to readjust.

 

Please take care. I hope things get better soon.

Re: Frustrated with psychiatrist care

@emma123 

 

As electricity goes against our head we shape it to form the subconscious.

 

It's always inherently against us.

The sub [as opposed to the dom]

The con [as opposed to the pro]

The 'suss' [as opposed to sense]

 

It's been there our entire lives like a shadow.

 

He is starting to notice it more.

 

It's good to notice it to identify the shadow.

 

But let him know that that's where these things are comming from. 

 

*hug*

Re: Frustrated with psychiatrist care

Hello @David_888 

I prefer psychoanalytic approaches and found your post extremely succint and evocative.

 

@emma123 Sorry you and your husband are going through this.  Glad to hear you are informed educated.  I am pretty dissappointed in so called "professional" care as too many of my loved ones have slipped through the system in various ways.  Yes I am angry about it too, but have to calm my farm about it to keep functioning, especially when people say ... there is help out there ... and do not want to understand the many limitations.

 

Medication is not everything, but simple follow ups when titrating down are totally appropriate.

 

There are concepts of biopsychosocial model ... the medical model ... often pdocs do not have adequate training in the former.

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