Seeking out psychiatric assistance for mental illness can be daunting, even here in Canada. It’s appointment after appointment asking for referral after referral just to find yourself waiting month after month at the bottom of a wait list. It can suck – no bones about it. But what I’d like to do today is share my own experience with you in the hopes that it can make your experience suck a bit less. I call this:
HOW TO WORK WITHIN THE SYSTEM TO GET THE SYSTEM TO WORK FOR YOU.
Let me start by setting the scene here. Say you deal with your appointments, get your referrals, and endure your wait lists long enough to finally get in to see a psychiatrist. You find yourself in their lobby for, say, half an hour of waiting, before spending all of ten minutes in the office actually speaking with the doctor – if that. Then they hand you a prescription and send you on your way. Dutifully, you get the prescription filled and begin taking your new medication. Pause.
This is where the narrative can deviate pretty significantly. See, in an ideal world, this new medication would work perfectly and managing your mental illness on a day-to-day basis would be made a lot easier for you. Unfortunately, at least in my experience, this is usually not the case. And that’s okay – as long as you know what to do next.
What I hear about most often is this route: You begin taking your new medication. About a week or so into it, you feel like it might not be working for you – you might even feel like it’s making things worse. So you stop taking your medication. But you have your follow-up booked for next month at least, so no big deal, right?
Here’s the thing: psychiatrists aren’t psychics. They don’t have x-ray vision. They can’t see exactly what’s going on in your mind, and when your brain is having difficulty functioning, to begin with, your account of what you’re experiencing may not be the most reliable. Basically, at that first appointment, they didn’t have a whole lot to go off on.
So they spend ten minutes with you, and in that ten minutes, you describe experiencing A, B, and C symptoms. Based on this entirely subjective and extremely limited account of what’s happening in your head, they may have a list of generic medications from which they can choose a good option to start you on. And if, by now, this is all sounding a little bit unscientific to you, then congratulations – you’re picking up what I’m putting down here.
Folks, your first medication is a crapshoot. An extensively educated, regulated, and professional crapshoot, but a crapshoot nonetheless. Because your psychiatrist can’t see directly into your brain in order to understand what’s going on from the get-go. What they can do, however, is take your rough list of symptoms, make an educated guess, and then gauge efficacy from there.
So let’s go back to that pause, pick up where we left off, and take another route, shall we?
You begin taking your new medication. About a week or so into it, you feel like it might not be working for you – you might even feel like it’s making things worse. But, knowing that the pursuit of psychiatric support is not an easy or quick endeavor, you document these new feelings and continue taking your medication. Then you share your observations with your doctor at your follow-up the next month, where the necessary adjustments to your medication will be made.
See, the vital difference between these two scenarios is context. By taking the prescribed medication and noting any differences as you go along, you are providing your psychiatrist with crucial context for what’s going on in your head. You were experiencing A, B, and C, but now on this new medication, you are experiencing B, C, and D. Maybe there was an adjustment period where you felt A through to D all at once, but things have since evened out. Okay. So? Well, this information is far more important than it might seem.
Your psychiatrist may not know your brain individually, but they do know how certain medications are designed to affect the brain. Do you see what I’m saying here? By giving them context with which to gauge your brain’s reaction to certain medication, you are helping them gain their x-ray vision. At that first appointment, they didn’t have a lot to go off of, but now they’ve got more.
… That is, unless you stopped taking your medication. I mean, then it’s back to square one again, isn’t it? Worse yet, because their understanding of how the medication actually affected you is limited at best, they’re now having to potentially rule out other medications that might have been good for you just because their function might be similar. Because all they know is you didn’t like this first medication. And they don’t really know why.
There are certainly exceptions to this rule, which you can (and should) discuss with your psychiatrist individually, but here is my advice to you:
Keep taking your medication. Take note of what it’s doing. Have your follow-ups booked.
Because yes, this current system is flawed, and that sucks. It is underfunded, overbooked, understaffed, and overwhelmed. But for now, work within it. Make it work for you. And once you’ve gotten the help you need? Then we start working to change it.
About Samantha Hogan
"Hi, my name is Samantha and I have acne and depression." Having spent the majority of her life defining herself by these factors, Samantha is now working to change her own attitude as well as those of the people around her. Although she has been diagnosed with BPD, MDD, and GAD, she does her best not to "suffer" from them. Relaying her experiences with honesty and finding humour in what she can have helped her find balance and connect with like-minded individuals. You can find her on her own blog, Sadness and Skin Problems, to read more from her.