CW for abuse, eating issues Not sure exactly where this goes as it deals with autism, gender, and abuse in passing, but it's not really about any of those so I'm putting it here. I've been seeing a psychiatrist for four months or so now, and I'm not sure if he's the right one for me for a variety of reasons. I didn't pick him, exactly, I was just out of spoons and expressed to my dad that I really needed someone to talk to and to prescribe me some sort of medication but that the process of figuring out who to go to was absolutely overwhelming, and he made me an appointment with the same doctor that almost everyone in my family sees. I've been trying in a roundabout way to bring up things that I have going on that seem pretty autism-typical to me, because I've got this nagging feeling that if I straight-up say "I want an analysis/diagnostic test/whatever for autism" that he would say "no, I'm not doing that". I don't know if that feeling is brain-weasels or my finely-honed bullshit instincts, either. He does treat one of my sisters for autism, but that is a whole 'nother kettle of fish that I don't want to go into - suffice it to say that that is not a reason to trust him to be knowledgeable of autism in general, especially in adults. When I do bring that kind of stuff up, he attributes it to my ADHD or OCD almost immediately. Personally, I feel like I'm not being listened to, just placated, but I don't know how to bring this up. And I don't know whether I am just being hypersensitive (narcissistic mom with DID/addict dad means I really was never listened to, so I tend to be over-reactive to that) or if there is something there. The reason I care so much about the diagnosis is a) accommodation reasons for classes; I have a feeling that the reason I get so overwhelmed with school stuff has to do with those issues and b) I'm one of those people that needs some sort of formalized authority saying that yes, I am not just making things up. I doubt myself constantly. So I'm just going to list my problems with him. Any outside perspective much appreciated. For reference, I'm 22 and female-presenting, and my doctor is in his late fifties, I think. After about age 40, my ability to judge age goes out the window. 1) On my first appointment, I brought up the concern that I might be bipolar, based on me having A LOT of the symptoms and both my parents have it. He basically dismissed this out of hand, because my mood swings were too regular. (Basically, every two weeks or so before I got on medication.) He did say the rest of it did sound a lot like bipolar, though. I was diagnosed with OCD on that appointment. 2) I was given antidepressants (Cymbalta) after my first visit that came in a gel-capsule form. I had a really bad reaction to that, and was then given Prozac. I'd taken Prozac before with mild side effects, but this time I had a reaction so bad that I had to go to the ER, because the symptoms were basically those of serotonin syndrome. I was told that he had no idea why that would have happened, and that there was no way that it was serotonin syndrome. I'm extremely sensitive to medication, and have had serotonin syndrome before. The Prozac I was given several years ago was in a tablet form, and this time it was in a gel-cap. I asked him if that was a possible reason - I cannot take any meds in liqui-gel form, or supplements with that gelatin coating - and he said that there was no way anyone was allergic to that and that it couldn't be the reason. I did some research and there's at least one scientific journal article on gelatin allergies out there, so it definitely exists. 3) After that, I was put on a mood stabilizer (Lamictal) which has seriously helped me with a lot of my symptoms. He seems pretty bemused as to why this works for me, saying that it really shouldn't, and that a SSRI would probably be better. I'm not complaining - if it works, it works - but it doesn't exactly do a lot to engender trust in him in me. 4) I have some eating issues - when I'm stressed or sick or otherwise emotionally in flux, I find it really hard to consume food. Not because I'm not hungry, but because 99% of food, my brain refuses to process as food or things I can eat. Most things become as edible as concrete to me at those times. I have figured out several coping mechanisms of my own to get around this - liquids are okay, so I keep protein-shake stuff around for times like this, and I drink a lot of juice and soda - as well as stealing a couple of methods from friends with eating disorders, but I'm very aware that it's unhealthy and I'd like some professional help for it. I have huge issues with bringing this up - I'm pretty open about most of my mental health issues irl if someone asks or if there's a reason for them to know (e.g. letting coworkers know about medication changes so they know why I might be especially snippy for the next couple of weeks), but only two people really know how much this bothers me - my boyfriend, and one of my siblings, since they have a lot of similar issues and have some coping strategies to share. When I was younger, bringing this up with my family was a total minefield for several reasons, and I think my bad food associates started there. (My stepmother is very image-focused, and she hates me. No exaggeration, she has made it very clear. But she has this weird fixation on this image of a perfect happy family, and we always had to have dinner together, never mind that I might be hungry way before or way after and with six kids getting everyone together was a huge chore. Snacks were Not Allowed Or You Might Ruin Your Dinner and dinnertime was also the formal "scream at you because you are a failure" time, so I would fake sick a lot to get out of it and then eat snack food late at night later to avoid being in the middle of that. Then my dad decided to tell me that I had to stop eating snack food or I would get fat, and praising me every time I didn't get seconds or "made healthy choices" that boiled down to not eating enough even when I was hungry. This is nonsensical for several reasons, one being that I've always had a petite build [not that this would make any sense regardless, but since he judges on image, it seemed relevant] and one that I've always eaten several small meals throughout the day because I'm basically incapable of consuming enough in one sitting due to ADHD issues to have only three.) On my last appointment, I brought this up, and was trying really hard not to downplay it, but I have mentioned to him before that one of my biggest issues is downplaying bad things or things that bother me, because I assume that no one cares about my issues and other people's are more important anyway. I had begun this appointment by telling him that my moods had really evened out, and things that would have normally sent me into a downward spiral that I would be several weeks climbing out of recently had become cope-with-able. His response was "well, I thought you said you had your stress under control so this shouldn't be an issue", which immediately sent me backpedaling and trying to explain that it's cope-with-able but that I still get stressed, but I felt like I was trying to justify myself and eventually gave up. This one is probably my biggest issue and where I feel most like I've been dismissed. 5) I have some gender stuff going on, and I just plain don't feel comfortable getting into it with him; he's older and is not very conversant in gender stuff, I don't live in a very tolerant area, and he treats both my dad and my stepmother, two of the last people in the world I want knowing about this. I know that legally he can't get into it with them, but he treats several of their (minor) kids as well, so I'm worried that he'll slip up talking to them, since he can talk to them about most of my sibs. 6) For the same reason, I don't feel comfortable talking to him about problems I still have with my dad and my stepmother, because he's been treating them longer and I feel like he'd be obligated to be on their side, or at least neutral, and I kind of want someone to be on my side, since I was the kid and therefore really not at fault for all the stuff. I have no idea whether I'm overreacting, but I will say I'm inclined to trust my instincts, because the way I grew up left me with a very finely tuned Bad Intentions Radar (several friends have called me the human lie detector, and in one particularly memorable incident I kept the boyfriend from being coaxed into a cult; long story, but anyone I have a bad feeling about inevitably turns out to be bad news). The bad part about this is even with people I know and trust, I can have a hard time not reading bad intentions into things. Although this has gotten a lot better, and generally I'm very able to separate out "bullshit from my past" and "bullshit coming from people in the present". Thoughts?
A therapist you can't trust, is a therapist that can't help you. I highly suggest looking elsewhere when you can.
Nope, the only other medication thing I have is a Mirena IUD. The ADHD is mostly under control, I have a lot of coping strategies, and in my teen years I did go through the ADHD meds "attempting to find something that works" roller coaster and it just... didn't work. Mostly because ADHD meds are generally either stimulants or blood pressure meds, and stimulants make me miserable and I've got ridiculously low blood pressure anyway.
1. The sovereign diagnostic tool for ADHD is whether stimulants alleviate the symptoms. If they aren't working for you, chances are you have something going on, but it's not "ADHD". 2. As far as I know, there is no real psychiatric treatment for autism. There are, of course, treatments for other things people with autism have going on with their brains, but that's not treating the autism (*insert discussion as to whether autism should or can be "treated" into another thread, please*). Yet you report this psychiatrist is treating your sibling's autism. That seems really "iffy" to me. 3. It seems to be a heavy burden on a single psychiatrist to maintain confidentiality when he is treating multiple members of the same family. A heavy burden for a good one, and this one strikes me as not that good. If possible, I recommend seeing a different psychiatrist and getting a fresh start. In addition, have you been tested by an allergist?
1) Stimulants definitely alleviate the symptoms, it's the side effects I can't stand. They make my heart race, I can't sleep, and I'm ridiculously tired on them for no reason. I've been diagnosed with ADHD and treated for it for the last decade or so, and I think I still have an Adderall rx on file from a previous doc to take as needed for enormous important papers and things. My usual coping method for that normally involves an enormous super-caffeinated soda, though. 2) I don't know details; she's fourteen and got diagnosed several years after I moved out. Before her diagnosis was childhood bipolar. But from what I know (she and I aren't close, and for all my parents are messed up they do maintain psychiatric confidentiality) it is more of a "treatment" thing. To be fair, she also takes a lot of medication for other conditions, so she is treated for other stuff. 3) Yeah, I'm only seeing him because I needed to see someone, and I was absolutely not capable of finding someone myself several months ago. I only asked my father to help me out because I'm on his insurance and I needed someone that was covered, so he seemed like the best option. No one else I know is getting treatment, and the doctor I had and liked five years ago moved away. Now that I'm capable of doing things like "going through lists of mental health professionals", I probably will look for someone new. And I was tested by an allergist, but it was when I was six or seven, so a loooooong time ago. I think it was around the same time I was diagnosed with asthma, so they were looking for triggers then. I used to be allergic to nothing; now I'm deathly allergic to orchids and feathers, and probably other stuff. I don't know for sure if I have a medication allergy or w/e; I just found it suspicious that my doctor said there was no possible way that that was a thing, and then I did research and found that it was rare, but it definitely was a thing.
I've had bad interactions with hormonal BC and psych meds in the past. I'm not saying that's definitely what your reaction was, but it might be an alternate theory, if you feel in need of one. Good luck on your doctor hunt!
