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labeling problem


redgirl
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Hi-

Has anyone else out there had a problem with being labeled as "difficult" by potential therapists/psychs? I was diagnosed as bp a little over a year ago and since then I've been having trouble finding help because I don't trust the doctors. They let me come in and do an intake at their office and as soon as they hear that I'm bipolar and have had multiple hospitalizations (maybe 8-10 in the past 15 years) they say that I'm "too difficult to work with" and drop me as a client. This is especially frustrating due to the fact that the intake always triggers my PTSD as they want a detailed history and make me talk about things I'm clearly not ready to discuss, and I have developed serious trust issues with doctors due to a few problems I've run into in the past. The last doctor I tried did the intake, said yes she would help me, set up a month of appointments for me and the next day called and said she was dropping me as a patient because I'm bp and "too difficult to work with due to this." This wasn't the first time this has happened. I don't understand this since I do everything they tell me. I'm not being followed by anyone right now, so no meds, and I've moved to a different part of the state so that hopefully I'll find someone who will help me before I end up hospitalized again (which I'm trying VERY hard to avoid). I'm really angry over this and want to scream "I'm bp but I'm still a human being!" every time it happens. I'm sorry this is so long, I haven't had anyone to talk to about this and the many other problems I've got going right now.

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Hello redgirl,

Some thoughts and links for you. I suggest you take from the following what you find to be helpful and leave the rest.

redgirl: Has anyone else out there had a problem with being labeled as "difficult" by potential therapists/psychs? I was diagnosed as bp a little over a year ago and since then I've been having trouble finding help because I don't trust the doctors.

Here's my very simplified version of understanding doctors: If you want medication, you see a psychistrist. If you want talk therapy, you see a therapist. There are a few rare psychiatrists who still offer talk therapy and, depending on where you live, you may find a therapist with prescribing privileges but both are the exception rather than the rule. It seems to me that you're looking for both a psychiatrist and a therapist and some of your difficulties (I may be wrong) might be related to trying to find both in the same professional.

I'm not being followed by anyone right now, so no meds, and I've moved to a different part of the state so that hopefully I'll find someone who will help me before I end up hospitalized again...

You don't say if you're trying to get by without meds or if you're being forced by circumstance to get by without meds. Either way, the med issue is one that's worthy of following up on because you've been on them in the past and coming off abruptly can trigger a relapse. Here's a link that might offer you a bit more information in that regard: Matters to Consider When Reducing or Coming Off Meds.

Meantime, I'm going to assume we're talking about mood-stabilizers, anti-anxiety agents and anti-psychotics. I'm further going to assume that you were on meds, you found them helpful, you want to continue and part of the reason you need a new doctor is because you need a prescription. As a "getting by" solution you could consider:

- You might be able to get a prescription from a GP. That might not be the ideal situation but it would help fill the gap until you find a new psychiatrist you feel comfortable with.

- If you can't afford meds, you might be able to get some free samples from a clinic, someone like the aforementioned GP, a nurse-practioner and possibly, even a pharmacy.

- If none of those options are feasible, this link might have some helpful suggestions for you as well: '>Can't Afford Your Meds? Try These Programs.

Given that avoiding hospitalization is one of your stated desires you can probably help yourself do so by returning to the last dose of medication that helped you produce stability. If you want to come off meds, that's a whole different post and even then, you'd still want to be starting from a position of stability and slowly stepping down while maintaining good function.

Meantime, as far as the docs go... maybe it would help if you got your meds from a psychiatrist and your therapy from a therapist. That means that when you next go see a psychiatrist, you don't tell them about the trauma in your past, you tell them what you require from them in terms of medication. This link may be helpful: Reclaiming Your Power During Medication Appointments with your Psychiatrist

In the same vein, when you next go see a therapist, you touch on your traumatic past without feeling obligated to get into detail. You let them know that you have some trust issues and if they're any good, they will respect that and not press for more details than you're ready to share before you have had an opportunity to try and form a respectful and trusting relationship with them. Meantime, you don't need to talk with them about your meds, your diagnosis and maybe not even your hospitalizations until a trusting therapeutic relationship is in place.

This link might provide you with a bit more information on choosing a therapist to work with: How to Choose a Good Therapist.

And there you go -- some thoughts and some links. Best of luck to you redgirl. I hope you find some people in your new locale that will be able to give you the kind of help you're seeking.

~ Namaste

Edited by spiritual_emergency
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If you want medication, you see a psychistrist. If you want talk therapy, you see a therapist.

That's exactly what I'm trying to do and what I've always done. The major problem is that I always have to meet with a therapist first and wait until the psychiatrist has an open appointment. I've NEVER been told that I'm too difficult to deal with, until I was diagnosed with bp disorder, now I'm generally treated like I have the plague. I asked my PCP to prescribe something and was told they aren't willing to do that because they are mood stabilizers and anti-psychotics, so they won't do it. There aren't really any "clinics" in my area, the few that I've tried have told me the same thing or tell me I need to be hospitalized first even when I'm not in crisis. The cost of the meds isn't an issue, I've always been able to get samples, it's the cost of therapy and psych visits I can't afford, even with health insurance. I'm trying to cope the best I can and doing pretty well at it (at least I think so, besides the anger anyway) but a major reason I moved was in the hope that I'd find someone who wouldn't label me. That's what's making me so damn angry, I never had a problem like this before the bp diagnosis. They tell you to stay in treatment, stay on meds, I do everything by the book exactly as they say, and they treat me like crap everywhere I go because they decided based on my diagnosis that I am "difficult." I'm trying so hard everyday and they make me feel like I'm a horrible person.

The trust part- I had a therapist tell others about what I said and the others confronted me about it, I had a therapist call the cops on me and say I tried to kill myself when I didn't and the doctor at the hospital said I didn't but that was after the cops banged down my door and I was restrained in the hallway of the local ER and ignored for almost 12 hours, a psychiatrist over medicated me to the point that I passed out and blamed it on me because it was during a hospitalization and I thought it was too much and tried to refuse it and was threatened by the staff so I took it to avoid punishment (they were threatening me with restraints and I am scared of that), and a psych nurse told the entire floor of the psychiatric hospital I was admitted to all of my diagnosis.

Please don't take my attitude personally, I signed on to here to get feedback from others because I have no one else to talk to, I'm just really, really angry at this time and wish I had never gotten this damn diagnosis.

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No, I understand. There are good and bad professionals out there and I've certainly seen some of the attitudes you describe in action before.

It seems the diagnosis isn't working for you. Some diagnoses come with a greater stigma than others. It also seems that you've managed to find a solution for now to address the issue of the meds and finding the therapist is now the greater problem. You made mention of a traumatic event in your past. If that's what you're seeking therapy for, can you leave the diagnosis out of it and just seek help with the traumatic aspects?

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I was diagnosed BP almost 2 yrs ago but have not had the labelling problems you describe. That must be really awful. :)

All I can suggest is that you apply all the self-help techniques and learn as much as you can about BP (from books, the net, support groups etc). Keep a mood chart, regulate your sleep/wake cycle (especially wake up at the same time each day - use an alarm), eat at the same time every day, make sure to exercise, manage stress as well as you can with relaxation, meditation or whatever works for you, anger management techniques, read, read, read - all those things. They can go a long way towards managing your BP yourself. If you can find a support group in your area that would help a lot too. (I live in South Africa, most people here seem to be from America, but I don't know how it works there.)

Good luck!

Edited by Luna-
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