Friday, June 15, 2012


As a rule, I never criticize any one's doctor. I know how important it is that people have confidence in their doctors, and I don't want to undermine that.  There are exceptions, though.  Over a year ago one of the women in the church told me about being diagnosed with bipolar 9 years ago.  As I listened to her story, I realized that she had never seen a psychiatrist, and her primary care doctor had prescribed an antidepressant for her.  I also realized that she was having spells of mania.  She would go on shopping sprees, or get up in the middle of the night and start cooking, and various other things that screamed mania to me. 

I encouraged her to ask her doctor about a referral to a psychiatrist.  I explained that she might need medication to level out her mood and prevent the manic episodes.  She talked to her doctor, several times, and was told that the medication she was on was the only one she could take and she was at the maximum dose and there was nothing else that could be done.  He refused to give her a referral to a psychiatrist.  I suggested she talk to her psychologist, but he was unwilling to refer her, too.  The last time she filled in for our pianist it was obvious she wasn't in a good place. 

Her husband has been coming to worship alone the last few months.  I knew that meant she was in a bad place.  I also knew that she needed to see a psychiatrist, and she knew my feelings on that.  A week and a half ago she called me.  She was desperate.  She wasn't able to sleep and was in a bad place.  She wanted the name of Daughter's psychiatrist.  I explained that Daughter's psychiatrist only dealt with people with developmental disabilities. 

She wanted me to refer her to someone.  I told her I didn't know anyone here, and suggested several resources, including a member of the congregation who works as a case manager with the elderly.  I suggested she would be able to give her the name of a good geriatric psychiatrist.  I saw her husband on Sunday, and he said she'd called, and had an appointment for April.  I could hear the defeat in his voice.  He'd been encouraging her to seek a psychiatrist for years, and was very frustrated with her primary care physician. 

This afternoon I was in the house cooling off and taking a break and the phone rang.  It was the woman.  She told me she was going to see a psychiatrist.  I didn't say anything about my conversation with her husband, and said I was glad she'd found someone.  She then told me about all the calls she'd made in search of a psychiatrist.  There was the one with the appointment in April.   There was one who didn't seen anyone over 65.  There was one who had to check out her insurance.  Then she tried this one, who was one of them recommended by the member with connections and also had been recommended by the office of the psychiatrist who wouldn't see anyone over 65.  She told the office assistant her story.  The office assistant told her that her primary care physician would refuse to work with them or give them her records, because he didn't like psychiatrists, but they'd still see her.  She told her that she needed more than an antidepressant to control bipolar.  She said, "That's what my pastor said!"  Office Assistant told her her pastor was right.  She has an appointment on the 25th.  She called me because she was so excited that she'd managed to get an appointment.  She said she felt like a huge weight was off her shoulders.  She wanted to thank me and share her good news.  She's been averaging less than 3 hours of sleep a night.  She falls asleep fine, but then wakes up with her mind racing and has to get up and do something. 

I suspect that I hear more of these stories and have more credibility because the congregation knows about Daughter's struggles.  I'm glad that our struggles have opened the door for me to minister to people struggling with their own mental illness or that of a family member.  There are some doctors, though, who I don't think should be practicing medicine.  I can't believe he refused to refer her.  She refuses to blame her doctor.  "Maybe I didn't communicate well with him about how bad it is."  I know she's asked multiple times for a referral.  Now that she's found a psychiatrist, I'll go back to biting my tongue and not undermining her confidence in her doctor.  I hope and pray that this psychiatrist will be able to help her.  I cautioned her, though, it was a first step and would take time.  I hope she'll be patient with the process.  Of course, when you're manic, that is a challenge, to say the least. 


Chicago said...

I am sure you already know this, but just in case..the anti-depressant prescribed by her rotten primary care doctor is likely kicking off her mania.

Good thing the good Dr. doesn't also dislike dentists. Your congregant would have no teeth.

Reverend Mom said...

Yup. I've lived through anti-depressants triggering mania in Daughter. At least he referred her to an orthopedic surgeon for her shoulder surgery....