Mental Illness, Misdiagnosis, and Forgiveness

February 17, 2011

About a year ago, I had a terrible, two-week anxiety attack. My eyelids twitched constantly, I couldn’t sleep without serious pharmaceutical assistance, and—in lieu of a heartbeat—cold-winged butterflies beat around in my chest.

At first, I wasn’t sure what had triggered my anxiety. I’d experienced one similar episode about six months earlier, after starting a new job (I didn’t work for nine months after John’s hospitalization) and having a confrontation with a woman at one of my Twelve Step meetings. I chalked that experience up to nerves around the new job and a fear of conflict, and I didn’t think too much about it after the anxiety went away.

The second time it happened, though, I had to dig a little deeper to figure out what was really going on. And the truth was, I was still traumatized by the fact that my husband had been misdiagnosed after all my efforts to communicate what was happening with his psychiatrist.

The worst night of my life, in fact, occurred two days after said psychiatrist—Dr. Black—decreased John’s dose of Risperdal, and then proceeded to tell him that she “wasn’t that concerned” as his psychosis escalated and I pleaded with him to return to the hospital.

After my husband went back to the hospital, I was furious. I had trusted his psychiatrist. I had assumed that, because she had much more experience with mental illness than I did, she knew what she was doing when she ignored my calls and input.

I had, of course, assumed wrong.

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Top Three Reasons You Should Be Involved in Your Spouse’s Psychiatric Care

October 26, 2010

I never accompany my husband to dentist appointments or routine physicals, but I go to every appointment he has with his psychiatrist.

This wasn’t always the case. When he first came out of the hospital after his initial breakdown, he asked me not to come into the psychiatrist’s office with him. My presence would make him nervous, he said. It would make it difficult for him to be open and honest with the doctor about what was going on.

With some misgivings, I agreed to let him field the appointment by himself. The doctors from the hospital had been terrible about communicating with me, but I assumed that his private psychiatrist would have a better bedside manner toward me, John’s wife.

I was wrong. Although I asked to visit with Dr. Black for a few minutes after John had seen her, she told us that she didn’t have time. When I called her in between John’s appointments to let her know that his psychotic symptoms were resurfacing, she never called me back. She also had the nerve, when I finally did speak with her during my husband’s next appointment, to tell John (and me) that I was part of the problem, and that he needed to set boundaries around his interactions with me.

Her refusal to give my opinion any weight led to misdiagnosis of John’s illness (she thought he had anxiety and depression, when in reality he was suffering from a manic episode with psychotic features), and a second stint in the hospital for him.

Although HIPAA privacy laws can sometimes make it difficult to get involved in a loved one’s psychiatric care, there are three reasons I believe you should always fight to be an active member of your spouse’s mental healthcare team.

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10 Years

September 25, 2010

John had a psychiatrist appointment on Monday morning. He goes about once every three months, and I pretty much always go with him.

We like his psychiatrist, Dr. Wilson, a lot. The first psychiatrist John saw after coming out of the hospital misdiagnosed him, immediately started taking him off Risperdal (substituting Pristiq), and pretty much ignored me when I tried to tell her that John was psychotic again.

After John’s second hospitalization, Dr. Wilson met with the two of us for an hour, listened to me when I told him about John’s symptoms (because he was delusional, John didn’t perceive a lot of manic behavior as symptomatic), and diagnosed John with bipolar disorder. Over time, he tapered John off the Risperdal, relying solely on the mood stabilizer Depakote. When John continued to experience residual depression months after his psychotic break, Dr. Wilson gradually switched him from Depakote onto Lamictal, which has been working great for about 15 months now. No depression. No trouble concentrating. No manic swings.

On Monday, Dr. Wilson confirmed that John’s been very stable. He cautioned us, though, that sometimes when people are stable on the meds, they begin to question whether they really need them. He explained that due to the severely disruptive nature of any mood episodes (John was on disability for 3 months, and he was lucky that he didn’t lose his job), he doesn’t recommend playing with a medication that’s working unless a patient has been stable for ten years.

John didn’t have a problem with this recommendation. With the Lamictal, he doesn’t experience any side effects, so taking a pill every night is no big deal. Now, if he were still on the Risperdal, which left him lethargic and messed with his ability to focus and do complex math (he’s an engineer), I think it would be a different story. Fortunately for John, Risperdal isn’t part of the equation right now.

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