I've been busy working at getting my private practice up and running. I leased an office and applied for a business license. I've been working on my website. Days go by quickly and it feels as if time is very limited. I haven't ever felt this way before -- purposeful, intent, excited for what the future might bring. It's funny -- after having a manic episode and going through a divorce, things like this have greater meaning. I had to survive the depths of bipolar disorder in order to make it here today.
Although there are many gifts that come with bipolar disorder, such as creativity, productivity, and open heartedness, bipolar is a deadly beast, a deceptively beautiful one which left untreated can bring much horror.
Today I wanted to write about how to go about finding a psychiatrist. A reader recently wrote me and shared how difficult it has been to find a good provider -- a clinician who actually cared. This reminded me of my own journey and how difficult it was for me to find a psychiatrist, despite being a psychologist myself, and knowing generally what to look for.
I will never forget going to his office -- I was in the midst of my manic episode. Brian* had left, I had no family in the area. I told him what had been going on in my life. He listened to me, then quietly scribbled in his notepad, and said, "you have destroyed your life and it hasn't hit you yet because you are in the middle of a manic episode. when you come out of this, you are going to have a severe depression. Take this," he said, handing me two prescription papers for medications.
The medications were intense. I was afraid to take them. "This is what I recommend," he said. He was cold, blank, forceful. The way he spoke made me feel as if he didn't respect me, and that I was being judged for my symptoms.
I often think back to this time, and how much this doctor could have helped me, had he truly cared. How much it would have meant for him to express concern, some genuine human connection. How much it would have meant for him to recommend that I bring a family member to the appointment with me, or for me to go to an emergency room.
I now understand the harm that doctors can do. We place much trust in them, and the way they see us can shape how we see ourselves and what has occurred in our lives.
A good doctor can make a huge difference in our management of bipolar, as well as how we view our own illnesses, and make sense of how to build a meaningful life with it.
I ended up leaving that psychiatrist, and went on to try two others. With my third psychiatrist, I feel as if I have struck gold. I am so glad that I kept looking. What I like about him is his humanistic approach. Yes, strong training and clinical judgement are important, but above all, what I have learned from my experiences is that the human connection and positive regard matters so much.
It is important to build a treatment team for your bipolar management. The treatment team involves you (the leader), family, a psychiatrist, and a psychologist. Today I am going to focus on finding a good psychiatrist to be a part of your treatment team.
7 Critical Ways to Find a Great Psychiatrist for Bipolar Disorder
1. Think about what you want.
The first step is to understand what type of psychiatrist you want. Do you want someone who accepts insurance? Are you okay with paying out of pocket? Do you want to see the psychiatrist for psychotherapy? Or primarily for medication management, and to work with a psychologist for psychotherapy instead? Do you want someone who specializes in mood disorders or is a generalist okay? Is experience the most important thing to you? Or is it also important that you feel respected, that you sense they understand how difficult it is just for you to have made it here today - that there is positive regard for you?
2. Start searching.
a). Search insurance databases. Once you understand your needs, this will inform your search process. For example, if you know you want a psychiatrist that is in network with your insurance company, then you would begin to search insurance databases for psychiatrists that are in network. You could then cross reference their names with a google search of other patient reviews (e.g., yelp, doctor review websites, local magazines that provide physician rankings).
b). ask other health care professionals who they would recommend, or if they know any psychiatrists with good reputations. A lot of times, physicians will have good recommendations to refer you to -- they know the doctors with strong reputations. Ask friends and family if you are comfortable. Let the universe know you are looking.
3. Read through the psychiatrist's website. Read about their philosophy, training, and approach. Where did they go to school? How long ago did they receive their degree? What are their clinical interests and what are their specialties? Does something on their website resonate with you?
4. Meet with them a few times. It is important that you feel comfortable with them, that you feel as if you can be honest and open with them. With the second psychiatrist I saw, she was the chair of the department, and had strong clinical judgment and excellent recommendations. But I didn't feel as if she cared for me as a patient on a human level, and this was important to me, so I went to find another provider. So meet with the psychiatrist a few times and see how you feel. Do you resonate with them? Do you feel comfortable with them? Can you be honest with them about your symptoms? Do you trust them with your brain and its functioning? That was the most difficult part for me as some of the medications for bipolar are heavy duty with serious side effects. Its important that you trust your psychiatrist.
5. If you need a provider that accepts insurance, I highly recommend going to a hospital that is university affiliated (e.g., UCLA, UCSF, Hopkins). It is at these places where you will receive world class care on the leading edge of treatment; and where the doctors will accept your insurance. If you do not need a provider that accepts insurance, I would probably also start off going this route as well, especially if the hospital has a program that specializes in mood or bipolar disorders, such as the Johns Hopkin's Mood Disorders Clinic. If there is a long waitlist, get on the waitlist; it would be worth it to have a strong basis and assessment/diagnosis for the future treatment and management of your illness.
6. Read about bipolar disorder yourself, try to education yourself on management of the illness. This will assist in selecting a psychiatrist as part of your team. Do they seem up to date on the latest research in bipolar disorder? Are they familiar with the nature of the disease? Do they understand that it is a brain based illness? This will also help inform your conversations with your doctor. I recommend reading David Milkovitche's book on bipolar disorder to start off with:
7. Keep looking. Do not give up. There is hope. Know that you deserve to work with a psychiatrist whom you trust and feel comfortable with, who seems to care and to exercise strong clinical judgment.
Are there any other tips that you have found helpful in your own search for a psychiatrist? Please comment or email me; I would love to hear from you.