Kick-Start-‘Em Psychiatrist

Posted on March 21, 2006 in Lectures

This set of notes sounds hostile in parts. I want to say that this psychiatrist who spoke on the subject of “Recovering from Bipolar Disorder” was no charlatan like the osteopathic psychiatrist who ossified us last month. Where the osteopath showed us pictures of dubiously “proved” power points in the body, this psychiatrist spoke of measureable damage to the brain and the hope for perfect recovery. If I was to choose one or the other, I’d choose this psychiatrist.

Despite what the osteopath claimed, the psychiatrist did recommend exercise and diet. Meditation was probably a good idea, too. And he wasn’t just a pill pusher. In fact, he spoke out against doling out a pill every time there is a symptom. The osteopath lied.

What bothered me most was that his prescriptions worked well if you were a twenty year old who enjoyed plenty of genuine family support. If you are a 48-year old man who has never reached his potential, the hope is problematic.

1. None of the people who showed up last month came back. Guess they don’t want to face someone who would actually challenge them.
2. Field is shifting away from the use of antidepressants for bipolar depression.
3. The goal of psychiatric medicine now is to see the condition coming before the symptoms manifest themselves. There’s a delay when we’re dealing with the brain.
4. I wonder: Is the bipolar nothing more than a useful tool? I don’t agree that pushing a bipolar into a job is necessarily healthy or a healing practice. What about situations which crush egos? What is better, unstructured time or structured time with extreme hostility or oppression? And what about the situation where the bipolar is underchallenged by her/his job?
5. A bit of a bullying shrink who decides what is good for the patient? The man sounds like a quintessential kick-start-em-so-they-don’t-turn-lazy psychiatrist of the what’s-good-for-business school. Ah, he was in the military.
6. Says that “You should not do or say anything that would upset the person with bipolar, or you will make their illness worse” is a myth. Suggests that bipolars are nothing but manipulators? (He runs a group for families, so he has lost some of the bipolar perspective.) I would phrase the myth “You can’t communicate with a bipolar or set reasonable limits.
7. We take it out on those in the home because we don’t have the power to change what is outside. Patients are really in complete control of their will and the cause of everyone’s misery, he seems to say. The patient is powerless over the job, etc. His will does next to nothing for him there. Getting a job does not cure the systemic problem.
8. Doesn’t he realize what cunning manipulators families can be and how unreasonably punitive they can be. E.g. me.
9. Lots of guilt. A “capable adult’s schedule” — like we’re children when we are in episode. Gave us “the world is unfair” line which only encouraged me to do nothing about my suffering.
10. He talked about jumping from being a flight surgeon to being a psychiatrist, how he had to start as the low man, etc. But was he the low man? What if he had to make the shift to being an orderly or a janitor rather than an intern/resident whose destiny was being a full doctor.
11. Can we not be compared to Olympic athletes? The way some of these train, they could well be manic.
12. I will go as far as I can and I will ignore smirks and taunts.
13. Agreed: We need to be honest about the risks which include brain damage.
14. Very little talk about the attitude beyond regimen, nothing about what is called “spirituality”, giving the person more than shallow “I-fit-the-mold” sense of being.