By Julie A. Fast
After the diagnosis
I remember the week I was diagnosed with bipolar disorder. I was sick and scared and had no idea how this diagnosis would change my life. I got out of the day program at the hospital with a bag of pills and an appointment with a psychiatrist. We had an hour for our first meeting, which I thought was great, and then I was set up for a 20- minute session with the doctor per week! How could I manage this illness on such a short amount of time? I was just diagnosed! I hardly knew what the illness meant, much less how to treat it. The medications were making me sick and my mood swings were getting worse and worse. I know now that my doctor was under strict time restrictions from her hospital, but at the time I felt like I could not treat this illness on my own without seeing her more often.
Many people with bipolar disorder get frustrated because of the fact that they typically get only 15- to 20-minute sessions to talk with their doctor at their scheduled appointment. Does this happen to you? This can lead to feeling rushed when you get to the appointment, as well as feeling worried that you and your doctor can’t make the most of the visits. This post will cover a few of the obstacles you may face when you’re sick and need to get as much as possible from your limited appointment. The more communication and organizational skills you can learn, the more you can get from your appointments. And the more you get from your appointments, the more skills you will have to help you manage the illness between office visits.
When your doctor’s time is limited
The hardest thing for me is the short time I get to see my doctor. When I see him for 20 minutes, I get flustered and can’t remember what I want to say. All we do is talk about medications anyway. It seems the time just flies by and then I have to wait two weeks for my next appointment.
Time seems to be the biggest struggle people face when trying to get helpful treatment for bipolar disorder. We can be sick every day and yet we see the people who are supposed to help us relatively rarely. Luckily, there are options when dealing with this problem.
- Prepare ahead for your appointments.
- Try to stay calm and focused.
- This is a good time to have a list of what you want to talk about.
- Be clear on what you need, even if you feel too sick to talk.
- Respect the fact that your doctor probably didn’t choose this time limit and would like to see you more.
- Learn to voice your concerns. Ask your doctor how your appointments might be more effective.
- You also have the option to change doctors.
Considering that most of us don’t have an option when it comes to the amount of time we see our doctor, developing as many coping skills as possible is essential.
When the issue is communication
When is my doctor going to listen to me? The medications aren’t working. I think I’m sicker than I was without them. What are my options? Why won’t he help me? I ask for more ideas and my doctor just looks at me like I don’t know what I’m talking about. I know he knows more about the illness technically, but I think I’m a pretty good judge on what it feels like and what I need. How can I get help when I see him once a month?
When you’re sick and time is so limited, you may feel that the last thing you need is a doctor who doesn’t seem to listen, writes out another prescription, and minimizes your concerns about side effects (sometimes saying, “Let’s just give it more time”).
I’ve received many letters on my website from people complaining about their doctors. Here’s a communication tip for this difficult situation. Try saying this to your doctor (in a nice way of course):
I understand the time limitations you have when you see patients. But I’m frustrated and sick and can’t manage this illness alone. I see you because I know you can help me. How can we communicate better?
Whew! This is a tough one, but your options might be tougher. Once you’ve said what you have to say, it’s done and there is a chance your short visits can be so much more effective. Your doctor may be unaware that you are frustrated. Many people sometimes feel intimidated by their physicians and psychiatrists.
Talking with healthcare professionals
The more calm and prepared you can be, the better chance you have of changing your doctor visits into something that works for you. Even if you’re quite sick, there is still the “well you” in there who can talk rationally---you just have to pull it out of yourself.
- We live in an overburdened medical system. Fewer people are going into the field of psychiatry. More general doctors are treating bipolar disorder. Their time is often limited by HMOs. The more you understand and accept this, the less frustrated you can be.
- Make effective use of your office visits. Have a clear list of what you need to talk about. Let your doctor read this list so you don’t have to spend so much time talking.
- Try not to be too needy. Spread out your needs so you don’t overwhelm your doctor.
- Turn to people who seem the most willing to help. If you need to make a change, ask others and find a doctor who fits your style.
Get more from your office visits
- Use tips from books and magazines such as this one that offer tools that help you stay stable between doctor’s appointments.
- Check out the Internet.
- Help your family and friends to understand what you go through so that they can be a support between the appointments.
When you bring strong communication skills to your office visits, you can at least feel you have done all you can to get the help you need. We all have a tough time with these time restrictions. Over the years since my diagnosis, I’ve learned to manage this illness on my own—in between seeing my doctor. It was a long journey and may be a long one for you, but you can do it as well.
Julie A. Fast is a bipolar disorder specialist for the Oprah and Dr. Oz website ShareCare.com; the author of Loving Someone with Bipolar Disorder and Take Charge of Bipolar Disorder; a family and partner coach; and a professional speaker. Julie is also a regular columnist and blogger for bp (Bipolar) Magazine and bphope.com.