Finding A Psychiatrist Is Like Finding A Soulmate
(EXCEPT MORE EXPENSIVE)
TW: mental health, suicidal ideation, sexual abuse
Three months ago, I found myself writing a letter to a psychiatrist I had never met. The letter explained my diagnosis, symptoms and current therapies. Disguised as an informative letter, it was actually evidence that I was a good candidate for care. This letter was to show what a great patient I’d be. Pick me! I’ll take my drugs and arrive on time.
I’m sick but not a menace.
Sick but motivated.
Sick but competent.
This wasn’t my first crack at self-promotion; I’d mastered online dating which was lucky as it turns out, hunting for a psychiatrist is like hunting for 'The One' (only much more expensive and with a tiny dating pool).
Over my ten-year wellness path I’ve now seen five different psychiatrists. The first was organised by my parents (I was fifteen or sixteen at the time), the second was assigned by my university, and the third? That was all my doing. This third attempt marked my real leap into the clusterfuck that is the mental health care system.
At that stage I'd recognised that my mental health had been deteriorating. Life was held together by duct tape and strained thread. Something was wrong and getting worse, but I had no idea what. Efforts towards wellness had been intense but my state was unyielding. My doctor and psychologist were at a loss. I needed to see a psychiatrist. Now.
The process of finding one was chaotic at best. I took the prescribed route and saw my GP, who referred me to a psychiatrist working out of East Melbourne. Happily, I trundled home with my referral letter to book myself an appointment. Unfortunately Dr East Melbourne wasn't taking any more patients, and he costs $475 an hour.
That is a lot of money.
Something cheaper must exist, right?
I found Headspace - a free youth mental health service - but after extensive interviews, they told me they didn't have any openings. I contacted my work, who offer bulk-billing psychiatrists, but the next appointment was in three months. I did some fancy googling and found the Australian Psychiatric Registry, where all registered Australian psychiatrists are listed with addresses and phone numbers. My psychological soulmate mecca.
After I discovered the filter function I searched for “specialises in mood disorders” and “bulk-billing available”. Of the thirty or so different psychiatric offices I called, several didn’t answer. Several were disconnected. Several were the wrong address. And absolutely none of them bulk-billed or had appointments available in the next two months.
The receptionists must’ve heard my desperation and started offering me advice. I was sent on a wild mission down Wikipedia-esque holes until all the suggestions I was getting were ones I’d already tried. Finally, I got an appointment with a doctor in Coburg in two weeks time. She didn’t bulk-bill ($395 for the first hour session), and she didn’t specialise in mood disorders, but she was a psychiatrist and she was available soon.
Dr Coburg was a middle-aged woman who I think was Russian, based on her accent and last name. It was hard for me to understand what she was saying, and I was pretty sure she hadn’t grasped what I was saying either. I felt like a tourist, complete with wild gesticulation and unusually annunciated sentences.
Despite the communication difficulties, she gave me a pretty conclusive diagnosis at the end of the session. To put it vaguely, she told me I was suffering from a disorder that meant I had too many feelings - about four times as many as your average person. She put me on a new drug, and gave me a brochure for a year long psychological therapy program she said I needed to do.
I continued to see this doctor approximately every two to three weeks for the next eight months. Over those eight months, my regard for this woman took an exponential nose dive.
At first there were the communication problems. Then some odd things - she asked me to bring in a photo of myself as a child and then never spoke of it again. She seemed to forget key bits of who I was - relationships, medications, symptoms. But we were still in the honeymoon phase, and just like the beginning of any good soul crushing soulmate endeavour I ignored the flags turning red.
Yet the misdemeanours piled up into a bonfire waiting to be lit.
She prescribed me drugs without warning me of the side effects.
She regularly looked bored and trimmed her nails while I talked to her about death.
She told me that my history of sexual abuse was a symptom of my disorder.
After seeing her for four months, she re-gifted me the therapy brochure from our first meeting and suggested I do the program. Evidently, she had completely forgotten our last four months of conversations.
I felt like a drunkenly purchased half kebab that she had forgotten.
And I’d had enough.
I inquired about the inconsistencies. She denied them, which I had expected. Then she concluded that my paranoia and sensitivity was simply symptomatic of my condition.
Dr Coburg was making me feel crazier than I actually was.
Needless to say, the love had died, it was over. But like any serious relationship, we were entwined.
At this stage I was doing some programs at a private psychiatric hospital, and to keep doing so I had to see a psychiatrist accredited with the hospital, which was her. Bureaucratic entanglement at its finest. So I stayed with her like a loveless marriage held together by offspring, whilst trying my luck at psychiatric infidelity.
I finally did get a spot with a psychiatrist through my work. Dr Carlton was free and philosophical. The first session we spent two and a half hours talking about the concept of failure. I liked him, and I think he liked me. Well at least he said he liked my pants and he was keen to have me back if only to see what I'd wear next week. But like Shakespearan star-crossed lovers, bureaucracy got in the way. Dr Carlton was not accredited with my hospital.
And so my loveless psychiatric marriage continued whilst my fledgling side psych romance bumbled along. But the search was not over, I needed to find someone who I trusted and was accredited with my hospital.
But just like in the dating world, for all my online searching, the best match surprised me from left of field. A family friend put in an excellent recommendation for a specialist in youth psychiatry.
I called Dr Richmond’s office, she wasn’t taking new patients.
But I’d learned some things in my searching, and I suspected the receptionist was lying.
And like many people do when they get out of some heinous failed relationship, I wrote myself a list of what I wanted and of who I was, and I put it in that cover letter, and addressed it to Dr Richmond.
I wanted someone who would treat me as the struggling but competent person that I was. Someone who was understanding. Ultimately though, I wanted someone who was in it for the long haul. I was up to my fifth psychiatrist and my thirteenth psychologist, and I was ready to settle down. I wanted to buy that block of headspace and build some nice looking future on it and I wanted someone with brain-carpentry skills to help run the whole show.
So I sent off my wish list. A couple of days later I got a call from Dr Richmond’s office. Turned out she did have space. It was two months away, but I was happy to wait.
Dr Coburg knew I was cheating, she knew I was leaving, she was terse but had come to terms with it.
Dr Carlton had fallen off the face of the planet. I left a message trying to change an appointment time and never heard back from him. I compared it to a tinder date turned sexcapade turned disappearance. It was ok. I wasn’t offended, just a little surprised and disappointed.
My new psychiatrist, Dr Richmond, I like her. Her room is neat, a water jug and tissues sit on the table. She has a melodic voice that vibrates understanding. She’s expensive, but if I’ve learned anything in this whole process, just forget money, a healthy brain is your best accessory in life.
I tell her my story like I've done many times before, like we've all done many times before on dates. It's routine. I know the pitfalls and motifs; where people will laugh, where my eyes will well. She listens quietly, and she nods.
Then, unlike anyone else, she tells my story back to me. She's listening.
She tells me she sees how hard I'm trying.
She tells me it will get better.
After really good first dates, I often find myself day dreaming about growing old with that person, and the collection of succulents we’ll keep. After meeting Dr Richmond, I imagine myself growing well with her.
A life without chaos.
A normal life.
A life worth living.
This fantasy is warm and poignant. Heartbreakingly, it is both colossal and minute. This fantasy, the realness of it, is completely new to me.
I understand it as fantasy, but it’s one I’d like to hold on to. And this woman, Dr Richmond, she feels like she’s got some 'The One-ness' about her. Under her care, I can see what better might look like; the abstract idea of ‘wellness’ comes further into focus. With her, I can almost taste 'better'.
And so without settling, I’ll settle down here a while.