Second Opinion

I went to the Kid-Shrink today to get a second opinion on my own psych issues.

~~~REWIND~~~

My Med-Shrink has been treating me for a mood disorder for probably about 5 years. I have been growing increasing unhappy with the communication between us. He is always rushed and detached, doesn't want explanations or input beyond a one or two word reply. I never feel like I have had the opportunity to go over the questions and problems I came into the office needing to discuss. The more time that goes by, the more frustrated I get. I tried to bring the issues out into the open once before and composed a clear, concise and specific letter detailing how I feel, why, and what I would like to see happen instead. He responded and we discussed it and he basically said that that's how he is and nothing is going to change so adapt or leave. And so I adapted but with growing frustration. After this past December though, I can't continue this way. I need a different kind of therapeutic relationship.

~~~REWIND +/- 15 YEARS~~~

At 17 years old, I became so depressed that I refused to get out of bed half the time and became impossible to deal with. I was suicidal and self-harming (though no one saw that at the time) and having a lot of problems. The Mother dragged me to a shrink. After an extensive interview with him, he concluded that I had depression issues but so did my mother. He asked her about getting treatment for herself. The Mother freaked out and declared the man incompetent and evil and stormed out, dragging me behind her. She ranted for days about how dare he blame my problems on her. My problems were my fault, not hers; I was the problem, not her.

That shrink happened to be the Kids-Shrink.

~~~FLASH FORWARD TO PRESENT~~~

I was nervous about seeing the Kids-Shrink. He seems to have a high opinion of me both as a person (we share book recommendations) and as a parent (based on the degree to which he includes me in the decision-making process with them). I was afraid that once he saw my symptom list, he would write me off as incapable of making those decisions. Of maybe accuse me of faking and exaggerating because that's not how I present when I am with them.

I was also afraid of what he would say. Would he take one look at the cutting and suicidal behaviors and declare me hopeless? Would he decide that the Med-Shrink si doing just fine and that my expectations are unrealistic? Would he tell me I just need to try harder? Would he say he knows how to make it poof-all-better and I'd get my expectations too high only to crash? Or could he make me poof-all-better and I'd find out that I really am just lazy and selfish and spoiled and there is no hope for me?

The difference between what I expected (or rather feared) and what happened spans oceans. He reviewed the paperwork I turned in and asked a few questions. He had me fill out an assessment on attention symptoms, which made me feel like someone had crawled into my head. I told him that the Med-Shrink had told me it's not possible to have ADD if there are any other diagnoses present. He reassured me that isn't the case (Kid-1 being a perfect example) and that there are very clear attention difficulties here that, given that they have been lifelong, point definitively to ADD/ADHD.

He then said that my symptom cluster profile speaks directly to PTSD and asked if I had a past history of trauma. I cannot tell you how much I despise that question. I generally nod and hope it will blow over but I know it won't - it can't - and they will then want to know what and when and who and I can never get the words to come out of my mouth and I'm lucky if I can struggle through staying present long enough to present enough information for them to get the idea. He did get the idea, though, and made his notes and then dropped it.

He asked about what meds I'm on and what they are doing for me. I couldn't really vouch for the efficacy of the Depakote or even the Wellbutrin because I haven't seen a difference with the Depakote and I've been on the Wellbutrin so long I don't know if it's helping or not. I've had plenty of rough spots despite being on the Wellbutrin but, like the VNS, I may not know if it is helping or not until I go off of it and see what happens. I do find the Seroquel helpful in a way I can back up with concrete experience. I feel the same about the Xanax, though I remain cautious about that and want it monitored closely.

When all was said and done, his (technically second) opinion consisted of the following diagnoses: PTSD, ADD, Mood Order NOS. He recommended some changes in my meds (namely stopping the Wellbutrin and the Depakote and adding Concerta). He said he is really glad I am seeing The Shrink as he thinks he does a great job. And he has hope for me...