a full psych evaluation and the spouses role

[Anonymous]

When you go to a psychiatrist for a first visit/intake, are you not supposed to be getting a full psych evaluation?

My DH has seen two psychiatrists. Neither one showed any interest in having me, the only person who has closely observed my husband for 20 years. and the only one who knows what he WAS like and what he is like NOW come to any of the appointments. DH even gave them permission to talk to me. OR for me to talk to them. But I was never part of any session. When I called boths doc to report a bad reaction to the medicines presccribed, both literally ignored me. One sat silent on the phone, the other never answered the email I sent.

It seems to me that this is information they should want.

How can a person who is experiencing anger and depression and blames everything on circumstances or me or other people give an accurate report of what is going on?

I actually had one doctor I called to chat and make an appointment for my husband (who has ADD among other things and relies on me for exactly this tupe of thing and many more things) say that it was somehow more "appropriate" for her to talk to him. Not surprngly, they played phone tag and the appointment never was made.

How am I to get my spouse the help he needs if doctors dont listen? HAs anyone else run into this?

[Anonymous]

Sorry OP, but unless your husband gives permission or you agree to see a counselor together, you are not allowed to get any information from a Dr. and technically you aren't even supposed to make an appt for him (although a lot of offices will allow you to). It has nothing to do with the therapists. They may have suggested it to your husband, but if he says no, they have to honor what he says. He is the patient.

I think what you need to do is agree to see a therapist together (and you will both be considered patients). Not a marriage therapist though. Just a regular therapist.

[Anonymous]

Anonymous wrote:Sorry OP, but unless your husband gives permission or you agree to see a counselor together, you are not allowed to get any information from a Dr. and technically you aren't even supposed to make an appt for him (although a lot of offices will allow you to). It has nothing to do with the therapists. They may have suggested it to your husband, but if he says no, they have to honor what he says. He is the patient.

I think what you need to do is agree to see a therapist together (and you will both be considered patients). Not a marriage therapist though. Just a regular therapist.

PP here. Same with reporting a reaction. Unless your husband was in the hospital and unable to call or email himself, they have to go through him, not you. It's just the law and I'd recommend you read up on it before getting into a huff about it. You can also get a therapist for yourself and then invite your husband to join you at an appt.

[Anonymous]

Anonymous wrote:Sorry OP, but unless your husband gives permission or you agree to see a counselor together, you are not allowed to get any information from a Dr. and technically you aren't even supposed to make an appt for him (although a lot of offices will allow you to). It has nothing to do with the therapists. They may have suggested it to your husband, but if he says no, they have to honor what he says. He is the patient.

I think what you need to do is agree to see a therapist together (and you will both be considered patients). Not a marriage therapist though. Just a regular therapist.

Read up: SHE wants to inform THE DOCTOR. As in, recite information relevant to the case at hand. Not necessarily FROM the doctor.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sorry OP, but unless your husband gives permission or you agree to see a counselor together, you are not allowed to get any information from a Dr. and technically you aren't even supposed to make an appt for him (although a lot of offices will allow you to). It has nothing to do with the therapists. They may have suggested it to your husband, but if he says no, they have to honor what he says. He is the patient.

I think what you need to do is agree to see a therapist together (and you will both be considered patients). Not a marriage therapist though. Just a regular therapist.

Read up: SHE wants to inform THE DOCTOR. As in, recite information relevant to the case at hand. Not necessarily FROM the doctor.

It doesn't matter. The Dr. can listen and the Dr. can read the email. That's about it. Anything more and he could possibly give information about the husband. Or perhaps the husband said "I do not want you to talk to my wife. At all. If she contacts you, please do not reply."

[Anonymous]

OP here.

YES, we had permission to be together. But I was never given indication as to when that would ever happen.

NO, I was not seeking ANY information from ANYone.

I was specifically asked by Doctor one via a leaflet that it was the FAMILIES RESPONSIBLITY to report adverse reaction to medicine.

Doctor one then never called DH to ask about the panic attacks he was having after she added adderal to the wellbutrin. WHen he went to his regular session, she just said "that can happen". No concern, no follow up. We just took him off the adderal ourselves.

Doctor two I called to report the adverse reaction of signficantly increased rage on the 300 mg buproprion prescrined by her, double his previous does of 150. She did not try to call DH to follow up. She sat on the phone silent with no concern or direction. I asked her does this not sound like one of the possible side effects, and what does she think we should do? She was perfectly ok with leaving him on it and waiting till the next appointment.

So, can you see how this seems off to me?

WHy is it so hard to get competent care.

[Anonymous]

OP again, based on advice read HERE I took him OFF the adderal, and based on the advice HERE I had him go back to the 150.

BOTH times I got ass-saving advice HERE and NOT from the doctors. Thank goodness. Rage is a terrible thing to cope with.

Can you see how I would think this lax approach to adverse reactions is off?

[Anonymous]

Where are you getting your referrals from? Are you going through insurance? (I've been to therapists and the best ones are the ones I've had to pay out of pocket for). It sounds like you have had 2 bad eggs, but it also sounds like your DH isn't doing much to help either. I wonder if she really said "that can happen" or if that is all DH wanted to report to you.

I don't know. It sounds like there are multiple issues going on, and I"m not totally convinced it is just the doctors. Time to find a referral from someone you trust who has seen the therapist themselves.

[Anonymous]

Anonymous wrote:OP here.

NO, I was not seeking ANY information from ANYone.


Doctor two I called to report the adverse reaction of signficantly increased rage on the 300 mg buproprion prescrined by her, double his previous does of 150. She did not try to call DH to follow up. She sat on the phone silent with no concern or direction. I asked her does this not sound like one of the possible side effects, and what does she think we should do? She was perfectly ok with leaving him on it and waiting till the next appointment.

So, can you see how this seems off to me?

WHy is it so hard to get competent care.

NP here. You are wanting information. I can see how it feels off to you if you've never been involved in the health care system as caretaker, spouse and/or child of an adult who is competent to manage his or her own care. But it doesn't sound off to me as both a former social worker and mental health professional and as a child who had to deal with a parent's healthcare. Your role is very limited and you have to figure out how to work within it.

I'm sorry that you're going through this.

[Anonymous]

OP, I know you've posted about this situation before.

It's still not clear why your DH can't speak with the doctor directly about these adverse reactions. Get him to call the doctor and get advice about that. The doctor can't go fixing someone's dosage based on a spouse's comment unless: (a) the patient themselve complains about the side effect, or (b) the patient is incapacitated and the spouse is taking full care of the patient (but more likely that patient would be in hospital).

I think the doctors are not incompetent. They are doing their jobs. For all they know, you could be wacko.

I know it must be hard. But it sounds like you've been doing way too much for him already. I had a situation like this with my mother several years ago (she was on medication, had fits of rage, had difficulty coping with basic life needs, ...). I wrote a letter to the doctor and my mother took it along with her when she visited the doctor (on her own). This seemed to be a great way to approach the situation because the outcome was perfect. I would suggest doing that.

[Anonymous]

Anonymous wrote:Where are you getting your referrals from? Are you going through insurance? (I've been to therapists and the best ones are the ones I've had to pay out of pocket for). It sounds like you have had 2 bad eggs, but it also sounds like your DH isn't doing much to help either. I wonder if she really said "that can happen" or if that is all DH wanted to report to you.

I don't know. It sounds like there are multiple issues going on, and I"m not totally convinced it is just the doctors. Time to find a referral from someone you trust who has seen the therapist themselves.

I have asked people for psych referrals. Its not easy to find personal recommendations from people you know. The only one that came highly recommended was the one who would not take my calls to make an appointment.

Doc one I found at te Thrive center. The Thrive center was recommended by someone that went to it with their son, but that turned out to be not so great. Among the gems that this place offered up was a therapist (not the psych) who confessed upon husbands arrival that he knew him (he had attended a business presentation DH gave for a friend who it turns out is friends with this therapist) and did not offer an alternative therapist or a reschedule. ONly "are you comfortable to proceed?". The psych herself acted "chummy" as described by DH and all she ever talked about wtih me, and rudely, was billing. (We paid all our bills, and she jumped the gun assuming we would not- guess they have a lot of deadbeats there? I dont know).


The other doc I found online by reading online reviews which were absolutely glowing. I had only an "ok" feeling about her, but we needed to get out of the other place. DH never bothered to talk to her before scheduling.

NONE OF THESE FOLKS TOOK INSURANCE!

And we have carefirst bc/bs.

I have never found any psych who actually took insurance.

[Anonymous]

I HAVE posted HERE for a psych referral and got only one!

[Anonymous]

Anonymous wrote:OP, I know you've posted about this situation before.

It's still not clear why your DH can't speak with the doctor directly about these adverse reactions. Get him to call the doctor and get advice about that. The doctor can't go fixing someone's dosage based on a spouse's comment unless: (a) the patient themselve complains about the side effect, or (b) the patient is incapacitated and the spouse is taking full care of the patient (but more likely that patient would be in hospital).

I think the doctors are not incompetent. They are doing their jobs. For all they know, you could be wacko.

I know it must be hard. But it sounds like you've been doing way too much for him already. I had a situation like this with my mother several years ago (she was on medication, had fits of rage, had difficulty coping with basic life needs, ...). I wrote a letter to the doctor and my mother took it along with her when she visited the doctor (on her own). This seemed to be a great way to approach the situation because the outcome was perfect. I would suggest doing that.

Ive thought about the letter approach too.

The reason DH could not call about adverse reaction is because he was having the adverse reaction. When he is in a rage, he does not connect that to anything except his perceived circumstances, which are quite distorted. This then continues after he has calmed down. He still does not to this day connect that there was a huge spike in rage on the increased dosage and now back on the other dosage he is back to his former self.

When DH did talk to the doctors they equally did not respond in terms of any real advice. That is the part that is incompetent. This is not a person taht has tried every drug unde the sun. He has tried ONE antidepressant.

The second doc called him while he was having the adverse reaction (he had missed an appointment) and said three times "I didnt sign up for this". He did not insult her. He was terribly upset and confused. She gave him no advice, like go to the ER, please call when you are more calm, etc etc etc.

I think that is pretty incompetent. A doc should NEVER say to a patient taht they didnt sign up for this, That sounds crazy.

[Anonymous]

Anonymous wrote:OP, I know you've posted about this situation before.

It's still not clear why your DH can't speak with the doctor directly about these adverse reactions. Get him to call the doctor and get advice about that. The doctor can't go fixing someone's dosage based on a spouse's comment unless: (a) the patient themselve complains about the side effect, or (b) the patient is incapacitated and the spouse is taking full care of the patient (but more likely that patient would be in hospital).

I think the doctors are not incompetent. They are doing their jobs. For all they know, you could be wacko.

I know it must be hard. But it sounds like you've been doing way too much for him already. I had a situation like this with my mother several years ago (she was on medication, had fits of rage, had difficulty coping with basic life needs, ...). I wrote a letter to the doctor and my mother took it along with her when she visited the doctor (on her own). This seemed to be a great way to approach the situation because the outcome was perfect. I would suggest doing that.

I think this is great advice. I would also recommend talking to your doctor or someone other professional who may have some suggestions. While it has worked out so far for you, I'd caution using strangers from DCUM for advice on medication dosages. There are certain meds where if you stop taking them or don't taper them properly, they have can have severe side effects.

[Anonymous]

I'm wondering how much the information you are getting form your husband is accurate. By your own admission he isn't thinking clearly.