diabetes Depression Compounded

[geb]

Hello, this is my first post here.

I have been treated for depression for a little over twenty years now. I have had various success with therapies and medications and have been essentially stabilized for the past five years.

I left the USAF in '87 and was subsequently diagnosed with chronic depression. I was attending a large and prestigious state university at the time and had the opportunity to be diagnosed and treated by many of the most reknowned mental health and specifically depression-research clinicians in the country. While in college I took the opportuntity to learn as much as possible about my condition.

Approximately ten years after graduating college I found myself unemployed, alone, withdrawn and without many resources. I enrolled in the VA outpatient clinic in my area and was seen and treated by many fine clinicians in the past five years. I was essentially stabilized. The service related aspects of such mental health conditions are, understandably, open to much useful debate -- I'd rather not engage in that here.

About five months ago my primary doctor within the mental health section moved on and I was assigned another. Soon my depression was compounded. This has been the most disspiriting and demoralizing experience I have ever had while dealing with this condition -- and now it seems far from over.

As I noted, I've been diagnosed by some of the most highly regarded clinicians in the country at a world reknowned facility devoted specifially to the purpose of researching and treating depression.

I now found myself under the care of a doctor who took it upon himself to entirely overhaul my profile - in a disturbingly aggressive manner. He told me that I didn't need medication. Fine. I was fully willing to hear him out.

In the course of the next four months he proceeded from one enthusiastic declaration to another -- I was obsessive/compulsive. I was traumatized by something awful in my upbringing. My descriptions of some past experiences suggested to him evidence of manic behavior. I would benefit significantly only (in his opinion) through "two chair gestalt" therapy. I asked what benefit 45 minutes of "gestalt" therapy once each month would do for me and he responded that it was all he could offer. He just made the diagnosis, the rest was up to me.

He was so enthusiastic and excited that I kind of went along for a bit. He finally had me so twisted in the wind that I'd had enough and decided to change doctors. The last two visits with him were actually testy exchanges of wit and sarcasm in which he finally derided me for being stubborn. I was absolutely shocked and astonished by the exchanges I was having with a mental health professional. Im not exaggerating to say that he frightened me a bit. I havn't mentioned yet that he is the head of the unit that comprised approximately eight other doctors.

Now my depression is compounded. In my records now is a diagnosis for Obsession/Compulsion - suggestion of childhood trauma/abuse - manic behavior - and finally, given the testy challenge of wits that concluded our visits, god-knows-what suggestions on his part that I might be dangerous.

This is all complete nonsense from someone who very likely needs a good deal of psychiatric intervention himself. But right now I am truly worried. I have spoken to the patient representative at the clinic and have decided that this mental health unit is compromised enough to me by his presence that I'm moving my primary care to a neighboring city sixty miles away.

I was ready to go back to the patient representative tomorrow and request that any notes and comments contributed to my files by this doctor be removed. This, it seems to me, is only reasonable if I could make a clear case to the proper VA authority. I did some research online and have discovered that this is unlikely to happen. It seems that medical files may be amended but under no circumstances wholly deleted.

This is pretty unsettling. Diabetes, cancer, xrays, major surgeries, medication, etc.. Clearly such concrete and discrete information cannot be amended. But I am now labelled by some loose cannon with an oddly inspired mental heath diagnosis that will stick to me for the rest of my life?

I cannot believe that I have no recourse here at all. If anyone can help me with similar past experience and subsquent success at a remedy I am at your mercy. I am so dispirited by these events that don't know which way to turn.

Thank you very much, sincerely, for this forum.

[cowgirl]

Liz; do you have a current copy of your Cfile? When you ask for the notes, it may be a great time to request a complete copy. My last request took well over three weeks and that was by snail mail. Yes, I hope you do request assistance and if possible have a supporter in the room when you do so. An idea is to type a request letter addressed to the office you are visiting; that may be filed in your Cfile some where in the future too.

A question; Do you believe the patient;doctor relationship has been "compromised" at the VA you have been going to? Can you request another doctors care, say at a military installation or other government facility? Will the VA consider your request for a different physcian or "off campus" care?

Wishin' you best thoughts!cg

[john999]

If you want compensation increased for a mental condition stay away from any doctor who talks about you having a condition related to your childhood. This plays into the VA's pre-existing condition thing.

[jmack]

Sorry, for what you are going through. I'm with Pete geb. Best of luck.

jmack

[cowgirl]

So true. Took 3 very different doctors to get a valid diagnosis of current SC MDD. Still cant get over childhood "personality disorder" tag first "contract" ikky pysch used, yup, that terminology still bugs me, has caused me more stress than I can or will put here. When I researched a year later for that particular Doctor; didnt appear anywhere in the town or state for that matter; bit interesting, eh.

I am happy with myself to have continued admitting my sadness and requesting mental care during intakes with other clinic appointments (feet, flue, back,etc). I got a true professional "puzzle solver", why I'd even mortgage my pocketbook to see this doc! Best thoughts to ya,cg

If you want compensation increased for a mental condition stay away from any doctor who talks about you having a condition related to your childhood. This plays into the VA's pre-existing condition thing.

[geb]

Thank you all very much for your additions to this thread.

It is always a comfort to meet fellow travellers on the same path for a while.

This seems to be a pretty well balanced board for the range of comment I've read here and in other threads.

Looks like I'll be requesting a look at the notes added to my file by this doctor and then formally requesting my Cfile since it's been mentioned that it may take a bit of time to get. Perhaps I can discuss "amendments" to his notations when I get reassigned in the neighboring city.

One other point made at another forum was checking the status of being "flagged" in your file. Seems that you can ask, you can look over the shoulder of the VA staff accessing your file, or you can submit the appropriate forms to check on this. There is a box at the top of a patients efile that can be highlighted to indicate to any subsequent personel using your file that you may pose a physical danger to them.

Such a notice is a very useful tool when dealing with the truly violently imbalanced. As another patient in the facility, I'm glad it's there -- sincerely. But some patients (doesn't take a great deal of imagination to see the possibilities) have discovered that their "care-giver" has taken the opportunity to simply put them "on the radar" with this flag as generally troublesome. I'm afraid that "troublesome", simply by virture (and i do mean virtue) of wishing to be treated with optimum fairness, might apply to most of the members of this forum. In any case, I'f I were to discover such a flag resulted from my conversations with this doctor, I would demand some form of peer review and dissection of whatever notes and tape recordings were available, and try to salvage just a little more of my reputation.

I suppose the points discussed in this thread must affect other clinics and proceedures, but mental health presents another host of opportunites/obstacles to getting into, and back out of, bad relationships. Can any part of this care be the subject of a rigorous scientific method? Virtually none! The "acadamy" comprising this branch of care-givers is still riddled through with "flat-earthers" and all these types need to display to their gatekeepers on that path toward their wall of certificates is sufficient cunning and persuasion and the right dash of earnest. Scary thought.

No more effective at his job than a gypsy with a dark room and a glass globe (persuasion can be a great placebo to the mentally anguished) a bad psychologist can eventually end up heading an outpatient clinic in a mid sized American city! This could never happen in the case of a radiologist, heart surgeon, eye/ear/throat specialist, or frankly any other health professional in the system. For all this I should be able to suggest something, but I cannot.

It seems to be the best we can do until some true copernican genius (to maintain the analogy above) is able to map the brains chemical and geographical architecture sufficient to get beyond the Jungian Freudian XXXXian (et al) sandtraps that many sufferers still find themselve in at the hands of certain quacks. We're likely to have colonized mars well before this is accomplished, so I'm afraid we're just stuck doing the best that we can. I'm glad that tools such as this forum are available to us in negotiating this mess.

Very best of luck to you all, and thanks again for the input. I'll stop back in occasionally to update progress on this thing.

[goofycow]

cowgirl;

I can find no one in the VA organization to takem my side. I have written to my congressmean & senator. They defer to VA's spin. Surprised?

The issue of personality disorder never came up during my 20 year navy career. I had a top secret clearnace. Not only did they allow me to re-enlist on several occassions, they actually PAID me to do it. When I was battling weight issues toward the end, the Navy could have saved a ton of cash by kicking my butterbutt out the front gate. Instead they sent me to a 6 week inpatient faciliity for eating disorders at considerable expense. Why did the Navy send so much money & time on a malcontent?

Everytime I ask for a new shrink, it just gets worse. If i could sue the bastards, I would! :)