Folks who have never struggled with their mental health seem to think of psychiatry as a quick and easy fix. Pop some happy pills and ta-daaaa! Your struggles will magically dissolve.
What these folks fail to understand (other than, like, how psychiatric medications actually work) is that, for many of us who are in the midst of mental illness or crisis, sometimes a psychiatrist’s office can be the most dangerous place for us to be.
When I was 18 years old, my therapist told me it was time to start thinking about medication to manage my bipolar disorder. I was suicidal, experiencing severe dissociation, and was dangerously depressed. I had experienced bipolar symptoms for most of my life, and we knew that medication to help regulate moods could be a game changer.
I went to a clinic that my insurance covered, and saw the first psychiatrist that I could. I knew the situation was urgent, and I was fortunate enough to find an opening sooner rather than later. I filled out the necessary forms, came in for my appointment, and waited for what I assumed was going to be the first miraculous step in my recovery and healing.
When we think about mental health professionals, we hope and even assume that they will be compassionate, encouraging, and at the very least, competent. But the woman that I met at this clinic was none of these things.
Her first question for me was to ask why I was depressed. When I told her I didn’t know, and that I had been depressed on and off for a long time, she didn’t believe me. She accused me of exaggerating my symptoms, telling me that I was “just a teenager” and that I couldn’t possibly be as depressed as I claimed to be.
She tried to shame me for seeing a psychiatrist. She said to me, “You know, I have children, and they’re around your age. I’d be pretty skeptical if they decided to seek out pills to solve their problems.”
Not once in our appointment did she ask if I was suicidal (I was). She didn’t ask about my history with self-harm (long and complicated). She seemed completely uninterested in my past, and instead, spent a lot of time asking about where my parents were, and why I would see a psychiatrist if I was “getting good grades in school.”
When I handed her a list of symptoms that my therapist had helped me to write, she looked at me and said, “Did you just read a psychology book recently and decide you were sick?”
I wish I could say that this was the worst thing that she did. But it only went downhill from there.
After she could see that I wasn’t leaving without some kind of help, she sighed, rolled her eyes, and asked me, “What pills do you want?”
I was completely baffled. What pills do I want? Wasn’t it her job to prescribe a medication that made sense based on my experiences? Wasn’t it her job to make an educated decision on how to manage my symptoms?
“I don’t know. My aunt takes Prozac,” I said quietly. “Should I be taking Prozac?”
“If it worked for her, maybe it’ll help you,” she told me, completely apathetic.
She wrote me the prescription and told me to leave.
This psychiatrist had confirmed that I did, indeed, have bipolar disorder. There was no confusion there. And yet she prescribed me an antidepressant without telling me that antidepressants can increase the risk of mania or rapid cycling in folks who have bipolar. Most psychiatrists will prescribe them with a mood stabilizer rather than prescribing an antidepressant alone because of this risk.
(Of course, I learned all of this from my next psychiatrist who, upon learning that I had taken Prozac by itself, looked at me and said, “I don’t understand why any trained psychiatrist would’ve done this.”)
Instead of prescribing a medication that took into account my diagnoses of anxiety and bipolar, she let me choose my own medication – as if I had gone to medical school and had a background that made me at all qualified to prescribe meds to myself.
Let me say that again: A so-called medical professional let a teenager prescribe their own drugs.
I was so very young, and in no way equipped to deal with the very serious disorder I was diagnosed with. I came to her for help – in arguably the most vulnerable place a person can be – and I was shamed for it, invalidated, re-traumatized, and worst of all, prescribed a medication that endangered me.
I trusted her, and she failed me.
And yes, of course, I began rapid cycling. I experienced volatile mood swings, vivid suicidal ideation, mania like I’d never seen before, complete breaks from reality. I scared everyone around me, including my parents, who at that point didn’t have much knowledge about bipolar and thus often missed the red flags with my episodes.
It was pretty exceptional stuff if my parents were taking note.
At my mother’s urging, I called the psychiatrist. I assumed that, perhaps, it was an honest mistake. But to my complete shock, despite several urgent voicemails, she did not call me back.
Not only did she endanger me with the wrong medicine, but when I called her in crisis, she made no attempt to help me.
My gut said that this psychiatrist had no right to invalidate my pain or shame me for asking for help. My gut said that asking a patient to choose their own pills was not how psychiatry was supposed to work. And my gut said that she had given me the wrong medicine, and that she should be held accountable for irresponsibly ignoring all of my calls.
But I was a teenager, and I was afraid. She was well-respected at this clinic – one of the best, I was told. It was my first time ever seeing a psychiatrist, and I thought that maybe this was just how psychiatry worked. Maybe it really was just quick and abrasive. Maybe I was being too sensitive.
Looking back, I deeply regret not making noise for the very clear wrongs that happened here. While I am in no way to blame for what happened, I fear for all the patients that came after me, especially the younger ones who are in many ways the easiest targets for this kind of abuse because we are placing our trust in adults that we are told are there to help us.
The sad part about it is that these psychiatric horror stories are not at all rare. We often come into these offices very vulnerable, even afraid, and are expected to somehow advocate for ourselves. We are asking for help, which is the most difficult thing in the fucking world to do, and when a professional preys on that vulnerability, it can be disastrous.
I share my story not to scare folks who are considering psychiatric interventions or discourage them from seeking help. Because as terrible as this was for me, and as long as it took to get past it, psychiatry as a whole has still helped me immensely. I’ve had the great privilege of having doctors that I can honestly say are my heroes, who modeled the kind of compassionate and competent care that we all deserve.
But people need to know that psychiatry is not infallible. That doctors and psychiatrists, too, are not infallible. In fact, in my experience as an advocate, I can tell you that abuse, intimidation, shaming, and endangerment by so-called professionals is not exceptional. In fact, tragically, it’s all too common.
Folks who are seeking out a psychiatrist need to know that they are entitled to the best possible care. If something feels wrong, if the experience was traumatic, or if there is an issue of trust, you are not obligated to continue seeing this person. I’ll repeat that: You are not obligated to stay. You’re not even obligated to be “nice” or polite, especially if you feel unsafe.
You can leave at any time, or call them out if you feel like you’re in a position to do that. You can seek out local mental health organizations if you feel you might have been the victim of abuse, and of course, any feedback you can give the clinic, even if it’s anonymous, is vital.
Well-intentioned loved ones who push us to seek out psychiatrists need to understand that this is not an easy bake oven, where you hand us over to a psychiatrist and we emerge on the other side perfectly composed and healed.
If you are invested in our well-being, I would encourage you to keep an open line of communication with us. Ask us about our psychiatrist. Don’t pry about the details of what we shared, but do ask us questions about the experience as a whole. “Did you feel safe? Did you feel validated? Did anything feel off or wrong? Do they seem trustworthy?”
Those questions can actually be life-saving.
While it’s clear that reform is needed to address the lack of quality psychiatric care and the dire inaccessibility of that care, it is crucial that we advocate for our loved ones to ensure that they are receiving treatment that does not hinder their healing, but rather, facilitates it.
I walked away from my first visit with a psychiatrist feeling like an imposter. Maybe I was a liar. Maybe I was wrong to ask for help. Maybe I was selfish. I walked away confused, more fearful than ever, and convinced that nothing could get better.
This should go without saying: No one should walk away from a medical professional feeling ashamed, afraid, and traumatized.
It took me years before I could write about this experience, but it’s my hope that sharing this story can give insight into the kinds of struggles we face not only as folks with mental illnesses, but as people trying to navigate a failing system.
I am not the first person to encounter abuse in the office of a psychiatrist, and I will certainly not be the last.
So when you gently suggest to a friend that they “just see a psychiatrist” as if it’s a walk in the park, let me remind you that it’s more like a bath with piranhas, or slathering on some honey and slow dancing with a bear.
You should probably, you know, adjust your sympathy accordingly.
Sam Dylan Finch is a queer activist and feminist writer, based in the SF Bay. He is the founder of Let’s Queer Things Up!, his blog and labor of love. With a passion for impacting change through personal narrative, Sam writes about his struggles and triumphs as genderqueer and bipolar with the hopes of teaching others about his identity and community. When he isn’t writing, he’s probably eating takeout and dancing to Taylor Swift.