Monday, September 12, 2011

No, You Aren't a Psychiatrist "bro."

I have Obsessive Compulsive Disorder. For whatever reason, I didn't take the diagnosis seriously at first. I resisted medication and treatment, but continued to see my psychologist because I knew that something wasn't right. Though she was the one who handed down the diagnosis that I didn't believe, I trusted her. I liked her. I had seen psychologists prior to her, but they had all been male and they made me uncomfortable, which makes sense given my history (well, that and the first psychologist I saw told me that I had nothing to worry about because I was "a gorgeous and intelligent young woman" which put me off trying to get help for another two years).

My psychologist was supportive of my decision not to immediately take up her diagnosis. Like I said, I trusted her. I told her everything, including my apprehension about the diagnosis and my subsequent negative reaction to medication. She didn't press me to change my mind. She didn't nag me. She didn't talk down to me. She listened quietly to all of my concerns and then gently began explaining what OCD really is and why she felt that I should try the medication (but also that it was ultimately my choice). Because of her approach and because she framed OCD in a way that made a hell of a lot more sense to me than the recurrent popular culture definition and portrayal of it, I went to see a psychiatrist she had referred me to. She made sure the psychiatrist was also female. I liked my psychiatrist. We saw each other four times before I finally agreed to start taking medication.

I think that these two women helped me enormously at a time when I really, desperately needed help. They were the kinds of doctors that perfectly fit my needs (and I think that they would still if I were still in the area). When I went back to school I started seeing another pyschologist who was similarly wonderful and really opened herself up for me in terms of support and the time she was willing to give me. I was sent to a psychiatrist who would continue to write my prescriptions for psych meds that, as it turns out, were as helpful as the time I spent with the psychologists themselves.The medication was enormously useful. It helped me. I felt better for the first time in years.

I was reluctant to take the medication at first because I had heard horror stories from so many other people that they knew someone who was prescribed psych meds who were seriously harmed by them. I had been told that psychologists and psychiatrists don't actually care about their patients, but instead prescribe them medications and toss around diagnoses on a whim. But none of that fit into the experience I had with my doctors and I gradually managed to shed this bias against psychiatry in general. Looking back on it, I feel like a complete idiot, but there are lot of people who still find it appropriate to keep on insisting that psychiatry is wrong.

The entire time I was going through treatment, I was semi-open with my diagnosis. I figured it was a big part of me, and that in a lot of ways the OCD informed parts of my personality. I told my closest friends and some of my family members when it became relevant. My new roommates knew. I was okay with it. A lot of them were really supportive.

But then I started paying closer attention to the things that outsiders were saying, and I became more and more confused about the public perception of both psychiatry and OCD.

I was an undergraduate at the time, and I was studying Philosophy and English Literature simultaneously. I concentrated in Medieval Literature as far as my lit. degree went and so I didn't run into anyone who bothered to make sweeping generalizations about the practice of psychology. But for whatever reason, it seemed to crop up with some frequency in Philosophy. I don't know if it's because sometimes people think that Philosophy=New Age and so they enroll in courses thinking they'll be treated to any and all of the alternative theories to EVERYTHING they've read so much about on the internet, but there seems to be at least one person in every course who has to bring up something about science and/or psychiatry that is patently false.

I think the most unsettling objections came during Senior Seminar in Philosophy, when two of my peers would insist both on our class's online forum as well as in person during class time that the health sciences are wrong. Period. One babbled on about how Native Americans didn't take depression seriously and that they were the better for it, while another claimed with tenacity that any and all of our discomforts are the direct result of not being in tune enough with nature. Given the fact that I actually have a mental disorder (AND my boyfriend is a type I diabetic, which is definitely not caused by a lack of touch with nature), I was really put off by these people and felt nothing but contempt for them. Ordinarily I would ignore them as they are obviously sadly misinformed. However, it occurs to me that they don't realize (and probably never even think) about the negative effect they might have on vulnerable people who are on the verge of seeking help.

Psychiatric disorders are things you are expected to be ashamed of. You aren't really allowed to talk about them earnestly, especially not with other people. You are, however, allowed to have an opinion about them, provided it's subversive.

I became more open about my OCD precisely because of these people and I met many more. They tried to engage me in finding "the root" of my problem, explaining that I would never be helped by my medication after a certain point. They'd claim that it stops working because the real cause of my disorder is not chemical or biological: It's the result of some traumatic event that I've blocked out of my mind, and had I tried hypnosis?

Look,"bro." You are not a fucking psychiatrist. I'm aware of the traumas I've suffered, and yes, I've talked about them in depth my psychologists. They do, in fact, think that my experiences in the past have something to do with my OCD. They also think I have PTSD. But to try to tell me that I'm not managing my mental illness the correct way because you happen to have a pseudo-political disagreement with it is insulting AND it's dangerous. You do not try to talk a patient out of treatment, particularly not when that treatment is effective and ESPECIALLY if you are not a doctor.

On top of this, there are some really batshit insane assumptions about OCD that I have been confronted with (in fact, some of them are the reasons why I didn't believe I had it to begin with). I've been told by lay people that there is no way I have OCD, because they watched Monk and I don't behave like he does. I have also been told that I'm lucky to have OCD because I have some sort of magic psychological drive to do the best I can in everything I do (like OCD is an amphetamine or something). Both of these assumptions are false. I've been told that if I went into computer programming, I'd do really well because they need obsessive people. I've been told that if I was really OCD, I would not have quit smoking cigarettes.

I don't intend to explain what my OCD is like, and it's worth noting that like Bipolar Disorder, people DO experience it differently. To provide a full and comprehensive explanation of it would take a lot longer than I care to right now. But, I accept the fact that I have OCD. I'm just completely bewildered by how many other people don't, both on the basis of what they think OCD is and on the basis of what they think psychiatry is. And I wonder, is this purely a cultural phenomenon? Is it unique to the United States? Why do we have such a terrible outlook on psychiatry and psychiatric disorders?

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