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Discouraged with the system and losing hope

by Dr. Marie Hartwell-Walker

Lately I feel like I’ve been getting kicked around and going nowhere. I was released from the psych unit at the hospital on Wednesday following a 12-day involuntary stay. My preceptor (psychiatrist) thought I might be a danger to myself and had me admitted against my will. Although I was having suicidal thoughts, I’m bipolar. This honestly happens to me all the time, and I was never in any acute danger. Obviously she didn’t believe me.

While I was in the hospital, I dealt with two separate psychiatrists who had totally different opinions of me and completely different treatment plans. The first guy didn’t even want to bother with me. He brushed me off in such a callous way that I was very hurt, even crushed. The second guy was more open-minded and thought it would be worthwhile to try me on an MAOI, which I have never taken before. He discontinued the wellbutrin I was taking on the assumption that my outpatient psychiatrist would go along with that plan (he even talked to him about it). On Friday, my outpatient psychiatrist said that he didn’t like the MAOI idea and that I should go back to the meds I was taking prior to hospitalization, except without the antidepressant. (Take a depressed person and remove the antidepressant… good plan.)

So what did my hospitalization accomplish for me? Well, it screwed up my schooling. Now I have to take a leave of absence, repeat my psych rotation, and delay my graduation by months. It also did nothing to change my mood. I’m just as depressed as I was before, but with an altered set of stressors now. There have been no promising changes in my treatment plan. I gave the docs over a week of my cooperation as an inpatient in the hopes that they could help me, but it now seems that the entire ordeal was a complete waste of my time and a rather disruptive/destructive force in my life. I can’t think of anything good that has come of this. Nothing.

I’m going into medicine. I’ve always had an interest in psychology. However, this experience has done nothing but leave me disappointed and disheartened. Disappointed that those who are providing my care can’t agree with each other. Disappointed that I would be callously brushed off when I am in genuine pain. Disappointed that one would get my hopes up, and another would put me right back where I was before. Disheartened because when I finally made myself vulnerable and accepted a need for help (like frequent suicidal ideations maybe aren’t normal or healthy), I received three different responses and have made no progress whatsoever. Disheartened because I’m starting to feel like I can’t be helped (or at least no one wants to try). Now THAT’S depressing.

A recommendation has been made for therapy, and I’ll agree that I need it, but I don’t want to put all of my eggs in that basket. I’ve done therapy before. Years’ worth, and it has only been a moderate help. I know I don’t handle stress well, but my history includes bouts of major depression even when everything in my life is going well. Can therapy fix that? Really?

Obviously I’m venting, but I need to know – how do I overcome this frustration, discouragement, and newly-found skepticism as I try to pursue care from the people who I feel have let me down so badly, and who seem to be tired of dealing with me? I haven’t quite given up on myself yet, but sometimes I think I’m really close to throwing up my hands and calling it quits too. That’s when suicide starts to sound so inviting again, because sometimes I think I would rather die than live like this for another 50+ years. I need a reason to hope.


Thank you for writing. I hope you won’t give in and give up. You obviously are thinking hard about options and trying to take charge of your life. I’m very, very sorry that you seem to have been caught in the gaps of the current health care system. Each doctor was undoubtedly doing what they thought best. But it’s frustrating that there wasn’t more collaboration among them. I’m not surprised if at times you want to throw up your hands in dismay. It may be a small comfort to know that many people with a bipolar diagnosis try for years before they get the right providers and the right strategy to manage their illness.

The good news is that it can be managed. Yes, talk therapy helps. I recently attended a reading by David Lovelace who is the author of Scattershot, My Bipolar Family. He also has bipolar illness. He joked that his mechanic takes longer to change the oil in his car than his psychiatrist takes to review and prescribe his meds. Psychiatrists often have to see 3 or 4 people an hour; not exactly a pace where they can dig in and understand what is going on with someone. That’s why the talk therapy piece is so important as a long-term strategy. Your therapist can help you understand your illness better and learn strategies for coping with it and even using its positive aspects. Ideally, there should be a partnership and good communication between your psychiatrist and your therapist and you. Learning how to live with bipolar illness is a process of self-discovery; not just a matter of popping the right pills.

I think you might find it helpful – even inspiring – to read the books by Kay Redfield Jamison and the previously mentioned book by David Lovelace. You are indeed in very good company. Many people with a diagnosis of bipolar are extremely bright, creative, and productive people. Once they learn how to live with the illness, they become their best versions of themselves.

I wish you well.
Dr. Marie


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