Seeking A Psychiatric Referral, Part 1

Fighting with health care practitioners for the sake of dealing with more health care practitioners.

Image by Gerd Altmann from Pixabay

"No."

His answer, short and abrupt, clapped like thunder. Silence reigned in its aftermath.

There was no follow-up, no explanation. Not what I expected after asking for a referral to a psychiatrist.

When the shock subsided, I pressed, and Dr. T offered his impending retirement by way of excuse. He would be retiring soon, he explained, and wouldn't be able to follow up, therefore I should wait until my regular GP returns before seeking a referral to a psychiatrist. My usual doctor had disappeared without notice, leaving Dr. T as the only available alternative at the clinic. The clinic itself, probably one of the worst in Vancouver, kept a tight lip when it came to my doctor’s expected date of return. Left in the dark, it dawned on me; I likely wouldn't get the help I needed.

It was early 2020, life as we knew it hadn't quite blipped yet, but my mental health was already in sharp decline. In conjunction with regular talk therapy I had spent a year on Trazodone, my first antidepressant, but despite an increased dose, the benefits diminished. My insomnia worsened in frequency and severity, my mood dipped to a debilitating new low, and my suicidal ideation could no longer be ignored. Prior to his disappearance, my doctor and I had made a plan to drop the Trazodone and start Mirtazapine, a tetracyclic antidepressant. I stuck to half of our plan.

Weary from my experiences with Trazodone and its side effects, I filled but never followed that Mirtazapine prescription. The bottle of pinkish pills sat diligently on my desk as I self-managed my mental health in a number of questionable manners. It was a rollercoaster. (I promise I’ll tell those stories in the future.) My methods proved pointless, I knew I needed another approach. Still, the decision to seek a psychiatric referral wasn't entirely my own.

Strong-armed are strong words, but my therapist took exception to my reluctance to properly treat my own depression. There may have been a thinly veiled threat to report my suicidal ideation to the appropriate authorities. I agreed it was time to give medication another try, preferably under the guidance of a psychiatrist. Which brings us back to that day in Dr. T’s office.

An elderly man who spoke over me, two-finger typed and waited far too long before pulling his mask back over his nose, Dr. T was a far cry from my ideal GP. The idea of following up with anyone other than him coated my disappointment with some small measure of relief. Still, I was stuck. No psychiatric referral, no advice on medication, no plan.

There's a certain amount of shame I carry from that encounter. I didn’t advocate for myself. I didn’t fight the clinic for more information on my GP's return or demand to see another doctor. I didn’t seek out another clinic or another doctor to refer me to a psychiatrist. I didn't seek out emergency services. Instead, I turned to that bottle of Mirtazapine sitting on my desk, and with no guidance save for a drug facts sheet, I swallowed the first pill. 

It would take two years of trial and error, a new doctor, a new therapist, five more medications, and countless days lost to depression before I would once again seek a psychiatric referral. I'll share that even more ridiculous story in my next post. In the meantime, please subscribe for more, share this post, and share your own experiences if you're comfortable doing so. Every little bit helps break the stigma.