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Psychiatrists, Psychologists, and Therapists- the Good, the Bad and the Ugly, or Knowing When It's Time to Bail

Scott Wilkerson
Comments by Lori Wilkerson

One of the hardest things that I still struggle with today is my doctors. I've been treated by physicians, psychiatrists, psychologists and a few other "ists" that I'm not sure what they were (although I will admit that one that fit in the other "ists" categories was one of the best at helping me).

At one point in my life, I was on top of the world. I was in an industry dominated by people 20-30 years my senior, but I managed to finagle my way to a coveted position with power and money. None of my peers in the industry were even remotely close to my age. Part of the reason for this rapid ascent was because I have bipolar disorder. Unfortunately, it also led to my eventual downfall.

When I first started in the industry, I worked incredibly long hours and was tireless at achieving goals. I also had unbelievable ideas that were so far out there that nobody could believe they actually worked. When I wasn't a raving lunatic, I could charm anybody into believing anything I told them. It was about this time, however, that everything began catching up with me. When I would travel on business, which was frequently, I would always sleep with a different woman each and every night, whether I picked them up in the bar (and sometimes it was two women) I was getting drunk in, or I called an escort service, which is simply a pretty name for a professional prostitution service.

As you can imagine, it wasn't long until I got caught. I was so out of control, I was putting whores on my credit card. It didn't take long for my wife to find out and things got very ugly, very quickly. My uncle came to my rescue; he took me to see a psychiatrist who diagnosed me as bipolar and started me out on low doses of Depakote and some anti-depressant. Over the course of several months, he kept upping the Depakote and changing anti-depressants. I don't remember how many he tried, but at least three. I remember thinking that there had to be something better out there, but didn't know how to find it. While I was seeing this psychiatrist, I went to see my uncle's therapist. I went one time and knew this guy wasn't for me. He was a body-builder, arrogant, conceited, and self-centered. All he wanted to talk about were his body-building trophies and how women were bitches and the ruin of men; this theme will come up years later and haunt me again.

At this same time, I received an offer from a Fortune 100 company that gave me a set career path and a 45% pay increase. This offer came via a head-hunter who had heard of me and tracked me down. Like I said, I was good at fooling people and performing on the job. I relocated to Ohio and continued to keep it together in the surface.

With new surroundings and a new company came new doctors. I tried a couple of psychiatrists and settled on a woman about 40 minutes north of my home. She had a therapist in her practice that I spoke with once or twice a month, not enough to do any good. The psychiatrist saw me monthly and also kept upping the Depakote until I reached 2000mg per day. She also had me on a couple of different anti-depressants, but she added Ativan into the mix. Life went on and was good for awhile. For the first time in my life, I had friends. They were actually the parents of my daughter's friends, but I think we were all friends. It felt good, I felt good most of the time. Then there was the corporate merger, which ultimately resulted in my firing (which I will go into detail about in another article). Again, my world came crashing down around me. I was too young and too highly paid for my industry and position (I was actually told this by a V.P. of a major corporation). So I kicked around between jobs for several months until the money ran out and we moved back home.

Another move, another psychiatrist with his own therapist on board. Sometimes I think it should be unethical for therapists and psychiatrists to be affiliated in any way; nothing ever gets challenged or questioned otherwise. I went to a psychiatrist that my wife (we soon after separated and then divorced) wanted me to go to. It was one that her uncle went to. I will call him Dr.U. Dr.U upped my Depakote to 2500mg/day, and over the short time I saw him had me on numerous different medications. In the end I was taking Ativan several times a day, the Depakote, a couple of other meds, including Zyprexa, Wellbutrin and a couple of anti-depressants. The Wellbutrin was given at the maximum allowable dose, and I suspect some of the others were as well.

During this course of treatment, I fell deeper into depression, became almost completely withdrawn from my family, was really paranoid, had the shakes so bad I couldn't drink without a straw or eat soup, and was still extremely anxious almost all of my waking hours. I was quite literally in hell. The only thing that I enjoyed in my life, my daughter was being taken away by the in-progress divorce. Dr.U didn't seem to care a whole lot about my getting worse, nor did the therapist in my office. Although I will admit that I was an expert by this time at covering up my real feelings when talking to the therapist. But he was the expert, the professional; shouldn't the therapist have realized by my actions, language, tone, etc. that it was all a ruse? I guess not.

During this time I became reacquainted with an old high school classmate via e-mail. I felt comfortable enough with her to tell her I was bipolar and having a rough time. She told me her sister (I will call her Dr. S) was a psychiatrist and had a supervisor, Dr. L, who was excellent, highly regarded, etc. She said she would have her sister contact me if it was okay with me. At this point I felt any help was good help, and the more help the better. So we talked some on the phone and she compared Dr. L to Gandolph from The Lord of the Rings. My initial conversation with Dr. L did not impress me. When I next spoke with Dr. S I said he reminded me more of Frodo than Gandolph. This was my honest assessment and expected some dialog to follow that would get to the root of my impression. This didn't happen, what did happen was that Dr.S got very irate, started yelling at me, telling me "Who do you think you are and what made me think I was in any position to judge this great man…?" I should have known then that these people weren't right for me, but I was so far down and feeling so worthless at this point that I believed her. (If this same scenario would have happened today I would have told her off immediately and reported her to the licensure board for her state). Instead, I chose to move forward and Dr. L and Dr. S decided that another young doctor in their group could handle my case and be within my price range. Money always seemed to be the driving force in their practice, which should be an indication of what is most important to them, $ not patients. This group protected their financial interest very well; later on they got to my parents and had my mother believing Dr. L was godlike. This young guy I was not real impressed with as far as being helpful, but he was easy to talk too and he did get me started writing in a notebook everyday, which I have found therapeutic on its own.

Somewhere in here things went downhill rapidly, spiraling out of control actually. I can remember lying in bed, covers up to my neck knowing bugs were crawling around in me, under my skin. I wrote about it as it happened, it was weird. I began using the Internet to meet people, and hooked up with a woman, far from my intellectual equal. We were about as opposites as you can get, but she had a great body and liked to screw. Sexually we were what I call highly compatible; we rocked each others' world. Some people just really hit it off in bed, but you have nothing else in common, including feelings. Some people you love so deeply it hurts, but in bed it's just so-so. I've learned that the latter is better. I digress, that relationship was the only good thing in my life, or so I thought. But she broke it off, probably because I was so out of control and pathetic.

Shortly after the break-up I ended up wanting to kill myself. Not over her, but just because I was so far gone and nobody was helping me and most, I thought, didn't even care. How my doctors couldn't see this coming I'll never know. Prior to The Night, I had two suicidal ideations; both were in a car. The first was a woman in an on-coming car looking down and swerving into my lane. I didn't take evasive action, I didn't blow the horn, I took off my seat belt. I figured very quickly (because my mind was racing as it always did) that this way my family could sue for big bucks and my daughter would be financially taken care of, and I wouldn't be a bother to anyone any more. But it wasn't meant to be - she looked up at the last second and missed me by only a couple of feet. The next day I was driving at a high rate of speed, probably over 90mph, down the interstate and a tractor trailer approached me. I figured I could cross the medial and hit him head on. It was night and there was no other traffic. I thought the truck driver would probably have his seat belt on and the size/weight differential between the two of us would spare him getting hurt too badly. At the last second however I jerked the wheel to the right, careened off an exit ramp, slid into a parking lot and sat there silent for some time. I then picked up my cell phone and called Dr. S. She calmed me down and assured me I was going to me okay. I don't really remember what was said, but I did proceed to go down to see my sex kitten.

At this point I would think there would have been a red flag waving in the storm; that Dr. S and Dr. L in all their glory and wonderfulness would have done something to stop the train wreck that was happening. I was wrong. Nobody seemed to think these incidences were any big deal. Let's review: bugs crawling under skin, can't drink or eat because shaking so bad, and taking high doses of 6 or 7 medications that aren't working, condition worsening, suicidal ideations, reclusive, only goes out for sex… nah, nothing wrong here. This, folks, is WAY beyond the point of getting a new doctor. This almost led to the biggest tragedy my family would have ever seen. One night I was just lying in bed as usual and decided that the time had come to relieve everybody of my burden. So I wrote a goodbye letter to three people, a friend I was recently in contact with from college, the woman from high school whose sister was Dr. S, and I don't even remember who the third was, I just remember writing three e-mails. Then I went out in my car, a brand new, very fast (I'd had it over 125mph before), Camaro that my daughter loved for the T-tops and stereo, and was going to hit a bridge abutment or something. By the time I got to the highway I had decided that I was absolutely not going to hurt anyone else in the crash. So I drove around I-70 and I-79 looking for the right spot. Each time I found a good spot there would be another car too close to risk it, besides I really didn't want anyone to watch me. After about an hour I realized how horribly this would impact my daughter and called it off.

I got off the highway immediately and drove slowly toward the hospital, I knew nowhere else to go. I called my local therapist, I guess hoping he would meet me or something, and all he said was go to the emergency room and hung up. So I called my (separated) wife and told her I was going to the emergency room, that I needed help and could she call my parents to come by the hospital in the morning, because they wouldn't be allowed to see me tonight anyway. On the way to the hospital I gave wrecking the car one last thought, just to hurt myself, maybe that way everyone would realize how serious the problem was. But I didn't. When I got to the hospital the nurses were excellent. I didn't write down a reason on the sign in sheet for the visit and when they inquired I took the nurse aside and explained why I was there. She very discretely took me into a side room, made sure I was safe and fairly stable, and then explained what would be happening the rest of the night. She told me I would have to strip down and put a gown on with a policeman present, and I told her that it wouldn't be a problem.

It's funny, they never let you alone in the ER when you're suicidal, but they will if you have a knife in the chest. Everything seemed fine until the cop hand-cuffed me to the bed, which was a small detail the nurse failed to mention. I didn't see a doctor until the next day, when Dr. U took me off of everything I had been taking, and was amazed that after six days of group therapy, etc, that I hadn't come out of my deep depression. Dr.U then decided that ECT (electro-convulsive shock therapy) was the only course of action. He set it up for the next day. I was flipping out, literally. There was no way in hell I was going to have ECT without another opinion.

I called my parents and a whole host of calls took place between my parents, Dr. U, Dr. S, Dr. L and my sister-in-law who was a nurse in Pittsburgh. Dr. U demanded that ECT be done. The next day I had my review with Dr. U and all of his colleagues. I made one hell of a scene and got into a shouting match with Dr. U in front of everyone. As a result of this debacle, my parents had until midnight to find another psychiatrist that would take me or he was going to turn me loose and drop me as a patient. Don't keep the nuts so we can treat them, let's just piss them off and then turn 'em loose. This is SOOO beyond needing a new doctor that it's almost comical, if it weren't so tragic.

Lori's Turn:

I don't know if Scott remembers much about the condition he was actually in during this phase, but I visited him while he was in the hospital, and I agree completely that Dr. U was out of line and that a second opinion was absolutely necessary. From the time Scott was taken off of his medications, he was infinitely worse, and to this day I don't understand why he was abruptly taken off all medications and then simply expected to go to counseling in that condition every day. He was going through drug withdrawal.

When I saw Scott my heart broke. He was shaking so badly he couldn't hold a cup of water without spilling it, he drooled constantly, and his eyes were dilated and glassy. It was obvious he was about to fly into a million pieces, and when I tried to talk to him, he confided that he felt "crawly," like his skin was on fire or moving, and any time someone talked to him, he wanted to lash out. He was ready to snap or break down and cry at any second, and his pain was absolutely raw. Then, just twenty minutes later, he became nearly catatonic and excused himself to curl up on his bed and stare at the wall.

Back to Scott:

My parents found a doctor near Pittsburgh that would take me, Dr. H, so I was transported by ambulance that night to another hospital. Dr. H agreed to work with Dr. L and Dr. S. By now Dr. L had gained my parents confidence so he was set. I spent another week in the new hospital and was released. Dr. H prescribed lithium in the hospital and I was given Ativan as needed, however on some days I was taking 4mg within an hour. I constantly paced the halls, doing lap after lap around the central "pod." I joined in the arts and crafts class and remembered how proud I was when I painted a couple of plastic sun catchers. I thought, how silly of me to be so proud of such a childish task. I ended up giving one to my daughter later.

Lori's Turn:

This is one of those moments when I read something about my brother that he has never shared with the family and I realize how many baby steps it can take for him to achieve wholeness after he has been through a severe episode or a prolonged depression. Even here he downplays the pride he felt when he painted some sun catchers in the arts and crafts class, but I can almost imagine how that felt after months or years of despair. I ache for him, and wish I could have seen those sun catchers - I would not have laughed, and I would not have thought it silly - I would have been proud of him.

When you finally begin to feel like yourself again, every achievement is a major step and there is joy to be found in the smallest of things. If you have bipolar disorder, you should not diminish the potency of anything you can take pleasure in, no matter how small. It is often the little things that end up "jump starting" your return to enjoying a normal life.

Back to Scott:

After I got out of the hospital I seemed to slowly recover. My blood was monitored weekly at first, then bi-monthly and finally monthly. I now take 450mg of lithium four times daily. I saw Dr. H monthly and his therapist, a very nice woman with whom I was very comfortable. I saw her weekly. She was very helpful, and to this day I believe she has been the best therapist I have ever come across.

I ended up trying to speak with Dr. S on the phone, but she deemed me too difficult of a case for her to handle, and she was the director of a V.A. mental hospital. I guess I was REALLY crazy. So instead I started talking to Dr. L, her mentor. At this point I was in my mid-thirties, unemployed, divorced, living with my parents and crazy.

When I got out of the hospital, my wife filed a Petition for Emergency Relief. What this meant was that my ex didn't want me near my daughter. The court granted her petition and I was devastated. I couldn't imagine how she would actually believe I would ever hurt my own daughter. All of my time with my daughter, limited though it was, had to be supervised. However, the judge did waive the stipulation that it had to be with someone appointed by the court, and allowed the supervision to be adults in my family. The petition was only in effect for a couple of weeks until Dr. H's findings could be reviewed by the judge. Dr. H told the judge that I had never been nor currently was a threat to my daughter, and that in fact it, was thoughts of her that actually prevented me from continuing with the suicide.

So I was seeing Dr. H monthly, his therapist weekly and speaking with Dr. L a couple of times a week. Dr. L always wanted me to talk with him exclusively, to drop the lady therapist I liked so well. So to appease him, I just acted like I wasn't seeing her any more. I went back to college, WVU, and commuted for one semester, but the drive got to be too much so the family bought a townhouse that I could live in. I had also met a beautiful, young woman 14 years my junior and I fell almost immediately in love with her. When I moved to Morgantown, I could no longer see the female therapist or Dr. H, it was too far for even me to drive.

At some point, Dr. L slowly took control of my life. He wanted a say in what classes I took, how, when and where I studied, whom I dated and how I should live my life. He basically despised my girlfriend because she also had mental problems with which I had to contend. He did not like her past or how she conducted her life. Over time I found out that Dr. L pretty much hated all women. He always put them down, he said numerous times that women couldn't be trusted, that they all had ulterior motives, and that in any relationship, especially marriage, there is no benefit to the man, he will always get screwed in the end by the woman. But somehow he kept my mother hooked, so I stayed.

If I would ever challenge or question something he said, he became irate, argumentative and condescending. He would insinuate that I had no right to question his authority and remind me of his numerous qualifications to "put me in my place." At one point my girlfriend became severely depressed and suicidal. All I could do was stay with her 24/7 for an entire week, and literally beg the Dr. L to take her on has a patient. I didn't know where else to turn. So he did, and he did a whole battery of tests ($2000 worth). He came to some conclusions, and wanted her to be on a certain medicine. It wasn't until this time that I found out he wasn't a psychiatrist but a psychoanalyst. I asked him about this and he spewed some bullshit that convinced my parents and me to some extent, but not totally, that this was okay and a misunderstanding on my part, not his.

My girlfriend initially talked with him twice a week for a few months but was never comfortable with him and she asked me to call him and tell him she was going to seek other options. Dr. L had always said that not every doctor-patient relationship works out and that everyone has the right to choose and change their doctor. However, this apparently worked in theory for him, but not in practice. He was pissed when I called to tell him that she wouldn't be using him any more. I was calm, and simply explained that she wasn't comfortable talking with him and that she wanted to try someone else locally. He was upset that she didn't call herself, that he took her in as an emergency situation, and that she was leaving after "all he had done for her" and because everything was done as a favor for me. I don't remember what I said, but I know the conversation didn't end well. My girlfriend has since that day become my fiancée, and although we have our problems and struggles, we love each other and have our long-term future pretty well mapped out. As for her test results and interpretations, we still don't have them over 1 ½ years later.

Eventually, I stopped going to Dr. L not just because of the disputes over my fiancée, but because of numerous problems with his unprofessional behavior. Dr. L liked to tell stories about other patients to me. In fact, he once told me something about my fiancée that she had told him during a session (fortunately, she had already confided this information to me). He would often spend ½ our time talking about his women problems, other patients, and how great he was. He would give unsolicited personal advice that I thought was unethical and immoral, but he continually did so. By now we were talking on the phone three or four times per week, way more than I wanted to, but he played my mother and me against each other very skillfully. I think this was all part of his ploy to get me to "need" him, especially as mediator between my parents and myself.

When my fiancée and I made the decision to live together, Dr. L insinuated himself into the discussions between my family and myself. In fact, he insisted on being a mediator and "setting the terms" and negotiating how things would work since my parents were helping me out financially. Keep in mind that none of us asked him to do this - he insisted that this was necessary for him to continue treating me, and demanded group sessions for the entire family.

As time went on, Dr. L began repeatedly calling my parents without my permission and discussing my case. My parents, of course, liked getting the additional information and having their own "inside track" on my condition, despite the invasion of my privacy. However, when they discovered that Dr. L had blatantly lied to them one too many times in an effort to set us against each other to his advantage, everything fell apart.

Lori's Turn:

Part of the reason, I think, that our parents loved Dr. L so much was that the man fed my mother's needs so well. He constantly told my mother that Scott ( who undeniably is a bright, intelligent man) was a genius and could do anything he wanted to do. He also told her that Scott should continue pursuing his education indefinitely, going to grad school and getting at least a PhD.

His focus on Scott's intelligence rather than Scott's bipolar fed my mother's desire to ignore the real issue. She always said, "Dr. L says Scott's a genius. He should go to school more." It was frustrating. I wanted to scream, "He could get fifteen degrees and still be unemployable if he doesn't get his bipolar disorder under control, Mother! He'll just be an overeducated, smart, crazy person!"

Back to Scott:

After an incredibly heated argument on the phone (I recall calling Dr. L a "hypocritical bastard"), I informed him that I would be finding a new doctor. It was, looking back, one of the best things I've ever done. I now have a psychiatrist and therapist who are helping me immensely here in Morgantown, and have become much more stable. My relationship with my parents has also improved greatly.

Lori's Turn:

I agree 100% with Scott's assessment. Most of the time that Scott was seeing Dr. L was a drama with Dr. L at the center. This doctor even called me at my home one night looking for my brother because he hadn't called him for a scheduled telephone call, and then proceeded to ask me questions about Scott and to talk about him. I knew right away that this was entirely inappropriate, and told the doctor that I didn't want to talk to him without Scott's permission. Dr. L replied that Scott didn't always do what was in his own best interests. The man was an appalling doctor.

Back to Scott:

The tragedy of this is that Dr. L was a professional and took advantage of all my vulnerabilities. I have a habit of second guessing myself and questioning my judgment when it comes to doctors and therapists, and I let the situation with him drag on for far too long. In part this was because my parents were so pleased with him, which I'm sure he counted on. After all, I had caused my parents years of aggravation and they were helping me out with housing and financial support - I didn't want to disappoint them. Since then, I've learned that it's far worse to ignore your instincts because there's more damage in the long run to yourself and your family from bad doctors and therapists than anything else.

So any time you're evaluating a physician, psychiatrist, psychologist or therapist, keep a few things in mind:

• Be cautious, check to make sure they are what you think they are.
• Make sure the doctor listens to your concerns, about mood, medicines, family life, what ever and does something to help, not just nodding the head or taking notes.
• Keep notes, get a notepad or day planner and jot down quick notes about every session as soon as the session is over, so it's still fresh in your mind, and be sure to date each entry.
• Check over your notes monthly and look at the notes for the entire year - you may see a bad pattern developing before it's too late.
• If something feels wrong, it probably is; ask a trusted friend who knows about your condition what he or she thinks.
• Don't be afraid to change doctors if one makes you uncomfortable or if you or your loved ones think you aren't progressing or getting worse.
• Don't settle for mediocrity. Demand high quality care, you are worth it!

About the Authors

Lori Wilkerson and Scott Wilkerson are brother and sister and contributing writers for BipolarCentral.com.

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