Psychiatrists Won't Listen to Patients -- 8 Reasons Why
Why won't many psychiatrists listen to patients? Your psychiatrist is supposed to be helping you. Your psychiatrist is supposed to be on your side. You and your psychiatrist are supposed to be a team to fight mental illness together. But this just doesn't always turn out to be true. So many of us have, in fact, experienced the opposite. So why is it that psychiatrists won't listen to patients?
Psychiatrists Won't Listen to Patients -- Why
I actually get this question all the time so yes, in my experience, many psychiatrists do not listen to their patients. I can't speak for psychiatrists with any degree of authority, but from the patient side of the room, here's what I've noticed:
- Psychiatrists often think, or at least act, like they're better than they're patients. Why this is? I'm not entirely sure but puffed egos sure do seem to make their way into doctors' offices.
- Psychiatrists think they know better than their patients perhaps because they simply know more. But what psychiatrists forget, of course, is that while they may know more about mental illness, they definitely don't know more about any one person's experience of that illness, which is always unique.
- Psychiatrists are pressed for time. It is an unfortunate reality that psychiatrists are squeezed by insurance companies just like patients are. Sometimes there isn't time to listen even if they want to.
- Psychiatrists may buy into a parental relationship with their patients. In previous generations this was common. The doctor was the "parent," the patient was the "child," and the child was to be seen and not heard. We now know there are better ways to work a doctor-patient relationship.
- Psychiatrists get burned out. Unfortunately, there aren't enough specialists like psychiatrists to go around meaning that some psychiatrists have a ridiculously high workload and they just, plain burnout. Their "compassion sensors" go on the fritz. Psychiatrists then stop listening to patients. This is human.
- The professional distance they must have gets overgrown. While it is true that psychiatrists must maintain a professional distance from their patients in order to do an effective job, sometimes this distance becomes too large and stands in the way of a working relationship.
- For some people -- even psychiatrists -- in the back of their brain, they're still thinking that people with mental illness are crazy and not to be believed (this is related to the next point).
- People like psychiatrists tend to see the worst of the worst cases. These cases often involve people who don't know what is good for them due to the effects of the illness. These cases mean that the psychiatrist must make the decisions for the patient because they're the only one who can. Unfortunately, sometimes this transfers to other relationships with even high-functioning patients who do know what is good for them.
I would like to be clear in stating that not all psychiatrists are like this. Not all psychiatrists don't listen to patients. I have a great doctor who listens to me, but I've certainly had others that didn't. I certainly wouldn't want to paint all psychiatrists with the same brush, however.
Next time I'm going to talk about how to handle this problem and what to do if your doctor won't listen to you.
Tracy, N. (2019, May 24). Psychiatrists Won't Listen to Patients -- 8 Reasons Why, HealthyPlace. Retrieved on 2023, October 1 from https://www.healthyplace.com/blogs/breakingbipolar/2019/5/psychiatrists-wont-listen-to-patients-8-reasons-why
Author: Natasha Tracy
If you're not R.D. Laing or a close student thereof, you're likely just another pompous, tweed jacket wearing, DSM thumper. The DSM is not even a good diagnostic manual in medical context, let alone the authority over mental health treatment it's worshiped as. I suffer from a severe mental illness that has been so diluted through the DSM IV/V as a spectrum disorder that if you fall the extremes of the disorder you're likely credited as untreatable or faking. Highly likely to be prescribed medication that will exacerbate the more extreme presentations of symptoms. The condition? According to the DSM is called Bipolar Type 1, in Laing's era it was originally Manic-Depressive and the first 2 DSM carried much of the diagnostic criteria. Males afflicted with a classical diagnosis of Bipolar are much more prone to overt aggression and act of interpersonal violence. The sensation between the ears for patients is not pleasant and if the patient is still in control should not need to announce their homicidal inclination to receive first line treatment outside of a hospital. Benzodiazepines work wonderfully in treating account and rapid onset of mania, provided the patient hasn't shown addictive tendency toward the drug....I'm talking max 4 doses over a 30 day time frame. But now it won't happen because the of strict language of "no" regarding the drug for that use in the DSM. This is because the low end of the spectrum on bipolar disorders doesn't even qualify for treatment.
Modern psychiatry as a whole is in no way a service to those it is aimed to treat. As recently as the 1970's there were three primary schools of thought in the study of psychiatry. Now there is one and if you don't work with it you don't work, that school of thought is the DSM. Modern Psychiatry could be done with an algorithm, except anyone enduring psychosis would rage hard against the firm, cold touch of yet another app, it would validate many schizoid disorders as well.
I've had 1 good psychiatrist and she was good enough to get out of the clinic for poor people and move on to one I cannot access nor afford. But psychiatrists as a whole are the problem as long as they remain complacent in the pharmaceutical endorsed DSM. If Laing could find absolute remission of Bipolar symptoms through a rigorous agrarian lifestyle and no medication, it proves alternative treatment is feasible. Laing also believed in a world where all neurodivergent people should be treated the same way modern autism is. It's not always the symptom, it's quite often the sociological response to the symptom that makes mental illness a social blight. Psychiaty has been regressive for the last ~50 years, but they keep hanging labels so they can sell antidepressants.
Thank you for your comment. I appreciate that not everyone thinks the DSM is a good diagnostic tool. The IDC may be more to your liking as it's international. See here: https://www.who.int/standards/classifications/classification-of-diseases
As for the use of benzodiazepines in the treatment of bipolar disorder, I'm unaware that the DSM has anything to say about that. Perhaps you can provide a link.
I do know there is evidence that benzodiazepine use in bipolar disorder can be a negative marker, but this doesn't mean it's true of everyone, of course: https://pubmed.ncbi.nlm.nih.gov/20193647/
I'm sorry you no longer have a good psychiatrist. I know what a big difference that can make. I hope you are able to find one that is more helpful.
I continue to believe that psychiatrists are, indeed, who need to treat mental illness, but that doesn't mean that their treatment, or their tools, are perfect.
-- Natasha Tracy
20 years of an I bearable life, as they are too ignorant to get me better, and have without doubt, caused even greater problems.
My experience with psychiatrists, leaves a lot to be desired!
I've been in the psychiatric system for 20 years now, having been sectioned, at least 5 times, and none of their drugs have worked!
I even believe that some of their drugs may have caused irreversible harm!
Since I started seeing them, my respect in the profession has gone downhill, and I have no respect for them at all!
They tend to be unnecessarily arrogant, pretentious, and sadly equally as ignorant, and obsessed my making people's lives a greater misery by detaining the, for months, sometimes years on end.
They usually have no respect for their patients and also deeply offend them with marks, associated to their Dsm manual, that can, and are conceived as deeply offensive, and sometimes unnecessary, especially when they can't offer anything, and won't admit it.
The best thing anyone can do, is assert yourself with your psychiatrist, without being rude, and also stand up for yourself and your dignity, no matter how much may remain. In conclusion they are usually not pleasant people! They call people personality disorder and the like! They should look at their own, and their pronounced lack of ethics!
Hi, I’m 24 female recently been sectioned under mental health act. I suffer with really bad anxiety and depression. I took 2 overdoses and 1 overdose whilst on section. My section is supposed to end in 3 days but they have taken it off early as the doctor can’t let it phase out and isn’t here when the section is suppose to end. I have told her I’m still very suicidal and I have a plan ready. She isn’t listening to me and is telling me it’s my responsibility to change my thoughts. Wont prescribe me any meds. They think I have BPD and I know full well I don’t. I may have 2/3 symptoms as I self harm but have done for years as my anxiety stops me from expressing my feelings. I tried to explain I’m suffering from depression, as I ticked all the boxes for it barring one which is restlessness. Tried to explain this to her. My mum, sisters and brothers have depression all on antidepressants. In the beginning of the section I wasn’t engaging as I couldn’t understand how I even got in this situation and didn’t understand why they were doing what they were doing as it is my first time being in psych ward. Stayed in my room for the first 3 weeks as my anxiety was really bad and I had no motivation. When I finally started to engage they diagnosed me with BPD after me telling them how I am thinking/feeling this was just in one 25 minute session. They aren’t listening to me. I am still very suicidal and can’t shake it off. I feel so stuck right now as I’m leaving the ward on Monday and I have made my plan. I had to ring my GP as I feel unheard and I feel really exposed and ashamed now as I thought they would want to help but they aren’t taking my feelings into consideration. I can’t seem to make decisions. My GP ended up ringing the ward, but no one has approached me about it. I live with my sister and she is very concerned and obviously can’t take the pressure of keeping me safe. The doctors said they will not be extending my section at all. I feel really unsafe even on the ward as I know I can just leave whenever I want and they can’t do anything about it. The doctor has said I don’t have depression as I don’t look depressed, she said she thinks I’m obsessed with taking overdoses. I tried to tell her that the reason I have taken 3 is to end my life. They also said that depression only comes in episodes and isn’t always there. I just don’t know what I’m suppose to do anymore. They have advised that i need psychotherapy for the BPD but I can’t concentrate on anything as I don’t want to be alive anymore and I can’t make my suicidal thoughts/feelings go. I also feel like this isn’t the correct treatment for as i know im dealing with depression and anxiety. My suicidal thoughts and feeling are there constantly and I’m really stuggling right now. I just feel so stuck and not taken seriously. I just give up as it’s hard enough to find the motivation to want to get better. Is there anything you could suggest please.
I'm so sorry you're going through all that. It sounds very difficult and it sounds like a lot.
You did the right thing by calling your GP. You may have to try that again. You need to feel safe wherever it ends up that needs to be. If your GP is listening to you, then keep that line of communication open. And be honest. Just tell your GP you have a plan and aren't safe. They have a duty of care to make sure you are safe in that situation.
Sometimes there are issues in how we're communicating with doctors. You sound very clear to me but maybe it's not coming off as clearly to the section doctor. That's why you need to keep talking to your GP. And if you just can't get through to the doctor on the ward, see if you can see someone else. I understand you're usually assigned someone but you do have the right to request someone else. Lodge a complaint if you have to. Get a family/friend to talk to your GP or your ward doctor to confirm what you're trying to say. Do whatever it takes to get yourself the care you deserve. (And don't forget to mention your family history.)
If they end your section and you still don't feel safe, walk into an Emergency Room. Tell them your plan. That is another way of getting help.
In my experience, sometimes there are doctors who just don't care and just won't help and you have to work around them. I know that's horrible because you're the patient and you're doing all the work just staying on this planet, but it is necessary.
One other thing, no matter what they offer you therapy for, I recommend you take it. Likely, they will be offering you dialectical behavior therapy (DBT) and that can help you no matter what.
I'm standing with you on this. You deserve better. Hang in there until someone listens to you and you get it.
- Natasha Tracy
40 years of medications nothing helps side effects horrible. Did TMS 6 years ago got way worse.
No ne knows what to do. Switch docs 2 weeks ago he diagnisis me with a mood disorder because I can't sleep on SSRI's. Pulled me off Klonopin been on 6 year and Trazadone for 3 year gave me depakote said I'd sleep. NO sleep up all night , went back on Trazadone/Klonopin now what he wn't return my call. I feel helpless. I've learned over 40 years not to have Dr's just stop meds abrutly to wean but they don't
I'm sorry you had your experience. I have had plenty of bad experiences with doctors too. What I have learned is that we need to advocate for ourselves, sometimes in the loudest voice possible. This reminds us we are not helpless. If this doctor won't work with you, keep looking until you find one who will. Don't give up. I know how hard it is, but you can do this.
- Natasha Tracy
I've had in my ran in with my former psychiatrist, he had a huge ego. Whenever I told him the nasty side effects of the drugs, he would just blow me off, thinking it wasn't a big deal. I should've walked out of treatment sooner, lesson learned life goes on. He cured nothing, instead he said I would have to be on medication for the rest of my life, should have told him to pound sand and left.
I was inpatient last year and got diagnosed with bpd by the consultant after only seeing her once. I started a mood diary and realised my mood changes and stuff last months eg I’ll be severely depressed for 3 months and then the next 3 months I’d be really really happy to the point I believe I could of been hypomanic and I realised after researching bpd that I only have 3 of the symptoms and are the symptoms that overlap with bipolar. When I got discharged the only doctor I have access to is my gp so I decided to go private to get a diagnosis but the psychiatrist in the appointment was just not listening to me and when I mentioned that I got diagnosed with bpd she just seemed to switch off and said that she agrees with the diagnosis and now idk what to do because I don’t want to keep spending money to try and find someone to listen to me.
I'm sorry you're in that spot. It's terrible when you feel like people aren't listening to you.
Here are two thoughts:
1. Try to get your GP on side. Your GP may not be able to diagnose you, but they might be able to hear what you're saying and think that misdiagnosis is a possibility. This means they could write a psychiatrist a note saying so. This could help your case greatly.
2. Try asking a doctor to explain their reasoning to you. If the psychiatrist says, "No, I think you have BPD," say, "Please explain to me why you think that when I only have three of the symptoms? I would like to understand your reasoning." You need to be polite but firm and get them to explain their thoughts. They may really have good reasons for their opinion or they may not, but either way, you need to know about it.
A new psychiatrist may be the one to have that conversation with. Try getting someone who specializes in bipolar disorder. They will be the best at ascertaining whether you have it or not, and have a good reasoning for believing so.
- Natasha Tracy
My psychiatrist diagnoses me with bipolar because I accidentally told her I had 1 episode of mania "not knowing what mania is". I told her the medication Im on isnt helping me and I may have been misdiagnosed. She wont listen and told me to get another opinion whixh I cant get unless she transfers my fike which she hasnt done in months. I feel hirrible.
Hello I find it hard in speaking to doctors because of the assumption that they won't help me from previous experiences. They persrcibed me medications that they thought would be benefical for me which was resperidone and olanzapine. These medications messed with my psyche so much I got into a brutal car accident. I am 22 and they still used the child patient excuse to give me those types of mood altering medications. I now have an appointment with another psychiatrist who may seen to be alot better in diagnosing my issue. My question to you is how to speak to the psychiatrist with detailing my symptoms. I am look to get on noahtropics. Thank you.
Hey Simon. I hear you're frustration. I'm in the same boat and need a second opinion about my diagnosis. I have bipolar 2 disorder and supposedly "delusional disorder". (Eye roll). What you do is make an appt to see a regular family/ internal or general medicine doctor at any hospital. (Make sure the doctor is covered by your insurance. Call your insurance company first and they will find you a practitioner). Upon the first visit, you will get a physical exam, possibly some blood and urine tests will be administered, I'm not sure. Upon that, you should be able to get a referral to a new psych doctor for psychological testing for a second opinion without interference. He or she will need your records from the first psych doctor, but I doubt your first doctor will fight him. Likely he will cooperate. If he doesn't, find a new doctor. A good doctor will respect your right to a second and even third opinion. You can also get copies of your medical records from your hospital, but you have to pay for them. Contrary to popular belief, they may fight you on this. Legally your entitled to them, but my hospital is giving me a hard time about this as I sit here and write this to you....You, as an adult, can psychological testing pretty much anywhere without your current doctors permission. But you need a referall. It doesn't have to. It don't have to come from your current general medicine doctor. It can be from a new doctor you've never seen before and you likely wont have to see them again...just get that referral. Psychological testing is mega expensive though...FYI. 😇
Recently had an appt with my psychiatrist and my community psychiatric nurse.
I've bnn diagnosed with ptsd, which I allready knew I had been diagnosed with this in my early 30s, I'm now 46.
Im on 200mg setraline, for ptsd. My moods have bn very unstable lately I've experienced mania and then depressive episodes where I am housebound and have no motivation to look after myself or my home. I first experienced trauma at the age of 7 when I witnessed a close family member being raped, I also have been raped twice once age 18 and then age 44.
I often feel nothing, no emotion or I become super sensitive, I am prone to reckless behaviour not caring if I live or die.
My mother died 3 years ago and I've grown steadily worse I believe I have BPD but my psychiatrist says no, refuses to consider it and will not give me anything to stabilise my moods. I do not want to be here, I have no motivation and my body is often in agony, I fantasise about walking infront of a bus, I feel guilt and feel like I'm a burden to my loved ones, I just want to be with my mother. I need help.
I'm so sorry you're in that place right now. It sounds very hard.
I would definitely be concerned about mood instability if you're feeling this distressed about it. Perhaps your psychiatrist doesn't understand how serious this really is. It sounds like you need help immediately.
What I would recommend is being forthright with your team and say something like, "My moods are fluctuating in ways I can't manage. I'm in so much pain I'm suicidal. No matter what you feel my diagnosis is, I need help with these things immediately."
That should spur a conversation about changes that will help. If it doesn't, I recommend getting a referral and seeing someone else as soon as possible as obviously your team is not taking you seriously.
In the meantime, remember, you can always reach out to a helpline. That can really help you get through this time. People there will be able to listen and suggest additional resources for you. Please see our hotlines page here for more: https://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-refer…
I hope that helps. Just remember, help is out there but it sometimes takes a lot of access it.
- Natasha Tracy
I have been seeing a psych for years and have questioned her drug choices several times even getting a second opinion. She had me on 300mg doxepin160 geodon 40mg clematis and 2mg klonopin for years adding geodon later. I did pretty well. Able to get out socially paint function. Rather lethargic not very active though. Starting having heart palpitations at night after I took geodon. Looked it up stoppped geodon rather fast ended up in hospital with severe depresssion. Dropped out socially quit everything. Put on a number of medicines that didn’t help. Months went by. Saw another doctor put me on medicines with bad side effects including Latiuda which helped mood but heart palpitations right away. Started back tiny bit of geodon and low dose Doxepin mood little better but all this time insomnia for months. Saw old doctor told me to take 40mg geodon and Doxepin which not only didn’t help anyway and my heart rate went up. Couldn’t take geodon and didn’t work at low dose. Anyway. Second doctor put me on 10mg lexapro Nd 75 geodon at night. Heart palpitations almost went to hospital. I had been put on synthroid in hospital and after finally taking heart rate one month later sent me to hospital. Family doctor gave me propranolol which I take for these problems stopped synthroid. I give up.. after telling my doctors of these problems ignore my issues. Ready to give up. Didn’t take anything last night but klonopin melatonin and magnesium. Thought about killing myself today. Talked to family doctor said try holistic!! Can’t even move from my chair. Help!!!!! Haven’t slept in months no help! Went from heart rate of 75 bam to 113 bpm in a year.
I'm so sorry you're going through that. I can understand why you want to escape that cycle. It sounds like you need a whole new approach. It sounds like you need all new medications. A new doctor may even be in order.
If it were me, I would put things very plainly to a doctor -- if there's one thing I know, it's that they _can't_ read between the lines. I would say something like, "I'm at the end of my rope. I need medical treatment now because I'm thinking about suicide."
I know that seems drastic, but it's what they need to hear to take you seriously.
Then I would say something like, "I am very concerned about my heart rate. Can we start on a small dose of medication and see how it affects my heart?"
Then write down the rest of your needs and make sure they are addressed. It sounds like sleep is a very big one so make sure you mention that to the doctor. I know that sleep and lack of sleep affects me and my bipolar greatly, so I would say that getting that on track is critical.
I know this is really hard but you need to stand up for yourself and be as forthright as possible. You can do this. You can get better.
- Natasha Tracy
Bravo on this topic. It is so true about psychiatrist not listening. I have observed my therapist peeking at the clock and you can tell by their body language they have tuned out. Sometimes it takes going through a few therapist to find the gem.
I take 4 one mlg of Klonopins a day for my paranoia and anxiety when I go in for my med check they take an urine test and watch me I feel they are treating me like a drug addict I feel very offencive about this what should I do?
That does sound unpleasant. That said, I don't know that there's anything you can do. If that's their policy, that's their policy. If I were you, I'd talk to your doctor and get more clarity on why they're doing that and if you can be exempt -- at least sometimes.
- Natasha Tracy
Good article; always found out the hard way!