A letter to my psychiatrist

I may have shaken your hand yesterday and thanked you for what you’ve done the past 2 years, but I promise that was not genuine. I did not just search for a new psychiatrist because of insurance (although that was part of the problem). I cannot be your patient anymore because you are a threat to my recovery.

The nurse knows to weigh me backwards and turn off the scale right away. It is in my chart, loud and clear (I assume). They won’t even place me in the exam rooms with normal digital scales. The office wants to protect me from the harm seeing my weight can cause. My real doctor doesn’t even mention it. She trusts that my dietitian knows and I don’t need to. You have the exact same information as they do but apparently just don’t care.

You may think that your words don’t hurt, because you follow or precede with something like “oh, I forgot I’m not supposed to talk to your weight.” That doesn’t change the fact that you said I have gained weight since last spring and that I can surely feel it in my waist and how clothes fit.

You probably don’t remember what happened last October, just about a year ago. I do, and it will probably stick with me forever. I came in for a routine, first of the school year med check and left with my BMI (and subsequently my weight, because computers and calculators are a thing). To top it off, you added a little tip: I could lose 5-10 pounds and that would be better. What came after was relapse and eventually IOP. You didn’t directly cause it. That doesn’t mean the seeds you planted were harmless.

I may weigh more than last spring. I may be weight restored. I may look normal. I am not normal. I JUST came out of an entire summer of intensive eating disorder treatment. I fought like hell to make progress there, but my recovery is far from perfect. I’m not to the point where seeing or even speaking about my weight is okay.

I don’t need you to tell me I gained weight. I don’t need you to talk about how I must feel my body is different and how my clothes fit differently. They do and I know. I struggle every day to live with that fact.

Even now, a day and a half later and after talking in group/therapy about it, your words linger. They play over again and again. The eating disorder ate it up and now doesn’t want me to eat. I am struggling. I wish it wasn’t the case and I wish I was stronger, but I was not prepared for this, not fully.

I know I’m not the first, but I want to be the last eating disorder patient that you ever hurt like this. I found out today that you’ve been saying these type of things for years and still haven’t changed. How could you not trust a therapist or dietitian who work exclusively with ED patients?

I’m sorry I didn’t speak up more or sooner, but tomorrow I am. I am going to tell someone who has more pull than you do and maybe that will keep you away from more ED patients. Even if it doesn’t I will have done my part to help prevent this.

I am not going to let your words bother me anymore. They don’t deserve any power. So, here I sit, crying over my night snack. I may be overwhelmed, ashamed, disgusted, anxious, and triggered but I am also angry and fighting like hell.

Emily

Oh how I love my psychiatrist

Hopefully you can sense the sarcasm in that title because my God has he been progressively worse this year v. last. I’ll give a quick rundown of what I’m talking about before I share on yesterday’s appointment.

In October he oh so kindly told me my BMI, which was significantly higher than the last time I had seen him in the spring. That’s bad enough in itself, but then he added on that I could lose 5-10 pounds. I see now that this was definitely a catalyst in my relapse; not the main cause, but still…

Since then:

  • was basically convinced I had OCD when I was talking about using DBT skills (???) and wouldn’t believe me at first that I have never been anywhere close to diagnosed
  • asked why I am not eating and if it’s *just* that I’ve decided I’m too fat
  • insisted on upping my one medication even though my blood showed I have above therapeutic levels (which after that point doesn’t have increased effects)
  • in general a complete lack of understanding of EDs and how to approach them in an appropriate way

I went into the appointment yesterday automatically assuming I would get some sort of ill-advised advice or comments. I was right, but didn’t expect the absolute disregard for my struggles. At first it was just remarks on my sleeping patterns (1-3 am and wake at 7:30-8:30). His advice: go to bed earlier. I then talked about the major lack of motivation I’ve had. We are trying a new medication to possibly replace another one. That I am fine with. He made more comments about me choosing not to eat and how that isn’t helping blah, blah. The last part, however, is the worst advice I have ever heard from a medical professional regarding my eating disorder, right up there with my old therapist asking for diet tips.

His suggestion for being tired all of the time: give me either Ritalin or Adderall. What the hell?!!? Does he not realize that one of the main side effects is weight loss? Does he not know I am diagnosed with anorexia nervosa, a disorder that already has a huge focus on weight and thinness? In addition, it is highly addictive/causes dependency/can easily be abused. I have had a history of addictive type behaviors (eg SH). I really don’t need another opportunity for that to happen. I can see this causing so many issues. If I won’t be addicted from the actual effects of amphetamines, I would probably be hooked on the weight loss it causes. On a less serious note, it can affect my heart as well.

I left in disbelief and very distraught over the entire appointment yesterday. I just don’t think I can handle having a doctor who doesn’t get this anymore. Hell, I would almost settle for Dr. VH. Almost. I think it’s time to consider switching to a different doctor. I hate doing it. I hate change, but maybe this is worth it? I’ll definitely be talking to my mom, support people, and treatment team about this. Maybe one of them can talk to him for me, ha.

Has anyone experienced something like this? Advice? Am I overreacting?