Being referred to psychiatry has a lot of emotional baggage attached. “What! Do you think I’m nuts?” “Will everyone else think that I’m nuts?” Or worse, will the person himself think he’s nuts?
I was at a local eatery enjoying my lunch when I could not help but overhear the words of a successful looking gentleman who was back to back with me on the upholstered wooden booth bench. He was pouring out the story of his journey through anxiety and panic attacks to his friend.
The gentleman went to see his PCP who was sympathetic and alarmed to see his patient in such an uncharacteristic state. Benzodiazepines were prescribed, Xanax to help with the panic attacks that ambushed him during the day and Klonapin to help with the insomnia that plagued him at night. Much as the man wished his anxiety and panic gone, every time he tried to decrease the benzodiazepines his symptoms became worse. Over time the dose of benzodiazepines gradually were increased in amount and in frequency. Finally, his PCP arranged for admission to an inpatient clinic for treatment of what had become an addiction.
Throughout this distressing conversation not once did I hear that the man had been referred to psychiatric specialty care to have his anxiety and panic attacks addressed before he arrived at the place of drug addiction. So much suffering probably would have been avoided if only the man had been seen early in his illness by a psychiatric provider. Sadly, the experience of this anguished gentleman is not an isolated incident.
All over our country, every day, people are suffering with poorly treated, or untreated, psychiatric illnesses that would benefit from a referral to a practitioner who specializes in the diagnosis and treatment of mental health problems. But all too often the referral is not made, or if it is made, the suggestion is not followed through with for fear of what others might think - what one’s self might think - about seeing a psychiatric provider. Sad.
Lack of a referral to psychiatry may be a major reason why it takes, on average, seven years of ongoing and unsuccessful treatment for a person with Bipolar Disorder to be accurately diagnosed and appropriately treated. Imagine that! Seven years to an accurate diagnosis. Seven years of discouragement, emotional suffering, damaged relationships, monetary expense and … if only this were all. (Note, ‘depression’ is often a loosely used term to describe a feeling state. This feeling state is a symptom of many things and not always the ‘illness.’ Antidepressant medication can actually make a person with bipolar disorder worse.)
If a patient comes in with heart problems a referral to a specialist quickly ensues. Let’s hope that soon the day will come when a patient having problems with their emotions will just as quickly receive a referral to a specialist in psychiatry and mental health.