How to Become a Professional Patient – Guest Blog Spot

This is another Guest blog spot from Emily K Harrington, please enjoy.

How to Become a Professional Patient

When you first start psychiatric medication, you honestly don’t know what you’re doing. I wish that there was a class on how to be a good and helpful patient that anyone could take for free when they get their first script, but instead, I will write out the things I believe are crucial in order to make significant progress aided by meds.

Although I am not a doctor or any sort of health professional, I do consider myself a “professional patient,” due to the past 13 years of dealing with bipolar disorder, major depressive disorder, and generalized anxiety disorder. All that time, I have been in treatment with psychiatrists, psychologists, therapists, general practitioners, and specialists in various fields. The following is what I’ve learned.

THE RULES

  1. One psychiatric medication does not work the same on everyone. And if you’re already telling other people about your meds (what works for you and what doesn’t), then please read the disclaimer that needs to come before any advice you hand out.
  2. Sometimes a psych med has the effect of causing health problems, making things worse, or affecting you in a way opposite of its intended purpose. An example is that for some people, some antidepressants can cause suicidal ideation, and some antipsychotics can cause hallucinations. These effects happen to a small minority of people, so this doesn’t mean you shouldn’t try them. Because…
  3. Psychiatric medication can save your life. A med can bring you back from the brink. A med can improve you enough to be able to use coping skills, which is difficult in a nonfunctional place…
  4. Doctors are stabbing in the dark when you begin treatment. This means that you will probably have to try more than one medication before you find one that works. Once you find one that works, then you will need to…
  5. Adjust your dosage and time of the dose with the guidance of your doctor. Often, a medication that works for you a little bit can work for you a lot after you figure out what time(s) of the day make you feel best. This is often called “tweaking the dose.”
  6. To learn how the dose needs to be tweaked, you will need to KEEP NOTES. Print out a mood chart from the internet (search “mood chart”-it’s easy). Go to Kinko’s or the library if you don’t have access to a printer. I know some apps do the same thing, so look for those instead if you’re inclined. Or just keep a notebook. It doesn’t matter how you do it as long as you have the following information in an easy to read way:
    • Your daily mood status
    • What you are taking, what time and how much (you don’t need to write down the things that don’t change every day)
    • Your mental illness symptoms, especially anything severe or unusual for you
    • Other health problems
    • Any problem behaviors or events (like self-harm or episodes)
    • Any insight you notice about how you are being affected
  7. Bring your notes with you to the doctor. Some doctors’ appointments are as short as 10 minutes, so every sentence counts. Having all the information on hand eliminates the need for telling long, rambling stories full of irrelevant details. This is probably the most important thing to do in your relationship with your psychiatrist.
  1. If you are prescribed more than one medication, only change your regimen one way at a time, for a trial period of a week or more. Ask your doctor what adjustments are appropriate for you to try if you feel you have an insight about your medicine. My doctor allows me to do trial-and-error testing with the timing of my 6 daily doses because he now trusts my judgment. The reason you should only make one change at a time is that if you’re making multiple changes at once, you cannot clearly determine what is helping or hurting you.
  2. You will probably have to try multiple medications and multiple mixes of meds before you find what works. This process sucks, because the ones that don’t help leave you feeling hopeless of getting better, and sometimes they even make you worse. This is why note-keeping is so vitally important; it allows you to limit the amount of suckage you experience with a med and move on to the next trial, instead of waiting around forever on something that is not right for you.
  3. If your doctor’s office has an online service, learn it and use it.
  4. Pick a pharmacy that is open late hours, 7 days a week. Walgreens and CVS have many stores that fit this bill. Walgreens also has a website and app, and you can put your prescriptions on auto-refill so that you don’t forget to refill them (this does not work with controlled substances like benzodiazepines, which are restricted). If you do not have an auto-refill option online, you can request one in person or over the phone, directly from a pharmacy technician.
  5. Find ways to set reminders to refill your medication. This seems simple and is not. Phone alarms and calendars are options for reminders. Take this very seriously. Missing a dose can send you spiraling.
  6. Ask your doctor if you can get 3-month prescriptions so that you don’t have to go to the pharmacy as often. This is a good practice for preventing missed doses and late prescriptions.
  7. Set alarms on your phone to remind you to take your medication. If this doesn’t work, then set another alarm for ten minutes later. No joke, this is still a paramount practice for me, even after 13 years.

Congrats! You survived the bulk of this course. Now let’s wrap up with another look (for memory’s sake) at the framework of guidelines:

  1. One psychiatric medication does not work the same on everyone.
  2. Sometimes a med has the effect of causing health problems, making things worse, or affecting you in a way opposite of its intended purpose.
  3. A med can save your life.
  4. Doctors are stabbing in the dark when you begin treatment.
  5. Adjust your dosage and time of the dose with the guidance of your doctor.
  6. To learn how the dose needs to be tweaked, you will need to KEEP NOTES.
  7. Bring your notes with you to the doctor.
  8. If you are prescribed more than one medication, only change your regimen one way at a time, for a trial period of a week or more.
  9. You will probably have to try multiple medications and multiple mixes of meds before you find what works. This sucks.
  10. If your doctor’s office has an online service, learn it and use it.
  11. Find ways to set reminders to refill your medication.
  12. Pick a pharmacy that is open late hours, 7 days a week. Walgreens and CVS have many stores that fit this bill.
  13. Ask your doctor if you can get 3-month prescriptions so that you don’t have to go to the pharmacy as often.
  14. Set alarms on your phone to remind you to take your medication. If this doesn’t work, then set another alarm for ten minutes later.

This advice largely applies to other medications, prescriptions, and doctor visits. This is helpful for anyone with a serious illness, not just mental health. This is how you become a “professional patient.”

I hope you gained something from this course written by a totally unqualified stranger. All I can say is that these are things I’ve fought to learn over the past 13 years, and this was not easy knowledge to acquire. Now, these practices are an enormous part of how I stay functional. I do have bad times sometimes, but I also have times when I am in partial remission and feel genuinely okay or even well. Feeling well is a goal worth working for.

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4 Replies to “How to Become a Professional Patient – Guest Blog Spot”

  1. Not promoting but just learned about a test to help assist w/medications [possibly]…after some very bad reactions with two different medications my Dr. has suggested this: Pharmacogenomic Testing for Psychotropic Medication Selection. I haven’t completed in-depth research on it yet…but from her explanation & what I have read, thus far, it has given me some hope…..Thank you for a very comprehensive view from a 13 yr professional patient….many thanks & keep strong…..you are doing a great job getting your insight out there!

  2. This is an excellent list! Especially the keeping notes. Keep a notebook or notes on your phone, anything so you can bring feedback to your doctor. Also, if you feel like something isn’t working, tell your doctor. Don’t think he/she knows the absolute best about your body.

    I was given Topamax for depression years ago. I became an angry woman. Extremely angry. This was not normal for me. I told my psychiatrist. He said that I should give it more time. I ended up not being able to give it more time. I called my psychologist a few days later, in tears, begging her to help me. I was scared for myself. I knew I wouldn’t hurt anyone but I could feel the anger radiating in my body. She took me in immediately and asked if I wanted to go to the hospital to be with people who would watch me to make sure I was safe. I declined but felt a huge sense of relief that she was taking me seriously and that the hospital was an option.

    She called my psychiatrist the next day and told him he needed to come up with a new plan for me. I took my husband with me that day to see him. He wasn’t great, but he changed my meds and I found a new psychiatrist.

    Find a good psychiatrist. Ask your therapist if they have anyone they suggest.

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