New doctor erroneously decides on new diagnosis
While my psychiatrist at a local university affiliated mental health clinic was on maternity leave, I was assigned to another physician. My usual psychiatrist had prescribed three different antidepressants to be taken at the same time. This is sometimes done to treat "break-through" symptoms. Apparently, the combination caused side effects that looked somewhat like low-level hypomanic symptoms.
The substitute psychiatrist summarily changed my diagnosis from major depression of some 30 years standing to bipolar disorder, ignoring the information that I had never had bipolar disorder. He discontinued some of the antidepressants and simultaneously prescribed 1800 mg. of Depakote ER. I weighed less than 120 pounds at the time, making the top recommended dose less than 1200 mg., according to the manufacturer. He prescribed 150% of the recommended maximum dosage.
Soon I found it very difficult to think clearly, putting me in danger when driving or in any situation requiring higher judgment. I endured a change to another medication of the same drug class before the right diagnosis was re-established: major depression. I gained more than 30 pounds because of medication not required. The extra weight has affected my cholesterol, digestive system and blood sugar.
Subsequently, I requested a copy of my medical record from the clinic. This right of every patient is posted on the clinic walls. At that point, my social worker strongly criticized me and refused to treat me further. I received the copy only after I called the medical director. The record claimed I had exhibited "psychotic" and resistant behavior, apparently because I exercised my rights to see clinician notes. I needed to read the notes in order to refute them by adding a statement to my chart. I found many factual errors as well as judgments with which I disagreed. The clinic refuses to remove such erroneous documentation, requiring me to spend many hours reviewing all the errors and correcting them by adding my own notes. It was very upsetting to have to do this. It took some time, but I did it.
It took many months to recover from the trauma of misdiagnosis, criticism, wrong treatment and overmedication. I am still working on losing the extra weight. I have managed to lose one-third of it so far.
Many months went by before I received a new psychiatric evaluation and a new social worker. Neither my new psychiatrist nor my new social worker has found any psychosis. Both agree that I show no signs of bipolar disorder and never needed the erroneous medication. I am now on a new medication, but it took almost a year to get to that point. More than two years later, I am still dealing with the trauma of these events.
In a way, the worse abuse of all is that the erroneous diagnosis and information remain in my chart forever. Any subsequent clinician can review my chart and assume I was psychotic when I was not, thus coloring his/her judgment and subsequent diagnosis and treatment.
IT IS IMPORTANT TO UNDERSTAND that reducing the dosages and/or discontinuing one or two antidepressants would have been sufficient to resolve the mislabeled symptoms I was experiencing, which were also related to stress. This sort of conservative treatment would have prevented much if not all of the harm that I experienced.
Both the doctor and the social worker who misdiagnosed and mistreated me continue to work at this clinic. Few psychiatrists in this area accept my insurance, so I have no other practical choice. If I have an emergency, I refuse to deal with the doctor at all, instead asking for another clinician. I would call a hotline if necessary before trusting this doctor again.
If nothing else, I hope anyone reading this will remember to question doctors carefully about changes in medication and diagnosis that are surprising. Get second opinions if you have any question at all.