Inside Bipolar Podcast: Annoying Things Psych Docs Say to Patients

Meet Your Inside Bipolar Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com.

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at DrNicolePsych.com.

Episode Transcript:

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe: Welcome to the podcast everyone. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe: All right, Dr. Nicole, we have a lot of listeners who reach out to us and share their thoughts about the podcast. And just a quick note, you can go to my website, gabehoward.com, and email me. You can go to Dr. Nicole’s website at DrNicolePsych.com and email her. Or you can just hit up the generic show email and it’ll get to where it needs to go. And that is show@psychcentral.com. Okay, okay. Back on track. One of the things that listeners share are their frustration with the things that their psychiatrists say. And to help with this episode, I put an open question out on my social media asking folks what things their psychiatrists say that well, frankly, they just don’t like. And oh boy, did we get responses. We got such feedback, and I don’t know if you’re ready for this, Dr. Nicole, but the community was really on board with the idea that psychiatrists say a lot of stupid stuff.

Dr. Nicole: I’m sure they do. I’m ready for it. I’m ready.

Gabe: So, we’re going to call this episode Annoying Things Psych Docs Say to Patients. And the first thing that they say really isn’t your fault at all. According to our listeners. And I have to agree with this because I too have heard it. The number one annoying thing that psychiatrists say is I’m not taking new patients right now. And another thing along the same vein is I’m not going to take your insurance. And this really did come up time and time again. But of course, that’s, that’s really a complaint about the system as a whole, how difficult it is to gain access. And we can do several shows on that topic. But I did want to let the people in that poll know, we heard you. So, Dr. Nicole, do you want to know what things patients are saying psychiatrists say that are their fault? Is it time?

Dr. Nicole: Here we are. I’m ready though. I mean, I am certain that we probably say things that go without further explanation. So, then you think they’re dumb or stupid or whatever colorful word you choose to use. But I’m. I’m here. I’m open. I’m ready.

Gabe: All right, Dr. Nicole. The second thing that patients say annoy them when their psychiatrists say it.

Dr. Nicole: I’m ready.

Gabe: All right. Here it is. Quote. I think you have more important things to worry about than that side effect, unquote. And then the doctors go on to say, well, we’re not going to fix that right now because, hey, at least you’re not suicidal. And there’s lots of other examples through there because people went in and they said to their Dr. Nicole’s, hey, I’m having a sexual side effect. And they reported that the doctors immediately said, well, that’s an upgrade. When you first came to me, you were in psychosis or you were committed, you were suicidal, you were having all these problems, and now you’re just having some sexual dysfunction. You don’t need to worry about that at all. This sparked a huge conversation, a huge debate with lots of stories. Well hang on, it had 181 comments just off that one topic. People don’t like this.

Dr. Nicole: They don’t like it. I know, and I hate that. I mean, I hate it, so me personally, I hate that the meds we prescribe costs so many uncomfortable side effects I do, I hate it, and I do hate that it feels like, and maybe not even feels like sometimes. The reality is, the medications we prescribe that are helpful for your symptoms can cause some unpleasant side effects, and then we just have to figure out what to do from there. I think the biggest frustration on my end from that is a lot of times, honestly, I’m left feeling a little defeated myself. And I know you’re like, well, what are you defeat it for? I’m the one with the sexual side effects and not I’m the one that you know, can’t have sex. Why are you defeated?

Gabe: Right? Right, right. This is not about you.

Dr. Nicole: It’s not about you. But I do feel a little defeated because I’m like, oh, when people tell me, like, I’m having this thing. We have to just sit down and look at it. And I can’t tell you that I have not been guilty of asking the question, okay. At this moment, which is worse, the sexual side effect or the uncontrolled bipolar disorder symptoms? Because we may have to focus on one temporarily to get it together and then come back to the other. I have asked that question and I’m sure it ticked people off, but I have asked like, what? What? What do we want to do? Because if I go changing your mad because you’re having sexual side effects, for example, what if I change it to another one that also gives you sexual side effects? And in the meantime, your moods are still up and down and all over the place, and you don’t have stability there. Maybe the psychiatrist just wants to get you stable, and then we can focus in on some of the side effects. And I won’t say the lesser side effects, because I completely understand how important sexual dysfunction is to anybody. You want to feel normal. You want to feel human with sexual beings, I get that, but we may have to spend some time focusing on getting the mood symptoms under control, and you might be forced with the decision. And it’s not an easy decision for you to make. So, we may recommend that you focus in on getting your symptoms under control. And then we can try to figure out what we can do about the sexual side effects. We might have to I know, I know, that’s not what you want to hear I know.

Gabe: But. But you say it so reasonable. I like sincerely like I’m listening to you. I’m like, that’s really reasonable. Like, I don’t, I don’t, I don’t care, I can’t have sex. She’s making so much sense right now. I got to tell you, the patience here. It myself included as look; sex is not important. And especially if you’re young. One of the things that came up in the thread was young women. They were told by their psychiatrist, hey, you’re not married. This isn’t a problem. And so that opens up a whole other can of worms. But it really felt like if we boil this down to one specific issue, it was they felt like they told their doctor that this was a deal breaker and their doctor said, but it’s not I’m not going to do anything about it. And that’s what left them frustrated. Not the part where they were trying to work it out or get

Dr. Nicole: Yeah.

Gabe: On the same page. It was the hard no; we’re making no changes.

Dr. Nicole: Now I will fully say, in defense of every patient who complained about having a doctor, tell them you don’t need to be worried about that. Sex is the least of your concerns right now. You’re not even in a relationship like all of those things. I know those things have been said. I’ve heard people say them. I have heard doctors say things like, they aren’t even dating. They’re not in a relationship. Why are we worried about their erectile function? Why are we worried about sex drive? Like, why are we worried about these? I’ve heard these words come out. I know they’re said. And to that I say, well, that just sucks. And I still think the medical community, we have a ways to go when it comes to like being able to talk about sex and being able to kind of see that as a human right and a need and a desire. We just have a lot of work. We have a lot of work to do. And for the women out there, like, don’t even get me started on the way. Nobody cares about women’s sex drives. So, this is one of those times when it’s really not just your bipolar disorder that’s getting in the way. Nobody cares about women’s sex drives. Look at the drugs that are available for male sexual dysfunction and what’s available for women. You can’t even compare. Most times, the one drug that we have that has made it through the FDA approval isn’t even covered by insurance most of the time. But Viagra and Cialis most of the time they are. So, women get a bad rap anyway, so I know you’re probably already going into that encounter frustrated because of the way the system treats you, and then to be told that it just is what it is like.

Dr. Nicole: You just don’t have a choice. So, I think that sucks. I, I own the suckiness of that. I will own the suckiness of any of my colleagues who have told you that your sex life was not important because you weren’t dating or not important, period. I will own that. I will take that in. Yes, they’re wrong for telling you that. But there may be a time where we have to temporarily focus on one part, and then once that one part is better, then we can figure out what little tweaks we can make to kind of help with the side effect things. Because it just may in reality be that making a change is not in your best interest long term. It may be in your best interest for the right now, because you want this one thing to see if it gets better, but it doesn’t mean that it’s the long-term best interest. And I’m thinking long game. So, explaining that to you might help us with some conflict and some confusion, or at least get you to understand why I’m not doing the thing that you wanted me to do. Because just because you want me to do something doesn’t make it the right thing to do.

Gabe: All right, let’s go ahead and swing right back into Side effects that we want rid of, that you won’t help us get rid of because you say we have more important things to worry about. Look, while sexual side effects always seem to top the list, you know, what’s 1B?

Dr. Nicole: Weight, weight.

Gabe: Its weight, its weight.

Dr. Nicole: It’s weight.

Gabe: People don’t want to gain weight. And our psychiatrists say, hey, look, at least you’re not suicidal. You can stand to gain a few pounds. Who cares? It’s not important. Don’t worry about it. When I first met you in the emergency room, you thought this and now you’re 40 pounds heavier. Nobody cares. I there’s again not quite 181, but almost into the triple digits of people sharing stories

Dr. Nicole: Yeah.

Gabe: About how they gained a significant amount of weight. It made them feel lethargic and bad. And their psychiatrists were just like, look, we solved your mental health problem, so get on a treadmill.

Dr. Nicole: Yeah, again. Again. Wait, is. It’s so tricky. Nobody wants to gain weight. Heck, I don’t want to gain weight. And I’m not taking medicine for bipolar disorder like nobody wants to gain weight. And the reality of, I mean, have you read side effect profiles of the medications that we use to treat bipolar disorder? It’s not a sexy list. Let me tell you it is not.

Gabe: A anal leakage appears a lot more than is reasonable.

Dr. Nicole: [Laughter] It is not sexy.

Gabe: It’s on there a lot.

Dr. Nicole: It’s not it’s not a sexy list. And if you look at some of the kind of more serious things that can happen, they’re very scary things. So, I fully know that when we walk into the room to have conversations about changing medications and side effects, the scary things are there. But everyone cares about weight because it’s very difficult. And so many of the medications that we use to treat bipolar disorder do come with a risk of weight gain. So those are conversations to have up front.

Gabe: As you can imagine, when you put something out on social media, you get a lot of responses. And I want to let you know, Dr. Nicole, that by and large, they were very respectful. There were some horror stories that were shared of people who switched psychiatrists. And there were a few trolls out there who said some less than productive things, but for the most part, people they just feel, frankly, that this is a customer service improvement opportunity, for lack of a better word. And the third one kind of surprised me because this is not been my experience, but the third one was explaining their condition to them. Now I’ve got a figure that obviously, if they’re upset that the psychiatrist is explaining the condition, it must be people who have seen a psychiatrist for a long, long time. They’re probably not the newly diagnosed, but several people said that they would see their psychiatrist and they would say, well, you know, I was diagnosed with bipolar disorder, and the psychiatrist would start explaining to them what bipolar disorder is, or they’d say, well, I’m having this symptom. And the psychiatrist would start explaining to them with, the symptom is and no matter how many times the patient said, I understand you don’t, you don’t have to tell me what I’m living with. The psychiatrist would just continue to explain. And from the patient perspective, Dr. Nicole, they just felt like they were being talked down to like. Like they were just being told that they did not understand their own experience. And the psychiatrist who was not living with their symptoms, their diagnosis, et cetera. Was essentially taking up the time to explain to them what they were going through. And in fact, there’s one quote here who says, being told that I live with bipolar disorder and what my life is like by a psychiatrist is like mansplaining on steroids.

Dr. Nicole: Yeah, I could see that. And, you know, I mean, I can see that, um. And I can think of circumstances in which I would be having that conversation with someone who’s well aware of their diagnosis. So, one of those reasons might be that the person is telling me that they’re experiencing something, and they sometimes people say like, oh, I, I don’t know why I had an episode, like, I don’t know, all of a sudden, I just had a hypomanic episode two weeks ago, and I just can’t for the life of me, I just can’t figure out why I had that. Well, that would be a time that I would come back and say, well, it may have been just because bipolar is a cyclical disorder and it’s an episodic illness and you were due for an episode. We don’t always have the ability to point to. An episode came because this thing happened and then episode came after. So sometimes it’s just a reminder and maybe we’re trying to be reassuring. Like it doesn’t mean you’ve done anything wrong. It doesn’t mean that we’re on the wrong. It doesn’t mean that anything wrong has happened. It may just be the nature of this illness like it may be.

Dr. Nicole: And maybe that reminder is frustrating as heck, but it may be something like that. That is a time where I would go into talking to somebody about their symptoms. Another time that I would go into that is if I questioned the diagnosis. Right? If I questioned the fact that you had bipolar disorder, if you came in and you said I was diagnosed with bipolar disorder 15 years ago, and these this is what’s going on with me. And I might question that based on the history I get from you, based on the information you share, based on me seeing you for a while, I might start to question that diagnosis. So, I may start giving you that, because I’m just trying to see if me giving you that information in that way allows you to see it in a different way and maybe say, no, that’s absolutely what I’m experiencing. Or, oh, you know what? Maybe that’s not what I’m experiencing. So maybe I’m explaining it because I want to see what I get from you in response, not because I think you’re dumb. So those are a couple reasons that I could see me explaining something to someone that they’ve already been diagnosed with and already understand.

Gabe: Attached to that one, it got mentioned in almost every conversation when somebody posted that was the reverse, that when patients try to explain their experience to the psychiatrist, the psychiatrist is like, I’m an expert. I understand you don’t need to tell me. And the patient felt very strongly that, look, I’m telling you for a reason. I’m trying to tell you how it impacts me. I’m trying to tell you something that’s not in the brochure, but the psychiatrist is like, no, no, no, I got it, I got it, I got it, I got it, I got it. And this made many patients feel like, well, how can I trust your conclusion if I don’t feel that you have all the data? Other patients were like, well, clearly they weren’t interested. Or the ego on that doctor was so large they didn’t even care. We had a few well, they’re just pushing pills to meet their quotas. It was all over the place. But what everybody really did agree upon is that it was important to them that they share this story, and they were denied the ability to do so. I, I feel like you’re going to say, hey, we only get 15 minutes. They probably understand you’re going to move it along, but it’s got to be a little deeper than that. I mean, all roads can’t lead to, oh, we just don’t have a lot of time. We’re probably doing it good.

Dr. Nicole: Probably fine. It’s fine. Um, yeah. I mean, we all know about the time thing. I mean, it just is what it is. Um, there’s a lot of ground to cover in a short period of time, and. And because the person, the patient is very passionate about what’s going on with them, sometimes their ability to provide a succinct. History struggles, right? So.

Gabe: Why are you looking at me? I say succinct things all the time. I don’t, I

Dr. Nicole: Sometimes.

Gabe: Don’t. You should see the look that I am being given right now.

Dr. Nicole: Sometimes the ability to provide what you’re saying in a succinct way is very tough for you. And I know it’s become it comes from a place of passion, of I want to be heard. I want to be understood. Like I need you to understand how bad this thing is for me. But often times. Maybe you could do that in a way that isn’t four minutes long to tell me about this one thing. Maybe you can do it in 1 or 2, right? And so, I do know that when you’re in the moment, though, and you’re passionate about it and you and you’re telling me. But I need you to understand. Like I need you to understand sometimes more words doesn’t always convey how distressing something is. Like. Sometimes you can say how something affects you and let it go. And sometimes when you’re really passionate about it. And I’m sure when you have the perception that you’re not being heard, you become even more passionate about it, which makes you want to talk about it even more. So, I will say oftentimes people just really struggle with giving us things in bite sizes that we can use, because the reality is we don’t have a lot of time. So, the more the more succinct you can be, the better off.

Dr. Nicole: I’m a big fan of lists. If you have something that you need me to know, write it, write it, write it, write it, bring the list with you is a lot easier if I can see the list and I can see what you wrote or if you wrote it, and then you can put it into a little smaller package that would be very valuable to help you have the time to get that information heard and make sure you get everything in, but maybe a little more succinct. So that is one. That is one thing. I can’t tell you, though, that there aren’t people who are like, yes, I get it, mania. I understand, you know, you’re like, oh, but let me tell you what happened. So, then I did this thing and I can’t tell you that there is a part sometimes in the time crunch and all the constraints that the doctor’s not like. I get it manic like we don’t need always the deep, deep dive into the weeds of what happened to know that, oh, you were manic. This is a bad thing and we need to do something about it. So sometimes we don’t always feel like we need all of the information and all of the details, like what you were wearing and what that person said and what they had to eat. And all the three times you’ve been to this restaurant and every time they’re out of chicken, like, we don’t need all that part.

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Gabe: And we’re back discussing annoying things that psychiatrists sometimes say to their patients.

Dr. Nicole: We, we just need the, the, the, the facts. We need the facts. Because really, in our brains, we’re just weeding through all of that, like all that extra stuff weeding through. But I can tell your emotion conveys how passionate you are about something, how distressing something was to you. The fact that you brought it up lets me know. And maybe I don’t do a good job all the time of saying, hey, I can tell that this is really something that bugs you, but I think I understand how distressing this is for you. And then moving on to the next thing. I may not always do a good job, or the mise of the world may not always do a good job of that fact, but I do feel like most of us are sensitive to that, and we get it. We just may not be using the words that you need for you to feel like we got it.

Gabe: One of the things that I’m reminded of while you were talking is a famous quote that said, I’m sorry to have written you such a long letter. I simply did not have the time to write you a shorter one. That really speaks to somebody like me, because my writing and my, my, my writing is like my speaking. The first draft is really, really long, and then I shorten it and it takes time to shorten it. If you feel that there’s a story out there that is super important, write it and then condense it and find those parts that are important, and then bring it in and hand it to your psychiatrist. And then if your psychiatrist refuses to read it, you, you know, you know where you stand. And I think they think average psychiatrist is like, okay, you’re right. I’m glad I read this. There are details here that are important. But yeah, if you’re anything like me, yeah, it takes me 15 minutes to tell somebody what I had for dinner. I just I’m well suited for my job. That’s. That’s all I have to say. I’ve never succinctly explained anything ever, ever,

Dr. Nicole: You?

Gabe: Unless it’s pre written.

Dr. Nicole: What? What? I’m surprised. I’m shocked. I wouldn’t even believe that about you.

Gabe: You know, Dr. Nicole, when, when, when I put out the list and putting it out on social media, the majority of our listeners are people who live with bipolar disorder. So naturally, since they’re the majority, their concerns are going to rise to the top and make out our top three. But we have quite a few listeners who are family members and loved ones, and they participated in the poll as well. But because of the way math works, their concerns obviously couldn’t raise to the top three. But they are also annoyed with psychiatrists. Don’t don’t worry, they got some complaints too. So, this is sort of the honorable mention part of

Dr. Nicole: Okay.

Gabe: The podcast. But I think it’s really, really important because I actually do think that this issue impacts both loved one’s family members and patients. And the number one thing that came up over there is the psychiatrist won’t talk to me. I have valuable information and they just keep screaming that HIPAA is blocking me and it’s impacting my loved one’s care.

Dr. Nicole: Yeah, yeah, that’s a big one. Um, so yeah, I mean, yeah, you know, we are here just upsetting everybody, making friends and influencing people on a regular basis. Um, but I get that, I get that, I get that, I get that, and there are times, let me tell you from my end, I would love to have an open conversation with a loved one. I would love it if I could just have a very open, frank conversation. But HIPAA is real and people do have the right to privacy. But you know what? That does not stop you from telling me whatever you want to tell me. Now, you may not be able to get the me on the phone, because some people will just not even cross that line because they don’t want to even go there. They don’t want the appearance of they gave information that they that they should not have given. I cannot tell you how many times I have said not a word. And yet a patient has come back and said, my mom said you told her blah, blah, blah, blah blah. I’m like, whoa, I didn’t even speak. Like I just, I just listened. So, you may not get to speak to that person, but I will tell you this mom, dad, significant other, sibling, best friend, whoever you are, you can write whatever you want and you can drop it off at that office. You can email it, you can submit whatever you want. And I have a lot of family members who will send me notes that say, hey, FYI, I just want you to know this happened.

Dr. Nicole: This happened, this happened. Might be something you want to talk about. Now, I often am put in the situation loved one that I don’t like to be in by you because you will tell me things that are very valuable for me to know. But then you will expressly ask that I not share them with the person who is coming in to see me for a visit. How in the heck do you expect me to address an issue or address something that’s going on? If you then say, but don’t tell them I said it to you. What am I doing? You are tying my hands. I have no way to help you. I have no way to bring this up without them either. Already knowing you were the one that told me or without saying. Well, your mom said this happened last week. I can’t just randomly say, tell me about the incident that happened at McDonald’s last week without. How did you know that mean? You know, people already think psychiatrists are out here reading their minds and we’re psychic anyway. We need to not add to these stereotypes that we have to hold on to. But get, get, give us, give us some help here too. Like if you do share information with us. We have to be able to bring it up. So don’t tell me anything that you don’t then want me to bring up.

Gabe: I think there is a ton of wisdom there, and I am surprised by the number of psychiatrists that do say things are HIPAA protected that aren’t like, can I have your email address and email? You know, no, that’s HIPAA. Can I leave you a voicemail? No, no that’s HIPAA. Can I drop off a letter? No, no. That’s HIPAA and on and on and on. And I’ve pointed out to many a family member that either that psychiatrist is outright deceiving you or they don’t understand HIPAA. So, can you verify again that it is okay to email, leave a voicemail, drop off a letter to a psychiatrist, even if your loved one has not signed the HIPAA form?

Dr. Nicole: A person can share with me whatever they want about my pain. They can share. Now I. I may not even be able to verify that that person is a patient. So, I was kind of tricky. So, I’ll give you an example. Sometimes working in a hospital, a loved one will call and say, my son is there on the unit. I’d like to speak to Dr. So-and-so. The typical verbiage is going to be, I can neither confirm nor deny that that person is here. If that person who’s in the hospital hasn’t signed a release of information and allowed that family member to be privy to their things, we can’t say anything. So, it kind of makes it hard to talk to you if the person. Hasn’t given us permission, even for you to tell me something like that. That can be a very fine line. So also in the outpatient setting, I could see that being a similarly fine line. If the patient has said, I’m not signing a release, I don’t want you talking to anybody. There’s a fine line because even in talking to you, I am at, I am, I guess in some ways admitting to you that this person is a patient of mine, and that could be a slippery slope to go down, which could be perceived as a violation.

Dr. Nicole: And it’s really just going to depend on your psychiatrist and how comfortable they are continuing to have that conversation. But you can drop a letter off, you can drop it off, you can just drop it off and say, don’t know if this person’s a patient of yours, but if they are here you go. And that information will be there. But conversations can be tricky, and sometimes it is a lack of knowledge about what HIPAA is and what it isn’t. Sometimes maybe the person just doesn’t want to talk to you, and I can’t tell you that that’s not the case. But there are there are very fine lines. And I think HIPAA, as a physician, a HIPAA violation is like this big, very big, scary, hairy thing that’s always waved over our heads. And so there is a lot of concern. And maybe sometimes that concern goes a little to the extreme. But like there are reasons why these things may happen.

Gabe: As a patient. I love HIPAA and I’m really glad that doctors take it seriously. Now, I have signed HIPAA waivers for my family members because I have a good relationship with my family members, and because we’ve gotten past all of the all of the negative stuff. But I really do like a lot of the HIPAA protections, and I get worried when I hear about advocacy groups trying to remove HIPAA for people living with mental illness because they think, well, why can’t I have protections just well, it’s because you have a mental illness, so you don’t deserve them anymore. Well, that sounds really bad. And advocacy groups of course say, well, that’s not what we’re saying. But that’s kind of the outcome. So, I know that HIPAA is also one of those loaded topics. But it came up a lot. And I love our family member listeners and I, I wanted to address it.

Gabe: Now, I know that we’re almost out of time, Dr. Nicole, so I’m hoping we can fit it in. But there was a comment that somebody left that a former psychiatrist said, quote, only young girls harm themselves, men don’t unquote. And he went on to explain that he, in fact, was self-harming, and his psychiatrist did not accept it as a symptom because apparently the psychiatrist felt that men cannot suffer from this particular symptom. One of the reasons that I bring this up, Dr. Nicole, is because we discussed earlier about how women, they’re sort of getting the short end of the stick, medically speaking, all over the place. And unfortunately, in rarer cases, men are getting the short end of that stick as well. And I just want our listeners to understand that, really, if you have a psychiatrist that is playing into the stereotypes of the world, you may not be getting the best care. What are your thoughts on that? If you heard a psychiatrist colleague say that in an open meeting or to a patient, how would you respond?

Dr. Nicole: Yeah, I mean, I would think it was ridiculous first. So let me just go ahead and I would think like, oh, well, that’s ridiculous. But I don’t know. You know, I’d have some questions about like how old was the psychiatrist? When did this happen. Because I will say, self-harm behaviors, things like that. Um, I think with the way that psychiatry and mental health has thought about these kinds of, of traits or symptoms or behaviors, I think largely decades ago, we, we did really think of them as, as female traits. We know that we think of self-harm a lot with diagnoses like borderline personality disorder. And when I was initially a doctor, a new doctor, we were taught that it was almost exclusively women, um, you know, and now maybe we’re thinking, well, maybe it wasn’t exclusively women. We just weren’t looking at men in that way, and we just weren’t willing to see men in that way, in the same way that we weren’t able to see women as having antisocial personality disorder or disorders that we thought were more male driven. Was that more our societal views of women’s roles and men’s roles in society and how we viewed them. So maybe, maybe this person was older and so they trained at a time where maybe we kind of attributed those kinds of things to women, but I think it’s absolutely ridiculous to tell somebody that just because they are behaving in a way that is outside of. The norm that. What they are experiencing is not what they are experiencing. Like, I think we wouldn’t do that for a lot of other things. We wouldn’t do that with people’s race differences and ethnic background differences and what we shouldn’t. But guess we do those too. So maybe it’s just what we do. Maybe we are just not very good in the world of taking people who don’t fall within the parameters of everybody else. But I would say that’s absolutely ridiculous.

Gabe: Well, Dr. Nicole, the entire internet. That’s how I choose to frame it. The entire internet attacked you and you held up so well. Just I mean, lots of great information. How do you feel now that the entire internet has grilled you on this podcast?

Dr. Nicole: Listen, this is not a grilling. I received worse day to day. So, this was. This was light. This was nice. This was fun. I welcome your feedback anytime.

Gabe: Well, Dr. Nicole, I am glad that you had a good time, and I want to remind you, and I want to remind our listeners as well, that patients don’t usually get to see behind this curtain. We don’t understand what psychiatrists are up against. We don’t know what happens when we leave the office and we go to our support groups, but they have other patients in them. We go online, and that’s where other patients are, and we’re largely left to our own devices. So, I want to remind all of our listeners when Dr. Nicole explains things, it gives them some thoughts. Even if your knee jerk reaction is, I don’t know, that doesn’t make any sense. Just remember that unfortunately, largely because of the separation of patients and doctors. And that’s a whole other podcast we can discuss if that’s good for us or not. But we get stuck in our own little echo chambers where when we do have issues with psychiatrists, we’re stuck getting support not from other psychiatrists, but from other patients. And that can really delve into territory that is maybe not serving us.

Gabe: I know that I truly believe that the vast majorities of the Dr. Nicole’s of the world are looking out for us. They are interested in our care. They are interested in us getting well. And largely many of us are in fact, getting well. But unfortunately, they’re also human and we’re also sick. So those two things can converge to make the experience less than pleasant. But remember, just because it’s a bad day doesn’t mean it’s a bad life. And just because you have a bad appointment doesn’t mean you have a bad psychiatrist. All right, everybody, thank you so much for listening. My name is Gabe Howard and I am an award-winning public speaker. And hey, I could be available for your next event. I’ll even bring along Dr. Nicole. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon, but you can get a signed copy with free show swag. Or learn more about me by heading over to my website gabehoward.com.

Dr. Nicole: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych or on my website, DrNicolePsych.com.

Gabe: And, hey, can you do us a favor? Wherever you downloaded this episode, please follow or subscribe. It is 100% free. And do us another favor. While you’re in the giving mood, recommend the show. Share it on social media. Share it in subgroups. Share it in support groups. I’ll send somebody an email or a text because sharing the show is how we grow. We will see everybody next time on Inside Bipolar.

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