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Hi,
How’s it going? I hope you are doing well.
Yesterday I got an email from someone that
talked about how her doctor didn’t care about
her and that he only took minutes to see
her each and every time and many times the
doctor didn’t even remember what was going on.
Actually this person got one of my courses
that talks about a concept called the 95/5
rule with bipolar disorder.
Let me explain what it is.
When I first started helping my mom,
eventually I discovered that most people (95%)
that were going to see a psychiatrist
were getting what I called “assembly
line treatment.”
That’s when you go in and the doctor is like
“hi, how you doing, have this problem, how
are you feeling, okay see you next time.”
If you get this kind of treatment you are
probably in the 95% category.
If so, I call this assembly line treatment because
the person is almost going through an assembly line
where the doctor is not really caring all that much
about the person. It’s done in a mechanical kind
of uncaring way.
Now I know I am going to get some hate mail from
doctors that say this isn’t true, I don’t know
what I am talking about and so forth but it
is true.
It’s not only with psychiatrists but also with
all kinds of other professionals.
If you have bipolar disorder, there’s another reason why
I strongly encourage you to have a friend OR family member
become involved in your treatment so you can
get 5% treatment or become a 5 percenter.
Let’s kind of review the math.
Basically, out of every 100 patients a doctor has,
I believe 95 receive assembly line treatment. The
doctor comes in, looks briefly at the chart, asks a
couple of questions, writes a prescription, and then
moves on to the next patient. The doctor doesn’t give
these patients a second thought once he leaves the
examination room.
The other 5 patients, however, receive extraordinary
care. The doctor is attentive to them, listens to their
questions, explains things carefully, tries to reduce
their concerns, works closely with the families, and
thinks about their conditions even outside of the office.
Every person deserves to receive the “5 % care,” but
that’s just not the way the world works. Unfortunately,
even the best doctors are going to focus the majority of
their attention on a minority of patients. Obviously,
you want to be in that minority with your doctor and
other medical professionals.
The only way to avoid assembly line treatment is for
you AND your loved one to become actively involved in
the treatment process. Your loved one should periodically c
heck in with your doctor to ask about your condition,
drop by to chat with your therapist, and stay in touch
with your pharmacist. Every one of your medical
professionals should know your loved one’s face,
voice, and name almost as well as they know yours.
With my mom, I always called the receptionist, I went
in to see my mom’s doctor. My mom and I did joint reports
of how see was feeling. We emailed them, faxed them. We
were serious people. As a result everyone started to remember
us and we started to get into the 5% group.
You might think this is “crazy” but it totally works.
The reason this approach works is that it lets the
doctor know that someone is watching out for you—and
making sure that he doesn’t mess up. He knows he’s
going to have to stay on his toes, so he won’t take
sloppy shortcuts when it comes to your treatment since
he knows it could come back to haunt him if he does.
SUPPORTING AN ADULT WITH BIPOLAR DISORDER?
Visit:
http://www.bipolarsupporter.com/report11
SUPPORTING A CHILD/TEEN WITH BIPOLAR DISORDER?
Visit:
http://www.bipolarparenting.com
HAVE BIPOLAR DISORDER?
Visit:
http://www.survivebipolar.net
Many times, people who don’t have anyone else watching out for
their best interests (when they aren’t stable) or who
try to keep their treatment secret from their family
members or friends are the ones who end up in the 95.
Hands-on involvement is the only way to keep medical
professionals in line and to ensure that you get the
best treatment available at all times.
Well I have to take off now. I hope you have a good
day and I will catch you tomorrow.
PLEASE POST RESPONSES TO THIS EMAIL HERE
Your Friend,
Dave
P.S. Don’t forget to take a look through the
different programs I’ve put together… each one is designed
to help you with a different area of bipolar disorder whether
you have it or you are supporting someone with it.
You can see them all and get the details by visiting:
http://www.bipolarcentral.com/catalog.asp
P.P.S. Check out my F.ree blog with copies of emails
that I have sent in the past and lots of great
information for you:
http://www.bipolarcentral.com/supporterblog/
P.P.P.S Check out my F.ree podcast. Hear me give
mini seminars designed to teach you information
you can’t learn anywhere else.
http://bipolarcentral.libsyn.com
hi david i have read your newsletter and must say i aggree with you i have had at least five different psychiatrists, none of them seemed to listen even the one i have now didnt until i told her i wanted to see someone else and why.now i phone her up when i dont feel to well and when i see her she listens now
Dave:
What you describe is the exact situation that I am in with my psychiatrist, and I can only meet with him every two months. I think of suicide and death a lot now, and had my “plan” for three years.
My family lives 5 hours away by car and many of them have depression themselves, but from what I’ve seen, I’ve been hit with depression far worse than the other members of my family.
My dad kept my treatment for cerebral palsy, from other members of my family, never mind everyone else. He didn’t even tell my siblings I had cerebral palsy, so as an adult, my sister can tell me “you’ve been in the hospital half your life, so what?
I had my life ruined during one of my hospital stays, that’s what! During one operation, whether it was from negligence, accident, act of God or fate, I sustained severe nerve damage. Washing my feet, putting on footwear and socks, cutting toenails and many other things, causes me tremendous pain. Both legs from the knees down became like that, I cannot tolerate wearing most types of footwear. I wear my slippers and socks 24-7, except for showering and sleep in my clothes so my lower legs and feet are protected at all times. Without this precaution, even moving my legs in bed and having a blanket on my feet would hurt tremendously, and they weren’t like that before surgery.
I haven’t showered in almost two weeks because the replacement care provider I now have triggered my nerve pain too much when I tried to get into the shower. If my feet were okay, it wouldn’t matter if my regular care provider was on vacation for two weeks. But that’s what one particular hospital stay did to me, and to this day, I deal with hospitals only after a great deal of soul-searching, fear and prayer and even then….
I don’t want to gross people out, but I want you to understand the impact that just ONE hospitalization had on me. I have 10-12 operations under my belt and numerous hospital stays, meetings with a myriad of specialists, so many that I badly want to walk away from all this. These are the only humans I deal with, and probably ever will deal with on a regular basis, because the few friends I make would abandon me, sooner or later, “like everyone else has” a, so my father said while I still at home with him
25 years on, the hospital stay that so devastated me is still too painful for me to talk about, even with my doctors and psychiatrists.
My parents can’t be supporters, Dave and not even with my psychiatrist. When I finally came back from the psychiatric institute and wasn’t any better, my parents blamed me (I was seven years old when I got back) and to this day, will not sit down with my psychiatrist “because it’s all been done before.” (said in an angry tone of voice) My mother’s belief concerning her depression is “fake it ’till you make it.”
Given that I am still frightened to be in the same room as my father after almost 15 years away from home, my chances of including him on my support team are slim to none, nor can I go to my mom for emotional support when things get bad. It’s not that they don’t care, but they have issues of their own, have a lot of anger at me, and are apt to keep certain things a secret (like my dad yelling at me because I wasn’t better 4 months after one operation (I needed at least a year to recover. When I told a nurse on my care team about this, she talked with my father one day as she was leaving.
My father yelled at me after she left (for talking about a “private family matter”)
I have no one I can go to in order to “stand up for my best intersts”. I am far from stable, Dave. I may sound okay on here, but I have been afraid of being in contact with others, for fear that they would turn on me as well, like my father had. I think that there is something about me that makes me difficult to deal with or my parents wouldn’t be so mad at me.
I wish I had someone to act as “a supporter” for me in Ottawa. I have one friend in Toronto who deeply cares for me, but is too far away, and I have trust issues that keep me isolated.
It wasn’t that my parents didn’t care about me. They saw to my medical treatment and I never lacked for material things as a child, but they both say that “you were a difficult child to bring up.”
It may have been wrong to blame a seven year old for her mental problems, and to be still be angry at her 30 years on, but I have no right to be upset at them for my father’s emotional abuse and yelling (Mom did it too but to a lesser extent.). Communication with my parents is rare, but they do come up here twice a year to do housecleaning and bring up supplies and then go home. My depression causes me to isolate myself almost completely from others, even my own friends and family. I would like that to change, but I don’t think I can be fixed, Dave.
Were it not for my friend in Toronto and my friends at church, I’d take myself out because my life cannot be salvaged at this point, not because of my physical handicaps, but the mood disorder. (I often say that the battle of dealing with a physical disability is 90% of the battle. You have to be in tip-top emotional shape to deal with what this kind of life can bring you. God help you if you or your caregiver have to deal with mental illness on top of physical disabilities, or if, worse still, if both you and your parents have depression. A child looks up to her own parents for stability and protection and if you are scared of them or they abuse you, while you are reliant on them for care, especially when you are handicapped, who can you trust?)
And what do you do if your own mind turns against you, you are not stable and trust few people or no one?
Good e-mail, Dave. I may not have bipolar or I may have it, but either way, your information is proving useful and your description of the medical system and mental health system is so accurate….let’s just say that I’m going to throw up after I log off, because you basically described my situation all too well and because I am handicapped and poor as well as depressed, my situation isn’t going to get better anytime soon.
There is nothing for me in this world and I have no hope of things getting any better….with my family, doctors or my health problems. I have only myself to rely on out here and I am not stable, or at least, not at all myself. I pray for death every day now. That is not like me, but I have been enduring hell for three years, been begging for help for two years and the silence from the professionals is deafening. Believe me, I care deeply for my God and my friend in Toronto, or I’d have checked out long ago.
I need to see improvement soon, Dave, but it won’t come while I’m stuck on the assembly line. And given the accessibility issues here in Canada, I can’t get a new psychiatrist any time soon. (We don’t have a “Canadians with Disabilities” Act up here.
I am posting this in hopes that it will help others. I am beyond hope of recovery. If this post helps others, that will be a comfort to me.
Hi David
In the beginning, my husband would go to the doctor without me. At the time I was unaware and did not think much of it. I noticed that nothing was changing. I started to go with my husband and found that he was not giving the doctor the correct information in the first place (not lying, just unaware), I found the first visit it was as an assembly line and I made sure that changed and I also realized that the caregiver, spouse or partner really needs to be well versed in the diagnosis and medications and other treatments. I cannot tell you how many mistakes (potentially serious)that I have found. Now, to be on the fair side, we have also had doctors that have been very exceptional. Attentive, caring, careful and extremely cautious. My husband trusts me greatly to make his decisions. This kind of care is very important and if I am not satisfied with anyone dealing in my husbands care after we do our part in giving the doctor the up to the minute correct information and effort into the communication, I just Fire them and move on. We are in good shape now. What many clients and caregivers do not realize is they need to be proactive in their treatment, not reactive.
David, This is good to be the 5% IF the patient will let you go with them. My husband will NOT let me go anymore. He gets angry and walks out of the session. I have depression and I have to spend my treatment time talking about him. It costs me $90 to talk. If I could get him past the angry I’m sure the doctor could help him.
I have a question that maybe you can find the answer to or maybe do an article on. Is there a relationship between bipolar and erectile disfunction? Is it caused by the medications? I know you are not a doctor, lawyer, etc., etc., etc…
My son has bi polar, he is 32. Also he is in jail. Is there any help with the fact that he really was out of his mind when all this illegal stuff went down on him. Can you direct me to a site for help?
Thanks,
Pattie J
Hi Dave
I agree with you! It is not only in the U.S. I live in the remote part of my country and the phychiatrist only comes every 3 months. You pay alot just to sit down for 5 minutes, get a perscription and then that is it.
David,
Your newsletter is right on. I think unless one has an advocate of family/friend, he/she will not get proper care on a regular basis. As a retired nurse, I have observed your description of 95/5care as being accurate. I think it is even more difficult for medical professionals to get excellent care. I physically look much like I did when I owned a large home health care company. I lost my company and all my hard work mainly because the medical professionals around me failed to recognize how very ill I was. Family/friend advocates must be persistant in helping the ill one receives thorough care. Sometimes, it is necessary to interview doctors to find one that really will take an interest in the ill ones needs. I finally have caring doctors, but it is still difficult to get my medications regulated as I have several other disease processes that require medications. Please speak about bipolar and how it affects the seniors with the disease. I am seeing myself becoming less tolerant of stressful conditions. My husband and I are currently caring for my elderly parents–mother 87 and father 96.
David, thanks for caring!!!!
Hi Dave,
Express line medical care is true no matter what you try to see the DR about, My Dad is Bipolar and lives on the other side of the country. I never see him but I talk to him on the phone, I signed up for your list so that I can better understand him. I have lupus and thats the treament I get from my Dr, in out next please! Total BS
Mia
My son has been diagnosised as Bipolar I Mixed for 9 years now. We have been in several treatment facilities, outpatient clinics, etc. I want off this hamster wheel and so does he. I totally agree with the entire psychiatric assembly line process. After so many years, you can information piled up ontop of information, drugs piled up ontop of drugs. Then what do you do? I am seeking a dual diagnosis treatment center that will treat both his Bipolar disorder and substance abuse. Does anyone know anything about Chapman House in Orange County, CA? Any help is appreciated.
Oh wow, Dave. I was reading that news letter and my jaw somewhat hit the floor. That sounds just like my doctor.
dear David thank you so much for your site it has been a life saver 2 months ago my soon to be ex husband was on a 3day mania over using zanax crashing my car then finally lost it and threatened me and our son 7 I called for psychiatric screener and police he went to the hospital he is now “leveled”but takes no responsibility because he claims doc says it is the disease.thank you for your help to see the signs and get him help. he is feeling better but after 10years 7 of them with his cycling and refusing to get help i can no longer help. his ex-shrink was in and out in 5 min but charging $200 each time. now he does not even return my calls after what happened.
thank you for your help
sincerely Petra
dear dave, i happen to agree with you on the 95/5 rule.i would like to add that you can fire your doctor if you are not pleased with him or her. i recently had a bad experence with one of these kinds of docters. i dont care what they say .some docters do this very thing and they ALL know it. thanks again for the email.