I’ve been thinking about ‘psychiatric time’ – it works differently to ‘normal’ time, and if you have a mental illness you have to come to some accommodation with it. Patience is required.
Psychiatric time just runs slower than normal time. We’re dealing with human beings – not blood tests. We get brought up short the first time we present to a General Practitioner or Primary Care Physician. By the time we first present with our mental health concerns we have probably already been harbouring them and dealing with them for a long time. We present once we can’t cope with our situation any more – we’re by then at the end of our tether. By the time we present we’re desperately in need of a solution. What we find instead is that we have to enter psychiatric time, and start being patient. Our GP may want us to come back for a second appointment and send us away with some information or a questionnaire. They may refer us straight to a psychiatrist, which will take a varying amount of time. Whatever happens next will likely not be the release of tension we were craving. Then there’s the story telling. We have our whole story prepared in our minds, but find that there isn’t time in a first appointment (or a second or a third) to tell that story properly. If we’re referred to psychiatry we have to start again. Patience is required.
Our expectations of psychiatrists may be too high. At the point where we present we are often in such a bad way that we require superhuman efforts to sort us out. We therefore require our psychiatrist to be superhuman. It can be frustrating in these highly charged circumstances to realise that our psychiatrist is simply human after all. Patience is required.
Then there’s the general timescale of treatment. We may start medication with some relish, thinking that this is going to ‘sort things’, but we’ll have to learn to accommodate the fact that an anti-depressant, for example, is going to take several weeks to start to take effect. If you’re bipolar, and your mood episodes last for weeks or months, it’s going to take 6 months to a year to really establish whether new medication is having a useful effect on the pattern of your moods. Side effects may derail you early on, but most side effects will settle down after some period of time (it took 3 months for side effects of lithium to wear off for me – I felt sick as a dog this whole time – but now I’m good as gold on lithium and it works very well for me) – it pays to have patience.
Finally, the communication thing. We never get it right and complete the first time. We always leave feeling like there was something we wanted to say but didn’t. We may have some time to wait before we can meet with our psychiatrist and try again. Try again. Do. Don’t expect instant gratification, because the world doesn’t work that way. It’ll be a challenge to adapt to psychiatric time. But cultivate patience and try to look for the long term progress – it’ll always be there.