Hello everybody,

Today my husband and I met with a new psychiatrist to discuss hubby's ADD.  We haven't had decent insurance before now so, finally, at last, we were trying to make the most of it and get hubby on the proper ADD medication.  Up until now he has only been [inconsistently] taking Lexapro for depression, but in light of all the positive stories here we felt we should give some of the stimulant medications a try.  Unfortunately, since my husband is the "patient" between the two of us, most of these places will only let him make the appointment.  This means we had one failed attempt to meet with a psychiatrist in the last month when he made an appointment at a place that doesn't accept any insurance.  We wasted $230 on the assessment session with a THERAPIST (not a psychiatrist as intended) and could not afford to continue going there.  So today, after 3 long weeks of waiting, we had our appointment with a psychiatrist at a different office that took our insurance.  Additionally, my husband didn't want to go alone to this appointment so I took two hours sick time off of work this afternoon so I could join him at this first session.

My husband has been in therapy for years, at least 8 years, off and on.  Since money is tight he has only been able to go to cut-rate therapists through the local mental health center.  Sadly, none of these therapists seemed apt to help my husband.  That being said, I have sat in on a few of these sessions so I had some expectations about how today would go.  Suffice it to say, I was VERY surprised and taken aback by this Dr.'s "style."  Near the beginning of the session he asked me what I thought were the two biggest problems in the relationship due to my husband's issues.  I said irritability -at which point he cut me off to plug his book on how irritability ruins marriages- and then I eventually said lack of reliability was my second biggest concern. 

He then asked my husband a set of questions such as "how have you been sleeping?"  "How is work?"  Unfortunately, my husband can act like a bit of a curmudgeonly old man, so of course he goes on to complain and exaggerate about his troubles (example: "I only got two hours of sleep last night!" [false - I was there to hear him snoring away]).  Hubby likes to take any opportunity to go all "woe is me" and hope to attract sympathy.  (However, he did manage to screw up his story when he told the doc that he only takes 20-30 minutes to fall asleep, and then later pretended that it took him an hour and half to fall asleep.)

After getting curmudgeonly responses to these questions, the doctor starts jumping to all kinds of conclusions and starts "leading the witness" with questions like "Were your parents demeaning to you as a child?"  "Did your mother have post-partum depression?"  The answer to both is "no."  Despite this, the doctor starts getting all excited about some pet theory of his, and tries to gather more evidence necessary to fit his conclusion.  He then asks me if I think hubby tends to "obsess" about his anxieties.  I tell him that my husband gets easily frustrated and has low stress tolerance, but I explicitly state that hubby does NOT "ruminate" or worry, per se.  Husband agrees with this statement.  Nonetheless, later in the conversation the doc concludes that hubby's problems are mostly due to anxiety on the basis of poor sleep, lack of concentration, and a tendency to obsess over his worries.  Even though we both had contradicted this last supposition.  I definitely agree my husband has problems with anxiety, but it seems like this doc was so intent on hitting all of the bullet points on his mental list that he was ignoring what we were actually saying and just trying to get our problems to fit his predetermined mold.

Doc also got a bit too pseudoscientific for my liking, commenting that since my husband gets migraines he is likely of the genetic makeup that would predispose his moods to easily change.  He also goes on to speculate on the character of hubby's mother, and furthermore remarks that he can tell my husband is troubled simply based on his posture while sitting on the couch as compared to my posture.

Instead of prescribing an ADD medication like we expected (or really, even asking any ADD related questions at all, even though that's what we went there for) doc says hubby should lower his dosage of Lexapro on the premise that it might be making his symptoms worse.  Then, on top of the Lexapro, he prescribes Abilify and Lamotrigine!  Doc quite nearly prescribed a sleep aid too but backed off on that, and said hubby could just use Benadryl a few nights a week if he needs to.  This is crazy!  For one I felt like he was taking my husband's griping, especially about the sleep issue, way too seriously (and I think my husband was a bit surprised too at how "real" things got as a result of his exaggerated ranting).  And I felt like an anti-psychotic medication was a bit over the top for my husband's issues, and furthermore these drugs can have some serious side effects.  I'm wary about medication to begin with, took me a while to warm up to the idea of Ritalin, and this guy throws 3 different meds at once!

Doc asks if we have any questions.  I said that I was very surprised at the recommended medications, was concerned about the side effects, and pointed out that we did not discuss any of my husband's ADD symptoms.  Doc gets a bit snippy with me, and asks point blank if I want him to prescribe hubby stimulants.  I respond that I do not want to make him prescribe anything, but that I am confused that this very big issue was not discussed at all.  Doc asks me if I want to set up marriage counseling.  I tell him no, that is not necessary.  Doc goes on to be a blatantly condescending asshole towards me, talking down to me about how well he explained everything and basically implying that I am stupid if I do not agree with him, to the point that hubby and I are both a bit shocked.  Once we got into the hallway after the session, husband blurts out that he was quite upset at the way doc spoke to me, and he was ready for us both to just walk out of the session.  Instead of barging out, though, doc gave some free samples for the more expensive meds he prescribed and we picked up the prescription for the last med at the drug store.  So now we have a counter full of medications that I am not sure are necessary, but I guess we are going to try it.  Even though we are both appalled by our experience today, and on a gut level want nothing to do with this doc, on the other hand the "nice" doctors we dealt with before were fairly ineffective, so maybe this new approach will work.  I just hate the idea of "giving it a chance" with potentially dangerous medication; it is not a "safe" gamble in my mind.

Anyway, I am just looking for others' opinions.  Is this doc an eccentric genius or just an egotistical asshole?