I don't know what to say to my psychiatrist

[Placo]

So, I find myself in a somewhat particular situation, basically my psychiatrist left me his cell phone number so I could keep in touch with him in case of problems, it is not a privilege of all patients, in fact he gave it to me after some time.

Having said that, I find myself in difficulty on the percentage of truth to tell him to avoid risks, he does not seem like a coercive type, in fact he is nice but you never know.

For convenience I will divide the things I can tell him into 3 levels of risk:

Level 1: low risk, I should tell him that I have exaggerated with the medications compared to the protocol we decided yesterday, this is the least risky option and I have already said it in the past and nothing happened.

Level 2: medium risk, I should tell him that I use substances that are classified as illegal even if they are not hard drugs but more like psychotropic drugs that have been made illegal and kratom. The risk here is that he could direct me to a facility for drug addicts.

Level 3: high risk, this is the most dangerous thing to say, that is, that I have SN, I could perhaps say that I don't have SN but vaguely that I'm thinking about suicide, it would be much safer, the risk here is that he would make me throw it away and maybe if I refuse to have me forced into hospitalization.

In your opinion, how much truth should I tell him? Telling him everything seems crazy to me, a friend of mine did it and in fact they made him throw away SN and now he regrets this choice a little and finds himself with his family who keeps him under observation a lot and they are evaluating a facility to put him in.

 

[Jadeith]

Just a while ago i took part in rather fierce discussion about such topic. Personally, i opted for truth, only truth and nothing but truth.
Others pointed out that divulging certain information is not advisable as it might put you in mental institution of dubious reputation.
More on the subject here:

how much can i tell my therapist?

im finally going through with getting professional help, i havent even started yet, but im supposed to in about 12 or so hours, im worried that if i tell them too much they will report it to my family cuz thats a thing right? also i dont live in the US but im fairly sure its almost the same...

sanctioned-suicide.net

 

[Placo]

I even asked ChatGPT what to do and he surprised me, he says to tell the truth on level 1, on level 2 to tell a slightly nuanced truth and on level 3 to mention suicidal thoughts but not that I have SN, it really shocked me, I thought he was opting to tell the 100% truth!

 

[Jadeith]

It tells sth about mental institutions and mental healthcare providers when even AI doesn't trust them

 

[0bebe0]

I wouldn't lie, just refuse to answer some of the questions. You don't have to answer these questions at all. I never told my psychiatrist nor my therapist about having SA. I know that bad things will happen when I say the truth, so i don't say anything at all.

 

[Praestat_Mori]

What do you expect from telling your psychiatrists/therapist about all this?

Do you expect a "magical cure" if your therapist knows about it?

I personally wouldn't mention anything of that unless I would expect a benefit from that.

 

[Placo]

What do you expect from telling your psychiatrists/therapist about all this?

Do you expect a "magical cure" if your therapist knows about it?

I personally wouldn't mention anything of that unless I would expect a benefit from that.

Good questions, I'm actually thinking about it, maybe my hope is that they increase the frequency with which I'm given esketamine.

 

[Praestat_Mori]

Good questions, I'm actually thinking about it, maybe my hope is that they increase the frequency with which I'm given esketamine.

I think it's worth trying with a good strategy. If the esketamine therapy helps you it's probably worth a try. Weigh the pros and cons incl. the risks. Good luck!

 

[Placo]

In the end I made the most sensible choice, that is to tell him only about level 1, that is, abuse of psychotropic drugs, for now he has viewed without answering, let's see if he answers later.

Here are the messages translated from Italian, so there could be some errors:

[1/4, 19:36] Davide: Hi, sorry but I feel compelled to tell you that I have already broken the protocol we established yesterday, it's that on my way home I returned in a bad mood and I increased the dosage of mirtazapine, leaving the Latuda the same, then this morning I woke up exhausted and I lost count of how many I'm taking even if all in all I think I'm not at risk of dangerous interactions, I would need esketamine every day
[1/4, 19:37] Davide: Even if it's maybe a placebo I feel better and it helps me chase away bad thoughts
[1/4, 19:37] Davide: The only one whose dosage I respected is Latuda in practice

I added this message:

And all this manages to keep me at least a little active at home, my mother wanted me to go down to the tobacconist but I don't feel like it, in my opinion I'm a case of MAOI or some advanced treatment, if I respected the dose of the therapy it certainly wouldn't be enough, I could even force myself to do it but I'm afraid that the bad thoughts will get the better of me so this abuse in a certain sense is protective even if maybe more risky for other reasons but in my opinion between this and the bad thoughts it's the lesser evil, in the meantime I'm evaluating for the structure but the idea scares me a little to be honest