I am a junior doctor myself, as well as a patient of OCPD for the past 15 years and my answer to that question is no, they don’t. And I have seen 2 physicians and 3 different psychiatrists and a therapist in past 12 years. Psychiatry is a very poorly studied and very poorly understood branch of medicine and is thriving mainly because of pharmaceutical companies. If there were no drugs, the branch would practically go extinct and the study of the human mind will be just confined to psychology. Psychiatrists are the quacks of the medical field. They pretend to be doctors and play medicine. I feel like it’s all a huge lie propagated for ages to make people believe that psychiatrists actually help anyone.
Now let me elaborate.
I have suffered from OCPD for the past 15 years. When I first started getting symptoms I didn’t even know what was even happening to me. I was a grade-A student throughout my life and now suddenly every little detail about my studies started giving me anxiety. I was preparing for medical entrances then and I was so scared of not doing good enough, I wanted to utilize every minute of my day and do the best I can to get into a med school. Every minute of my day was planned and if even 15 minutes slipped it gave me huge anxiety. I couldn’t read a single paragraph without having to read and re-read it again and again until I was convinced that I have done it perfectly, that I have understood the concept perfectly, I used to read one line and but the time I was on the 5th line I had to re-read the first line again because I had forgotten it already, I would be stuck on the same page for weeks before finishing it. I had developed a kind of perfectionism that was severely interfering with my productivity, I had a timetable made for every hour, every activity, every chapter in the book to manage my time better, yet my whole schedule was falling apart. A year went by like this and I just dismissed it as normal exam stress. I was reading biology so obviously after a while I started to self-diagnose. I realized that my symptoms match OCPD. But I didn’t know what else to do about it. How and where to get help in my small town. I thought it’ll just go away after my exams. But it didn’t and it was severely affecting my productivity. I was just 17 at the time. And I failed my medical entrances. I was devastated. I was so shocked, being a topper in all my classes and tests. I went into a hyperactive mode and decided I will not make another mistake and will crack the exam with all my might. But again the symptoms went on to destroy all my plans and ambitions. I had made hundreds of timetables by now. And it turned into this vicious cycle of anxiety and failures. Then I decided to tell my parents that I need a psychiatrist. So they took me to one. And it was nothing I expected. The man seemed completely disinterested in helping me. It was like he is just there to prescribe meds and let the drugs do their magic. He diagnosed me as clinically depressed. I told him that my symptoms look like OCPD but he didn’t listen. He gave me antidepressants and SSRIs, so it doesn’t matter mostly because treatment for OCPD is also SSRIs and CBT (which I never got, despite asking for it repeatedly). I got many side effects, I was drowsy all day, slept 12 hours a day, slept through all my classes, had nausea, yawning every 10 seconds, but he never changed my drugs or dosage. He said the meds take at least 3 months to take effect, so you’ll have to wait it out. He said I have to take them if I want to get better. So I waited and waited. The whole point of getting treatment was because my illness was interfering with my studies. Now the treatment was. How could I study if I am sleeping all the time and yawning every 10 seconds? I couldn’t focus. It was horrible. I hated my life and wanted to die. But he just didn’t listen. He just kept giving me the same drugs.
3 years went by. I moved to another city and got into med school in the meantime. I changed my Doctor then. I went to my college professor and Head of the department of psychiatry. He didn’t even listen to a word, it was barely a 2-minute meeting, I showed him my old records and he wasn’t even bothered to ask even my history. He sent me to a psychologist for evaluation. The psychologist was very patient and listened to every little detail and finally gave me a diagnosis of OCD. I again tried to explain to him the difference between OCD and OCPD but he said it’s the same thing. And later I understood why, because the psychiatrists don’t give a damn about these details, they just prescribe drugs. And that’s exactly what happened. I went with my psych evaluation report to my professor who just took a look at the paper and said, oh, so you have OCD, and scribbled a few meds on a paper and sent me packing. Literally didn’t ask me a single question. I was shocked to see the same meds as my previous doctor. I took the and again same side effects, and I got the same answers. So I just decided to quit treatment. Because the treatment was not doing me any good at all.
I was in my 3rd year of med school now and I was just barely getting by hanging by a thread. Med school is brutal and nobody is kind to you. I was extremely anxious about my exams and results all the time and was getting panic attacks every couple of months. I saw a few physicians during that time. Again I told them about my history of OCPD and they gave me SSRIs.
See, here’s a thing you need to know about psychiatry. The whole business is controlled by pharmaceutical companies. They only have a handful of drugs that affects chemicals in the brain. And they have assigned them all to every illness. There are antidepressants, SSRIs, mood-altering drugs, sedatives, hypnotics, etc. Most of these psychiatric meds have addiction potential and are not safe. Most other drugs just make you sleep, so basically the treatment plan is to keep the patient asleep, if he is sleeping he isn’t experiencing his illness, he isn’t facing his disease, the disease doesn’t bother a patient when he is sleeping. SSRIs are the only safe drugs they have in this century and the pharma companies are bound to shove them down your throat. It’s all the Doctors ever prescribe these days for everything. And a little escitalopram and propranolol. That’s all they do. Even if they don’t work, even if they don’t help, even if they cause side effects. I repeatedly told my doctors about how the drugs were causing me sedation, but they were so living in denial about it, they said it’s impossible, these don’t cause sedation. They never listened to anything I had to say, and they downright dismissed my side effects, because they had no alternative drug available that could help me. Another surprise for you, the drugs that treat a particular illness also has the same thing they are supposed to be treated as a side effect. For example most anti-anxiety and anti-depressants, their side effect is anxiety and depression. Ironic, right? And honestly, they have no way of knowing if the meds are working. You go once a month for a visit and the only question they ask you is “how are you feeling now?” Now if I say I’m feeling better they just continue the same treatment, if you say “not so good” they’ll adjust your dosage. Now you could be feeling better for all kinds of reasons, maybe you had a good day, maybe you’re just in a good mood, maybe you’re feeling good because you got to see your sister for a long time, or spending time with your little nephew made you feel a little happy today. But they will ask no follow-up questions, they are so desperate for the meds to work that they will attribute everything to meds. After 1 whole year of treatment, I wasn’t feeling any better, there was no improvement in my symptoms but every time he just asked me this one single vague question and based my treatment on that. After a while I started to think maybe I’m not understanding and thinking right, the meds are supposed to work by now and maybe they are, and maybe I’m not feeling it because of lack of motivation or something. It was crazy.
In my 4th year of med school, I again changed my doctor. This time I went to a private clinic. I showed him my file which was huge by now. I had taken every SSRI there is in the world and many other meds. He again gave me fluoxetine and sertraline with propranolol and escitalopram. I told him about my side effects so he lowered the dosage. Now, this is all this doctor ever did. Every visit he would adjust the dosage, he went on to try every combination known to him in the cocktail of meds. But none ever helped. I was drowsy all the time, yawning all the time, was absent-minded in class, was anxious in hospitals, I was miserable. I lost 10 kg weight in a span of 10 days when he changed my drug combination because I got side effects of severe nausea and vomiting. Every meal I puked. But he just kept telling me I must take the meds if I want help.
Just explain to me how is this helping me? I have OCPD, I need help with my studies, so tell me how is sleeping all day, being distracted, being anxious, and being nauseous helping me focus on my studies? I asked all these Doctors if they can give me CBT because I have read that CBT is very effective in OCPD (or OCD for them, because they just called it that, which I do not have) but none of them ever referred me for it. They just wanted me to keep coming to them and keep taking drugs, even if they made me miserable.
After this whole ordeal of almost 11 years, I didn’t know what I was even doing going to all these Doctors and expecting them to help me? I was always drugged up, I was always drowsy, and I didn’t know what all these chemicals were doing to my brain. I was experiencing brain fog all the time, I felt my brain was turning to jelly. Nobody seemed to care, even when it was their job and I was paying them to do their job. I decided to look up therapists in my town and all I could find was one lady. But she was a total phony. She didn’t help me at all, took out thousands of rupees for all these sessions where she just made me fill up forms and kept them in her records for her research. All advice she gave me was to do yoga and mediation. That I could have looked upon google myself. Trust me in 12 years I have.
I have decided to quit all this treatment altogether. I don’t want all these drugs messing up my brain anymore. It was my greatest gift and now is my worst enemy. I am not a rich person, I belong to a middle-class family and have worked very hard to be a doctor. I am down by thousands of rupees and 12 years of my life. The psychiatrists are the phonies of Doctors and they don’t know what they’re doing. The field is extremely poorly studied. The treatment is not one size fits all. Treatment in psychiatric illnesses must be tailor-made for each individual. The human brain is like fingerprints. No two individuals have the same. Every person has a different thought process, a different life, different social factors, different environments they grew up in, different kind of childhood, different experiences, different memories, and each and every little detail has an impact on the mental health of a person. It is not like a fever or a cough that can be treated by the same medicine in every person. Every patient required a different combination of meds, dosage, and therapy. something that psychiatrists can’t seem to grasp. They want to be like physicians that can cure an illness by just prescribing a couple of drugs. They are lazy and do now want to do the work it takes to actually cure a mental illness. Honestly, every patient dies eventually and their illness dies with them. Meanwhile, my Doctors who lived in 2 BHK homes have posh bungalows now and I am still struggling to this day with focusing on one paragraph of conduction defects in ECG for the past 3 days in my book. I have no career, no job, no friends, no relationships, life is pathetic and miserable, I am not able to cope on a day-to-day basis. That’s what’s become of me. I don’t have anything against them making money, but it would be better if they actually helped anyone while making their money. I will never go to a psychiatrist ever again in my life, being a doctor myself. I wish I never had. God knows what all those drugs have done to my brain, I don’t know if I’ll ever be able to study again and do something with my life. All these psychiatrists have just filled their pockets and made me a loser. It gave me false hopes that someone could help me and made me dependent on other people for solving my problems who never ever wanted to help me. And I will only wish a mental illness upon my worst enemies.