Dear Jennie,

You evidently got an appointment at a teaching hospital. While they are the best place to go for physical diagnoses, they are the worst for psychiatric diagnoses. Here in San Francisco, Langley-Porter, the psychiatric teaching arm of the University of California, hands you over to Residents(!!) for continued care. They know nothing and are terrified to prescribe any medication. It seems to me to be malpractice per se.

The best thing for you to do is to shop psychiatrists until you find one with whom you feel a rapport, even if he is not a "preferred provider" on your insurance. Many of the best psychiatrists in SF do not accept insurance. Competent shrinks are scarce on the ground and they know if they are good. They don't have to take insurance. Most health insurers will pay 50% of what they consider the "typical charge" for a psychiatric visit. Here is SF, the insurers consider that to be $140, even though it is actually $175-$200+. However, a reimbursement of $70 is better than nothing.

I cannot believe that they didn't sign off on your Depakote prescription or offer you an alternative. That's why you went there. Do you think that they were scared of you?