Psychiatry as a pseudo-science often relies heavily on unscientific and non-empirical methods of diagnosis. There is no brain scan or blood test to detect or even rule out bipolar disorder or schizophrenia, you just go with whatever the doctor feels like when the patient comes in off the street.

Psychiatry is worse than veterinary medicine: a dog can't talk to you and tell you what's wrong; neither can a dog lie to you or be a deranged, unreliable narrator. Psychiatrists often ask questions which have a specific context or particular technical meaning to them, and the mentally ill will answer out of ignorance, or with a non sequitir, that seems counter-productive to the process.

I have often obtained medical records (it's interesting to see how difficult this can be, and the bureaucratic tricks that can be played to avoid complying with laws that allow us that access.) I've been incensed to see inaccuracies and often dismayed to see the state of things from the provider's perspective when I came to them in crisis. For example, there was one note that just indicated I'd been a chronic, habitual daily user of marijuana for years upon years. Nothing could be further from the truth. But there it is in my medical record, proof against any legal challenge, their word against mine, and God forbid I attempt to challenge it in a followup session, because I'm a crazy, unreliable narrator with a reputation for denying the truth.

It is dismaying that so-called "medical" professionals should withhold the truth from patients and are perfectly allowed to obscure anything in the chart that they judge to be detrimental to treatment. My psychiatrist is consistently unwilling or unable to describe the first-order effects of my medication, what benefits I should hope to enjoy from them, or just in a general sense why am I taking this toxic crap.

My psychiatrist freely admits to diagnosing me solely on affect. If I am sociable and pleasantly greeting people in the clinic, then I'm having a good day and I'm near baseline. If I'm reserved and sensitive, and have difficulty answering her questions, then I'm a good candidate for hospitalization! I was literally steps away from being forcibly committed after one video appointment that went poorly. A video appointment!

I try to read everything I sign, but it's fruitless to try to stay ahead of any medical bureacracy. One day I came in to file a request for my complete chart. The condescending jerk who filled it out put in my name instead of the clinic's, so I was requesting records from myself. Guess how long that took to fulfil.