DR. Apichat Jariyavilas

(I want to make clear that writing this is not an attempt to damage the doctor’s reputation. I fully respect that every doctor has undergone years of training, carries valuable experience, and has the right to make clinical judgments. My purpose in sharing this account is simply to ask that he and others in similar positions to reconsider the way such serious diagnoses and prescriptions are made, especially when based on highly subjective tools. The stakes are too high, and the impact on patients’ lives too profound, for anything less)

After only one appointment, the clinician diagnosed me with severe psychiatric conditions, including psychosis, bipolar disorder, and depression. These are illnesses so serious that they are often grounds for acute hospital admission. Yet his conclusions were based mainly on highly subjective psychological tests. For example:

1) Rorschach inkblot test: I was shown abstract inkblots and asked what I saw in them. There are no fixed “right” or “wrong” answers; the interpretation depends almost entirely on the doctor’s perspective.

2) House-Tree-Person test: I was asked to draw a house, a tree, and a person. The doctor then tried to read my personality and mental state from details in the drawings, such as the size of the tree or the shape of the house.

3) Rating-scale questions :

I was given a short questionnaire with about 20 questions asking me to rate my feelings or behaviors. These kinds of surveys are simple screening tools, not stand-alone diagnostic instruments.

While such tests might offer clues about a person’s emotional state, they are not scientifically reliable or objective enough to form the sole basis for diagnosing severe psychiatric disorders. Two different clinicians could interpret the exact same drawing or inkblot answer in completely different ways.

Despite this, the doctor convinced my family that I suffered from psychosis, bipolar disorders, personality disorders, severe depression and prescribed clonazepam. He even claimed the drug would permanently raise my IQ with long-term use. In reality, research shows the opposite: prolonged clonazepam use can cause tolerance, dependence, cognitive impairment, and withdrawal symptoms as severe as seizures or psychosis. Prescribing such a medication to someone without clear clinical need not only puts their health at risk but can also undermine their sense of self and trust in the medical system.

Later, when I sought third and fourth opinions, those clinicians concluded that I did not have psychosis. This confirmed my suspicion that the first doctor’s diagnosis had been rushed and unsupported. The impact on me was profound: I was left questioning my own mind, struggling with the side effects of a drug I should never have been prescribed, and dealing with the anxiety and rebound symptoms caused by tapering off it.

To me, this experience represents more than just a misdiagnosis. it was a violation of medical responsibility. A single subjective test and a brief consultation should never carry the power to define someone’s mental health in such an extreme way, especially when the consequences involve severe labels and powerful medications that can alter the course of a person’s life.

Dear Dr. Apichat,

I hope this message finds you well. I wanted to update you on my current condition, as the last days have been particularly challenging for me.

Today, I was once again extremely tired and drained, as I have been on most days. My energy levels remain very low, and I have been struggling to function in a normal daily rhythm.

Unfortunately, my eating situation has not improved. I could not eat the meal provided today and had to spit out most of it, as swallowing remains extremely difficult. This continues to be both physically exhausting and emotionally discouraging.

I know we have been addressing the psychological aspects of my condition, and I deeply appreciate your understanding and support. However, I feel that my physical symptoms – especially the swallowing problems and constant fatigue – are still very present and affecting me severely every day.

Regarding the medication change, I understand that Rivotril (clonazepam) was introduced to help with my anxiety symptoms, particularly in the context of my bipolar II disorder. While I recognise its potential benefits for calming the nervous system, I am concerned that it may not be addressing my primary physical issues and could potentially contribute to my persistent fatigue.

Additionally, I have noted that I am now taking two benzodiazepines at the same time – Temesta (lorazepam) and Rivotril (clonazepam). This combination may increase sedative effects, slow my breathing, and further reduce my energy levels. I am worried that this could be contributing to my ongoing exhaustion and reduced daily functioning.

I value your guidance and would be grateful for any thoughts you may have on how we can adjust the current treatment to improve both my mental and physical resilience. My goal remains to find a balance where I can manage my symptoms and have the strength to continue my daily life without constant exhaustion.

Thank you for your continued care and for listening to my concerns.

ขอบคุณ คุณหมอที่ทำให้ผมกลับมาใช้ชีวิตดีอย่างมีความสุข และยอดเยี่ยม

–

–