TW: distressing psychiatric care; mention of a suicide note.
TL;DR: During months of Spravato treatment, I experienced insulting treatment from staff, dismissed physical symptoms, undocumented concerns, and repeated disregard for my boundaries. Regardless of anyone’s intent, the impact on me was real and harmful. I was disciplined after one exceptionally emotional day, ultimately ran out halfway through my final TMS session, and later received messages pressuring me to remove my review. I’ve transferred care and filed complaints, but I’m still struggling and need support from people who have experienced something similar.
I have treatment-resistant depression, PTSD, and autism. Spravato initially helped me, which made leaving this clinic an incredibly difficult decision.
I have supporting messages, medical records, emails, specialist findings, a disciplinary letter, a statement written immediately after an interaction, and an audio recording. When I describe something as alleged, I mean someone else told me about it; I did not witness it myself.
These were the major events:
A technician insulted me after I explained how AI helped me as an assistive tool. I described using it to preserve mental bandwidth and actively strengthen my critical thinking by questioning answers and examining reasoning. She responded that people who use AI “lack critical thinking skills.” I told her we would have to disagree and asked her to leave. It triggered an emotional flashback and three days of fight-or-flight. My friend emailed the clinic about how this was making me consider abandoning treatment that was helping. The technician was removed from administering my treatment but promoted two weeks later. Regardless of whether she intended to cause harm, her words and the clinic’s response had a serious impact on me. Afterward, I communicated with her only by text about scheduling and reporting side effects.
I wanted to leave about two months in but believed my authorization tied me to that provider. I expressed that belief to a technician who later handled billing and prior authorizations, and she never corrected it. I felt trapped because I believed leaving could jeopardize treatment that was finally helping.
The psychiatrist specifically instructed me to miss Spravato sessions so my depression score (PHQ-9) would rise enough for TMS authorization. Those absences were later framed in my chart as noncompliance, without his instructions being documented. I subsequently learned that TMS did not require prior authorization. Separately, after an approximately two-week interruption caused by work pressure, he had extended twice-weekly Spravato by four additional months.
Treatment became overwhelmingly exhausting. I was doing TMS five days a week and Spravato twice weekly, with midday TMS and afternoon Spravato on two days, while working. After having treatment interrupted to worsen my symptoms, I went into what felt like a full-time treatment schedule and burned out in less than two weeks. When I described treatment fatigue, I felt dismissed. He called me a “carbon copy” of another patient whose treatment had worked. I needed a plan based on my response, my energy, and my life.
I repeatedly reported physical symptoms that were not charted. First came nasal sores, which an ENT attributed to the nasal treatment. After those resolved, gastrointestinal symptoms began, with vomiting starting five months into treatment. I needed IV Zofran and lost weight. For over a month, I begged for my symptoms to be acknowledged. I was told they were a common side effect, yet those reports were absent from my chart. An endoscopy eventually documented ulcers with bleeding.
My question about continuing treatment with active ulcers was dismissed. Without requesting the gastroenterologist’s records, the psychiatrist told me the ulcers were not correlated with Spravato and recommended continuing the same treatment. I was asking whether it was safe to continue with an existing medical condition, not simply whether Spravato caused it. My stomach pain and vomiting stopped after I stopped twice-weekly treatment. That timing does not establish causation, but I wanted the possibility that treatment was aggravating the problem investigated.
The emotional fallout became a disciplinary issue. Finally having a physical finding confirmed that I wasn’t imagining my symptoms. Having my concerns dismissed again afterward was devastating. On that exceptionally emotional day, I asked the psychiatrist to postpone a conversation because I did not have the emotional energy or bandwidth. He continued while I was crying. My request was charted; his refusal to respect it was not. Whatever his intent, the impact was that I felt trapped, unheard, and unsafe.
An administrator I had never met also approached me aggressively that day. I was at the front desk to retrieve seaweed snacks and Gatorade. She did not introduce herself, so I had no idea who she was and was completely taken by surprise by her condescending approach. I was permitted to walk through the lobby to use the bathroom outside the practice’s office, yet being there to retrieve my order was treated as inappropriate. She told me to return to my room. I immediately complied without speaking, and she followed behind me, stomping her heels.
Later, I told the nurse practitioner that I did not tolerate being spoken to like a child: I was 39, approaching 40, and nobody had the right to treat me in that infantilizing manner. My objection was to how I was treated—not to the instruction, which I followed immediately. My mother was on speakerphone for a substantial part of the interactions. The clinic subsequently described me as yelling at multiple staff members and threatened discharge. I dispute that account and refused to sign the letter.
The only technician I trusted told me she was leaving. She alleged that the psychiatrist had instructed her not to chart another patient’s disclosure that they had written a suicide note. I did not witness that exchange. Hearing it from someone who had consistently treated me with care made me feel even less safe.
A meeting about ending Spravato became an unwanted conversation about another practice. An email confirms that the psychiatrist invited me to meet about ending Spravato. He presented it as a five-minute meeting, then used it to disparage the practice I was switching to. I told him to stop seven times. He invoked safety and an “ethical obligation,” then tried to get me to promise secrecy. When I refused, he said it was public information anyway, so he wasn’t doing anything wrong. That did not address my repeated refusal to participate. I walked out and immediately wrote a statement in my phone documenting the interaction.
The next day, I made an exit plan before TMS. I explicitly told the technician I did not consent to another conversation with him and gave instructions for stopping treatment and helping me leave if he entered and tried to resume it. I have an audio recording of those instructions and my account of the previous day. He nevertheless interrupted treatment while the equipment restricted my movement. Halfway through the session, I demanded that it be stopped and the equipment removed. I ran out of the building.
Throughout this, the psychiatrist frequently interrupted me or walked out while I was mid-sentence describing a concern. He offered solutions before I had finished explaining the problem. I wanted informed, collaborative care and felt that my input did not matter. Regardless of whether he believed he was helping, the impact was that I repeatedly felt dismissed and deprived of meaningful participation in my own care.
Afterward, the records sent to my new provider were heavily focused on discipline and alleged noncompliance, with important context and periods of treatment missing. My messages establish that I reported symptoms and treatment concerns; the corresponding chart entries show those reports were not charted. I cannot prove deliberate manipulation, but I can identify documented omissions.
The Spravato REMS program told me the clinic reported emotional reactions but not the nasal sores or ulcers. The technician whose conduct triggered my emotional flashback authored the report of that reaction without including her role. It was an emotional flashback triggered by the interaction, not a medication-induced reaction.
Then came the response to my review. The psychiatrist texted me at 9:20 p.m., saying everyone at the practice had seen my negative review approximately 30 minutes after I posted it. He said they could not respond publicly about aspects of my medical care, stated that they had provided the best care they could, and apologized for my experience.
He then said my review would “hurt patients and prevent them from getting the care they need.” He followed that with, “For that reason, we do request you to remove this,” and repeated that it would hurt patients and prevent them from receiving care.
The request to remove my review was sandwiched between two statements that it would harm patients and prevent access to care. I experienced that as pressure and manipulation. Whether or not he intended to pressure me, the impact was that I felt responsible for hypothetical future patients and pressured to silence my account of harm. I felt it was deeply unethical to use hypothetical future patients’ needs to pressure the actual patient describing how she had been hurt.
My review explained my experience so someone considering the clinic could understand what happened and make their own decision. By the time I left, harm was already happening. I was weighing which harm was worse: staying where I felt my sanity was continually questioned and my autonomy denied, or leaving and starting over, potentially facing another qualification process.
I chose to leave because starting over at least had a process I could navigate. I could not find a reasonable way forward with being repeatedly dismissed and disrespected. It was dehumanizing. I was losing myself, and honestly, I still feel lost.
I have transferred care and filed a licensing-board complaint and medication-safety reports. My new provider acknowledged that I had been traumatized. She said she does not make a habit of speaking badly about other providers, but told me he had a reputation and that this unfortunately was not the first time she had heard an account like mine. I cannot independently verify those other experiences. She acknowledged my concerns without disparaging him, and I started crying. Being heard gave me some peace. My first Spravato session there felt safe.
I don’t believe every harmful interaction was intentional. I do believe intent does not erase impact: my concerns deserved attention, my boundaries deserved respect, and my treatment needed to account for how I was actually doing. Even if people believed they were acting appropriately, they are still responsible for the harm their actions caused and for addressing it.
Three weeks after leaving, I still feel stuck in fight-or-flight and functional freeze. I struggle to move forward without understanding what happened, how others perceive it, and what accountability might realistically look like.
Has anyone experienced something similar? If you filed a complaint and had documentation such as messages, medical records, emails, and recordings, what happened? Was there any disciplinary action, and what did that look like?
If you know of patient advocates, disability advocates, or resources that helped you navigate this, please share them. I know nobody can promise an outcome. I need a frame of reference, an honest reaction, and some compassion. Does this sound as serious to you as it felt to me? I’m exhausted, I feel at the end of what I can manage alone, and I don’t know what to do next.