For years, I have navigated the complexities of the psychiatric system in Québec while striving to maintain my creativity, identity, and well-being. As I write my memoir and openly share my trauma, I have faced not only personal challenges but also systemic obstacles that have made my healing journey even more difficult.
I am also sharing this letter as part of my advocacy efforts. I am reaching out to media outlets to shed light on these systemic issues, and I invite journalists, advocates, and others to read, share, and amplify this conversation. For context, Ricochet Media has previously covered the state of mental health care in Québec, and I encourage readers to explore this article for a broader understanding of the systemic failures many of us face.
The letter below, sent to my current psychiatrist, highlights my recent experiences with psychiatric care, the impact on my mental and physical health, and my fight for proper treatment. I am sharing it here because my story is not just mine—it reflects the struggles of many who have been misunderstood, overmedicated, and dismissed by a system that often fails its most vulnerable patients.
For privacy reasons, I have replaced the names of doctors with initials, but the content remains unchanged.
Dear Dr. Z,
I am writing to express my deep concerns about my current treatment and to request a reassessment of my care plan.
Since our first appointment on September 20, 2022, I have consistently communicated my belief that I am experiencing Complex Post-Traumatic Stress Disorder (CPTSD). My primary diagnosis of bipolar disorder, which I have carried since 1999, has further complicated my treatment journey. Despite this, my symptoms have not been fully acknowledged, and this lack of recognition has significantly impacted my well-being.
Following our most recent session on February 13, 2025, I have been experiencing a severe migraine that has persisted for over 36 hours. Revisiting my most traumatic experiences without adequate support during our session triggered one of the worst migraines I’ve had since 2021. As noted in this PsychCentral article on PTSD and headaches, PTSD and CPTSD are well-documented triggers for migraines. I am certain that the emotional strain of unpacking my trauma during our appointment caused this current migraine episode.
Additionally, your recommendation to resume Cariprazine (Vraylar) is concerning, as my pharmacist confirmed that this medication likely contributed to the debilitating migraines I experienced while on it previously.
From 2009 to 2015, I was followed by Dr. A. at the Montréal Neurological Institute, one of Canada’s leading migraine specialists, during which time we explored every possible treatment option for my migraines. After his retirement, I was followed by a series of other neurologists, with whom I continued to try every available treatment plan over the years. This extensive process has given me a deep understanding of my condition, and previous doctors have trusted my self-awareness in managing my symptoms and recognizing what works best for me.
My creative work is an essential part of who I am and a key component of my healing process. This was acknowledged by Dr. F in 2009 during my six-month treatment at the Allan Memorial Institute, where we agreed on a minimal-medication approach that allowed me to maintain my creativity while managing my symptoms. This approach provided stability and respected the unique interplay between my mental health and creative expression.
Additionally, under the long-term care of Dr. Z (2009-2018), I experienced years of stability. She trusted me completely, supported my treatment choices, and acknowledged the complexities of my mental health without over-medicating or dismissing my experiences. While my time under Dr. W (2021–2022) was challenging, he recognized my creative genius and respected my need for a treatment approach that preserved my creativity without excessive medication.
Given my history and the care I received from Dr. Z, Dr. F, Dr. A., and subsequent neurologists, I am deeply concerned about the current trajectory of my treatment. I am requesting a reassessment that takes into account my lived experiences, past successful treatments, and the recognition of my CPTSD as a core factor in my overall mental and physical health.
Thank you for considering my concerns. I hope we can work collaboratively to find a treatment plan that respects my mental health needs and my creative identity.
Sincerely,
Ilana Shamir
I share this letter not just as part of my personal journey, but as a call for change in how creative minds are treated within the psychiatric system.
The Gap Between Policy and Practice in Police Responses to Mental Health Crises
The Gap Between Policy and Practice in Police Responses to Mental Health Crises. While the SPVM established the Équipe de soutien aux urgences psychosociales (ESUP) in 2012 to provide appropriate responses to mental health crises, my personal experience in 2021 reveals that this system often fails to deploy the right resources when they are most needed.
That year was an exception in an otherwise stable life—I have long managed my mental health, but 2021 was a severe crisis, an intense period of pressure that led to frequent police visits. Although further measures have reportedly been adopted since the COVID-19 pandemic to improve crisis interventions, those changes came too late for me. Most interventions during that time were benign, but not all officers were adequately trained, and one encounter involved extreme brutality, including the use of a knee on my neck—an inhumane and unacceptable use of force that no one in crisis should ever endure. My experience highlights the gap between policy and practice in Montréal’s mental health response system.
Please note: I am open to discussing my experiences further with journalists, advocates, and others who wish to shed light on the urgent need for mental health system reform.
Totally Surreal 
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