Need a psychiatrist

I need a psychiatrist but am in debt and cannot afford to pay a $25 or so copay every week. I need medicine so this is why I need to see them but don't know if my PCP knows enough about psychiatric drugs to prescribe them. Should I trust her? She wanted to put me on a drug for possible bipolar but my brother in law is a psychologist and said that is it definitely not advised for me to take it.

Any ideas?

Well , considering your brother in law is a psychologist I would heed his advice , I do not think a PCP has the knowledge to manage mental illness and the types of medications. Very complex.

Its doubtful you would be seeing a Pdoc weekly for long ,usually once your on a medication that seems to be helping your visits will stretch out to months.

Have you looked into local mental health clinic, usually run by counties , they offer sliding scale co pays or even free ones and many times have samples of medications to try.

Maybe your brother in law would know of local Pdoc's or clinics that can help you with your current financial situation Or even offer you a small loan to get your started with a Pdoc. Is that a possible option?

Good luck

it depends how comfortable pcp's are with psych meds to prescribe them. i mean there is a general list of meds that can be taken for bipolar disorder. it is pretty much a hit or miss situation as to which one is going to work for you. i had to try them all before i found one that worked. if you pcp has that list, he/she can start at the top and work their way down with you. there is no way of knowing which one is going to be the best drug to work with your system, with all the psychiatrists i have been to, i think they just start with the one they prefer. some are old school and use lithium, some like to start with the antipsychotics and go with risperdal or seroquel, a lot start with one of the antiseizure drugs i cant remember the name of off the top of my head, the list goes on and on and on. but the thing is, you dont typically see a pdoc once a week. all they do is precribe meds, you go in for your initial eval, and then you may see them a month later but typically you only see them every three months for med refills. so you wouldnt be paying that much to see one.

Hello cremedelacreme: Personally I don't feel like there is enough information here to really say much. Ideally it would be best for you to see a psychiatrist. I don't know where you live, or how things are done there, but I've never known of a pdoc who sees patients every week. Generally it has been every 2 to 3 months, in my experience.

As for whether or not to trust this other provider, it really depends on the person's experience & qualifications. But then, to some extent, this would be true with a pdoc as well. There's always an element of uncertainty involved in these types of situations.

You mentioned your brother-in-law is a psychologist & that he said not to take the med your PCP suggested. Did he give a reason? Perhaps one option here would be for your brother-in-law to attend an appointment with you & your PCP. Then the 3 of you can come to some mutual agreement as to the best course of action for you. Otherwise you're just stuck in the middle, surrounded by conflicting pieces of advice.

This is true! I do feel conflicted. Changing drugs is also a scary thing. I have had bad experiences as many have with taking things that didn't mesh well with me.

Thank you all - so glad I posted this because I was under the impression that you saw a psychiatrist weekly like a therapist? Am I confusing this with a psychologist or counselor?

Psychiatrist is 15 min. for prescribing medication like PCP but they know psych meds. They are usually 1-3 months depending how well you are. A therapist or psychologist sees you every 1-3 weeks depending on their availability and your comfort.

Bipolar Disorder is very difficult to diagnose. Psychosis disorders are hard to diagnose. Usually, psychiatrists end up treating the symptoms so a person really has to be in-touch with what's going on with themselves and be able to convey it to a doctor. I wouldn't put my mental health in the hands of a general doctor. Some Universities that teach medicine have outpatient clinics and they have sliding fees. There used to be several in Philadelphia area (ie. U of Penn). (Between 1990-92 I spent a total of about one year in psych hospitals and no one could diagnose me correctly.)

Psychologists tend to be against medication, or at least against it as a first line treatment for psychological distress. They object to what they call "the medicalization of problems of living." That's how one psychologist put it to me. So your brother-in-law is coming from a natural bias that people with his training tend to have.

If you're new to the option of getting medication for a psych issue, you might find that where a PCP will start is not too different from where a psychiatrist might start, in what either one might initially put you on. All doctors use "decision trees" that kind of tell them what to do when faced with a given set of symptoms. So I would say that starting with your PCP is probably as good a place as any to start.

What would be likely to happen next is that, if you don't improve on what the PCP puts you on, she will refer you to a psychiatrist for at least a consult. That can be a one-time visit for an "expert" opinion. Your PCP has some advantage in that she already knows you.

Bipolar Disorder used to be considered a heavy duty diagnosis that doctors of any type were slow to pin on you. Now the definition of what can constitute bipolar disorder has been expanded and expanded, so that almost anyone can be considered a possible candidate for at least the diagnosis of Bipolar Disorder Type 2.

It's entirely possible that you don't have any true psychiatric disorder, but do have some problems that you are having trouble addressing. That might be how your brother-in-law would want you to initially view your situation.

It's unlikely that medication alone is going to alter your situation all that much. But you never know till you try it.