Should I see a psychiatrist if I don't really want meds?

I don't know what to do. My GP wanted me to see a psychiatrist two months ago but after I told this to my T, I felt like he is scolding me for wanting to do this, he said there are no meds for BPD and it's very possible that I'll end up in 5 years changing 20 different meds and so on.
I felt somewhat ashamed that I wanted to go, after this talk.
He gave me some contacts but I haven't made any appointment yet because of this.

Lately I'm feeling worse and worse, not sure therapy is working, but it's bringing up strong emotions of hopelessness, disappointment and abandonment.

I'm much worse than I was when I started therapy, having suicidal thoughts more often than not. Depression, anxiety, anger....I don't see improvement. Relapse with SH, ED issues.

In a way I want to see a psychiatrist because I need validation for how I feel. That I'm not making it up. Also I need more help.
Don't know if I should just find another T and that would solve it...I'm so confused.

But also very self destructive and I think I'd need help.

Even though there is this thought in my head saying that I should solve everything by myself.
Maybe I could.

I don't want to end up taking medication though on the long term. I don't know if I need it. But right now I'm self medicating with alcohol and what not and that's bad.

Also still thinking that I am not in such a bad state to see a psychiatrist. That I don't have some serious mental illness...well except BPD

Idk what to do...I guess I'm trying to get some clarity by writing down my thoughts.

Depression and anxiety can accompany BPD, so there's meds for that. But if you don't want meds, tell him or her up front.

Hi, subtle lights. I'm thinking you could talk to a psychiatrist to see if there might be meds that could help. I'm thinking anti-anxiety drugs might help.

Surely the doc couldn't force you to take meds if you don't want to. Say you just want to see what he/she says without taking any--at least yet. My two cents' worth. I used to have BPD.

Also my T suggested that if I want to go to the psychiatrist (though he doesn't recommend it..) I must tell him that I have BPD...I'm not sure if I want to...
My T says that in 15 minutes it will be impossible for him to get a clear image of my issues. Well, okay, I agree with that. Still, I feel reluctant somehow about telling upfront about the BPD.

I can understand. There seems to be a real bias against those of us who are BPD.

That said, I think we often somehow send out unspoken messages that professionals pick up on!

I would think you'd need to at least tell the pdoc about what symptoms you're having. That said, it would be best to just say "BPD" right out.

I'll tell you some thoughts I have. They are opinions, and not everyone would agree with me.

I am leery of a therapist who tells you to ignore your doctor's recommendation. Actually, that's unprofessional. I think you should follow through on your GPs direction. Your GP should give you a referral to a specific psychiatrist. Psychiatrists do two things: they diagnose, and they prescribe medication. I, myself, do not place a ton of faith in a diagnosis developed by a therapist. I believe in leaving diagnosing to doctors.

The federal government holds to the same standard, and won't grant disability social security on the strength of a diagnosis from a therapist. Having said that, diagnosing is not an exact science. A psychiatrist told me that it can take quite a while to know a patient well enough to come to a firm diagnosis. Initial diagnoses are "provisional/tentative." I know someone who was sent by a federal court to be diagnosed by a PhD psychologist. The psychologist spent 48 hours interviewing and testing the person, paid for by the federal government. I read the psychologist's report. It was thorough and persuasive. It rejected a diagnosis this person had been given for the previous 20 years. If you get seen by 3 different psychiatrists, it's possible to get three different diagnoses, though not usually. Also, having a psychiatric problem doesn't necessarily constitute "being mentally ill." What constitutes "mental illness" can be a matter of philosophical debate among thoughtful people. I happen to think it requires very serious difficulty coping with the demands of life . . . to the point of being somewhat incompetent. (If a person is competent to babysit children, then I'ld be slow to call that person mentally ill.) Many psychologists say that we have become too quick to "medicalize" problems of living. Another thing I've noticed is that what diagnosis a doctor gives you can be affected by whether the doctor likes, or dislikes you.

I think, if you've been dealing with considerable emotional distress for a good length of time, and you seem to have some chronic impediment to getting your life situated in a way you feel reasonably content with, then an assessment by a psychiatrist can be a sensible thing to get. As you say, it can be a source of validation. It doesn't have to be carved in stone and shouldn't be thought of as such. It's a place to start to organize a remedy to your difficulty.

The "remedy" will usually involve a mixture of things. One thing might be medication. Sometimes only a trial of various meds can tell you whether, or not, medication might be helpful. Sometimes meds don't help. I think medication is over-rated and over-used. Prescribing it is the main way that pdocs make money. Patients tend to like getting medication because, I think, most people would rather believe they have a "chemical imbalance of the brain," rather than an approach to life that isn't working for them. You not being real disposed toward taking meds is, IMO, a healthy attitude. But keep an open mind.

Often, psychiatric problems tend to come in clusters. They mutually aggravate each other. That's why, more and more, you see people being given multiple diagnoses.

Besides believing that medication is over-rated, I also believe that therapy is over-rated. Patterns of behavior are extremely hard to change. But it can feel supportive to have a counselor.

So I would say: go for a consult with a psychiatrist. Listen to a variety of opinions, besides just the opinion of one therapist.

You can't solve everything in your head, by thinking about things. You solve problems in the workshop of life, by living day to day, seeing what behavior on your part gets a good outcome and what doesn't. There's probably some aspect of life in which you lack adequate experience. About the only thing you'll get experienced in by sitting in a therapist's office is you'll get experienced at talking to therapists. That's an artificial relationship where someone gives you their undivided attention.

If you talk to any human being long enough, you'll eventually here them say something that they're just wrong about. Maybe you've come to that point with this therapist you've been seeing. Don't be over-awed by your therapist's pretensions to having you all figured out. That same therapist is struggling with personal problems - sometimes unsuccessfully - just like everyone else in the world.

(((((((Subtle Lights)))))))



I understand your situation. You want/need more support (better support?) than you're getting, but not sure if the pdoc will push meds on you. You know what you could do is go to one appt. w pdoc, and if they say they want you to try a med, say "I will think about it.". And think about it. Nobody can force you to take meds. It's your right to say no thank you. That being said, I have heard of meds actually helping some people. I take medication. I have no idea if it helps though. I've been on it for so long..that's another story though.

It is a little confusing to me that your therapist is saying not to see a pdoc. Is he against meds altogether? Still, it's a little strange to me to push that on you. Do what you want to do. Knowing you are in control.

"you can't solve a problem with the mind that created it.". I heard that today and found truth in it. Basically, yeah it's nice to be able to rely on yourself, but sometimes we need a different perspective from someone else.

I'm really sorry you're struggling I know how you feel. Tbh, I'm not sure your therapist is being very professional there.. it's almost like he's pushing his ideas, when in the end, YOU are the patient and YOU have to make the final choice. So please, think about that. Remember that no one will force you to take meds, and that your feelings are completely valid.

This is an interesting opinion and I've been thinking about this but I think I see it a bit differently. Through talking to a therapist (in certain therapeutic approaches) someone can actually test out and even change different kinds of behaviours. Sure, life won't automatically change from that as one needs to act like that in a "real" social setting as well, but basically everything influences everything. Talking to a therapist, even if it happens in an isolated setting, it doesn't end there, I mean, it affects and changes a persons perspective.

I think my therapist's main arguments were that
1. there is no med for BPD so it wouldn't help me (though I also have other issues and as some people have said, there are symptoms that might be eased with medication for a while...well, if I'd choose to take it
and
2. if I'll see a psychiatrist, he will only have like 15 minutes for me, so it might be difficult to correctly assess my situation...here I see the point.

My T didn't say "don't go", but he still seemed very determined about this. Now, I would maybe not want to go if I saw improvements, but I don't. Even so, seeing the psychiatrist might not be the solution.
Yeah, I know I'm overanalysing this. I'm just afraid that I'd go there and then will get influenced by whatever he/she says and do that, bc I'm very influencable...especially lately.

I understand your fear, I'm pretty suggestible too. Easily swayed. So is the reason why you want to see a pdoc because you might get extra support or help? And your doc suggested it? I see this as valid. Especially if you are not feeling well usually.

I'm sorry you've been struggling lately. I don't know if most people's experience is more like yours or more like mine but I feel much better after therapy, not worse. It is also concerning that the therapist is trying to dissuade you from seeing a pdoc. Have you ever considered changing to another therapist? I would think the goal would be to eventually bring you to a point of feeling better. Have you been seeing this therapist for any length of time?

I don't see how seeing a pdoc would hurt. The initial assessment will be longer then 15 minutes and I'd say more likely then not, the pdoc will try to prescribe medication for your anxiety and depression. You could take the prescriptions and then decide whether that's a road you want to travel.

I hope you start feeling better soon. Best wishes.

Absolutely I think you should still see a psychiatrist. Their role as a mental healthcare provider goes beyond that of just prescribing medication. Monitoring your mental health and responding to it is their primary concern.

Honestly though I don't trust Ts to make a Dx, psychiatrists are much better at it and they typically give you an hour assessment as the first appointment. It is typically a more expensive appointment....if you do have bpd I hope you're getting dbt therapy to my knowledge it's the only one that works for that.

I don't think that your T is doing you any favors. They are working for you not the other way around. Therapists cannot give you a diagnosis but they can help to provide a means of education in dealing with the diagnosis via CBT or DBT or some form of therapy.

My own T has said to me that any good T will be trying to do himself out of a job. Meaning he is there for a time to teach skills to people how to live life to the best of their ability, not to be a permanent fall back.

A psychiatrists first appointment with you will be more that 15 minutes and they should take a history and come to a some form understanding of life through your eyes. You may or may not have BPD. You may or may not have type 1 or 2 bpd.

There are meds that that can ease the stresses, high and lows. Whether you choose to take medications is up to you. Nobody is going to force them upon you. The doctor that suggested you see a p'doc is well trained and I doubt would do it if there wasn't a need. Do you have a family member that might see how your life is being affected?

Where I live there are P'doc's that will see you for a short period and others that will also provide therapy at the same time.

Couldn't hurt to get a second opinion from a p'doc. What you do with the information from there is up to you. Wouldn't hurt to see another T either.

Many psychotherapists I have met have a wrong attitude towards medication. Most of the time a therapist is not a medical doctor, so you can simply ignore a therapists personal thought about medication. Taking medication or not is up to you at this point; as long as you are voluntary/out-patient.

If a therapist cannot help you out of the situation you are in within a couple of sessions, they are "supposed to" refer you to a psychiatrist. You seeing the same therapist for several years and they telling you to not see a psychiatrist sounds fishy to me.

Of course there are no meds that can "cure" a certain condition but given for that medical condition. That is when the medication eases the burden of "symptoms" to give some "breathing space".

Before prescribing a medication a medical doctor is supposed to weigh the benefits vs side-effects. Sure some medicine do have side effects. But in my case, I wouldn't even complain about those because they are much more bearable than the symptoms I originally had. You can always do some research before actually taking the medication. A doctor can only prescribe and you should have the liberty to decide weather to take or not after researching yourself.

Some medication such as Cymbalta for an extreme example have quite terrible withdrawal symptoms for a couple of months, not weeks or days. But other than Benzos that give an immediate relief, most psychotropic medication are actually not addictive. If a psychiatrist recommends, it is not that a bad thing to take a medication that makes life more livable.

One thing to remember when starting psychotropic medication is that you have to give up on self medication of any sort and be clear with your PDoc about whatever substance you use. They cannot take you to DEA or police for substance abuse, other than offering help.

Thanks. As far as I heard, there are also other treatments which work for BPD, like schema therapy or mentalisation based therapy for example. But my chances are low now to get access to those. Though, who knows...

Yeah, I will probably contact a psychiatrist, thanks for your input.
Here where I live clinical psychologists can make diagnoosis, afaik. Which is the case of my T.
Regardless of course it's good to get another perspective.
In the same time my family doctor had almost no info about my mental state, only what I told her in 10 minutes chaotic appointment (she is very busy and multitasking).
I do think me and my T might not be the perfect match though. His method doesn't really work for me, but he was not the first one to suggest the BPD diagnosis and that after several sessions.
I do hope the first appointment with the pdoc will be 1 hour, though still, not comparable with several sessions. But yeah, I'm still very scared of this apointment for some reason

Have to admit that change doesn't thrill me much either. Being prepared for the appointment with the psychiatrist may help ease the anxiety. After you have the made the appointment with the P'doc you can always phone where they work and ask how long the first appointment is likely to be.

Writing down issues that you deal with will help you to say all the things you need to say in the first session. The first point of contact is also an opportunity for you to ask questions that you may have. Again you are equals. It's not a parent/child relationship.

Your T should not be confronted by the fact of the appointment. If that is the case then that is their problem not yours. If/when you do make the appointment you don't even need to tell your T.

Wishing things go well for you.

i think i've been on every med so far and have been finally stable until the doc tried to add a new one. it gave me a 10 day migraine headache. i finally determined it was the med. In my situation, i was forced to take meds in the 1980s where i would be poked with needles in the psych ward. I've seen and witnessed this happening to many of the patients there. maybe it was just the hospital. sometimes i think these people working there are sick. I do also believe in the power of medication if you can find the right one. i finally have and feel myself getting better and better every day. i am only asking to be stable and the meds start working just this past year. good luck to all of you.

Your therapist doesn't sound like a good one.
A good therapist wouldn't dismiss something you want to do right away. The least the T could do is question your decision.
As for BPD, while the personality disorder cannot be treated with medications, its moods which come along with it can be treated with medications. However I am not a professional so it's best to consult a mental health professional, though it doesn't seem your current therapist is very professional about this.