[Fading]

Hello,
Last week was my first visit and it was mostly filling out forms and giving her a brief background of what brings me there. I know it's too soon to really understand much. This is the first time I've been to a psychiatrist.
I've been reading alot of other's posts here and trying to get a better grasp on what to expect.....

Is it just me? Or is it 'normal' to feel this way ..... I just sorta got the feeling that she doesn't really care much for me ..... she seems 'cold' and distant. Is the first visit supposed to go that way?
Neither one of us knows anything about each other, so I answered all her questions respectfully and honestly.
She gave me a few papers to take home ...."Welcome to my practice, etc" and it describes what my rights and obligations are.

I dunno....it just sorta seemed like I was conversing with a robot or something. If I didn't give direct answers to her questions, she would cut me off ....sorta reminded me of how lawyers are when a person is on the witness stand ...
Example: "About how many times a week do you get anxiety?".......Well, I guess it kinda depends on..... and then she'd cut in "HOW MANY, as in ONE, TWO, FIVE?"

Is this the way it's supposed to be??

[online user]

Most psychiatrists don't do counseling anymore--they just see patients, do diagnoses and prescribe meds. The first visit is generally a longer one, to assess what degree and manner of illness you have, if any. Often the psychiatrist will also refer you to someone for counseling in addition to medication. For many people, this combination works the best. I've been seeing my psychiatrist once a month, then once every two months, for medication evaluations and adjustments. Then I see a therapist about once a week for counseling.

Does sound like she was a little curt with you. Could be she was pressed for time and trying to get through a lot of questions in a short order. She probably needed the answers to all of them to work on your diagnosis to get you the right meds. But she wouldn't be trying to solve your life's issues--that is more work than her brief time with you could accomplish. For that, you need a counselor of some sort.

[nannypat]

My psychiatrist does do both meds and therapy. I know that is becoming more unusual than it used to be, but he feels that he needs to know how my life is going to see how the meds are working(or not) or what else I might need. I do see a cognitive therapist also and they do work as a team. This works well for me.

[dizgirl2011]

Hey,

I agree with online user, these days psychiatrists aren't very involved in their clients situation, all they seem to do is diagnose and give medication and then thats it. They dont usually tend to listen to your feelings and problems the way a therapist would and so you would really need someone like that perhaps to help you feel more supported.
I seem to see my psychiatrist every 6-8 months now, no matter how i am feeling and in fact i have seen various people the last few times, just so that they can say "someone seen her"....i never feel psychiatrists care or are helpul when in mental distress... they are only good (just my opinion) for diagnosis and mediction.

The questionnaire type thing is an assessment thats done on your first visit - as it is for everyone and there was probably also a risk assessment in their also. In all honesty that will most likely be the longest appointment you may ever have with your psychiatrist as after this you are lucky to get 15 minutes every few months just to 'check in' on how you are. Thinks may be different where you are but this is certainly my experience.

I think you need a mental health worker or a therapist to help support you

all the best
xxx

all the best
xxx

[splitimage]

The first meeting with a psychiatrist in my experience is pretty bad - they're basically doing an intake assessment to get an idea of what your problems are, severity and whether you're at risk. I'm like a lot of other people here, my psychiatrist doesn't really do talk therapy - he manages my meds, and he has all the therapeutic warmth of a dead fish. I see him for 20 min. every 3 to 6 weeks depending on how I'm doing, and if we're making changes to my meds. But he's really good with meds and referrals to other programs within the hospital, so I wouldn't give him up for anything. I see 2 different T's on alternating weeks, one for trauma, one for addictions, and I see them both for 50 min., and they both do counselling.

I just had a 2 hr intake assessment at my hospital's anxiety clinic after my pdoc referred me there for a social phobia treatment group. It was horrible. 2 hours of a guy with no facial expression, going rapid fire through a series of diagnostic tests getting into my whole mental health and addictions history, as well as my experience with SA and my anxiety. I got through it - mainly because I really want to get into the program.

So yeah in my experience first appointments are usually pretty grim.

--splitimage

[Christina86]

Depends on the psychiatrist, sadly.

I'm sorry you're turned off by her treatment of you. Doctors are specialists, psychiatrists are specialized in mental illness/mental health. If they only do meds, then they're time-crunched and have limited time to get to the root of your issues that bring you to them, so they can prescribe you meds and see how things are working out.

Also, first sessions are always more formal than normal.

[Fading]

Thanks for these responses

Wow! See, I guess this shows how confused I really am!
At one point I asked her what is the difference between psychiatry and psychotherapy and she said it's the same thing
It's a very uneasy feeling NOT knowing for sure why I'm there....I mean, I just don't 'get it' as far as ..... how can ANYbody just see you briefly and then start throwing meds at you according to what 'they' perceived from such an impersonal visit.
Part of me feels like bailing ship.....but I guess that would be a bit premature. I should at least go for the 2nd visit and see how that transpires.

Do most people go on their own accord, or because of a Dr referral?

My pain doc recommended I see this lady because of the stress my chronic pain condition is causing and I'm having to consider throwing in the towel with my job and try for SS disability....
So, it's my understanding that I'm seeing her to help manage my meds and how to deal with the stress/depression which is part of this nightmare that the pain is doing to me.

From our brief time together and the info she gathered, she's somehow decided on 2 possible meds to put me on ??
--- Trazodone
--- Hydroxyzine wth?? The LAST thing I need is to just jump into a new med that I know nothing about....all I have to go by is the 'info sheets' she gave me which describes these meds.

I feel really lost with this. Thank you for your feedback. I guess I just sorta feel like an 'idiot' or something. I mean, I guess it is 'assumed' by all parties involved that I'm supposed to understand what's happening....and I DON'T.

In your opinion and/or experience, do you think I should just blindly take whatever she prescribes, even if I'm not comfortable with it? I mean, am I just supposed to 'trust' that she's the pro and I'm a 'mental case' who can't seem to think for myself? I'm 47 years old. It's pretty humiliating to feel like a 'child'. I used to have a pretty respectful place in society....but now that I'm so down and out, it's almost as tho I'm losing my 'rights' to any dignity that I once had.
I mean, if I had committed a crime or if this were court-ordered or whatever, I could see that it should go this way.....but I'm just a person who's in a real bad place in life right now and seeking help. I'm very humble and willing to do whatever it takes, but since I know absolutely nothing about what's going on (for the most part), I don't know if I should pay heed to the 'red flags' I'm getting.....or just resign myself to the fact that when a person is this down and out, this is how it is supposed to play out??
At my next visit, I'll be up front and let her know everything I've said in this post. She needs to be aware that I really need this explained more clearly to me.
Your feedback is all I've got....other than that 'form letter' from this lady.

Thank you so much

[lastyearisblank]

Ugh that sounds bad! To put it in perspective, from my friend who is in med school. there are 2 career paths to becoming a psychiatrist. One is, some people start medical school with a lot of empathy for the mentally ill, and for them it's a natural vocation. The other is, psychiatry is the easiest specialty in med school... so the least motivated students get into it. My experience definitely bears this out too, there are very good psychiatrists and very bad ones. Sorry you found it didn't help- can you lean more on a psychologist or a therapist after this?

[dizgirl2011]

Hey,

I just wanted to reponde to your second post in this thread...

I want you to know that soooo many people do not know the difference between psychiatrist, psychologists therapists, CPN's, mental health social workers etc and why should you if you have never had to deal with them before? Please don't beat yourself up about not knowing the in's and outs of everything because it is nothing to do with you or how intellegent you are or your status. The only reason most of us know is that we have been dealing with these people for a while and have come to learn the differences and thats why we can answer your question.

You are not a mental case, a down and out, a child or someone who has lost their status just because you need a bit of help...we all do once in a while..please understand that.

Perhaps she misunderstood your question about psychiatriy and psychotherapy and said they were the same because they both examine or work with how we are mentally and emotionally, however there is a difference in a psychiatrist and a psychtherapist.

A psychrist is a trained doctor who specialised in mental health. They are allowed to perscribe medications as they are a doctor. Most often they only see patients for short periods of time and try to decide what might be wrong and either diagnose, perscribe meds or both. I understand why you are saying that it seems odd that they can perscribe something when they hardly know you or your problem and this is very true and sometimes they do get it wrong. what often helps is having a therapist or mental health worker - psychologist, cpn, mental health social worker etc who works alongside him, who sees you regularly and can report back to him anything that is important. In some circumstances psychiatrists may spend more time with clients but its certainly not as common as those who dont.

A Psychotherapist (could also call themselves a psychologist) is not a trained doctor. They may have studied counselling studies, psychology and things like this in order to be able to know the various schools of thought on how to best treat people who are in distress they usually offer therapy were you see them on a regular basis and talk through your issues. The work you do in your sessions with them will varey depending on the type of therapy they use for example person centred therapy, cognitive behaviour therapy and so on.

A CPN (not sure if this is what they are refered to in the usa) is a community psychiatric nurse - they are people who train as nurses and then work in mental health. They have the ability to dispense (not perscribe meds) and often also will sit and talk with you and listen, a bit like a therapist only they dont have the training to really conduct therapy as such, they are just a listening ear. Some people may see them in their local mental health department or the CPN may call out to the persons home.

A Mental health social worker often does similar work to a CPN, they are people who trained to be social workers who then went on to work in mental health, They cannot dispense meds but will talk and listen (like the CPN) and often just monitor how you are keeping. They usually report back anything important to your psychiatrist.

hope this helps a bit.

I dont think you should give up on the psychiatrist. They may actually be able to refer you for therapy if you would find it benefical and also it is good to have one just incase you need them. You dont have to try the meds, you can ask for more information or even say you would rather try a different form of treatment first such as therapy or releaxation or something before trying meds and if that doesnt work then you will consider it. They cannot force you to take anything you dont want to and you dont have to accept everything they say just because they are the professional - what you want matters just as much.

Also to answer your question the reason someone sees a psychiatrist is because they are refered to one by your doctor, you cannot self refer to a psychiatrist the way you can to see a therapist.

all the best xxxx

[nannypat]

If it helps at all, Trazadone helps most people get a decent nights sleep while also being an antidepressant. I found it a rather mild drug with out many side effects except a dry mouth. I took it many yrs. and it is not addicting. I don't recognize the name of the other one.
Like I said before .My psychiatrist does therapy as well and he is wonderful but I know they are few and far between. We are just a good match. That is going to be important no matter who you see for therapy if that is what you choose to do. There are many different kinds with many different degrees or levels of training. The letters after their name don;t mean nearly as much as whether you "click" with them. Do they seem easy to talk to? Are you comfortable around them? Is the office space comfortable for you?
When I had to look for a new one once, I saw one and went into his office and sat where he indicated. He sat on the other side of the desk. On each side of the desk where file folders piled so high it was like I was looking through a window to see him. The rest of the office had card board boxes all over the place with files and who knows what else filled to the brim. I knew right away it wasn't going to work. I am not a total neatnick, but I can't sleep in my own room if it is too messy. I will get up and straighten it out a bit so I can sleep. I was so anxious, it didn't matter how nice he was.
Unfortunately you have to shop around a little to find a good match. Your pain doc might be able to help if he knows you pretty well. He may have a suggestion or two to try.
Don't beat yourself up for not knowing all this stuff. I didn't and I am sure many more of us didn't either. It comes with experience, but we are here for you and will be glad to help any way we can and answer any questions the best we can. I hope this has been a little helpful. Write and tell us more about yourself so we can get to know you.

[Fading]

Oh THANK you ALL!
The time you took to explain this to me means more than you know!
I've become so 'inverted' and shut off from everything and everyone that have been important to me. I've become an empty 'shell' with a pulse.....and that's about it.

You have done a wonderful thing in helping to make this more clear to me....and I can see that I have a long way to go yet....but this is obviously the place to be for support!
You all are absolutely fantastic!

Perhaps this lady I will be going to will be similar to Nannypat's.....because she has put us down for 10 'sessions'.....
This next visit will certainly say alot I guess.

To let you know a little more about myself and why I've come here....
Chronic pain is the main issue.....and it's literally robbed me of my 40's! ....and where did I read that our 40's is supposed to be the 'prime' of our life!

I am at a point of having to give up a job I've loved for the past 25 years.
My husband and I have absolutely NO intimacy!
I feel exactly like what my screen name is....... I'm 'Fading' away...... My life is coming to an end. I don't foresee a future for me.
This is NOT normal for a 47 yr old! I don't have a terminal illness, so I shouldn't be constantly giving in to the thought that my life is over....mostly because I'm just too tired to keep fighting on. It's not worth it to me......the pain is a battle that has gained an upper hand, despite having a wonderful pain doc and have good pain meds on hand.
Don't want to face continuing into further physical and mental decline.

I guess I've had suicide 'ideation', but haven't attempted anything. Tho I have 'fantasized' about hiring a 'hitman' to 'off me' ......just being honest. Figured if it wasn't 'suicide' per se, then my family could collect from my life insurance policy.

Such a sad unfortunate story is this, I know. I used to be very active in church and helping in youth music ministry. I had so much going for me.
I've tried continuing to fight this battle for the sake of my family....but at this point, my kids are pretty much grown and I feel that I'm just bringing them down. I carry extreem guilt with me because of how much I've contributed to the already declining healthcare system with my medical needs. I see that my family would be able to carry on just fine without me (not trying to sing a sad song here......it's just the reality of what I perceive). Sure, they'd be sad to lose me....but in a way....they already have.

I know that YOU know that I'm not looking for pity. None of us here are.
Thank you for welcoming me in and recognizing that I'm a lost soul here and that this is all so new to me, but I truly want to reach out for help and get to a better place in life....a place where I can perhaps be helping others a bit more.
Thank you also for helping me to 'fit in'.....you've opened your arms to me and I am forever grateful

Fading

[Christina86]

Originally Posted by Fading

Thanks for these responses

Wow! See, I guess this shows how confused I really am!
At one point I asked her what is the difference between psychiatry and psychotherapy and she said it's the same thing

Wow, what a way to confuse you more! No, they're not. They're both about helping those with mental illness, but unless you're in a country where someone without a medical degree can prescribe meds - they're not the same thing!

Some psychiatrists do psychotherapy.
Not all psychiatrists do psychotherapy.
Most psychotherapists do not have much to do with psychiatry.

Psychiatrists prescribe meds, and go through med school.
Psychotherapists go through school, but do therapy.

I should at least go for the 2nd visit and see how that transpires.

Do most people go on their own accord, or because of a Dr referral?

Definitely go to at least one more appt. I went of my own accord, but not everyone does. Most psychiatrists need a doctor referral anyhow.

From our brief time together and the info she gathered, she's somehow decided on 2 possible meds to put me on ??
--- Trazodone
--- Hydroxyzine wth?? The LAST thing I need is to just jump into a new med that I know nothing about....all I have to go by is the 'info sheets' she gave me which describes these meds.

Trazodone is good for helping you sleep and managing some anxiety. It works pretty well, makes you dizzy though before you fall asleep in my experience though.

Hydroxyzine seems to be something for allergies, but also to treat anxiety. Fact sheet: http://www.nlm.nih.gov/medlineplus/d...s/a682866.html

In your opinion and/or experience, do you think I should just blindly take whatever she prescribes, even if I'm not comfortable with it?

What are you uncomfortable with? No, you don't have to blindly take meds just because you're prescribed them. Do your own research on the internet, talk to people who've been on the same meds and see what you think. When I've been prescribed meds, I always do my research before I take them. I've even been told to go away, think about it, and then come back if I want to take them (or been given the choice to not fill a prescription if I'm not thrilled with the idea). I've always wound up taking them, but only after I knew the risks and benefits.

At my next visit, I'll be up front and let her know everything I've said in this post. She needs to be aware that I really need this explained more clearly to me.
Your feedback is all I've got....other than that 'form letter' from this lady.

Thank you so much

Good job. Being upfront helps.