[skysblue]

My M.D. suggested that I take an anti-depressant but I think it's best to review that recommendation with my T. What do you think?

I hope that your MD is a psychiatrist, in which case, I might give him or her a little more credence. But, in either case, I agree that it's a good idea to talk it over with T. T might have some good insights as he or she does know you better. Even if T isn't trained to give medical input, medication impacts your life, and anything that impacts your life is a good thing to discuss. Right?

[critterlady]

Neither of therapists I've seen while on anti-depressants recommended specific meds for me. When I was decided whether or not to go on one, the T I was seeing then did weigh in with pros and cons of taking them and with some pros and cons of individual drugs.

All my current T does is review my status - if he thinks I need a dosage adjustment, he'll tell me and than I talk to my MD.

[skysblue]

I'm quite concerned about taking any meds and will resist it but if my T and my MD (she is not a psychiatrist) both recommend it, it will be tougher to decline.

[unaluna]

Why not talk to a psychiatrist? Can your T recommend someone she works with?

[InTherapy]

In some places, (Ontario, Louisiana, New Mexico) Ph.d level psychologists can take additional coursework (NOT the entirety of medschool!) and be able to prescribe.

If you know anything about the system, you know the current one is kind of ineffective.

If you WANT to be a psychiatrist, you have to go through the entirety of your coursework learning about blood and broken bones and things you probably don't particularly care about, only to get to you're first chance to specialize like 5 years in and only THEN can you start even learning about your interest.

There's a lot of good arguments for therapists being in a better position to prescribe, since they're already quite well versed with understanding the psyche at graduation...

Unfortunately, a lot of the medical field is saying, "NUH UH! THAT'S OUR JOB!" And fighting tooth and nail against it.

It's dumb, because psychiatrists are few, far between, and AWFULLY expensive. And it's not getting better.

[BlessedRhiannon]

My T and I had a discussion about meds last week. She knows it's important to me not to be on meds, if I can avoid it. My T told me that if she thought it was very important for me to be on meds, she would push for it. She says that I've chosen the harder path by not going on meds, but she thinks it's possible for me. If both of us decided that meds are needed, she said she has a psychiatrist she works with and would refer me.

Personally, I wouldn't go to my GP for meds...I tend to have strange reactions to meds and I want someone that is very familiar with the psychiatric medications and how they might affect a patient.

My therapist recommended medications to me a little bit after I started therapy. He basically said he didn't think he would be able to help me if I didn't take medication. I was severely depressed and anxious and agreed to give it a try, reluctantly, and the medication has helped a lot and helped me work better in therapy.

My T has in the past recommended medication and often spoke of a specific med. Like, she wanted to me try anti-depressents so when the one I was on wasn't working she specifically mentioned the name of another one, but of course with that came a recommendation to a great P-Doc that she knew of. Sometimes though, I think certain meds can defeat the purpose of a T session. Like for instance, I would not go to a T session right after taking a Klonopin (a med which mellows you out and calms you very quickly) because then I feel like whats the point? Not all of them have that effect though. I would go ahead and talk to your T, then get a referral to a PDOC. Good Luck.

[critterlady]

There are also advanced practice nurses (basically psych nurse practitioners) that can prescribe in most US states. Most of them are also therapists, some with PhDs, some with MSW or other graduate degrees.

[mcl6136]

My old cold T pretended that he could prescribe, but he could not! What a putz!

I'm in family practice and I'm really comfortable with psych meds. I prescribe them every single day. I probably wouldn't want to start someone on heavy duty anti-psychotics, but I'd be happy to manage that once they were stable. If you have a good relationship with your regular primary care provider, they can probably get you something helpful, or refer you if they really aren't comfortable.

I sometimes discuss meds with a patient's therapist (I work closely with a psychologist who used to be a pharmacist and she sometimes has specific recommendations). Medicine does have a lot of people who think only their particular specialty can do a certain thing, but in general most patients just need a doc who is willing to work with them. If you have that, treasure it!

[critterlady]

My anti-depressants are prescribed by my family physician. She's really good with them. Plus, I have a close family member who's an APRN, who prescribes pyschotropics on a daily basis. I consulted with her as well and gave her recommendations to my MD.

My family physician did put one condition on her prescribing for me - I had to be in therapy as long as I wanted her to continue prescribing. If I choose not to continue therapy, she'll refer me to a psychiatrist for ongoing meds. She wants me to be monitored by a mental health specialist one way or the other.

[healed84]

Yes, my T was the one who recommeded that I take meds for my depression and anxiety. Actually, he was pretty presistent with the recommendation. I go to my family practice to get the rx.. I see a NP or a PA..

[sunrise]

Originally Posted by skysblue

My M.D. suggested that I take an anti-depressant but I think it's best to review that recommendation with my T. What do you think?

I don't think it's necessary to review the recommendation with your T, unless that is important to you. Is your MD a pdoc? If so, he/she is fully qualified to make the prescription. Therapists are not trained in meds, it is not within their scope of practice. Sometimes they do make less than optimal recommendations because of their lack of training. The best stance for a T is that they are open to their client taking meds and won't be judgmental if the client chooses meds. With my first T, I was interested at one point in possibly taking an antidepressant and mentioned this to her. Back then, I didn't realize therapists knew little about meds, in fact I thought maybe she could even help me get meds. I knew nothing! She got horribly pissy and said she would refuse to do therapy with me if I took meds. I was shamed and cowed. Now I am older and wiser and know she should not have been making that judgment of me and meds. Because of this experience, I would NEVER ask the advice of a T on whether to take meds. They need to stay in their own corner and do what they are trained to do.

BTW, my current T is very open to clients taking meds. He will not judge them if they do that. He just welcomes them to therapy and tries to help them in the ways he knows how. I love him for knowing what his own expertise is and being so open like that!

That said, there are some conditions that I have heard it impedes progress in therapy to be on a med. Like anti-anxiety meds and certain anxiety disorders that have very effective behavioral therapy treatments. On the flip side, sometimes a patient is so depressed (can't get out of bed, etc.), they cannot engage in therapy without some initial medical help.

If you are not seeing a pdoc, be cautious of a generalist MD's recommendation. They don't always have the training to do much more than prescribe an SSRI to a patient they think might have depression, whether it is the best choice of an antidepressant for that client or not. My own family doctor is the first to say she does not have a lot of training in psych meds. She would like there to be more providers like pdocs and Psych-NPs out there so she can make referrals, but we seem to have a shortage in my area.

Good luck!

[healed84]

You know, I have only ever seen one T, but he seems very informed about the different med choices out there for all types of mental illnesses. I don't know if it is b/c he is a PSY.D and they do more "clinical" type work while training.. but I am more than comfortable getting my Ts opinions, advice, and info about meds from him. That doesn't seem the case with the majority of people here.. I am suprised actually.. I know Ts can't rx, but I thought the would all at least have a good working knowledge of them.

[InTherapy]

Originally Posted by healed84

You know, I have only ever seen one T, but he seems very informed about the different med choices out there for all types of mental illnesses. I don't know if it is b/c he is a PSY.D and they do more "clinical" type work while training.. but I am more than comfortable getting my Ts opinions, advice, and info about meds from him. That doesn't seem the case with the majority of people here.. I am suprised actually.. I know Ts can't rx, but I thought the would all at least have a good working knowledge of them.

I agree with you, healed.

Most Pdocs only see patients, what, once a month? If even? And they don't know their client's nearly as well.

Therapists are there, day in, day out, and really KNOW what's going on in your life. They have an outside, clear perspective on how the meds are effecting you.

Therapists know a good bit about medication and how it effects mental health. It IS part of their "corner", even if they can't usually prescribe.

Sunrise's response seemed unnecessarily harsh to me.

[lostmyway21]

Yes my T recommends medication. Hes not my pdoc but they do communicate and agree to the type of medications I need to be on. I am open to anything my T recommends, he sees me 2x a week and gets at least daily emails from me. Who is going to be more knowledgable about ME? Ofc my T. My pdoc has almost know idea half the time. We actually made it my specific goal of my last session to get my meds changed. He told me my bipolar can't be controlled w/o help from proper medication. Mine weren't working anymore. Which is why my symptoms are out of contol. He's not afraid to tell me when I need a med eval though. I appreciate his honesty and openness. I need to hear it sometimes.

My T has a great deal of additional training in psychopharmacology, but does not prescribe. All that training has been helpful though as he is much better at explaining how my various mess work. He's always the first person I talk to when I notice any med issues as he has some really good resources of information. He always defers to my pdoc though for anything that is questionable.
.

[sunrise]

Originally Posted by InTherapy

Therapists know a good bit about medication and how it effects mental health. It IS part of their "corner", even if they can't usually prescribe.

Sunrise's response seemed unnecessarily harsh to me.

I'm sharing my experience and knowledge. I don't know what you mean about it being unnecessarily harsh. I am not making up what happened to me. I am telling the truth about my experience. Do you want me to lie? Not post? Surely we want to hear the experiences of a variety of people to get a sense of the full range of how things are? Therapists may have opinions on medication, but meds are definitely not within their "scope of practice." If you ask a therapist, "are meds within your scope of practice?", they will tell you no.

If anyone was "unnecessarily harsh", I believe it was my first therapist who told me she would refuse to work with me if I took medication. I love that my current T is open-minded and non-judgmental and will see clients who take meds or don't. That's the way it should be, IMO.

[ECHOES]

My T and I have talked about meds a few times. There have been times I feel SO bad, and I am so desperate to feel better that I think I should be on something. Those times don't happen as frequently as they used to.

I don't want to take meds, and my T knows this. She supports my feelings on the issue, and would support any decision I make. When really pushed once, said that she also feels meds wouldn't be helpful to me.

So, that's me. I think if you would feel better talking about this with your T first, then that's what you need. It sounds like a good idea.

[skysblue]

Originally Posted by ECHOES

I think if you would feel better talking about this with your T first, then that's what you need. It sounds like a good idea.

Yeah, my T knows my emotional state better than anyone else so I trust her judgment. I'm pretty sure I'll do without meds but I do want to discuss it with her anyways.

[InTherapy]

Originally Posted by sunrise

I'm sharing my experience and knowledge. I don't know what you mean about it being unnecessarily harsh. I am not making up what happened to me. I am telling the truth about my experience. Do you want me to lie? Not post? Surely we want to hear the experiences of a variety of people to get a sense of the full range of how things are? Therapists may have opinions on medication, but meds are definitely not within their "scope of practice." If you ask a therapist, "are meds within your scope of practice?", they will tell you no.

If anyone was "unnecessarily harsh", I believe it was my first therapist who told me she would refuse to work with me if I took medication. I love that my current T is open-minded and non-judgmental and will see clients who take meds or don't. That's the way it should be, IMO.

Sunrise, did you read through the entire thread? I'm guessing probably not.

I am sorry that you had a bad experience, and while it is true that some T's know nothing about prescribing, that is not true for all T's.

Originally Posted by InTherapy

In some places, (Ontario, Louisiana, New Mexico) Ph.d level psychologists can take additional coursework (NOT the entirety of medschool!) and be able to prescribe.

I am absolutely sure that some T's know nothing about meds, but I am equally sure that other T's DO KNOW a lot about medication, and can sometimes even give prescriptions.

[pbutton]

Mine has asked me 3 times if I wanted him to make me an appt with the center's Pdoc. I have said no 3 times.

[sconnie892]

My t asked a few times about meds. I'd have to go through my MD for them. I've always said no.