[The Grey Wolf]

How long does it take for a therapist to come up with a diagnosis? Or to figure out what medications to prescribe? Does the medication work the first time usually? I mean obviously all medications don't work for everyone people are different but what I'm asking is does the therapist usually get it right the first time? Or does it take trying a bunch? Is it possible for no medication to work? I was sent to mental health clinic when I was 10 and prescribed Depakote and Risperdal neither of them worked although I did gain weight but I've read on this site that they have worked for other people so I'm wondering if any medication would work on me. I've also tried Valium didn't work either but doctors gave me that for muscle spasms not mental health.

[geis]

Well, these days, most therapists aren't MD's, so they can't prescribe meds. You'd need to see a doctor for that, most likely a psychiatrist. What meds work (if any) and how quickly varies widely from person to person, so there's no hard answer to that question.

As for how quick you get a diagnosis, that varies a lot too. Some therapists don't think a specific diagnosis is all that important, and they choose to focus on the client's particular issues rather than a broad category that may not completely fit the client. Others feel a diagnosis is much more important, and they may do extensive diagnostic testing. It really depends on the clinician.

[sunrise]

If they are billing insurance, they have to send a diagnosis code with the claim. But after only one visit, they may put down something quite broad, such as Adjustment Disorder or Mood Disorder. Then after more sessions, as they get to know you better, they may refine the diagnosis to become more specific.

For medications, it's as others have said. You need a different sort of provider from a therapist. Selecting medications is not within a therapist's scope of practice (unless they are also an MD, ARNP, etc.).

[The Grey Wolf]

I thought Psychiatrist and Therapist was the same thing so I would probably have to talk to two people?

[sunrise]

Yes, many patients talk to two people, say weekly therapy with a therapist and monthly appointments with a psychiatrist for medication. You can also see your family doctor for medication if it is not too complicated.

A psychiatrist is a medical doctor, specialised in psychiatry. Most psychiatrists do not offer psychotherapy.

A psychotherapist offers psychotherapy. They may or may not be psychiatrists - most are not.

This does not necessarily apply in all countries because educations are different, and the job titles may mean different things. "Psychotherapist" is a protected job title in many states but not everywhere.

My previous psychotherapist would not say anything at all about the meds I was on when I was seeing her, since she had no medical training. Instead she referred me to a psychiatrist.

[The Grey Wolf]

I don't know about talking to two people I was terrified about one. It also seems like that means more money.

Don't overthink this, Grey Wolf. You're nervous about contacting these people so you are trying to prepare for everything, and that is understandable. And it is always better to be as well-informed as possible. But you can't know for certain whether you will need medication or not, and the person you'll meet with will be able to tell you how things work at that clinic - no strangers on the Internet can do that. (I'm not saying you shouldn't ask for advice or support, of course. Just remember that our advice is limited because we live in different places and have different experiences.)

[The_little_didgee]

Originally Posted by The Grey Wolf

How long does it take for a therapist to come up with a diagnosis?

It depends. Some psychiatrists will make a diagnosis at the end of the first appointment. A more cautious psychiatrist will take longer. I got my diagnosis at the end of my third appointment.

Originally Posted by The Grey Wolf

Or to figure out what medications to prescribe?

It depends on the situation, the patient, and the prescribing style of the psychiatrist.

Originally Posted by The Grey Wolf

Does the medication work the first time usually? I mean obviously all medications don't work for everyone people are different but what I'm asking is does the therapist usually get it right the first time? Or does it take trying a bunch?

You won't know unless you try. It may take a few tries to find the right medication. I've taken medications that didn't work years ago. The SSRI didn't help. Actually it made my situation worse. I took it during a stressful time in my adolescence. A lot of changes were happening and I had trouble coping. A psychiatrist misdiagnosed it as a mental illness, but it wasn't. Sometimes people just need talk therapy to get through.

Medication can work on the first try. Years after my adolescent problems I became psychotic. Medication really helped that. I noticed my thoughts started to clear up after the fourth day. It was profound.

Medications don't always work. They can definitely make the situation a lot worse.

[The Grey Wolf]

Medication is the one thing I'm sure I need lots of. I'm skeptical therapy would work the only reason I was going to go was to get the medication I needed. Of course I'm overthinking it I overthink everything I do. I was prescribed medicine when I was 10 and I'm much worse now.

If you have a condition that medication helps, then yes, it's a good idea to get that sorted out first if you have to choose between that and therapy. It will help you identify what you need therapy for (if at all).

As for cost, health insurance will cover psychiatry the same as any medical appointment, and you will see them less often than you would a therapist. Maybe more in the beginning while you try different medications, but it eventually becomes a once a month or once every 3 month sort of med management appointment.

For me, I know within a couple weeks if a medication is not going to work. And even if it seems it might, it usually takes about 6-10 weeks to settle on a combination (and that's fast). So, it's not an overnight process, although I've heard of some people finding success a lot faster.

[AncientMelody]

Originally Posted by Mastodon

Only a medical doctor (such as a psychiatrist) can prescribe medication, and most psychotherapists don't have the right or qualifications to do that. My T is also a psychiatrist so he manages my meds as well, which is very useful for me, but I don't think it is that common - and many people prefer to have two different people for therapy and meds.

.

Just a slight correction, there are other medical professionals are authorized to prescribe medication: Physician assistants, nurse practitioners, and in a few limited areas I think there are a few psychologists who have specialized prescribing certification. The latter case is very very rare though.

Originally Posted by AncientMelody

Just a slight correction, there are other medical professionals are authorized to prescribe medication: Physician assistants, nurse practitioners, and in a few limited areas I think there are a few psychologists who have specialized prescribing certification. The latter case is very very rare though.

I'm an idiot. My post is a prime example of why we should never give information about this kind of thing - what applies where we live is almost certainly not universal. I'll have the offending post removed.

[AncientMelody]

No worries! Just wanted to put it out there