[ImNotHere]

I have been to therapists and counselors and received medication from my doctor. My doctor says she can no longer help me because she will not give me any stronger medicine than she has given me in the past (nothing strong, nothing like xanax) and altogether they basically told me that they can no longer help me and I need to see a psychiatrist who can prescribe medication that is stronger.

I don't have much money and my insurance is crap so I don't know what they expect me to do.

What will it be like visiting a psychiatrist for the first time? Is it different than my first visit to my therapists?

Will I be prescribed medication on the fist visit?

Do you mean psychiatrist? Psychologists cannot prescribe medications.

[ImNotHere]

Originally Posted by lolagrace

Do you mean psychiatrist? Psychologists cannot prescribe medications.

Yep, that is what I meant. Sorry.

[ilikecats]

In my experience, visits with psychiatrists are much shorter than with therapists. Like 10-15 minutes. Also, I don't tend to talk to my pdoc about feelings and whatnot very much. It's more about symptoms and stuff. And I did get prescribed medicine on my first visit.

[Victoria'smom]

My experience was the first was an interview where it took about an hour and they generally ask your history and give you a dx. (that can change) and meds. They'll prescribe meds and give you a followup appointment in 1-3 months. Those appointment will be 10-15 min.

[ImNotHere]

Originally Posted by Miguel'smom

My experience was the first was an interview where it took about an hour and they generally ask your history and give you a dx. (that can change) and meds. They'll prescribe meds and give you a followup appointment in 1-3 months. Those appointment will be 10-15 min.

This may sound stupid to ask but are they going to give me a physical examination of any kind? I don't like people touching me.

[LonesomeTonight]

Originally Posted by ImNotHere

This may sound stupid to ask but are they going to give me a physical examination of any kind? I don't like people touching me.

I've been to several different psychiatrists and have never received a physical examination. Well, I guess one took my blood pressure before prescribing me a beta blocker, but that's all, and that was in a later appointment.

I've had intake interviews ranging from an hour to almost 3 hours. They want to get your full mental health history (like back from childhood) to make a diagnosis and determine what medication would be best for you. They may or may not prescribe something at the first meeting. You may also have to fill out questionnaires, like with symptoms of various mental health conditions, to help determine a diagnosis and what medication/combo of medications can best help you. Future appointments will likely be just 15-30 minutes to check on how it's going with the medication.

Hope this helps!

[kecanoe]

I have never been physically examined by a psychiatrist. The offices have had desks and chairs, no examining table. As far as a first appointment, I've had one that was 15 or 20 minutes, and others that were hours. I think an hour is not unusual. And you will almost certainly leave with a prescription or two.

[Victoria'smom]

No physical exam but they did take my weight.

[ilikecats]

Wow, I'm surprised that some people had such long initial appointments. My first one was only 30 minutes, and the ones after that have been about 10. I wish mine were longer, especially that first one.

[growlycat]

I have found pdocs to be a waste of time. My regular doctor has done a better job recommending meds. Can you switch primary care doctors? I've never had one who drew the line at certain meds.

[ImNotHere]

Originally Posted by growlycat

I have found pdocs to be a waste of time. My regular doctor has done a better job recommending meds. Can you switch primary care doctors? I've never had one who drew the line at certain meds.

It would be difficult for me to switch because I don't like physical examinations and can't stand being touched. I was shocked when my doctor told me "there is nothing more I can do for you, you have to see a psychiatrist" when it came to medication. I was also in therapy at the time but she was not willing to give me anything strong for my anxiety or depression even though my therapist diagnosed me with avpd, severe anxiety and major depressive disorder. She did have me try several medications but none of them were strong enough even at the high doses. I felt like she gave up on me.

[SingDanceRunLife]

My first pdoc appointment was about an hour long. I came in prepared with some history, a list of symptoms and a list of meds I had tried. We talked, he gave me a diagnosis, explained the diagnosis, prescribed some meds and sent me on my way telling me to come back in 3-4 weeks. Followup appointments with him were usually about 10 minutes long. A huge waste of time and money IMO.

My second and current pdoc first got my history from my T (with my consent of course), and we talked for about an hour to an hour and a half, mainly about my symptoms and medications, but also about life. Followup appointments with her are usually about a half hour. She has never told me a diagnosis, but for insurance and billing purposes she always puts the code down and I look it up lol.

The third pdoc I've seen, who was an interim, initial appointment lasted about an hour, we went through my history, what meds I was on, what meds I had tried, he prescribed some new stuff and said email me in a week to check in (long story short, I had to see someone 3 hours away from where I lived at the time). That was the one and only time I saw him. Beyond that it was email and phone contact.

[sub-dural]

Originally Posted by ImNotHere

It would be difficult for me to switch because I don't like physical examinations and can't stand being touched. I was shocked when my doctor told me "there is nothing more I can do for you, you have to see a psychiatrist" when it came to medication. I was also in therapy at the time but she was not willing to give me anything strong for my anxiety or depression even though my therapist diagnosed me with avpd, severe anxiety and major depressive disorder. She did have me try several medications but none of them were strong enough even at the high doses. I felt like she gave up on me.

My own PCP pestered me on these same notes for a long time. She was rx'ing the same meds from a former (very damaging) psychiatrist, but was uncomfortable doing so - she knew my history and was simply implementing a "continuity of care" as doctors are ethically responsible to do.

However, she gave me many referrals and talked/emailed me about it a lot. I had an appt with her after a terrible night at work and a lot of turmoil going on that I was dragging myself around. She could not change my scrips or give me higher dosages of the benzo I was on (she only continued to rx this because it worked for sleep).

But, through all of this, you cannot think of it as rejection. PCPs are not specialists in psychotropic drugs. A responsible doctor refers you to someone more well-equipped to help you. They will not give you a physical examination, they will probably give you a scrip, however, you can always take your time starting these. A good psychiatrist will be able to help you out, it seems.

Originally Posted by ImNotHere

It would be difficult for me to switch because I don't like physical examinations and can't stand being touched. I was shocked when my doctor told me "there is nothing more I can do for you, you have to see a psychiatrist" when it came to medication. I was also in therapy at the time but she was not willing to give me anything strong for my anxiety or depression even though my therapist diagnosed me with avpd, severe anxiety and major depressive disorder. She did have me try several medications but none of them were strong enough even at the high doses. I felt like she gave up on me.

That is pretty normal operating procedure for PCP's though when it comes to many things, not just psychiatric. They'll treat to an extent, but there is a point where they refer to specialists. My PCP was the same about psychotropic meds; he was comfortable only to a point after which he preferred I see a specialist more knowledgeable and comfortable dealing with those meds. It isn't about "giving up" on you; it is just about them deferring to a specialist.

First appointments with a pdoc are generally longer than what they will be for follow up. I've never had a physical examination by a pdoc. At the most, they might check your weight before they prescribe, but that's about it. Might ask you to have some bloodwork done; might not. Depends on what he feels needs to be checked at the time.

My physical examinations are: blood pressure, heartbeat and weight. (and height, but that's the same every time ) Pdoc says he should technically also do waist circumference (or whatever it's called in English) but he never does.

[caseygirl]

I met my first pdoc when I was hospitalized but there was no physical examination. Even though my BP, weight, etc. were on the chart, when he made his rounds with questions, he double checked the BP and issued appropriate meds. When I first met with him as an inpatient appt., I could tell he wasn't a therapist, only a prescription pad "person".