First appointment with a psychiatrist...advice?

[Treefa]

Sup Bl..

So basically i'm going to see a psych. doctor about my addiction issues and problems with anxiety. I'm really going because one of my signifigant others wanted me to(i was in wd and slept all day, so apparantly i need help).
I'm also in chronic pain which i use opiates for(not always legally), should i tell him the truth that i'm pretty much a chronic relapser or should i even mention it?

I honestly am really sceptical about going to see this guy here are my predictions/questions;

1.)I'm not really depressed per say, my main problems are anxiety and physical PAIN, which is extremeley undertreated(no doubt this causes me occasional depression, anxiety, etc). I know psychiatrists prescribe meds, and can Rx controlled substances, but what are the odds of me getting Rx'd a mild analgesic(tramadol, codeine, vicodin, etc) to help the pain since it is causing me mental anguish? My Gp will prescribe small doses of tramadol or 5mg vicodin, but a very small amount, no refills, and they usually won't refill unless i come in complaining which makes me feel like a seeker.

2.) I will flat out refuse to take SSRI's, SNRI's(besides tramadol), NDRI's or any other blahblahRI's, or antidepressants. How will this sit with a pdoc?

3.) I am currently on a low dose benzo for anxiety, but i would really like to avoid benzodiazepines and am trying to quit them all together.


Basically, i will not trade in my opiate addiction for antidepressant addiction, or benzo addiction(which i've pretty much beat on my own). I'd rather use what works and be addicted to 1 class of drugs than others at the same time.
I don't want amphetamines, antipsychotics, mood elevators, GABAergic drugs, or really any other psych drugs at all.

Telling my doc this, is he more likely to perhaps try a low dose of an opioid, or is he more likely to say something like "i want to try you on {INSERT SSRI, BENZO, ETC.) and see you back in a month" and honestly i don't have time for bullshit like this and I will probably end up telling him something like "well sorry you wasted my time, but i don't think we are going to be able to do business"
...but thats only worse case scenario.

So any of you guys who go to a psychiatriast regularly or have even been once, if you could shed a little light on what kinds of meds a shrink can prescribe, or what the fuck the visit will even be like it would be a great help.

-Cheef Treefa

 

[Polluted_Mind]

(I think this is in the wrong section so will probably be moved)

1) Psychiatrists don't prescribe pain-killers. No chance, sorry. To get painkillers you need to generally see a pain specialist, or be in hospital with pain.

One thing that doctors are always very cautious of (my father is one so have learned this): they worry about both their insurance (ie: getting sued, which is sometimes unavoidable even for the best of doctors) AND their reputation (which in effect will determine their ability to practice and their income from referrals). THUS no psych is going to go handing out pain-killers to anyone, especially on a first visit, as one overdose and they're legally in the grey.

Ie: my father pays >USD$200,000/year for insurance. So do you think a doctor is going to risk $10,000 in premiums just to write someone a questionable script? No way.

The best you will get from a psychiatrist is klonopin, and even then you'll be lucky (then again you're in the US where they seem to be very "prescription happy")

2) Imho psychs are professional SSRI-pushers. It's a religion to them. Don't offend their religion, they won't like you.

3) Yeah.

4) You should seek opiate maintenance rather than trying to source from doctors. Ie: suboxone. But see it as a transition, don't stay on that shit for more than a few months imho, or you WILL regret it.

 

[Euphio]

Not all psychiatrists are created equal. If you don't like the psychiatrist or don't feel comfortable with him/her, switch and find another. It's important to feel some trust.

I had a psychiatrist about a year ago (I no longer see him). I told him almost immediately I wanted nothing to do with SSRIs or any other anti depressants and he had no problem with this. He was a "behavioral" psychiatrist, so he focused more on changing behaviors to change your mood. It actually helped for me.

Honestly, it doesn't seem like a psychiatrist will help you right now (in my opinion). If you're just going for some opiates, I'd say don't waste your time. However, a psychiatrist may be able to help with your anxiety. I notice that feeling well mentally can also help deal with physical pain!

 

[fairnymph]

What PM said. Psychs don't prescribe painkillers, and psychiatric meds are their bread and butter. You will be wasting both your time and the Dr's.

 

[skillz~4~thrillz]

I have been in therapy and on meds for 11 years. I went because I was so strung out on so many substances that MY better half gave me the ultimatum-get help or I am gone.

The above statements about no RX for opiates from a psychiatrist is true. It isn't within the rules to ask how or what to say to a Dr to GET any medication. I will tell you this. Not all shrinks are worthless-and not all shrinks are assholes who just write RXs. Cognitive Behavioral Therapy(or CBT) is what you want in a patient/ psychiatrist relationship-especially when drugs and/or addiction is involved. A Psychiatrist's job is more than just pushing pills. A patient's job is more than just bullshitting and hiding and trying to manipulate in order to get a specific(s) drugs. And not all patients and Dr.s click the 1st time. But when you find a Dr that you are comfortable with-and do some research prior to making appointments. Sometimes a simple google search can really save you time and money,
My advice-give it a go. what is the worst that can happen? you decide this isn't the right Dr or form of therapy that works for you. I will say as a late blooming psych major that you can uncover the underlying reasons for your problems and alternative ways to deal with them. I do believe in therapy. I see my shrink almost every week. There is no place on earth that I feel as safe as I do in my shrink's office. I am 36-been using since 12-recently kicked a 3 year IV opiate/speed addiction. it was not my 1st relapse and may not be my last but I know that for myself therapy works-if you want it to!

oh-be honest. It is a private relationship,Dr/Patient. nothing you say will leave that room w/o your signature-unless it is illegal or if you are dangerous to yourself or others. trust me-shrinks hear about drug use,abuse and addiction ALL the time.
And you should see a pain management Dr or an addiction specialist. I too have pain more often than not-but there are alternatives and that is the route I have chosen.

give it a shot. you might find it is the best thing in the world. you may find it isn't for you. But you won't know if you don't try. and if someone you love is insisting on it...it's probably because they love you and want the best for you.

Hope my rambling helped!
Good Luck!

Much peace and love..................................skillz

 

[Treefa]

well thanks for the advice guys.

I haven't made it in yet, and haven't even found which doctor i want to go to. There are about 15 or so in my area and i can see their stats and etc...but no reviews.

I largley feel that psychiatrists are just drug pushers, and i've known they 'can't' prescribe opiates but would it be feasable to get maybe some tramadol prescribed off label?

Honestly i wish there was medical marijuana where i'm from, it would benefit me greatly IMO. In high/constant enough dosages of weed(i only smoke the really good shit) it pretty much replaces opioids and benzodiazepines for me.
Marijuana is obviously the lesser of the evils, but it takes much more of a financial tole than prescrption drugs, and the legal aspects are really a pain.
Not to mention if my insurance covered like an oz. of weed per 30 days i would be set.

I woke up today feeling like shit, sweating, already in pain, no energy to get up, pissed as all hell etc etc..
I'm feeling a little better on nothing but 100mg of tramadol and 2 bowls of this kill so far and it's 3 o clock.

I'm considering extracting and dosing my adderall xr because i have miraculously been given a whole nother 24 hours to complete my midterm paper(professors dog is in kahoots or some shit), and i don't want to not do it with all this extra time.

I'll probably just do that in the morning as i have till like 5 o clock tomorrow. Oh and im a real procrastinator. fuckin psychiatrists, i still don't know if i'm going to go, i honestly don't think he can help me and it probably would just waste both of our time.