Mental Health Questions about seeking a psychiatrist

[bluelightFtw]

Hi Bluelight,

I have been putting this off for a long time, but now, in my mid 20s, I think I need to do it. I have been depressed for much of my life. While I have never been addicted to hard drugs, I still obsessed about various drugs and I would say I have had alcohol dependence issues for a few years. I still drink too much. But I now know why. It's because I can't deal with my past and with the present. Drugs, alcohol, and video games were just the most convenient means of escape.

Blah blah blah. I'll spare you an angst-ridden rant and get to the point.

1) I feel like I may benefit from the services of both a psychiatrist and a psychologist. I recently got a decent job and I actually don't feel like I'm in the gutter emotionally. I can actually perform decently at this job which requires my brain to work pretty well. So I cannot afford to become depressed. Because I know what happens when I do. Not much, actually. I simply become useless. Everything becomes difficult, bleak, very pointless, and even trivial things can seem impossible to go through with. I also know that anti-depressants work. Not for everyone and not in the same way. But they are powerful tools. However, as I understand it, psychiatrists are much more busy and see it all from a medical standpoint, more than psychologists. So I may get to see a psychiatrist 1 or 2 times a month. I think a psychologist could fill in those gaps. Or rather, a psychologist would serve a different purpose entirely. To actually work on problems at a.. psychological level, instead of treating it like a medical problem.

2) I'm not sure how to handle my past non-recreational pharmaceutical use. I was briefly on an SSRI and it didn't go well. It may have been because I was drinking on the night a certain depressing incident happened. But it made me very antsy and anxious at times (while very happy and full of energy at other times). What it did not do was simply stabilize me and calm me down. Which is what I'd expect a medication to accomplish. I do know that SSRIs take a while to 'stabilize' and I *had* to stop taking my SSRI because it was causing erratic behavior and thoughts.
Also, the reason why I'm concerned about this point is because I was on the SSRI while at uni. It was prescribed to me by the school's psychiatrist. I'm not sure how I could effectively tell the psychiatrist that I don't want to be on an SSRI without telling them about me actually having been on one. I can say that I heard/read about SSRIs, but I'm afraid that such a therapist/psychiatrist could surmise that I know a little too much about pharmaceuticals and mental illnesses than I should for someone who supposedly had never seen a therapist or taken drugs recreationally or therapeutically.
If I did mention that I had briefly seen a psychiatrist at school and something about the SSRI, I have a strong suspicion that the new psychiatrist/psychologist would want to request medical records of me from said prior therapists. And that would reveal my past drug use. And that could change this new psychiatrist's treatment approach. He/she could decide I'm dangerous/unstable/untrustworthy and refrain from prescribing certain types of medications. Possibly ones that have even a slight chance of being misused.
Maybe I'm making this too complicating, but this is keeping me up and worried quite a bit.

3) How do I find a psychiatrist? Or a psychologist? I mean I know how to Google. I actually *can* find them, but how do I find a good one? I believe that finding a good psychiatrist should be easier, simply because it is so much harder to actually become one (because of medical school and all), so the bar is higher in that field. But finding a psychologist seems harder, when everyone and their grandma is into psychology.

If it helps, BlueLight, I'm in the Pacific Northwest. Thanks and I await your wise input!

 

[spork]

Welcome to Bluelight!

Congratulations on deciding to get help. It's a huge step, but I think you'll definitely benefit from it in the long run. I think you may be getting ahead of yourself a bit on assuming that a doctor will request previous records. Even if they do want to see that, they have to get your permission to do so beforehand. I also don't think a doctor wouldn't come to the conclusion that a patient is a recreational drug user because you're knowledgeable about medications and mental health. When someone is suffering from depression, anxiety, or any other kind of health problem I think it's only natural for them to research more about treatments and the condition itself before asking for help.

Have you only tried one SSRI? Finding a psychiatric medication that works for you is a lot about trial and error. Just because one thing didn't work for you doesn't mean that something else won't either. I'd be honest about being on medication before and even about your drug history, these things are important for a doctor to know in order to give you the best possible treatment.

I first told my primary care physician about my depression and anxiety and she prescribed me a medication for it and gave me a referral to a psychologist. The psychologist in turn gave me a referral to a psychiatrist who helped me out further with medications. This system worked out well for me. Talk to your primary care doctor to get the wheels turning.

Keep us updated once you talk to someone and let us know how you're doing. All the best.

 

[bluelightFtw]

Thanks for your input, spork.

I first told my primary care physician about my depression and anxiety and she prescribed me a medication for it and gave me a referral to a psychologist. The psychologist in turn gave me a referral to a psychiatrist who helped me out further with medications. This system worked out well for me. Talk to your primary care doctor to get the wheels turning.

I don't really visit my primary care physician. It's been years since I saw him.

I think you may be getting ahead of yourself a bit on assuming that a doctor will request previous records. Even if they do want to see that, they have to get your permission to do so beforehand.

I'm going off a past experience with the medical staff at the school, where I was trying to pursue ADD medications - which had worked in the past. Before lifting a finger, they wanted to see a bunch of medical records first. I think they were doing everything to avoid prescribing abusable medications - to a guy. Girls get that **** with little effort.

 

[spork]

Yeah, ADD meds are different..especially in a college setting where it's abused/sold a lot. They have to cover their own ass with that kind of thing. Medications to treat depression aren't as sought after or easy to abuse so doctors will probably be more open to prescribing what will work for you.

When I talked to my pcp about depression it was actually the first time I had visited her. Seeing some sort of family practitioner is just a good stepping stone to get referrals to specialists.

 

[ad lib]

When I talked to my pcp about depression it was actually the first time I had visited her. Seeing some sort of family practitioner is just a good stepping stone to get referrals to specialists.

I totally agree with this.

When my pcp referred me to a psychologist, it was like my life changed -- in a good way. Like spork mentioned earlier, what may happen is your psychologist giving you a referral to a psychiatrist. The psychiatrist manages the meds and the psychologist talks to you much more.

 

[jobe28]

1) I feel like I may benefit from the services of both a psychiatrist and a psychologist. I recently got a decent job and I actually don't feel like I'm in the gutter emotionally. I can actually perform decently at this job which requires my brain to work pretty well. So I cannot afford to become depressed. Because I know what happens when I do. Not much, actually. I simply become useless. Everything becomes difficult, bleak, very pointless, and even trivial things can seem impossible to go through with. I also know that anti-depressants work. Not for everyone and not in the same way. But they are powerful tools. However, as I understand it, psychiatrists are much more busy and see it all from a medical standpoint, more than psychologists. So I may get to see a psychiatrist 1 or 2 times a month. I think a psychologist could fill in those gaps. Or rather, a psychologist would serve a different purpose entirely. To actually work on problems at a.. psychological level, instead of treating it like a medical problem.

Ive been to "therapists", "personal coaches", "psychologists" and "psychiatrists". And to be TOTALLY honest I havent really learnt TOO MUCH from them. I personally one of the best things I can imagine someone else can do for someone like yourself or me or anyone whose looking for help with their "mental health" is to just LISTEN without JUDGING.

Anyway.. if its knowledge youre looking for I think you can get the information straight from books yourself and skip the middle-man. And if you are going for the actual person-to-person service/whatever then I urge you to really look at EVERY form of therapy first. For instance Ive been diagnosed with "schizophrenia" and Im MUCH MORE comfortable talking to a "jungian (as in Carl Jung) therapist" as opposed to a regular psychologist. I find that the woman i spoke to just had a more empowering belief about my condition/situation, which was honestly shocking for me to find out that a lot of psychologists can (SUBCONSCIOUSLY/UNINTENTIONALLY) make me feel like shit (just like a weirdo/broken/sick person).

It can also just feel like your perpetuating your problems by constantly seeing someone who treats you like you do have problems. Eventually you need to or will want to leave that therapist or whatever. And that can sometimes be hard.. because if a doctor thinks you are "withdrawing" or "isolating" yourself from others deciding to stop your "treatment" can actually look kinda bad from their perspective.

2) I'm not sure how to handle my past non-recreational pharmaceutical use. I was briefly on an SSRI and it didn't go well. It may have been because I was drinking on the night a certain depressing incident happened. But it made me very antsy and anxious at times (while very happy and full of energy at other times). What it did not do was simply stabilize me and calm me down. Which is what I'd expect a medication to accomplish. I do know that SSRIs take a while to 'stabilize' and I *had* to stop taking my SSRI because it was causing erratic behavior and thoughts.
Also, the reason why I'm concerned about this point is because I was on the SSRI while at uni. It was prescribed to me by the school's psychiatrist. I'm not sure how I could effectively tell the psychiatrist that I don't want to be on an SSRI without telling them about me actually having been on one. I can say that I heard/read about SSRIs, but I'm afraid that such a therapist/psychiatrist could surmise that I know a little too much about pharmaceuticals and mental illnesses than I should for someone who supposedly had never seen a therapist or taken drugs recreationally or therapeutically.
If I did mention that I had briefly seen a psychiatrist at school and something about the SSRI, I have a strong suspicion that the new psychiatrist/psychologist would want to request medical records of me from said prior therapists. And that would reveal my past drug use. And that could change this new psychiatrist's treatment approach. He/she could decide I'm dangerous/unstable/untrustworthy and refrain from prescribing certain types of medications. Possibly ones that have even a slight chance of being misused.
Maybe I'm making this too complicating, but this is keeping me up and worried quite a bit.

I would freely tell them about your past drug use. I dont think you can really still be criticized or anything for something you did in the past. But I wouldnt tell them about your drug use if you continue to use it presently. Firstly because its illegal and you shouldnt disclose that information to anyone. And secondly its only a bad sign from their perspective (as a doctor whose looking out for you).

3) How do I find a psychiatrist? Or a psychologist? I mean I know how to Google. I actually *can* find them, but how do I find a good one? I believe that finding a good psychiatrist should be easier, simply because it is so much harder to actually become one (because of medical school and all), so the bar is higher in that field. But finding a psychologist seems harder, when everyone and their grandma is into psychology.

Like spork said - if you just go to your GP he will be able to hook you up with good therapists/whatever. And be willing to end your professional relationship with anyone until your completely satisfied with who you are seeing. YOU are the one paying and its your choice who you go with so dont feel bad about not liking that person.