My spidey sense is telling me you need to try talk therapy. I can see a lot of insecurities in what you just wrote.
You shouldn’t feel rushed at the psychiatrist’s office, but as others have said, a psychiatrist is only there to check how your meds are working. He isn’t there to work out your twisted thinking. That’s what therapists do. It’s also entirely possible that you feel rushed at the psychiatrist’s office because of your anxiety.
At your next appointment ask your psychiatrist to recommend you a therapist. Chances are he’ll give you a better referral than if you just pick one out yourself. Then talk to your therapist about whether you should change your psychiatrist. Your therapist should be able to see through your insecurities and tell you if your psychiatrist is really no good or if it’s just you.
For what it’s worth, I had three appointments with my psychiatrist. At first I was prescribed Lexapro, which at my next appointment I told him had no effect. Then I was prescribed Cymbalta which again had no noticeable effect. At that point he said I should try cognitive behavioral therapy and recommended the therapist I’m seeing now.
IMHO it won’t matter if you stay with him or not. You only had two appointments so you can easily tell another psychiatrist the drugs you took and how you felt taking them. It also won’t hurt if you stay with him to see what he’ll recommend next. What will hurt less is if you try talk therapy. It’s just talking, so there really is no medical downside.
That goes for any clinical doctor, actually (that means “anybody except a surgeon or an anesthesiologist”). Your traumatologist isn’t your physical therapist, but both should be interested in knowing that a patient’s painkillers seem to be going off early-ish and able to tell the patient whether that is to be expected or not. My mother’s last three GPs all refused to get her on stronger painkillers on grounds of “I know you, and I know that when you’re not in pain you overdo things” (this is over a period of about 20 years), but they had listened and they did know her.
Ask your GP (or her nurse) and your therapist for recommendations on a psychiatrist. IMO, therapists know who are the good psychiatrists and who are the whack-jobs.
You should NEVER simply turn your life (or your body or your brain) over to a doctor and say “you’re the expert, you make the decisions”.
Window-shop. Ask around for recommendations.
With regards to psychiatrists in particular, if you feel like the shrink is heavy-handed and authoritarian, get the fuck out of there and go find another doctor. This is one place where you really want someone who will listen to feedback, even little nuances from you, and respect your self-determination as a patient.
Anything that is prescribed for you, read up on it, in detail. good and bad. Watch your own symptoms, keep a journal.
DO NOT be passive and inert and wait for the doctor to wave the magic wand.
I’ve had two psychiatrists, and while neither pretended to act as therapists, both of them were interested in what was going on in my life and how my medication was working with it. Many of my appointments were ten minute med checks - but that’s because they already knew me and everything was working just fine at the time. My initial appointments with them were easily a half hour or more.
Actually, my current psychiatrist is easily my best doctor out of my PCP and every specialist I’ve seen. He’s ancient, and I’ll be devastated once he finally retires.
And I second getting a talk therapist. They perform different functions, and studies say that a combination gets better results than just one or the other. You sound like you could use one.
If I understand what is meant by “talk therapy,” I’ve been doing this for over a year and a half with a therapist in the psychology clinic at my university. I talk, she listens, she suggests I try to challenge negative thoughts, and it seems to work for a while. But part of my problem is the disparity between what I know intellectually (the “I know I must do this, this, and this if I want to solve this problem” part of my brain), and my internal feelings that I’m just wired wrong. I can’t help but think to myself, “I know exactly what she’s going to say. I know this already!”
I am just starting with a new therapist at the clinic, as the previous one had to take a leave of absence. We’ll see how the new one does. Maybe she’ll have a different perspective.
I don’t want to hijack but gotta ask. How does a psychiatrists make such an assessment in only 5-10 minutes? I mean, surely his job can’t be just writing prescriptions with no knowledge of the person he is writing for.?
As I understand it, there is an intake process that takes longer (in my case, over an hour), where the psychiatrist talks with you about your problems and tries to make a diagnosis. In my case, I had to fill out an extensive set of forms about my symptoms and thoughts before he even saw me. The 5-10 followups are supposed to be medication management appointments, and don’t need to be as long because the doctor (supposedly) already has an idea of your clinical symptoms. In my case, though, I feel as if I have to measure every word in those 5-10 minutes or I’ll be cut off and told, “You’re thinking too much. It’s your OCD talking. Don’t expect the pills to work wonders. See you in 3 weeks.”
While I’m thinking about it, I highly recommend the community Fucking_Meds.
Not only is it interesting reading and a very supportive and nonjudgmental group of people, it’s been very educational. You find out about all those side effects that only, like, 1% of people get, that you’ve never even heard of. For instance, I never knew what a bitch Effexor can be to get off of once you’re dependent (months of weening, or things like taking an eighth of a pill a day, what the fuck), or that the B vitamins might combine badly with SSRIs for some people. (It’s for all medications, not just psychiatric, by the way.)
Have you explained this to your therapist? In my experience therapy works better when you force yourself to explain every messed up thought in your head. I held back for a while because I did not want my doctor thinking I was crazy, but then I opened up more and it allowed her to explain where my thinking was going wrong.
Everything you hold back form your doctor might be ill thought out but you don’t realize it yet. For instance, the fact that you think you are wired wrong and can’t solve your problems might not be true. Without knowing you I can’t be sure which is which, but your therapist should. Bottom line is don’t trust your negative thoughts and don’t keep them from your therapist.
Maybe your new therapist will be better. Don’t give up hope. It all seems hopeless right up until you actually get better.
Disclaimer: I’m not an unbiased source, much like Greenpeace is not an unbiased source about the behavior of tuna fishing fleets. Having said that…
How they do it in 5-10 minutes? They use algorithms like the ones embedded in this software.
I’m a FileMaker Pro database developer and I (briefly) worked on this system for these folks. You would not have to have a single psychiatric rotation under your belt to use this system and follow the prompts and spit out the appropriate prescriptions. This software is sold TO psychiatric practitioners, to simplify their paperwork for insurance purposes, and there’s nothing to KEEP them from making more individualized assessments but it makes very strong assumptions:
• your symptoms will fit into a small and finite list, and will mean the same thing as those same symptoms mean for anyone else.
• there are an even smaller and QUITE finite number of diagnoses, and for each of them there is a 1st tier standard medication. If you take it you end up “better”, “the same”, or “worse”. If “the same” or “worse”, there is a 2nd tier medication to try.
• Exceptions to the standard tier setup (and the order to try the meds) are mostly caused by certain specific side effects that the database recognizes as typical of an entire CLASS, so it skips over subsequent meds in the same tier list if they are in the same CLASS.
Now, obviously the typical practicing psychiatrist does all this without having a computer screen handy to say “Prescribe Lamictil in this dose and schedule follow up apt in 2 weeks”, so yeah you’d have to know the algorithms off the top of your head if you did not want to look amateurish in front of your patients. The POINT IS, the software would not be very useful except to practitioners who do indeed rely heavily on a “one size fits all” algorithm. You come in and sit down and explain what brings you there today and the psychiatrists listens for a few key words and categorizes you accordingly, and will have a standard “go-to” pill for that problem to start with first. Come back at next appt time and you sit down and again explain your current situation and the doc listens for (or probes for) certain specific symptoms to chart “yes” or “no” to and listens for (or asks) better worse or the same and based on that either leaves you on the same pill or goes to Pill #2 appropriate to the same ailment.
To listen deeper, to keep the categorical system of psychiatric diagnoses and psychiatric theories of etiology in mind as a resource but to only apply them to you where and when intuition says they might really help you in your specific situation given your specific personality and your specific concerns, etc, requires a different approach and a different attitude (and also would result in not finding the above-described software product to be very useful). That the guy who developed this sw for his own practice has found it far more lucrative to resell the software to other psychiatrists indicates that this is indeed how a great many of them practice.
It is also (and this is a point the software developer points out) what the insurance companies like to see. Standard and very predictable patterns. One size fits all.
statsman, are you doing Cognitive Behavioral Therapy? If you are, you should have homework that requires you to change your behavior in addition to challenging your negative thoughts. If that doesn’t sound like what you’re doing, I highly recommend you do it. OCD is a very treatable disorder if you are using evidence-based treatments.
Don’t make the same mistake I made and waste 8 years of your life on treatments that haven’t been proven to work. Just because someone is a ‘‘specialist’’ doesn’t mean they’re using science.
I have been given homework in the past. There is a thought challenging worksheet I’ve gotten that asks me to record
–The stressor
–Initial thoughts
–Challenges to those thoughts
–Reassessment of situation
I’ve also gotten sheets where I was told to write down activities I did during the day and give a pleasure score and a productivity score, both on 1-10 scale. This was used to help me examine the things I like to do and increase my pleasure from them (one of my problems is not really liking to do anything that people would pay money for, i.e, I love useless activities).
AHunter3, although he didn’t use any software in my presence, he did do an assessment of me that involved reading a list of prompts that required yes/no (“and only yes/no,” he reminded me) responses. I think they were categorized as “narcissism,” “aggression,” “anxiety,” and a few other things. We ran through these as if he was trying to break some kind of intake speed challenge.
“Remember, I don’t need details. Just Yes or No, please!”
I have been given homework in the past. There is a thought challenging worksheet I’ve gotten that asks me to record
–The stressor
–Initial thoughts
–Challenges to those thoughts
–Reassessment of situation
I’ve also gotten sheets where I was told to write down activities I did during the day and give a pleasure score and a productivity score, both on 1-10 scale. This was used to help me examine the things I like to do and increase my pleasure from them (one of my problems is not really liking to do anything that people would pay money for, i.e, I love useless activities).
AHunter3, although he didn’t use any software in my presence, he did do an assessment of me that involved reading a list of prompts that required yes/no (“and only yes/no,” he reminded me) responses. I think they were categorized as “narcissism,” “aggression,” “anxiety,” and a few other things. We ran through these as if he was trying to break some kind of intake speed challenge.
“Remember, I don’t need details. Just Yes or No, please!”
That is annoying. While a lot of places require you to fill out that sort of stuff, the best let you explain, and help you figure out whether the answer is yes or no for their purposes. And they’ll take notes on the stuff you do say that strikes them as important.
Then again, I’m really big on people getting a full battery of tests, and not just that questionnaire. When you have multiple tests that point to a specific diagnosis, it makes you a lot more confident in it. One thing I worried about a lot was whether they had caught everything.
One of my psychologists actually gave me a Rorschach test, which agreed with the rest that I had OCD.
Psychs don’t dedicate a lot of time to the patients; that’s what the therapist is for. But you shouldn’t be pushed through without him listening to your concerns about the meds.
Psychiatrists are physicans (MD or DO) and the quick session you had was simply to verify that your therapist made the correct diagnosis. Most likely the OP was interviewed prior to seeing him. The intake therapist wrote everything up and by the time the patient came in he had already read the report. So he just needs to confirm and assign med.
Though it can be done, despite what you see on TV and in the movies, it’s hard to fool them. When I visit my regular physican for my annual checkup, where he basically renews my med, (blood pressure and asthma) it lasts about ten minutes. He’d talk to me more, but I usually don’t need to.
If you like your weekly therapist then I wouldn’t bother to swtich psychiatrists. After all he’s only there to see you have meds and they are or are not working.
When you first start meds it can take a long time of adjusting meds and type of meds to get it right.
But if you simply don’t like this psychiatrist then change. There’s no reason to put up with anyone you don’t like. You’re paying for a service. If you go to a resturant and the waiter is quick, efficent and outwardly polite, but you get a bad feeling about him, then you have a right not to go back.
