Seeing a psychiatrist for the first time.

I’m looking for some opinions on this. How do you go about setting something like this up, I rarely go to the doctor and am unsure about the whole process. I’m twenty years old, going know where, full of goals I want to pursue, but havn’t the ambition to do so. For the last year I felt depressed and it’s gotten worse. My emotions run up and down. The second I want to do something and get somewhat motivated, I crash. I want to change but don’t know where to start. I want to tell my parents because I know they care about me very much, but I feel as though I’ll let them down as I have so many times in the past. I want them to know why I’ve been quiet so many years, why I’ve never talked to them about things. I owe them atleast that, right? I think they might know already but I’m unsure of that. Have you ever told your family and friends about this, whether or not they already probably assumed it anyway - what was their reaction? Did they treat you diffently. That’s what I don’t want, telling my parents and then they treat me diffently or they’ll try to love me more or something - not a cool situation. I don’t need pity. Your input would be greatly apprecitated.

It sounds like you already have. Admitting to yourself that you want to change and that you need help to do it is a big first step.

That sounds like the depression talking, personally. If they care about you, then they will want you to be happy. You’re better off talking to them about it frankly; you may be surprised. My recent round of therapy initiated some conversations with my parents that I’d wished I’d been able to have much, much earlier, and I now feel that I understand both myself and them much better. Admittedly I was a little concerned that they would feel that they had somehow failed as parents because I was depressed and needed therapy, but that’s why you need to talk to them about it.

No advice on how to find a good doctor, sorry.

I cant help you with finding a good doctor, but I can give you my own experience on this.


I’v been where you are very recently. jr8 is right you’v taken the biggest step, admitting something is wrong. Well, that was the biggest step for me. I’m married and had no fears about how my hubby would react, he’s very supportive and obviously knew “something” was wrong anyway. My parents, well, I knew my mom wouldent react well to me going on anti depressants, because she dosent believe in medication, and I was right, but she still supports me and is there for me . I dont really talk much to her about it because I have my hubby as a sounding board and feel more comfortable talking to him. As to being treated differently, no, not by my friends or family, I only found support. I only told a few close friends and my parents and sisters, because even though I know other friends noticed, once I started on the medication the change in me obviously put there minds at rest. I understand completely the not wanting sympathy thing, but my mom has never done that to me, and neither my hubby. I’m not very good at expressing myself, but what I’m trying to say is that once your on medication and seeing someone you can talk to, things will look a whole lot better, and you’ll find feelings that were ruling your life dont seem so important anymore. So if your mom tries to love you a bit more or show a bit of sympathy you’ll be able to cope better with it.
About going to see a phsyciatrist, I went because my doctor recommended it, but just wasent comfortable going and would sit like a dummy saying “yes everything is fine”, and I know I should have put more effort in because now I do have concerns that when I come off the medication I’ll only have treated the symptom and not the cause. So when you find a good phsyciatrist, please speak up and tell him/her how you feel, it will make all the difference.
I hope thats helped, good luck :slight_smile:

First of all, recognizing that there is a problem is huge. Good for you.

Secondly, you should consider how you want to go with this. A psychiatrist will primarily prescribe you drugs, and monitor how you are doing on those drugs. And while drug therapy works, if your problems are not biochemical in nature, but are more psychological, you might want to seek out a PhD rather than an MD. The most effective way, IMHO, is to find a therapist you can talk to, who uses a therapy system that makes sense to you (for instance, interpersonal therapy addresses your social interactions, and how to improve them, as depressives often isolate themselves, while cognitive therapy addresses feelings of worthlessness in the patient) and then have the therapist coordinate drug therapy with a psychiartrist or your primary care doc.

As to how to find a therapist, I am in the same boat. Now that I have insurance, I’d like to get back into it, but I just don’t know where to go. It also doesn’t help that I am a psych major and a shrink’s daughter, so I have VERY specific ideas about what will work for me. I have an appointment with my primary care doc tomorrow, and I plan on asking her if she personally knows anyone good.

Know that your guilt and your fear about letting your parents down is not a reality. It is a symptom of your illness. Have you looked at You might also want to look up Major Depression in the DSM-IV (diagnostic and statical manual of mental disorders, aka: the shrink’s bible) and see how many of the criterion you meet. This is a very stressful time in your life (as a 21 year old, I know…) and having someone to talk to will help a lot.

Good luck, and if you need to talk, my email is listed below. Keep us updated.

Well, don’t take any psychological advice from us, we aren’t doctors.

You might do fine with a psychologist the same sex as you are for the first time. Just open a phone book & look. Or you could check to see if your city has a referral agency.

If the counselor talks about themselves without your asking, thats a hint to find another one quickly.

My view’s a little abnormal, since I live in Manhattan. If you haven’t seen any Woody Allen movies, everyone here is in therapy.

Now, i’m not a therapist of any kind, but it happens that my best friend is a certified social worker (another form of shrink - more on that below) and, of course, she sees a shrink, too. She recommended someone whose reputation she knew, and I’ve been going for some time, feeling much better.

From the sound of your OP, you don’t know anyone in therapy right now, so you don’t have that personal recommendation advantage. But the doctor’s a good place to start, especially if you get along well. (Actually, if you’re not close to your “primary care” physician but have seen a specialist you really like - ask the specialist.)

Don’t assume that the first shrink is going to be “right.” If you get a really bad vibe from your first session or two, find another. You might try calling a local mental-health center, or if you’re in college you might see the student health clinic. (Student health clinics are covered by very strict student-confidentiality laws, so don’t be embarassed or afraid to use them.)

Oh, and I meant to mention social workers. They’re another part of the mental-health field. Their training is somewhat different from a Ph.D. or M.D., and I’ve found that they can be a bit more grounded. The standard degree is the Masters of Social Work, which is usally a two-year graduate degree rather than the four (or more) years of a Ph.D. or M.D.

My friend decided that she really didn’t see much reason to getting a Ph.D., which is a tremendous effort and often only bears a tenous relationship to the practice of therapy. The problem is that the quality of social workers varies tremendously; my friend got her degree at N.Y.U., which is very highly regarded, but there are a lot of not-so-great programs out there that seem to function mainly for people who can’t get admitted to med. school or a Ph.D. program.

Another note: in most jurisdictions, only psychiatrists can prescribe medication, which means that if you’re seeing a CSW or PhD and you decide you’d like to try meds, your regular shrink will have to refer you to a psyciatrist for an evaluation and prescription. That’s an extra cost, but for me it was worth it - I didn’t want to start on meds right away, but once I felt ready and my shrink and I had agreed to try it, I liked getting a sort of second opinion from someone who really knows the drugs. It took about three sessions with the M.D. to iron out what works for me, and since I haven’t had any problems I just ask my regular physician for renewals.

Lastly, cost - here in NYC, for private practice, psychiatrists are more expensive than ph.d.'s, who are more expensive than MSWs. As you can tell, I really don’t think it’s a case of “you get what you pay for;” it’s much more a question of your relationship with your shrink and what approach works for you. Some shrinks, like mine, offer a sliding scale. Don’t be afraid to ask.

If you’re under health insurance, be sure to familiarize yourself with the mental health coverage. Often it isn’t much, but even a little is better than nothing and there’s often hoops you have to jump through to get even that. (Coverage is the reason I get my scrip renewals through my regular doctor - visits to him are covered, but visits to a psychiatrist weren’t.)

Hope this helps.

The input about going to a shrink has already been,uh, inputed, but I wanted to say a bit about the parent’s part.

I too, have often felt like I have let down my parents, especially when i was a bit younger.
I realized only very recently that I am probably still letting them down, but neither of us realized it.

I let them down by not being honest with them. I should have been more open. I’ve been going to therapy for several months now, but I never told them.

A few days ago I wrote a letter to my mom and explained a little bit about who I was, all the stuff she never quite understood. She can’t relate, it’s hard for her to understand exactly what it means to be bi-polar, but I told her.
I think it was the most honest and helpful thing I have done as far as matters with my parents go.
I think if something’s a part of you, there should be no need to feel ashamed, like you have something to hide from the world.

That’s all.

Put the first thing first. Go to your family doctor and have a complete physical. Ask for the works - blood, urine, the entire ball of wax. It’s important to rule out things like thyroid disease first. My GP also handles my anti-depressant medications and has a great relationship with the therapist I used for a couple of years. It was comforting to know that all I had to do was give authorization and they could share info on my case.

Second, talk to your family. I kept quite about my illness for a while and finally came clean with my mother. Come to find out there is a family history of depression that I didn’t know about. It helped my GP and my therapist to know the family history and gave them the ability to help narrow down the problems I was having.

Don’t be afraid or ashamed. Everyone gets depressed at one time or another. Some of us just get depressed and stay that way until we get help. The next time you see a group of four women sitting together think “statistically one of those women has suffered through at least one bout of clinical depression in her life” (or one in 10 for men) IIRC. Don’t be scared of anti-depression medications, a good doctor will listen to your problems, prescribe accordingly, and follow-up on a regular basis.

Above all keep in mind that you are not alone! You’ve taken the first step, all the others are much easier.

Good luck!

“My view’s a little abnormal, since I live in Manhattan.”

I always thought Manny might have a double personality.

I thought I’d add that making the decision to speak to a professional is probably one of the best ones you can make. It’s also a personal one. My parents looked at me with hairy eyeballs when I started going, only because they felt they had done something wrong. (This seems to be a fairly common response when one hears that someone else is going to therapy.) Here’s a humble bit of advice. You’re making an investment in yourself and in your own happiness. As hard as it is to do sometimes, you have to let what other people think take a backseat to what you have to do for yourself. :slight_smile:

See- I knew something was wrong when you posted about jumping off a bridge…
In the same boat- I’ll try to input more l8r- kinda rushed now- car’s broke down, fuckin hate that, but I gotta do something, either re-wire it or find a new one- long story and poopy of me to tangent like this- anyway, hold on tight, k?
I think handy’s suggestion of a referral service is goo- they are usually in the yeelow pages, and would be mixed in withthe category you want- be careful though- sometimes it seems like these services are no more than fronts for a particular set of therapists…
And please get it out of yor head that you’re letting your parents down- there is someting actually wrong with you- is it realistic for a daughter to feel bad because she let her father down by not being a boy when that’s what he wanted?
It’s no more realisitic for you to feel this way either, and it won’t help you.
See? you are laboring under a problem, or set of problems, whatever they may be. Thinking of yourself as a piece of worthless shit is mistaken in the first place, and, more importantly, being mistaken, doesn’t help you to overcome whatever it is.
So, let’s just stop that right now, shall we, you little worthless shithead? :wink:

Two points:

  1. Not all therapists re good theripsts. Someone touched on this before, but I want to repeat it–a bad therapist can be worse than a waste of time and money, it can actually make you worse, and make it harder for you to trust later therapists. If you are nt comfortble with someone, change. Don’t worry about insulting them or anything–thsi happens all the time, therapists and patients have to “match”.

  2. Write down what you want to say–your symptoms–before you go and take the list with you. Once in a therapist’s office it is easy to have all your details reduced to “Uh, duh, well, I been down sorta. . .hard to describe. … um, er” Pay particular attention to things that have changed over time-- "I didn’t use to. . . ". This also will help with another problem, where the doctor asks if you have been experienceing something (and he has to ask because you are going through the "duh. . .er. . .I dunno’s) you say yes and then you wonder if it isn’t power of suggestion.

for she spake not out her asseth.

Most people I know see all kinds of professionals that give them all kinds of treatments, so it’s kinda hard for me to put myself in the shoes of a closet case. I can only imagine that it makes things worse to bottle them up that way and my suggestion is that you not only talk to your parents but see some kind of professional, it can’t hurt can it?

I know you have fears about your parents reactions but like you seem to have already realized, they probably know. The last thing anyone wants is for their child to be unhappy or afraid to come to them with their problems, this will factor heavily into their reaction as well.

The feeling of having let your parents down is very familiar to me, however. I’ve been told that it’s very common among depression sufferers.

Like Manda said, there are all kinds of doctors and I had to see a few before I found one I was happy with. I actually came close to putting one guy in a hospital, he believed in agressive confrontational therapy. It just made him afraid of me and I left, so I can’t recommend it unless you are a very calm individual :wink:

I haven’t really gotten much out of my attemtps of seeking help, I’m pretty much as unhappy and off my nut crazy as ever. A lot of my friends have turned their lives around that way though, and I’m gonna keep trying. Worryingly enough I am also studying to be a sociologist/psychologist at the moment, muahahhaa :smiley:

Best of luck mate! :slight_smile:

— G. Raven