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Thursday, June 28, 2018

Why It's Worthwhile To Go To A Psychiatrist


I've talked recently a few times about going to therapy, and how it can change you life. I happen to really like my therapist and have found going to her to be very useful. Some people, therefore, might ask whether there is any point to go to a psychiatrist if they already have a therapist. What can a psychiatrist actually do that a therapist doesn't already do?

Here's my thoughts on the matter.

First of all, I want to start off by saying that this certainly differs from location to location, but where I live you can get free therapy covered by your health insurance, with one caveat. You first need to go to a psychiatrist who then refers you to go to therapy, which is then covered. If you don't first go to a psychiatrist, you will generally need to pay privately for therapy. So going to a psychiatrist can help save you money on therapy. That's one.


On another point, I went to my old therapist for approximately a year without first going to a psychiatrist. (I went privately to a discounted place, not through my health insurance.) When I went to her, I found it helpful, but to a point. A therapist (that is not a psychologist, but a social worker or another type of therapist), at least where I live, is not allowed to diagnose patients. Therefore, the type of therapy that is given to most people is the standard talk therapy. For some people, talk therapy works wonderfully, and can really help them. People like my friend Daniella really find it extremely helpful and life changing.
But there are other people for which the standard talk therapy model doesn't really work, or doesn't work as well as other therapy types can. There are so many different therapy types or modalities, and depending on your diagnoses, there might be different types of therapy that would be recommended. Without first going to a psychiatrist to get a diagnosis, you might not be going to the type of therapy that would be most useful to you.
Fortunately, after close to a year in therapy, and with a bit of serendipity, I was able to be self aware enough to self diagnose myself, and found out what modality of therapy works best for what I have, and then switch to my current therapist that works in the modality that is best for my diagnoses. If I hadn't been self aware enough and informed enough to figure out what my diagnoses were and know what style of therapy is best for someone like myself, I would have just stayed in standard talk therapy which isn't nearly as effective as the type of therapy I'm in now. Going to a psychiatrist from the start to get a diagnosis would have been helpful, and would probably have saved me money as well, because spending money on the wrong type of therapy is a waste of money and time, in my opinion.

But even after I switched to my current therapist, who does the type of therapy I needed, I still ended up going to a psychiatrist. But why? If I'm at the right type of therapy for what I have, what is the purpose of going to a psychiatrist?
That was my question at first, and I spoke to my therapist about that our first few sessions. She said that even if I didn't have exactly what I thought my diagnosis was, I have enough of the markers that the type of therapy she'd do with me would be the same. And it was my choice whether or not I wanted to go to a psychiatrist. In our sessions we discussed what the benefits would be, and basically, I decided that for myself, I like things concrete; I wanted to know if I definitely had what I thought I did, because then it was easier for me to process. On top of that, having an official diagnosis would help me validate myself and empathize with myself and to understand myself and even forgive myself, because there's a "real reason". For myself, therefore, I thought it worthwhile to get an official diagnosis from a psychiatrist.

Additionally, another reason I was unsure about going to a psychiatrist was because I didn't want someone who's answer to everything would be to medicate. I wasn't completely convinced that I wanted medication or that it was the answer for me, especially not a large cocktail of different things. A good psychiatrist won't just automatically prescribe medication. Some of them will discuss other types of things; my psychiatrist recommended that I do a specific type of behavioral therapy as well as an intense group therapy as his main recommendation. We talked at length about medication, and in the end he convinced me to go on medication temporarily, to get me to a state where therapy would be more effective; I had reached a low where I wasn't functioning enough to benefit from therapy, and he recommended a short term medication. I am really glad I listened to him about that, because my life and mental health have only improved since taking medication. (If anyone wants to lecture me about how bad psychiatric medications are, that I should do everything natural, just know that I am pursuing all avenues including natural things, and I only medicate when necessary, which it was.)
A cousin of mine said that his psychiatrist recommended that he go on medical marijuana; good open minded psychiatrists will go more than just hand over a prescription for medication to you.

With all that, still some people may choose to not go to a psychiatrist, and that's ok. Your choice.
But in my books, even if you have a great therapist, I still recommend having occasional appointments with a psychiatrist.
But go only with highly recommended people. A bad psychiatrist can really mess you up, as can a bad therapist. (P.S. If anyone local is looking for a recommendation, feel free to email me.)

Do you have a psychiatrist? What are your thoughts on going to a psychiatrist? Do you think they're useful or helpful? Why is that?

11 comments:

  1. I have a psychiatrist via health insurance, I visit her once in a couple months (initially it was more often) as she is the one prescribing me medication and monitoring my dose. In addition, I go to a therapy privately, twice a week. In my country it is possible for therapy to be covered by health insurance, but after hearing a lot of bad experiences, like getting to go only once a month, staying with doctor only for 20 minutes etc, I decided it is worth my health to pay for it. I found experienced therapist who is in some kind of reeducation program so is taking patients in for a reduced rate. Still, I pay approx. 1800 USD per year (which is a lot for my 8000 USD income, giving I have to pay the rent). I am so very glad you are writing about this, as I have a friend who is ashamed of going to therapy and haven't told even her best friends.

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    1. Yea, I tried to see if I could go to therapy that would be paid for by health insurance, but they dont offer the type of therapy I need in my city at all, so I'm working on getting them to reimburse the therapist I see privately. So far they agreed to pay 1/4 of the price I'm paying, but I'm trying to pull some strings I have with the head of the health insurance, because I have connections. I'm really trying to break the stigma.

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    2. That is fantastic - reimbursement, since that type of therapy does not exist in your town for free! I hope you will be reimbursed the whole amount!

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  2. I love how open minded you've become (in regard to mainstream medicine) as you've grown older. I hope you continue to get the results you're looking for from your doctors.

    Are your kid continuing in school next year?

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    1. I try to not be bullheaded and be open to changing my mind. Trust me, going on meds wasn't a decision I took lightly, but it was something I needed. Even years ago, when my kids were quite sick, they went to the hospital and took regular medication. I just don't rush to meds, but I'm not opposed when necessary.
      Probably will have all 4 kids in school this coming year. For sure the younger 3.

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    2. I hope they all do well! I'm glad to see that you're taking care of yourself.

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  3. I've been on medication for a long time. A relative spent roughly twenty years in therapy, and other than paying for a lot of nice vacations for the therapist, saw little progress. Prozac did in months what twenty years of therapy couldn't.

    Since I had many of the same symptoms, and was able to see the difference, I went the medication route almost as soon as I had the chance. It took a while, but I went from being a generally miserably unhappy person to someone who has true joy in life. If it takes a pill to make my brain work right, I'll take it every day for my whole life. I'd love to be able to stop, but honestly, I don't think my brain chemistry can "do that" without the medicine. And I don't want to live the way I did before.

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  4. Here in rural Pennsylvania, there is one psychiatrist for the whole county; insurance doesn't necessarily pay for someone out of county. Usually the primary care doc takes care of psychiatric meds, and this isn't always good. Point being, here we don't think in terms of a psychiatrist if there's a mental problem.

    So when I received the scripts for my parkinsonism, I was amazed when all my anxiety vanished. Poof. Stress? Gone. I'm not sure which med is responsible or if they all are, or if it's the disease, but this has been a stellar positive.

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  5. Where we are, you usually get a diagnosis from a team usually headed by a psychologist, and then you get a psychiatric consult and therapy by a social worker or MFT.

    I've had psychiatric meds before, and at the time I needed them. If I get to that point again, I'll go back. Right now, I'm doing okay with just the therapist and the self-care and exercises she recommends. But when I was on that medicine, I needed it very badly. I could hardly work, and probably would have flunked out of graduate school.

    Getting complete psychiatric care is super important. Even if you don't have good coverage through your insurance or NHS, it is usually worth the financial investment. When I am in a healthy frame of mind, I need less help with housework (saving money on housekeeping and buying pre-made food), I am more physically healthy (saving money on doctor's visits), and I am better able to make money.

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  6. Psychiatrists are medical doctors who specialise in diagnosing and treating mental illness.They tend to treat complex and serious mental illness, and have a deep understanding of physical and mental health, and how they affect each other.

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