Finding the Right Psychiatrist for You

                  Last July I wrote about finding the right therapist.  As I was going through my posts a question entered my mind. How do you find the right psychiatrist?  I have had a few psychiatrists over the years.  It took a long time to find the right one. I spent a lot of time seeing psychiatrists that were not the right fit for me.  This is not to say they were not good at their profession.  I just did not click the right way with them.  

I spent over ten years with one of those wrong psychiatrists.  That shows It can be difficult to build a true psychiatrist/patient relationship.  It took a primary care physician’s assistant to show me how fractured the relationship with my psychiatrist at that time was.  I am sure this psychiatrist was good for many of her patients. Unfortunately, she either didn’t see what I needed, or she overlooked it to remain in her comfort zone.

I am sure I could do a Google search for what to look for in a good psychiatrist. You could to.  I think it is more important to speak from my own experience. As many of you know I have lived with depression and anxiety since I was a young teenager.  That is over about 37 years of living with mental illness.  During that time my illness has presented itself in ways that have needed the care of a psychiatrist.  I actually didn’t see a psychiatrist until I was well into my 20s.  Before that I either dealt with it on my own or therapists and general practitioners provided my care.  

I didn’t feel comfortable with my first psychiatrist, but she connected me with the psychologist who has guided me through therapy since.  I am grateful for that. Other psychiatrists were what I would refer to as pill-pushers.  The answer to every issue my mental illness created was a new pill or an increased dosage of one I was already taking.  This didn’t work for me. 

Good psychiatrists listen to patients before writing prescriptions.  Throwing medication at a mental illness without listening to the patient is not good practice.  I have had psychiatrists who would start writing on their prescription pad or pharmacy app before I had even taken a seat. That is not good practice.  In my case it resulted in me becoming overmedicated and addicted to one medication.  That psychiatrist never even noticed.  

I am not saying that medication is not an important part of the treatment of mental illness.  I just believe that medications that are prescribe must serve to heal the patient and help that patient live with the illness.  All patients deserve time from their provider.  The best psychiatrists understand this.  They treat their patients with respect and empathy.  There should be clear, open conversations about medications that include the purpose of the medication, how it works, and what the benefits and side effects are.  

I believe a psychiatrist needs to have a conversation with the patient in order to know the right medication to prescribe.  As I look back on my experience with one of my former psychiatrists I wonder if she was just prescribing whatever pharmaceutical reps brought to her that week.  She would prescribe a new medication before I even said how I was feeling or what I was experiencing.  

I had another psychiatrist who wouldn’t even look up at me.  I would walk in, and he would say, “what do you need refilled?” Then would say he’d see me in month.  Appointment over and I hadn’t said a word. I hope he was an extreme case.  

Sometimes I think I should have known better.  Neither one of these psychiatrists were good for me.  I need to know why I am taking a medication.  I need my psychiatrist to know what I am experiencing because of my mental illness.  I need to be heard.  I need a psychiatrist who understands medications don’t really work for me.  Luckily, several years ago, I found that psychiatrist.  Finding her was life changing.  I am in better place with my mental illness than I have ever been.  That doesn’t mean I am healed or beyond my mental illness.  I still battle depression and anxiety, but I have a psychiatrist who listens to me and understands what works for me as an individual.  

Here are some traits that I believe make a great psychiatrist.  Here’s a short list:

 

·      Listens first.

·      Doesn’t jump to the prescription pad.

·      Asks questions about how mental illness is affecting the person.

·      Engages in conversation with eye contact.

·      Includes the patient in the treatment plan.

·      Shows genuine interest in the patient and their healing.

·      Remembers previous conversations and follows up.

 

These are just some of the qualities that make a psychiatrist great.  As I said I could

have searched for these traits on Google.  I didn’t need to.  I described my psychiatrist.  After years of floundering with the wrong psychiatrists, I am now with a psychiatrist who sees me for who I am. She understands me and treats me with respect.  Her support has allowed me to grow even though I live with mental illness.  She supports my efforts to heal.  I think she has read every one of my blog posts, which encourages me to keep writing even when my blog isn’t getting the number of readers I want.

As a patient it is important to feel comfortable with your psychiatrist.  It is just as important to be confident in your psychiatrist.  There must be trust.  I trust my psychiatrist to make the right decisions for me because I know she is valuing my input on those decisions.  

A great psychiatrist also is able work as part of a team.  When it was time for me to try transcranial magnetic stimulation (TMS) and when I tried ketamine treatment, my psychiatrist welcomed the providers who oversee that treatment.  This gives me a team overseeing my mental health.  Likewise, when I was diagnosed with cancer, my psychiatrist spoke with my oncologist so that they were on the same page with understanding how my mental health affected my physical health.  A great psychiatrist is willing to be a part of a team. 

You may wonder where I found my psychiatrist.  I found her name on the list provided by my health insurance company of psychiatrists in their network. I scanned the names and marked a few whose names jumped out at me.  Then I looked for those psychiatrists on-line.  Something about the description of my psychiatrist jumped out at me.  I couldn’t tell you what that was because it was just a sense I had.  I picked up the phone and asked if she was taking on new patients.  Luckily, for me, she was. I felt comfortable from appointment one. Several years later, I am doing my best as I live with depression and anxiety.  Having the right psychiatrist makes a difference.

If you are seeing a psychiatrist, I would encourage you to evaluate your relationship with that person.  If there are things you would like changed, voice your concerns.  You may find that is not enough.  In that case, start looking for someone who will meet your needs.  It takes effort.  Sadly, that is difficult when you live with mental illness, but it can be done.  Consider asking a loved one or friend for help.  Ask your therapist or primary care provider to recommend someone.  Remember you are worthy of having a psychiatrist who meets your needs and who sees you as a whole person. Those psychiatrists are out there.  

 

 

 

 

                  

Different Types of Mental Health Professionals

                  When you are first looking for help with a mental health disorder, the number of different mental health professionals can be confusing.  In today’s post I will try to make sense of some of the options.  I am not a mental health professional.  By no means is this list meant to be authoritative or exhaustive.  I am a person with lived mental illness experience who has seen several professionals about my illness.  My intent in sharing this information is to provide assistance to those trying to navigate the mental health system.  It can be an overwhelming process especially when a person is struggling.

                  You may need more than one of these professionals.  I have a team that includes four members.  That is not always necessary.  From my personal perspective, each member of my mental health team adds to my treatment and healing and are instrumental.  I believe a team approach is beneficial to living with mental illness. 

                  Let’s look at some different mental health professionals.

Psychiatrist

                  A psychiatrist is a licensed medical doctor.  They are either an MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine).  Psychiatrists have completed a residency training in psychiatry.  They address both the mental and physical aspects of mental illness.  Psychiatrists diagnose mental health conditions.  Once they have diagnosed a patient, psychiatrists prescribe and monitor medication.  They also can provide therapy.  Psychiatrist can also prescribe alternative treatments for mental illnesses including transcranial magnetic stimulation (TMS), ketamine, and electric convulsive treatment (ECT).  

 

Psychologist

                  A psychologist has a doctorate degree in clinical psychology.  This can be a Ph.D. or a Psy.D.  They are licensed by their state.  Psychologists evaluate a person’s mental health.  They use clinical interviews, psychological evaluations, and tests.  A psychologist uses the information they gain from these tools to make a diagnosis.  They provide individual and group therapy.  Psychologist often use psychotherapy (talk therapy) with patients.  Some types of therapy used by psychologists include cognitive behavioral therapy (CBT), dialectal behavior therapy (DBT), interpersonal therapy, humanistic therapy, and psychodynamic therapy. 

 

Psychiatric Nurse Practitioner

                  A psychiatric nurse practitioner has a Master of Science (MS) or Doctor of Philosophy (Ph.D.) in nursing with a specialized focus in psychiatry.  They have either PMHNP-BC, which is board certification in psychiatric nursing, or they have NCLEX, which is National Council Licensure Examination.  Psychiatric nurse practitioners provide assessment, diagnosis, and therapy for patients with mental illness or substance use disorders.   Depending on their state, they can prescribe and monitor medication.  A psychiatric nurse practitioner blends nursing and psychiatric expertise when treating patients.  

 

Therapists/Counselors

                  Therapists and counselors have a master’s degree (MS or MA).  They can evaluate a person’s mental health.  When working with individuals they use therapeutic techniques based on specific training programs.  There is different licensing for therapists and counselors.  LPC stands for Licensed Professional Counselor.  LMFT stands for Licensed Marriage and Family Therapist. LCADAC stands for Licensed Clinical Alcohol and Drug Abuse Counselor.   Therapists work with people on understanding their thoughts, feelings, and choices.  

 

Social Worker

                  A social worker has a Master of Social Work (MSW) degree.  These professionals can evaluate a person’s mental health.  They use therapeutic techniques based on specific programs. Social workers are trained in case management and advocacy services.  Their role is often to empower individuals with mental illness to lead lives that are fulfilling and independent.  

 

Primary Care Provider

                  A primary care provider (PCP) is a doctor (MD), physician’s assistant (PA), or nurse practitioner (NP).  This provider can prescribe medication.  They can refer a patient to providers who specialize in mental health.  In the best scenarios a primary care provider works with other mental health professionals to provide the quality care.

 

                  Often, the first line of defense against mental illness is the primary care provider.  They are usually the provider who is going to see the patient most often prior to diagnosis.  Primary care providers should screen for mental health disorders and refer patients to the appropriate mental health care provider.  Once the patient has a mental health care provider, the PCP should work collaboratively with that provider to ensure the patient’s care.  

                  I have seen all the above providers except a social worker.  In my experience the best mental health professionals are the ones who listen not only to what the patient is saying, but also to what the patient is not saying.  They are empathetic and patient centered.  High-quality mental health care professionals treat the whole patient by being aware of their needs.  They ask meaningful questions.  They are not quick to slap a label on a person.  Instead, they see the person as an individual with an illness that they can treat.  

                  It is important to be comfortable with your mental health providers.  It is okay to try out professionals to ensure you have the right fit.  Being able to talk to your mental health care provider is crucial.  Even if you are not someone who is comfortable talking, there needs to be a comfort in the communication you have with your provider.  A good provider will support you in the communication aspects of treatment.  Don’t worry if you try a mental health provider and don’t feel there is a fit.  But make sure you try someone else. Don’t give up because a provider didn’t meet your needs.  We all deserve high-quality mental health care providers.  The right one for you is out there.  As an example, I have seen several psychiatrists over the years.  I had to learn that it was okay to change psychiatrists.  I have finally found the right one.  You will know when you have the right provider.  Trust yourself. 

                  There are a lot of great mental health providers out there.  If you are looking for one, ask your medical group for the names of providers.  You can ask your PCP to recommend someone.  There are also a lot of new ways to find a provider online, but that is for another post.  It is my hope that everyone can find the high-quality mental health providers like I have found.  It truly makes a difference.