Worst and best experience with a psychiatrist?

Question

I've only seen one who I swear was trying to get me to kill myself by letting me take Prozac for 6 months and upping my dosage when I told him the medication was making me so much worse. I did try to kill myself, but I never say any professionals after that. I quit the meds on my own. Do they get paid more for hospitalizations? He worked at a psychward too that's why I wonder. I had 2 appointments with him one both were shorter than 5 minutes.

Since that was years ago and I never saw anyone since, I have no best impression of a psycho-doctor. I think when I try meds again, and I will, I'll just see my GP. He usually has about 10 even 15 minutes!

Answer 1

I just wanted to provide a context to your question that may be helpful. I've been a therapist working with severely mentally ill people for about 30 years in both inpatient and outpatient settings.

Most people expect that a psychiatrist is going to be a therapist, and when they get only a 10 or 15 minute interview and then get medication prescribed, they are disappointed or angry.

Up until about 20 years ago, psychiatrists were trained and functioned as both psychotherapists and medication prescribers. However, in the last 20 years, insurance companies figured out that it was cheaper to pay psychiatrists just to prescribe medications during a 10 or 15 minute visit and to have other therapists (who cost less) provide the 50 minute therapy sessions. Up until then, standard psychiatry visits were an hour long and included both medication and psychotherapy. A lot of the psychiatrists fought their loss of the psychotherapy role but they ended up losing this battle.

While the older psychiatrists (say 55 years old or older) have training and experience doing therapy, ones younger than that may have had very little training in therapy...especially in comparison to the training in therapy that use to be standard for psychiatrists. Instead their training is mostly about diagnosis and medication, as well as general physical medicine. So they may not be all that empathetic, or trained in therapy, Because the insurance only pays for a brief visit, they just get the basic information in sessions needed to determine 1) if you need immediate hospitalization 2) what is your diagnosis 3) what is your general medical condition 4) what medications have you been on before and what did and didn't work for you 5) what side effects have you had from medications before or currently? and 6) what medication will the psychiatrist prescribe for you? (They also are suppose to try to establish a rapport with you in the 10-15 minutes too.)

That's a lot to figure out in 10-15 minutes and so while the doctor may want to know if you've had suicidal thoughts or been abused as a child, they don't really need to know the details and furthermore just don't have the time, given the other things they need to establish in their brief visit with you.

For therapy and enough time to discuss these things in detail you need to see a therapist as well as a psychiatrist as first of all, it is their job to be your therapist, and second, they will have the time to be able to talk with you in more depth about your own particular circumstance. In order to get the best care you want to get a psychiatrist and therapist who share the same office as this way they are more likely to discuss your care and work together. Although sometimes therapists and psychiatrists who don't share office space will communicate sufficiently by phone to coordinate your care, in the real world everyone is superbusy and so the odds are against it.

Therapists would include psychologists, clinical social workers or marriage and family therapists. Your insurance heathcare finder (number on insurance ID card, if you have insurance) should be able to direct you to a psychiatrist and therapist who share the same office.

Do psychiatrists get paid more for hospitalizations? Only to the extent that they have more tasks to do so they get paid more for doing more work.

I have been in this business 30 years and can't recall even one time where a patient admission was motivated by desire for making money. That's out of more than 10,000 admissions I've been involved with in several psychiatric hospitals in town. People are hospitalized because they are a danger to themselves or others, or because they can't function in society, or because they can't be safely treated in a home environment.

Most psychiatrists today either see patients as outpatients or inpatients so it's somewhat rare these days for the same psychaitrist to treat an individual in both settings. Most psychiatrists are superbusy and not looking for work, and are in fact putting in longer days than they'd like. I know there's always an exception somewhere, however I can say absolutely that I've never seen a hospitalization take place where the motivation was making money.

I would strongly urge you NOT to get psych meds from a primary care doctor, because if the medicine doesn't work, they don't have the training on how to adjust medication or prescribe adjunct meds. I see lots of inpatients who went the route you suggested (seeing the general practitioner for meds). When the prescribed meds didn't work the GP didn't know what to do next. Most people who take psych meds will need multiple medication trials and adjustments and the general practitioner just doesn't have the training to do this.

Instead consider getting a psychiatrist and therapist who work in the same office, understanding that each has a different role to play in your care. You'll get much better care. From your question I think you would benefit from medications and therapy, and treating your depression with only medicine is not as effective as getting both meds and therapy. Multiple research studies in the treatment of depression show medications and therapy together work better than just therapy or just medication. And since you have a history of trying to kill yourself, your depression has been bad enough to be life-threatening; you shouldn't be messing around with anything less than the most effective treatment.

Good luck to you. With good treatment you will be so much better off!

Answer 2

Psychiatrists should never be trusted since there is no external validation for what they do or what they say about you. This is not to suggest they have no role or have not benefited people. There are several mental disorders that exhibit a consistent framework of symptoms and behaviors for which it has been shown by formal trials that a range of medications can assist. But how to do we get from those cases to the standard scenario that if you see a Psychiatrist you must be depressed enough to warrant medicating? This is more alarming when you consider that this judgment is often reached on the basis of a few spoken words by the patient and a moment of observation by the Psychiatrist.

My own experience with Psychiatrists has not been pleasant.

Following an industrial accident it was standard fare to send patients with life changing physical injuries to a Psychiatrist for counseling and assessment. My upbringing was less than wholesome and I made the mistake of answering the questions about my upbringing with some facts. Not a lot, just some of the basics. Big mistake, he no longer saw anything about me other than mental illness, depression and in need of medicating and long term care etc. What a disaster, he couldn’t cope with my upbringing, and for that I needed medication.

That led me to my second experience with a Psychiatrist, debunking the opinions of the first. This time I was more circumspect, I did not out right lie about my upbringing, I just avoided the issues that seem to trigger Psychiatrist seizures. So I spoke of my difficult upbringing in the context of its ups and downs and how I dealt with it and had support of people to help me through it. What I didn’t say was that the support was often in the form of a place to sleep overnight, many times at stranger’s homes, so I could keep off the street when I was 14.

The second Psychiatrist took a totally different perspective to the first. All was rosy and I no longer needed all those medications etc, surprise. So where is the science? For me the danger is that I just don’t think Psychiatrists can cope with my past, I know I can’t, but surely they are meant to. If I could tell a Psychiatrists the all and everything without the “sorry our 5 minutes is up, take 2 of these 4 times a day and see me next week” routine, then my opinion of them might change. I think first appointments should be at least 60 minutes long with no treatment decisions made at that time, just a get to know you. Truth is even then I don’t think it’s a good idea to trust them or let them get any position of power over you, like hospitalization. I exclude from this scenario those well documented cases I mentioned earlier.

Well I don’t know if this helps you, but I guess my message is just be very careful what you say and to whom, and perhaps require that specific details not be documented in the Psychiatrists notes. It is ever hard to get away from some things once they are in writing where they can then be the basis for subsequent decisions with out any real consideration of you the person, the context of those events or whether they have any relevance to a current situation. Anyway Good luck.

Answer 3

I've been seeing my current psychiatrist for a little over four years and I have had no bad experiences with him. He quickly recognized that SSRIs don't work for me and tried a couple other anti-depressants until we found one that didn't have bad side effects. When that didn't do it he added an anti-psychotic and when I didn't like what that did to me he tried a different one. He pays attention to how I feel and what I tell him and works with me to find the right combination of meds.

The first doctor I saw was a psychiatric nurse practioner and I hated her. She got mad at me for stopping Lexapro after nine days even though when I called to ask about the side effects the nurse filling in for her told me to stop it. Then she put me on another SSRI. Then I left school so I switched doctors.

Answer 4

No good experiences just bad. First doctor failed to diagnose bi polar II and after a year of getting worst and when I refused to be treated by him further he refused to allow me a second opion! Got worst hung self. Intensive care for eleven days.

After eighteen months and threating legal action got second opinion. Diagnosed bi polar and said I should have mood stabelizers.

First doctor refused to accept I had it so represciber the anti depressants that made me go high, but he still refused to change his ways.

I also now refuse to see another one. I was made iller and if they are allowed to ignore second opinions when the patients wish to accept them then I want nothing to do with something so danerous.

Currenty eighteen months into legal action with doctor's employers!

Answer 5

Spot the blunders in his declare approximately CBT? It worked final time so it would desire to paintings lower back. If it had worked in the genuine sense of the be conscious you does not choose it lower back! If the provider you're being noted is for workers in basic terms then circulate on your GP and get a referral to someplace open to all.

Answer 6

I don't think that he tried to get you to kill yourself. Psychiatrists just believe too strongly in medication-that is just my opinion. Most are qualified to perform psychotherapy, but their specialty is medication. I’ve always had a lot better luck with regular old psychologists.