How to Talk to Your Psychiatrist About Depression
I am a psychologist. I am a doctor but not a medical doctor and I provide psychotherapy, not medication. Still, I refer many patients with depression to MD psychiatrists to provide medication to help with depression. Modern anti-depressants can truly be life saving medications. While many (mistakenly, I believe) get prescriptions from their family doctor, a well trained and caring psychiatrist can ensure that you are getting the most possible benefit from your medication.
Unfortunately many patients do not make the most of their time with their psychiatrist and they are only hurting themselves. Here are some tips to make sure your psychiatrist is doing the best they can possibly do for you.
- GET AN OUT OF NETWORK PSYCHIATRIST IF POSSIBLE If at all possible, seek an MD who does NOT take your insurance. While this won’t be feasible for most people, the extra expense is often well worth it. While the upfront costs are high, the long term benefits can be enormous. The reason for this is that there is a national shortage of psychiatrists. When there is more demand than supply, the provider of the service can take advantage and earn a better living with fewer hassles by opting out of insurance panels. To make up the difference, psychiatrists who remain in network must see more patients to make the same amount of money and often are more stressed and less able to devote the time and attention an optimum outcome requires. This is not to say that there are not many fine psychiatrists who stay on insurance provider panels, but they can be harder to find. If you must see an in network insurance psychiatrist it becomes even more important to make the best use of what is usually a more limited amount of time to talk with your doctor about your symptoms and your progress.
- THIS IS NOT A SOCIAL VISIT. You or your insurance company is paying a large amount of money for you to consult with a highly trained professional about your unique circumstances. Pleasant greetings are appropriate but you do not have to ask about your doctor’s day, his or her family or their most recent vacation. Professionals are human. If they can get paid to chit chat as opposed to working, it can be easy to fall in to that opportunity. They also don’t want to be rude by cutting you off and saying, “but tell me if you are still crying constantly” in answer to your asking, “how is your day going.” Skip anything beyond brief greetings.
- You are seeing a psychiatrist to help them find the right medicine in the right dose for your symptoms so familiarize yourself and concentrate on your symptoms and how they have changed (or not) since your last appointment. BE PRECISE DESCRIBING SYMPTOMS. When your doctor asks how are you sleeping, the correct answer is not, “pretty well”. What’s the pattern; any trouble falling asleep, staying asleep, or waking up too early? How many hours have you been sleeping. Keep a chart if possible. Patients tend to just remember the last couple days and an overall pattern is what is most important.
- PAY ATTENTION TO YOUR THOUGHTS When you suffer from depression you tend to ruminate on the unhappy things in your life. Notice if this is improving.
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