To ask why psychiatrists are viewed in this way

[busyweeks78]

I’ve only ever had positive experiences with them but as a general rule the stereotype seems to be a negative one. Aibu to ask why?

If thats only as of last year it hasn't been long enough to have changed peoples experiences.

@Gasp0deTheW0nderD0g you are correct, I'm very hung over and couldn't remember how much training psychiatrists do
I think people forget psychiatrists are medical doctors hence they will use a much more medical model as standard.

@hula008 maybe holistic is the incorrect word, I was just trying to show the difference in approach of psychiatry (medical doctors) and psychology due to vastly different training and education. Psychologists are trained more holistically but most also have solid understanding of biological and physiological processes. But in general a psychologist focuses on more talking based therapies (CBT being the main one) and do not have diagnosing or prescribing powers (they do not have the medical training required and although may be part of multi disciplinary diagnostic team they are not usually able to make a official diagnosis in the same manner a psychiatrist does).

I think like pp have mentioned many people have issues with psychiatrists due to not understanding the difference between the job roles and expecting a psychiatrist to do both job roles, but also due to the pressure medical services put on many mental health professions means many do not have the time to find out as much context or find out as much information about the patient as they would like to, and therefore have to make many quick assumptions based on limited information, and I feel that people often dont realise that the professionals dont enjoy that method of working any more than the patient, but as people only see there experience of the surface of mental health services they often dont realise the pressure and difficulties faced by many services at the moment.

@Gasp0deTheW0nderD0g I don’t think I have. Would you please elaborate? I know plenty of psychotherapists who are not psych graduates. They have counselling degrees.
Psychiatrists and psychologists are trained in various psychotherapeutic interventions which may be where you are getting confused.

This is what I said. Psychotherapists might be psychiatrists but are more likely people with psychology degrees who've had some postgraduate training in administering a particular therapy, like CBT, or a range of therapies. They might be clinical or counselling or health psychologists. I missed out mental health nurses as another profession involved in psychotherapy, but other than that, is it wrong?

No idea how common it is to get a degree in counselling, whereas psychology is one of the commonest degree subjects in the UK nowadays.

Hmmm well I am married to one and know many. Some are stereo typical chin rubbers and they tend to be the ones who have done some psycho analysis as part of there training. In the main most have completed many years in general medicine before specialising and there are many different types of psychiatrists, forensic, acute adults, kids etc etc. They are not experts in all areas which is the same in general medicine . As for ASD it's psychologists who conduct the formal assessments not usually psychiatrists. As for training my DH did years of training before becoming a Consultant when he was 34. So doctors train for many years before being in 'charge' unless you escape early and become a GP.

I know several and they are no more strange (in their ways) than other health care professionals of different specialities.

For instance I work with an ED consultant who only recently, when returning to work after an NSTEMI said “you know, heart attacks are quite painful”.

I guess because they make a lot of money from other people s misery? Happy people dont go to see them.
Dd s friend has severe MH problems and they re not really helping her. Having said that MH services (NHS) in our area are appalling.

About 7 years ago I was depressed and I saw a psychiatrist who diagnosed me with bipolar disorder and gave me medication for it. I don't have bipolar disorder. That's not denial, I just don't have it. At the time I was quite open to the possibility and I gladly accepted the medication he prescribed. But now I look back on that time and it all seems wrong to me. I don't just mean the misdiagnosis, but the medicating of my feelings in general with no thought to the actual real life occurrances that lead to them. I have a friend in the states who also sees a psychiatrist and it sounds similar. I am not against mental health drugs completely but overall I think they are over prescribed and feelings are often medicalised when really they're a normal reaction to events. For example, the last time my friend saw his psychiatrist his medicine was increased and he told me what he was told, that this was something to do with his serotonin levels. The fact he's in the midst of being divorced from his wife (and as a result has had to find a new home and a new job in a relatively short spare of time) apparently has nothing to do with his mood, it's all about serotonin levels. That doesn't seem right to me. I have no idea if this is a typical example of psychiatry or not but my feeling towards the field is not positive.

I see a counsellor now, I know it's not the same profession but I much prefer how my counsellor works. She specialises in trauma I think. There have been a lot of traumatic events throughout my life, childhood abuse, assault, rape etc. I find it much more helpful talking to her and she's taught me about behaviours I've learned as coping mechanisms which are not helpful/relevant today and seperating out what is an old feeling that doesn't belong in the present situation and so on. It just seems much more logical to me to understand and work through this stuff, compared to my experience with the psychiatrist where the answer to everything seemed to be to take drugs.

The reason over prescription of medication is becoming common isnt so much to do with the fact that professionals want to general population to be medicated but more so due to the fact that nhs provided therapy is difficult to access and therefore in a effort to try and help and alleviate the pressures of mental health medication is the only option they have.
In my area the waiting list for nhs counselling is over 19months, mind (the free counselling charity) is 12 months. If you are being seen by the physchiatrist you are likely to not be in a position to wait 19months for therapy so they have to do what they can to alleviate the symptoms in the mean time.
Unfortunately mental health conditions are often diagnosed through a system of deduction which means often people may have to try numerous medications before they find one suitable, and unfortunately the way mental health care works, it's not very geared towards assisting people with circumstances caused mental health as the services and funding isnt available (due to the need for more therapy based support then medication) as therapy based support is much more costly and time consuming both of which mental health services do not have.

Not all therapists are psychologists, as it's quite common to do a pure counselling based degree now or psych and counselling with a counselling/therapy masters as a way to BCAP accreditation. Although many of the.more complex therapies will be done by psychologists due to differences in requirements and understanding. Often CBT, EMDR, forensic counselling is done by psychologists, but person centred therapy and talking counselling is often done by counselling graduates (but not exclusive). There are many more routes to become and counsellor and many different forms of therapy,
but psychiatrists have a much more denfied route as they are medical professionals.

Thank you some very interesting view points.

My current psychiatrist is brilliant. He has helped me throughout my illness & found meds that work well. He's easy to talk to as well.

Very few people will ever see a psychiatrist in the UK. Usually private, or a referral requiring many hoops to jump through first.

Nonsense. I got a referral from my GP and got an appointment with a psychiatrist a couple of months later. It's the onward referral to Psychology that's taking the time.

Of course, that's the Scottish NHS so less fucked up, being devolved to a government that is committed to protecting it.

I dated a consultant psychiatrist in the nhs (so top of the tree) a number of years ago for a very short period. I can honestly say that I have never met someone who is so simultaneously intelligent and interesting, and yet so fucked up at the same time

Are you me? I have the exact same experience! I dated a consultant psychiatrist (I worked on psych ward for over 10 years). The one I dated was not an alcoholic or bipolar but he was definitely fcked up. He was controlling, manipulative and seemed to spend much time tying to "get inside my head" and play mind games with me. That said, he was pretty caring and good with his patients, but in terms of his personal life- yeah, he had issues.

I completely understand the difference between the different professions and why psychiatrists prioritise the medical model they are trained in. My point was about the fact they often lead mental health services and I'm sure have much greater say on how services are allocated than psychologists and definitely counsellors/psychotherapists in the NHS. If they feel overworked they're unlikely to say, we need fewer psychiatrists (who incidentally cost more) and more psychologists to deal with trauma. Hence the continued medication of people rather than therapeutic intervention which can resolve even long term issues.

I worked in a hospital and only has experience of one psychiatrist ( not as a patient) and she was as mad as a box of frogs!
She fell one day in the car park and deserved an Oscar for her performance. I had to ring her GP husband to come and collect her.

Can I just put right another misconception? People are concerned that they get prescribed antidepressants for "normal" life events and stress. This is actually correct practice as long as you meet severity criteria.

There are two ways (in simple terms) to develop depression: either you get a neurotransmitter imbalance for an unknown reason (endogenous depression), or you experience traumatic/stressful life events which cause the neurotransmitters in your brain to become imbalanced (exogenous depression).

Either way there will be a chemical imbalance that can be treated with medication, even if you're depressed because of divorce, bereavement etc. It won't remove the cause of the imbalance but it will correct it. This is completely normal in all walks of medicine. Treating your diabetes with insulin doesn't stop you being diabetic but we still do it and no one would have an issue with that. Similar principle with depression

Obviously it would be better to treat the cause, but that's usually beyond our power

The NHS psychiatrists I meet through work networks seem like lovely kind people. Not mind readers or anxious creeps. Ditto the mental health nurses I have met.

In relation to concern around Psychiatrists being ‘in charge’ of services and therefore driving a medical model - I would argue that this is not the case, more frequently lead practitioners are not Psychiatrists. I find this concerning personally as Psychiatrists bring a massive range of skills and knowledge to the table.

justdeckingthehalls Thankyou for what you do. It must be gur wrenching at times. Take care of yourself.

Mine was great! I had a GP who kept trying to insist I stay on an AD that caused massive weight gain (mirtazapine) despite that gain causing my depression to worsen (I have pins in both my legs for past injury/RTA) as I could then no longer exercise due to pain in my joints. My psychiatrist worked with me to find a medication that worked without this side effect for me.

Honestly wonder how much of obesity is the result of so many of these drugs truly having weight gain as a side effect.

One of my children has OCD, ADHD and ASD and is being treated abroad and his psychiatrist won't use certain drugs on him as his build means he already has to keep very active to stay on the right side of normal weight and certain drugs are known to cause not insignificant weight gain/obesity.

There are lots of papers, including in the Psychiatric Times, debunking the chemical imbalance theory. And the evidence is that anti-depressants only improve symptoms in 20 out of a hundred more patients than would have got better on their own.

As for your comment deckthehalls comparing anti depressants with diabetic medication, they're not really comparable. Diabetes medications address the issue for all patients. The medication is there to address a proven issue with a clear physiological cause. There is a crossover though with type 2 diabetes and depression. Both can be helped by non medical intervention. Diabetes with exercise and diet and depression/trauma by talking therapies. Personally I'd prefer not to be on drugs if alternatives are available.

Drugs saved my life and my son's as well. My son can function almost normally with them. All the talking in the world would have saved us . SO glad they're seen as a first line of treatment for so many of us.