Psychiatry, Psychology or Psychotherapy?

[ImaHogg]

Does anyone have any experience in any of these.
I am quite confused as which therapy would help me.
I am going to have to pay privately for this and can’t not afford to make the mistake of choosing the wrong type.
My gp just offers me CBT which I have had many times and sadly just doesn’t help me.
I have suffered from severe anxiety for many years (probably 40 years on/off), it’s started in childhood during which time I had many fears and anxieties.
It has waxed and waned over the years but has been very bad recently to the point I is now controlling my everyday. I have obsessions, unwanted thoughts and several different types of anxiety which are taking over my life.
I am in a vicious cycle of physical symptoms which exacerbate the anxiety and vice versa.
Because of the awful health anxiety which I have I am too scared to take medication and feel that I need a health professional who can support me with the right medication. My gp will just give me a prescription for antidepressants, check in two weeks later and then leaves me to it and doesn’t understand the absolute fear I have of taking such medication, I need someone who can help get me through that. I wonder if a Psychiatrist would be the best for that? I have no idea!

The thing is OP GPS are not specialists in mental health. They only have a few days mental health training before qualifying as a doctor. Even psychiatrists tend to be trained more about pharmaceutical methods of dealing with mental health issues. I once met one on a course and she told the group that she'd just started to recognise the link between trauma and addictions. Her specialism was working with people with addictions!!!!

If I was reorganising mental health, I'd train mental health GP specialists, who are specifically trained to be aware of many different treatments, including different therapies, medications and even non-clinical treatments. For example there's evidence that yoga is as beneficial as medications in treating PTSD.

Please don't be disheartened. I think you're very sensible informing yourself before paying out on treatments that may not suit you.

There is no one size fits all in mental health. Different approaches suit different people, and you need something that specifically works for you. Incidentally, it might be worth looking up the NICE guidelines on mental health for what you are entitled to if CBT hasn't worked for you.

When you finally decide to go for a particular therapist or psychiatrist, ask them what success they've had with your kind of problem, are they specifically trained in it, how they intend to work with you, how long they think it will be before you see signs of improvement. These are all very reasonable questions and you have every right to ask them.

Another good resource for learning about anxiety is the Panic Pod Podcast OP.

It won't be a treatment, obviously , but learning a little about what causes anxiety, how it manifests itself in the body and brain and ways to treat it, could be really important first steps to you getting better.

Thank you so much Grimacingfrog

You're very welcome, @ImaHogg you've got every reason to believe things can improve. You're doing all the right things.

Hi ImaHogg
I agree with the others - if you want to be on meds but don't find the GP helpful, see a psychiatrist who can look more closely into what might suit you. Sometimes there's a lot of trial and error though. I went through a lot of different meds in a short time when I was first struggling because I took all the usual ones and either they didn't help or the side effects were terrible. Later I developed further side effects and my new psychiatrist took the time to listen to my whole medical history and consult a psychopharmacologist to work out what would be best for me.

You might get lucky and find one that's good for therapy too but I've always had more success with clinical psychologists. As others said,look at the type of therapy they offer. I started with a new one a year ago and we are doing things I've never done before - trauma therapy and EMDR as well as other useful talk-based things. I think if your issues are complex you might need to do a trial session/phone chat with more than one to see if you have a good rapport with them.

I think anyone can call themselves a psychotherapist - some might also be psychologists or psychiatrists, but some might not be either. I am in a place where private health insurance is used and the insurance only pays for MH treatment with psychologists and psychiatrists as they are the relavant qualifications.

I hope you find someone.

MountainDweller thank you. I do think that I may now need medication to get me through the next few years as I now care for my mum who has Alzheimer’s and although I have limped along without meds for many, many years, I really don’t know how I can do this without meds as anxiety just overwhelms me these days. I may see if my gp can refer me although I don’t hold out much hope and even if she does I expect the NHS waiting times are very long. If this is the case I will then look into the private side of things.
How did you find EMDR? I have just joined Anxiety U.K. and have applied for this therapy through them as it has been recommended to me.
After these things, my plan will be to seek out a clinical psychologist for something longer term.

Hi OP,
If you do think ADHD may be a contributor you can ask your GP to refer you here psychiatry-uk.com/right-to-choose/
Sounds like psychotherapy would help, but you would want to work with someone who has experience of working with anxiety. Anyone can call themselves a psychotherapist (and believe me many unqualified people do!) so your best bet is look for a therapist via the UKCP as you can not get on this registrar without being qualified.
[[https://www.psychotherapy.org.uk/]]
A psychotherapist will help you work through old emotions and behaviours that are impacting on you in the here and now.

BigasdaB thank you very much for that. I will ask my gp.