What happens when you visit a psychiatrist?

[memoo]

Don't think I have spelt Psychiatrist right?!

Have finally got my referral through to go and see a psychiatrist about my ongoing anxiety/PND

I'm feeling really nervous about it, have no idea what to expect.

Doesn't help that its at the local psychiatric hosptital (the barbed wire around one of the buildings makes it a bit scary)

Can anyone tell me what exactly he/she will do?

Have been refered because despite all the meds I am on I am not really getting any better. GP has put my of higest doses of citalopram, diazepam and propranolol but says he is unsure what dirrection to go in now as its clearly not working.

The PND is slowly living but the anxiety is still hanging around like the proverbial black cloud, thats the thing I need the most help with.

Sorry for any typos, have a unhappy 6 month old hanging from my front in her sling, hard to find the keys

Hi, oh my goodness I know where you are at ..... my kids are a lot older now but had increasingly severe pnd with each of them and am depressed again now.

Its horrible walking in to a psych hospital ... I know. I have managed now to have all appointments in the community MH centres we have which makes a huge difference! is there any chance of that for you?

A first psychiatrist appointment is like telling them your life story! They will want to know about your recent history but also relationships with parents etc. I found it quite releasing to moan about the bits I felt they had got wrong!!!

I hope that maybe the psychiatrist will change your meds - citalopram is not great for anything other than mild depression and any kind of regular prescription for diazepam is a bad sign.

Hope that the psych appointment has you feeling better soon. Sadly my youngest dd is now 6 and I am still suffering - see them sooner rather than later is my advice!!!!

I have slowly got worse after each baby too. Just had my 3rd six months ago and have honestly never felt so bad my whole life.

I do feel a bit worried about keep using the diazepam but without it I am just a wreck. I am careful to take it only when I really need it though.

Think my GP is hoping that they will be able to find a medication that is more suitable for treating my anxiety.

I'm so terrified of doing this, its like having to admit that there really is something wrong with me.

I am scared of going in there and never coming out.

I am scared of having to talk to someone about it because I probably have years worth of repressed emotions. I don't want to let it all out, think I'll really lose it big time once I open the flood gates.

I think I really am going crazy. How shit is it that I have to medicated upto the eyeballs just to be able to function like a normal person

Shit like me, memoo. I am on antidepressants and an antipsychotic. Its life for some people.

Sadly, those people are us!!

They won't keep you there - there aren't any beds in psych hospitals right now, anyway.

Hopefully they will get you hooked up with the CPN (Community Psychiatric Nurse) who will support you at home - mine is a GEM!

Feel free to CAT if you need to. Its a horrid situation to be in - and people just dont understand - somehow cos its psychiatric you are either not really ill or so gut-wrenchingly weird people don't want to see you!

I hear ya too, I have a psych appt for the 16th april, first time. Also third baby, also much worse than before, also major anxiety.

I'm only on a low dose of lustral though as I'm breastfeeding and my GP doesn't know anything about meds and BF.

Scary biscuits isn't it?

Try not to worry memoo. They are just there to help you.

I have seen 3 different psychiatrists. One was really nice (the mother and baby specialist) the other two were quite weird TBH!

I found it really helps to have written down your feelings before hand, also some "goals" you want to get out of the appointment.

I used to get "railroaded" and confused in the appointments, which would sometimes lead my to cry and they would deduce I was "depressed", "paranoid" and "labile"

They do have a tendency to look for the things which confirm their (pre-existing) diagnosis, and make a judgement about you based on a 10 minute appointment.

If you have a CPN it's worth having them there at the appointmnet as they can stand up for you a bit.

HTH

I don't have a CPN yet getdown, but its something my GP has mentioned.

I've just been stood washing up really thinking about this and why i'm so scared and I just realised that the one thing that reallys worrys me is that they are going to turn round and tell me that actually they can't 'fix' me, that I have some deep flaw that means I am unable to be normal.

and I don't want to talk about stuff, I don't want to let out all the crap that has bogged me down for so many years.

That actually I hate myself and feel like one big failure, that i'm letting my kids down every day, that my DH will leave me because I never will be good enough.

I had a weird moment last night cooking dinner. I burnt myself removing a dish from the oven, it hurt for a few seconds but then a strange feeling of calm came over me. I liked the feeling of having burnt myself.

DO i tell the Psychiatrist all this?

yes tell them everything. And dont worry they wont a/ keep you in and b/ tell you they cant help you.
It IS horrible the first time you have to go to one of those places - i remember it for me very clearly. But just tell yourself its just another hospital appointment.
Hope it goes ok x

Hi Ladies,

I have a couple of qs.

What made you finally realise that you were specifically suffering from PND and why a Psychiatrist and not a Psychologist?

Thanks

I didn't realise I was suffering fading, I was diagnosed by my doctor, he is also the one who made the decision to refer me to a psychiatrist.

The psychiatrist will look at my meds and change as needed afaik but a psychologist isn't qualified to prescribe medicines.

Thanks Kizzie, I guess it'll be harder for them to help unless I'm totally honest

Fading, can I ask why you asked the questions? Don't mind but haven't seen you on here before and this is a very sensitive subject

a psychiatrist is basically a doctor. They have a very "medical model" approach to things i.e. what pill can I prescribe for your particular condition.

Whereas a psychologist would typically use talking therapies such as CBT.

You can see either on the NHS but there is usually a waiting list for psychology services.

A referral to a psychiatrist is done by your GP and occurs where the condition is too complex or specialised for him / her to deal with in their general surgery.

HTH

I think GetDown has already said what I was thinking. A psychiatrist will listen to you and ask questions that are relevant to getting you the right drugs. They are not there to listen to your innermost fears and worries. Please try not to worry or be ashamed!

I read an article at the end of last year in Times or telegraph with the man who designed all the 'Purple Ronnie' greetings cards. He had gone through a serious depression out of the blue and said 'my psychiatrist - i cant believe I am saying those two words together!!'
Thats exactly how i felt. I honestly couldnt believe a/ i was on AD's and b/ I was so bad that my GP thought I needed to see a psychiatrist.

But you just sort of get used to it x

I'm the same kizzie I just can't believe I am being seen by a psychiatrist.

Happily married, "normal" person who went a bit loopy after childbirth!

I have had my own prejudices and stereotypes about mental health and the people that suffer "mental illness" seriously challenged. In a good way.

No-one chooses this path. No one should judge or blame. It just happens sometimes and it is not the sufferers fault.

I think we all have the same fears!

My appointment is at a psychiatric hospital. They have in-patients there. I have passed this hosptial many times and there is one building that is fenced in with barbed wire!

I just can't believe I have to go there, I just keep thinking this isn't me, I don't belong in a place like that.

But I guess I do because at the moment I can't function without being totally drugged up.

When I say 'drugged up' I do mean on my prescribed meds, not on drugs or anything!

Just to let you know it is usually a good long appointment for the first one - 45 mins to an hour.

Take something to drink with you - a bottle of water or something (better not take Gin into the appointment ).

They really are there to help, but psychiatrists can be strange and I fell out with my last one who drew some very weird conclusions from the little she knew about me and ended up actually defending a family member who had hurt me very badly - no idea why, I do wonder if I touched a nerve!

A CPN is a great idea. If you can get one, I find mine very useful just to ask questions etc and know there is someone there if I am not coping for whatever reason - also gives easier access to out of hours CPN services which I have needed twice.

Memoo - all the stuff you are saying about never being good enough etc is me to a T. I am seeing a consultant psychologist at the moment for therapy adn it is slowly, slowly starting to challenge some of that thinking. But it is a long hard road.

I suppose I haven't really accepted it cpanda ... truth is I still rage against the idea I am or was "mentally ill" - that just doesn't sit right with me, or who I know myself to be.

My psychiatrist likes to say things over and over again in my appointments. Notably:
"you were an extremely severe case"
and
"you will probably be on medication for the rest of your life"

and it makes me so angry and upset because I just feel like screaming at him I AM A NORMAL PERSON, stop treating me like a diagnosis!

I feel like he keeps me in the "sickness role" and it's like a prison sentence because he implies I will never not have this diagnosis again.

I do not accept that I cannot me normal again. I will never accept that. It just feels like a constant battle I suppose.

There is nothing like mental health services to make you mad!

Hey memoo. I am a psychiatrist (2 years of training to do before I'm a consultant).

Just wanted to reassure you about your appointment. First appts usually last 1hr; 45mins or so getting an idea of what your problems are, & 15mins to discuss a treatment plan.

Things you will/should be asked are:
Your view of your probs (how long/symptoms/severity/any contributing factors)
Any previous episodes
Any similar problems in any family members
Medication; what has been tried in the past, any side effects, any problems with meds.
You'll probably be asked briefly about your own family relationships, childhood, school, personal relationships.

The doc will then carry out a mental state examination to look for signs to establish a diagnosis.

Please don't be alarmed if you are asked directly about thoughts of harming yourself (this is somehing psychiatrists should enquire about with all patients).

Sorry to the posters who have met weird psychiatrists; I don't view myself as weird, so hope it wasn't me

And if it's any consolation, I don't view people with mental illness as any different to people who have chronic physical illnesses like diabetes/asthma, etc.

Hi Derv78

Interesting to get your perspective, thank you!

I know not all psychiatrists are weird, but the one in my CMHT most certainly is (even my CPN agrees with me!)

I hate that question about "any thoughts of harming yourself"

When I was really really ill they would repeat it over and over and over again "any thoughts of harming yourself" "any thoughts of harming your baby?" "any thoughts of harming yourself" "any thoughts of harming your baby?" "any thoughts of harming yourself" "any thoughts of harming your baby?"

Although I had no such thoughts, this really haunted me and made me very upset. I know they have to ask it, but I feel it could be done more sensitively to those that are already in a very fragile mental state.

Thanks for the replys, some really useful comments.

The thing is I do have thoughts of harming myself.

I can't beleive i'm telling you this but I do thing about stabbing myself in the chest with a knife. I think about how it would feel and even the sound the knife would make. It has actually become a rather positive thought, like a fantasy.

What happens if I tell them stuff like this? Do want to lie to them but don't want to put myself in a position where they could say I am a danger to myself or my kids.

I would never harm my kids, and I won't harm myself because I can't bare the thought of upsetting my children

If it's any help (and bear with me here!) I was once given an inpatient bed after an outpatient appointment. It was about my tenth appointment and I turned up talking to god, covered in self inflicted injuries, jumping at everything and hiding and saying that I wanted to die (ie I was completely loopy) and even then it was only my Mum (who is a mental nurse) shouting at them that made them take me in, and they sent me home first for a couple of hours, and I was only in for a few days. (which I don't really remember)

My point being, you don't sound anywhere near having to stay in

In my old area, anybody presenting with MH problems gets sent to the outpatients bit of the local mental hospital for an initial assessment, so half the people I know have been. There's no shame in it, it is just something that happens. You'll be ok. Be honest and ask questions if you don't understand.

memoo - i can absolutely guarantee that anything you will them they will have heard many many many times before.

I had to go to a hospital exactly like the one you described for my first appointment - and it totally freaked me out. It just seemed to confirm in my mind that i had gone so far down to be 'in a place like this'. I was literally terrified that they would get me in there and I would never see the light of day again.

I tried to rationalise it by thinking about going to visit someone in a 'normal' general hospital. (ie. you could be there with a sprained ankle or you could be there with terminal cancer - not everyone is the same.)

I know its really scary but just try and tell yourself that its part of the process of getting better x

Thanks for sharing that Butterpie, what an awful time you have been through! and it does actually help me to hear it. Hope you are well now? or at least managing it, which is what I suspect most of us do for the rest of our lives