Psychiatrists: what can they DO?

LegacyUser

I'm 16, and after talking to my GP about my excessive sadness, I've been referred to a psychiatrist.

My problem is though, when I was talking to the GP, I underexaggarated everything. Will a psychiatrist know if I'm holding back? Because I just don't trust myself to actually engage properly and want to share. And I badly want help. And then I think, how the furk can she actually help me? All my problems stem from loneliness, and ultimately, I need friends to fix my life. What can a psychiatrist do to cure shyness? I figure it comes from fear of rejection or whatever but what can she do to fix that exactly? Am I going to get drugged up? My parents don't have a lot of money. How many sessions will I have to go to until I'm fixed? How much does each session cost? How long does it take to get an appointment anyway? I seen the GP about this in the last week of May, when can I expect to see a psychiatrist? Also do I have to tell her EVERTHING? There's some really messed up stuff that I don't want to talk about. Can she fix me with just a general idea of my issues?

Victor

A psychiatrist is a medical doctor and often partnered with a psychologist and/or psychotherapists.

Psychiatrists are generally at the prescribing end of the scale and psychologist are 'talk doctors', but that isn't their only tool. Psychotherapists are technician level psychologists, not doctors.

There is a Psychiatric Scheme run by the Health Service which costs nothing. However, private treatment is available. Depending on local circumstances, it might take a few days to a few weeks to get an appointment.

My problem is though, when I was talking to the GP, I underexaggarated everything.

Explaining more of your experiences will help more. Explain to whoever you see that you feel uneasy and let them reassure you.

And then I think, how the furk can she actually help me?

By giving you some tools with which you can help yourself.

All my problems stem from loneliness, and ultimately, I need friends to fix my life. What can a psychiatrist do to cure shyness?

Show you some exercises or skills that will help you deal with people.

I figure it comes from fear of rejection or whatever but what can she do to fix that exactly?

Fear of rejection, yeah thats a common one. I hate having arguments with people, because maybe they won't like me afterwards. I find it difficult to put it behind me. I don't know what triggers your fear, but talk it out at least.

Am I going to get drugged up?

I think you might be overstating that. It is for a doctor to decide as to whether to use medication or not.

Also do I have to tell her EVERTHING? There's some really messed up stuff that I don't want to talk about.

The more you tell, the more that can be helped with. Ask yourself why you don't want to talk about them - explore the concept. Then with the doctor explain that there are certain things you are uncomfortable with discussing.

Can she fix me with just a general idea of my issues?

Possibly, but I don't know. It is rather vague from this side of the PC monitor.

Look talk to her and see where things are going and explain the but about certain things you are uncomfortable with discussing.

You might ask your parents / doctors these questions and / or seek leaflets or books on it, they can fill in more of the gaps.

Ishindar

first of all u need to relax about it all. the GP your parents and the psychiatrist all want to help u and not hurt u in any way.

be assured that anything u tell a psychiatrist or a doctor will never be repeated to anyone else including your parents so no need to be worried about this.

the more open u are with a psychiatrist the better the chance they have of helping u overcome your problem so put your trust in this person and be open to them.

most people are too close to their own problems and they just cant see what is obvious to others, its strange but its true. in a lot of cases the problems are just small simple things that the person cant see, so cant figure out how to fix them.

the psychiatrist will ask u a lot of questions to help figure out what your problems are and they will help u understand your problems better and help u with simple ways to overcome them. this can take just a few visits for most people and absolutely nothing to worry about.

gl with it

im_invisible

Ishindar wrote:

the psychiatrist will ask u a lot of questions to help figure out what your problems are and they will help u understand your problems better and help u with simple ways to overcome them.

this is just in my experience, but,
ive been seeing psychiatrists for about two years now, took 5 months from when i went to the gp, they ask a lot of questions, yes, but i never found they helped me understand my problems, just prescribed anti-depressants and stabilisers, i thought i wanted to see a psychiatrist, but then i found out it wasnt what i thought it was, so i wanted to see a psychologist, but was sent to a psychotherapist (about two months ago), which is really helping me at the moment, but i think he's going to refer me on to a psychologist, (im confused myself at this stage), but im still seeing the psychiatrist, as he's the only one who can prescribe anti-d's, or whatever

just, if you're not getting any satisfaction after a few months, dont be afraid to tell them, and ask about alternatives, and be clear about what they do.

Esel

Victor wrote:

A psychiatrist is a medical doctor and often partnered with a psychologist and/or psychotherapists.

Psychiatrists are generally at the prescribing end of the scale and psychologist are 'talk doctors', but that isn't their only tool. Psychotherapists are technician level psychologists, not doctors.

AFAIK a psychologist is not a medical doctor.

OP, did your GP refer you to the HSE mental health service or to a private psychiatrist?

HSE is free, but might take a while to get an appointment. If you are prescribed medication there, it will also be free.

Private might work out expensive, and you will have to pay for medication, if prescribed.

It might be a good idea to return to your GP, be open and honest about your feelings, and, if the GP has referred you to a private psychiatrist, ask about the HSE option.

Miss Fluff

questionsss wrote:

My parents don't have a lot of money.

Have they/you got a medical card?

Victor

esel wrote:

AFAIK a psychologist is not a medical doctor.

Apologies, you appear to be correct.

aidan24326

That's right psychologists are not medical doctors. Like that 'Dr.Phil' guy uses the title 'doctor' but he isn't a medic he has a PhD. You get the feeling he wants people to think he is though. Like yer one Gillian McKeith they won't allow her use the title doctor anymore as it's misleading (and her PhD is dodgy)

Psychiatrists are always medical doctors. Clinical Psychologists would be fairly similair to psychiatrists in what they do only they can't prescribe drugs.

OP don't be worried about what you say to your doctor, counsellor or psychiatrist, believe me no matter how 'messed up' you think your situation is, or experiences have been, they will have heard it all before and worse. So don't be afraid to let them have the full story or as much as you can bear to let out, the more you tell them the better understanding they can have of your problems and how best to tackle them, whether you would benefit from counselling, medication, cognitive behavioural therapy or whatever else.

Make it clear to the GP that your parents aren't well off and that a private psych doctor might be too expensive, I'm sure he will be able to refer you to someone as a public patient and it might not cost anything. Talk the options through.

Moss

There was a debate on this in the Irish Times a couple of months back. Professor Emeritus of Psychiatry from UCD wrote into the paper to settle the matter. I think its a very good letter. I'v posted it here before but I'm going to post it again because its spot on topic.

Madam, - Having read the letter from the group of six professors of psychiatry in response to the piece by Breda O'Brien, "The Minister's View On Mental Illness," I do not share the view that the Minister's remarks were "downright irresponsible". I feel obliged therefore, to enter what is becoming a national debate on the nature of mental illness.

It seems an obvious thing to say that from before and after birth to adult death, human beings experience things that cause them suffering, but this is a fact of life that is overlooked. Some can bear more than others, some understand more than others; but suffering is a part of life and may become so unbearable that we want to fix it. At that point we look for help, usually from a doctor, and often find that our feelings are called "mental illness". There is such a thing as mental illness, of course, but not all sufferers are mentally ill.

Because of the mechanistic attitude which has accompanied the enormous advances in science and technology, the Western mind has fallen into the illusion that there is a remedy for every ill. The belief has grown up that it is the doctor who cures. The body is seen as a machine with which something has gone wrong, and the doctor's job is to fix it.

Similarly, we have tended to fall into the error of thinking that the therapist cures the patient. When applied to psychotherapy, or to psychiatry generally, this is an erroneous notion. In dealing with psychiatric illness there is no treatment which you can apply to people which brings about real change in them. People have to undertake the work themselves and this is involves pain and suffering.

The only lasting positive change anyone can make is within him/herself. The deeper the change to be accomplished, the greater the amount of pain and suffering involved. People resist change for this reason, even when they realise that change will be positive.

By giving tranquillisers and relieving symptoms, something has been achieved temporarily. But no real change has taken place, and sooner or later most people will have a recurrence of their symptoms with the added burden of the side-effects which most drugs inflict. Many drugs are useful on a temporary basis but are not treatments for specific "psychiatric diseases". However, no psychiatrist who deals with the full range of psychiatric disturbance could manage without them. The question is whether they are given as a treatment themselves or as aid to working in psychotherapy with the person. Often the drug is the only way of facilitating the initial contact so that therapy can begin.

It is not the drug, it is the message which accompanies the drug which is really damaging. Typically, if a person is "clinically" depressed they are told that whenever they feel a depression descending on them they must contact their psychiatrist and commence the appropriate medication. It is because of this, more than anything else, that many people are gradually entrained into a pathway of illness. Perceiving themselves as "ill" and helpless, they move into a state of chronic ill health.

Clusters of symptoms tell one little about the cause, or the natural history, of these so-called "disorders". They have a more ominous significance however, for once you can name symptoms as a "disease" you have created an apparent reality. Then, if you have a specific "disease", due to some, as yet unidentified, underlying biochemical abnormality, there should be a "specific" remedy to deal with it. This suits the pharmaceutical industry perfectly. Unfortunately, most psychiatrists have taken this great falsehood on board.

All that drugs can do is to temporarily reduce symptoms, making life bearable. No drug can teach you what you need to know to manage life or have a personal identity. Often in life we cannot see how we got to where we are, or why we continue to make the same mistakes no matter how hard we try. If a person could undertake whatever change is necessary to manage their life successfully, there would be no need for a psychiatrist or therapist. Of course, the person who comes to our aid need not be a professional; indeed, a great deal of helpful intervention is carried out by self-help organisations such as Alcoholics Anonymous, Grow, etc. but in many situations a friend is not enough and the objectivity and understanding of a person with experience and training is necessary.

Finally, I return to the fundamental principle that it is people themselves who have to undertake the work if they are to bring about any real change in their lives. If what we are attempting to change is ourselves, our deepest personalities, then this can be painful indeed.

If the person who is "mentally" ill is not prepared to suffer, then, to put it bluntly, you can have all the skills and training and be the most experienced psychiatrist, but you will be absolutely helpless to do anything for them. - Yours etc,

IVOR BROWNE, (Professor Emeritus, University College Dublin), Ranelagh,Dublin 6.

Victor

Moss wrote:

If the person who is "mentally" ill is not prepared to suffer, then, to put it bluntly, you can have all the skills and training and be the most experienced psychiatrist, but you will be absolutely helpless to do anything for them. -

It is true that it is for the individual to do the work. However, professionals can provide a lot of facilitation, guidance and advice.

Esel

Moss wrote:

There was a debate on this in the Irish Times a couple of months back. Professor Emeritus of Psychiatry from UCD wrote into the paper to settle the matter....

It's a bit much to say that Ivor Browne wrote the letter to 'settle the matter'.

It is an interesting letter. Ivor Browne ran residential weekends where Ketamine was administered to participants in a controlled setting, in the expectation that they might benefit from the hallucinations induced by the drug.

I do not feel it is accurate to equate modern anti-depressant drugs with tranquillisers. I accept this is not what he actually wrote, but it is easy to take that meaning from it.

Moss

It probably is a bit much to say 'settle the matter' because its one of those issues that will probably never really be settled. Still, its a balanced and reasonable letter and I think worth reading.

Jumpy

I think it is a brilliant letter. Makes a lot of sense.

KyussBishop

In my opinion, the best you can do is research your problems in as much detail as you can and try and help yourself, a psychiatrist will no doubt help with doing this but you can't use a psychiatrist or medication as a crutch. (personally, I think it's best to avoid medication altogether...but don't take my word for it, read up on it and weigh the pros/cons)

You will need to do some work with both learning about what your problem is and ways of fixing it...a good start is with the Wikipedia, your problem sounds similar to this:
http://en.wikipedia.org/wiki/Social_anxiety (recently discovered that I have that myself, feel free to PM me if you want more info on that)

However, I am obviously not qualified to evaluate your problem I figure that might just be a helpful starting point for you to begin developing a better understanding of what's wrong.

pete4130

Is it possible to get a private appointment to see a pyschiatrist without being referred by a GP?

Victor

KyussBishop wrote:

In my opinion, the best you can do is research your problems in as much detail as you can and try and help yourself, a psychiatrist will no doubt help with doing this but you can't use a psychiatrist or medication as a crutch. (personally, I think it's best to avoid medication altogether...but don't take my word for it, read up on it and weigh the pros/cons)

As I( said earlier - sometimes we need to recognise that we are ill and need help. Would you refuse painkillers on principle if you had a broken leg?

pete4130 wrote:

Is it possible to get a private appointment to see a pyschiatrist without being referred by a GP?

Possible, but I don't know of any that do. In general, you are much better seeign a GP first for various reasons (a) you can see the GP much sooner (b) cheaper (c) if everyone went straight to a pyschiatrist, it would be a gross abuse of resources.

KyussBishop

Victor wrote:

As I( said earlier - sometimes we need to recognise that we are ill and need help. Would you refuse painkillers on principle if you had a broken leg?

That's not really a good comparison, treating a mental illness isn't like treating a broken leg

With an illness like Social Anxiety (assuming for a moment that the OP has this) you need to tackle the underlying problems caused by irrational thoughts/beliefs which exaggerate your anxiety. (typically done with Cognitive Behavioral Therapy)
While medication might help reduce the symptoms of the problem, the side effects warrant a lot of caution and it's my opinion that they should be considered a last resort when all other methods of treatment aren't producing results fast enough.