Will psychiatrist prescribe medication first visit reddit

I see a psychiatrist. We meet for an hour each week and talk about my problems. She's terrific. She prescribes me meds, but they're secondary to the talk therapy.

As this is your first appointment, the psychiatrist will probably ask you questions about your symptoms to try to determine what sort of depression and anxiety you have. They may have you fill out a brief survey of your symptoms and their severity, which is useful for them because they'll give you the same survey every few months for comparison, to see if things are getting better over the long run.

If I recall correctly, during my intake, we just talked about what sort of anxiety I had (I was too ashamed of my depression to admit it at the time. As I became more comfortable with her, I eventually spilled the beans). There wasn't much about history. We actually jumped right into cognitive behavioral therapy by the second or third session.

As far as questions you should come prepared with, I recommend:

  • (If you're interested in taking medications) "Do you recommend any medications?" As your psychiatrist is still struggling to understand what kind of anxiety and depression you have, they might be hesitant to prescribe something until they know more (so after a few meetings). Some medications (mostly SNRIs) can make anxiety worse.

  • "Do you recommend any self-help books?" My psychiatrist is always pushing self-help books on me, and she likes to talk about the exercises with me. They can be a good way of getting some sort of treatment immediately (because when you're new, the waiting until the next appointment is very hard. At least, it was for me) and providing structure for your meetings.

If you are feeling suicidal or you're harming yourself, be honest about it. I used to hide my suicidal desires because I was afraid if I told them she would have me locked up, but they cannot actually do that without your permission (unless you specifically mention that you intend to harm someone else).

Also, I say, don't be afraid to talk about what is really important to you. Sometimes the psychiatrist can go on tangents and end up cracking a huge piece of the puzzle, but other times it is just a tangent. If your psychiatrist starts digging into something you don't think is important, don't be afraid to speak up and let them know what about your condition is really bothering you. They want to know what is really bothering you, because they want to fix it. I had a different psychiatrist once who thought my problems stemmed from masculinity issues, which they didn't really (sure, I don't feel as manly as I'd like to, but that is not a huge deal for me), and we wasted a few sessions exploring that to no avail (it never felt important to me, but I thought "doctor knows best" and I let him go on).

A while back someone asked me what to do when you go to your evaluation appointment for therapy or psychiatry so I wrote up a general guide as to what to do/expect. This is slightly different than if you are going to your GP (general practitioner) about your mental health problem, so if someone has done this instead please let me know how it is different.


Before you get to this point:

You must have made the appointment for an "initial" or "evaluation" session with a therapist/psychologist or a psychiatrist about a mental health issue that is concerning to you. To do this you sometimes have to go through your doctor (to get a referral) or you can call your insurance to help you. If you are in college, your school will probably have some sort of counseling center that you can call and get help from.

I am going to assume that you are at the building where the appointment is being held. Occasionally, these places are called "Behavioral Health Centers" and are located within another office building. If their website doesn't say that they are on a specific floor, make sure to get the room number ahead of time and check the signs near elevators or in the hallways. Note that this guide is general so different offices have different set ups.

Suggested Items to Bring

  • General Life Items (Phone, Car Keys, etc)

  • Insurance/Payment/ID (Depends on which you will need for your insurance)

  • Possibly a book to read if you are a person that gets nervous when waiting (Note that they sometimes ask you to arrive early to fill out paperwork)

  • Possible "concerns" journal or notes that you want to make sure you address if you are prone to forgetting things under stress

  • Possible schedule keeper/calendar if you plan to schedule another appointment

Arrival

When you walk into the office area, there will either be a receptionist or some sort of sign in sheet/area to let them know you are there. If you are in the USA you will probably need to show your insurance card/ID/pay at this part, though sometimes this is done afterwards. Just politely wait for the receptionist to recognize you are there then say "I have my first appointment with Dr. ______ at 3:00, what do I need to do?"

Indicating that it is your first time here will let them know that you need to fill out general paperwork saying you understand doctor patient confidentiality, where your billing address is, and in case of emergency information. They sometimes ask you to come half an hour early to complete this paperwork so you can finish it before your first appointment. Sometimes they also have a paper that asks general questions such as "Do you have suicidal thoughts" or "have you ever harmed yourself" etc. (Example form for anxiety found here or google "depression/anxiety rating scales".) It is always good to read (or at least scan) those forms and understand your rights as a patient and disclosure of information. After you finish filling the paperwork out, turn them in to the receptionist unless told otherwise.

Meeting and Evaluation

You will probably have to wait in a chair until Dr. ______ is ready for you. If waiting makes you anxious, you may want to bring a book to read, or you can just fiddle with your phone (as long as it is on silent). S/he will come out and say your name ("Joe Schmoe?") and greet you then take you back to a smallish room, typically with comfy chairs and plenty of tissues. They will ask you what brought you in today and you get to explain what your concerns are.

This is the part where you need to try to be as honest as you can be. The more honest and open you are, the better they can diagnose and help you. If you are uncomfortable talking about current drug/alcohol abuse, self-injury, or suicidal thoughts, then consider mentioning that you have had them in the past. Whatever help you get will be tailored to your needs, and it is difficult to get the right help if you don't explain all of your needs. This is where having a list of concerns or a journal helps for those of us that forget things under pressure. Not only can it be comforting to have something tangible with you, but it helps remind you to explain everything.

Response and Next Steps

So a few clarifying questions and sometimes some tears later, they may say something like "Yes, it sounds like you are having a lot of problems with anxiety/depression" or "It sounds like you are managing well now, but let's get you to where you want to be" or "I am going to prescribe you medicine right now/refer you to a doctor to see if you need medicine" and they give you a general guideline of what you should do.

If you are meeting a psychiatrist (a doctor that can prescribe medicine) they might suggest you find a psychologist/therapist to talk to while on the medicine they prescribe you. If you are meeting with a psychologist/therapist/counselor (people trained to help talk people through their thoughts and problems), they might suggest you see a psychiatrist or doctor to get some medicine. Explain any concerns or fears you have about medicine/therapy at this point. Also, if they don't recommend one for you, ask if they can, because it is easy to put off making an appointment by saying "I don't know how to find a _____."

The time needed for an evaluation can vary, but usually they block off an hour for the session. After you are done, it is often convenient to make the next appointment right then, but whether you can do this depends, again, on your insurance. After you finish, the psychiatrist/psychologist usually walks you to the door. It is good to ask "Do I need to do anything else before I leave?" just to make sure you have filled out all of the forms and paid. If you finished everything, you find your way back outside, heave a sigh of relief and drive home.

End

Okay everyone, since various appointment places have different procedures please let me know what I should tweak. I've only had a few experiences with this, but I'm sure that different places do different things so please let me know so I can add or remove specific aspects. Also, I'm sorry but this is really mostly for the USA. I'm sure there's a lot of similarities to other countries, but I'm not sure.

Can a psychiatrist diagnose you on first visit?

The first visit is the longest. You'll fill out paperwork and assessments to help determine a diagnosis. After that, you'll have a conversation with the psychiatrist and an NP or PA may observe. The doctor will get to know you and come to understand why you are seeking treatment.

Can a psychiatrist prescribe antidepressants on the first visit?

In most cases, a psychiatrist will not start you on medication at your first meeting unless you've been referred by another provider to specifically discuss medication.

What should I not tell a psychiatrist?

With that said, we're outlining some common phrases that therapists tend to hear from their clients and why they might hinder your progress..
“I feel like I'm talking too much.” ... .
“I'm the worst. ... .
“I'm sorry for my emotions.” ... .
“I always just talk about myself.” ... .
“I can't believe I told you that!” ... .
“Therapy won't work for me.”.

What is the first meeting with a psychiatrist like?

First Appointment This appointment might vary regarding length, but they are usually between 40-60 minutes. Your psychiatrist may inquire you about the issues that are concerning you, and how they are affecting your life. The professional might also ask you about your symptoms and how you do to cope with them.