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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by bonnie_ann on April 14, 2001, at 23:39:02
Hi all-
I have been wanting to see one for a long time, but have been putting it off (that whole stigma thing)
actually it's MORE intimidating getting my medication at a clinic where the nurses children go to the same school. Same with my pharmacist (thats why I opted for mail order - also cheaper through my insurance.)
I just want a once over, and some medication choices and guidance. I don't have a diagnosis- is that important to have? Will the pysch diagnos me on the spot? I have wanted a diagnosis for a while now- but on the same hand I'm afraid it would effect my recovery-the whole "what if?" thing. I would take it hard I'm sure. It would also be nice to know if I've been making a mountain over a molehill.
Thanks,
Bonnie
Posted by SalArmy4me on April 15, 2001, at 1:24:46
In reply to first visit with Pyschiatrist-what to expect, posted by bonnie_ann on April 14, 2001, at 23:39:02
In a little while none of this will seem embarrassing or intimidating when you realize that 1 out of every 2 people is on some kind of psychotropic medication.
Posted by JohnL on April 15, 2001, at 5:41:01
In reply to first visit with Pyschiatrist-what to expect, posted by bonnie_ann on April 14, 2001, at 23:39:02
> Hi all-
> I have been wanting to see one for a long time, but have been putting it off (that whole stigma thing)
> actually it's MORE intimidating getting my medication at a clinic where the nurses children go to the same school. Same with my pharmacist (thats why I opted for mail order - also cheaper through my insurance.)
> I just want a once over, and some medication choices and guidance. I don't have a diagnosis- is that important to have? Will the pysch diagnos me on the spot? I have wanted a diagnosis for a while now- but on the same hand I'm afraid it would effect my recovery-the whole "what if?" thing. I would take it hard I'm sure. It would also be nice to know if I've been making a mountain over a molehill.
> Thanks,
> BonnieBonnie,
Most pdocs will ask you a series of questions to arrive at a diagnosis. Then they will attempt to match a drug to your diagnosis. As evidenced by the many difficult cases here at this board, this commonly accepted practice has many flaws. Personally I find a diagnosis nearly useless, except in the beginning of treatment where it offers a starting point.I know one person who's lifelong anxiety was not cured by anything, until they tried something that has no clinical justification for anxiety...lithium. Miracle cure in one day for that person. Treatment resistent depressions often respond to antipsychotics. Yet there was no diagnosis of schizophrenia or psychosis. Etc etc. Examples go on and on and on. I think most people somehow feel the need for a diagnosis, but in all honesty I have found it fairly useless in many cases.
My favorite pdoc, now retired unfortunately, did not find a diagnosis very helpful either. He could care less. He would instead try patients on various drug categories to narrow down which ones might work the best for the particular person. No two people were ever the same. Each person has unique chemistry, circumstances, and personality. Those in my opinion are much more important than some diagnosis. Each patient is a unique case and cannot realistically be lumped into some guaranteed category.
Nine out of ten doctors though do practice the diagnosis routine. So you can probably expect that.
John
Posted by SalArmy4me on April 15, 2001, at 6:49:03
In reply to Re: first visit with Pyschiatrist-what to expect, posted by JohnL on April 15, 2001, at 5:41:01
Thank you for responding so thoughtfully...
Posted by sweetmarie on April 15, 2001, at 9:22:36
In reply to Re: first visit with Pyschiatrist-what to expect, posted by JohnL on April 15, 2001, at 5:41:01
> Bonnie,
> Most pdocs will ask you a series of questions to arrive at a diagnosis. Then they will attempt to match a drug to your diagnosis. As evidenced by the many difficult cases here at this board, this commonly accepted practice has many flaws. Personally I find a diagnosis nearly useless, except in the beginning of treatment where it offers a starting point.
>
> I know one person who's lifelong anxiety was not cured by anything, until they tried something that has no clinical justification for anxiety...lithium. Miracle cure in one day for that person. Treatment resistent depressions often respond to antipsychotics. Yet there was no diagnosis of schizophrenia or psychosis. Etc etc. Examples go on and on and on. I think most people somehow feel the need for a diagnosis, but in all honesty I have found it fairly useless in many cases.
>
> My favorite pdoc, now retired unfortunately, did not find a diagnosis very helpful either. He could care less. He would instead try patients on various drug categories to narrow down which ones might work the best for the particular person. No two people were ever the same. Each person has unique chemistry, circumstances, and personality. Those in my opinion are much more important than some diagnosis. Each patient is a unique case and cannot realistically be lumped into some guaranteed category.
>
> Nine out of ten doctors though do practice the diagnosis routine. So you can probably expect that.
> JohnBonnie,
I sympathise with your situation completely. It really does feel like a huge step to admit that you have a problem with mental health. But, as you can see (and John`s post confirms), there are loads of `us`. It really isn`t a rare thing (sadly).
I agree with what John says re. diagnoses being largely irrelevant. At the end of the day, it`s the symptoms that require addressing, and not `clear-cut` answers for specific illnesses.
My first psychiatrist was very limited in outlook - he acknowledged that I suffered from depression, tried a couple of traditional treatments and gave up on me when they didn`t work.
What you are looking for in a psychiatrist is not one who asks `how depressed are you?`, but one who asks `how do you feel?`, `do you have any physical symptoms?`, `what are you able to do?`, `what are you incapable of doing?`, `is this a recent problem?`, `does it have any circumstantial causes?` etc etc. This then enables he/she to narrow the field down, rather than chucking random medications your way and hoping for the best.
If your psychiatrist is a good one, then this is the kind of thing you can expect. Remember, you are not `stuck` with a psychiatrist - if you feel that he/she is barking up the wrong tree, then you have every right to change doctors. Don`t forget, it`s your health and your treatment.
Good luck.
Anna.
Posted by ChrisK on April 15, 2001, at 16:52:06
In reply to first visit with Pyschiatrist-what to expect, posted by bonnie_ann on April 14, 2001, at 23:39:02
Bonnie,
Give this website a visit:
http://mentalhelp.net/guide/dep2quiz.htm
A new patient will generally get questions along these lines to find out how depressed you are and what symptoms seem to be the worst. And No, don't expect to fill out a form like this. A good pdoc will get to these questions in a normal conversation.
Take this survey so you can have an idea of where you think you stand. It's really simple and harmless and only you know the right answers.
Chris
P.S. When you do see your pdoc be honest above all. He can't help if you don't confide in him just how badly you feel.
Posted by kazoo on April 15, 2001, at 23:19:05
In reply to Re: first visit with Pyschiatrist-what to expect, posted by JohnL on April 15, 2001, at 5:41:01
> Most pdocs will ask you a series of questions to arrive at a diagnosis. Then they will attempt to match a drug to your diagnosis.
^^^^^^^^^^
Idealistically, John!Most do it the other way around; i.e., use the client's reaction to the drug to arrive *at* the diagnosis.
"What works for you today, Kazoo?"
(a reversed) kazoo
Posted by bonnie_ann on April 16, 2001, at 11:22:55
In reply to Re: first visit with Pyschiatrist-what to expect, posted by ChrisK on April 15, 2001, at 16:52:06
>Thank you all for responding.
I think I'll be fine.
Bonnie
This is the end of the thread.
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