Managing Your Expectations at the Psychiatrist's Office

Before I sought the help of a psychiatrist, I went along with the stigmas of the masses and thought people who saw such a professional were crazy or weak. I had been working with a counselor, though, conceding that everyone needed help from time to time, but ultimately I thought there was nothing really "wrong with me."

However, about a year and a half ago, during the height of the pandemic, I found myself in a position where natural treatments weren't enough. Finally, I stepped up and went.

So far, it's been the best decision I've ever made.

When to see a psychiatrist

I was in counseling for about four years for various anxiety and depression issues, and while these weekly appointments made a huge difference in my life, I was still struggling to manage daily symptoms. My counselor mentioned that maybe it was time to try medication.

Initially, I was hesitant, but eventually, I agreed. I wanted to feel better, but when I learned my counselor couldn't prescribe medication, I refused to pursue medicinal intervention because I didn't want to leave my counselor.

"I want to point out that I'm a psychologist, so we don't prescribe medication," said Debra Kissen, Ph.D., MHSA and chief executive officer of LightOnAnxiety. "We can make recommendations and refer a patient to a physician, such as your primary care physician or a psychiatrist for medicinal intervention."

Their goal is to help every patient to manage symptoms and alleviate suffering, just like any other medical specialist.

While I knew logically that I needed to see a psychiatrist, I feared the potential visit because I was worried someone would find me out, think I was crazy, or that perhaps going to a psychiatrist to get medication made me a weak person.

Apparently, this is a common fear for many patients who seek mental health interventions, but psychiatrists are there to help. Their goal is to help every patient to manage symptoms and alleviate suffering, just like any other medical specialist.

"You are experiencing symptoms, an illness, no different than any other medical illness, so it doesn't make you a bad person [or] a weak person," said Holly A. Swartz, M.D., professor of psychiatry at the University of Pittsburgh. "Proven methods of psychotherapy or medication can help to treat and manage your illness."

The initial evaluation

The first thing to know about the process is that if you start to see a psychiatrist, you don't have to leave your counselor. This was one of my major concerns, as I had built such a strong connection with my counselor and I didn't want to start all over.

I was also afraid of the initial evaluation. I even worried myself with the thought, "What if someone sees me walk into the office?"

However, I learned that even before the pandemic, many psychiatrists used phone or video calls to perform evaluations. This helps to reduce a patient's anxiety and allows them to get an idea of your goals before meeting in person.

Another surprise was that this session worked in a similar way to a session with my counselor. The psychiatrist introduced themselves, asked me about my medical history and why I sought treatment. I was able to be honest about the goals I had in seeking treatment and voice my concerns about medication.

"We ask a whole series of questions because we're trying to find out as much about you medically [so that we can] understand your goals and expectations for treatment," Kissen said.

From my experience, these questions are extensive and include questions about your childhood and upbringing and also the baseline health questions.

"We also run blood tests because sometimes psychiatric problems are best explained by abnormalities in your hormones or vitamin levels," Swartz said. "So we might ask when you last had your thyroid levels checked or rule out anemia."

Overall, the evaluation took about an hour, with the first half-hour focused on physical and mental health history. The second half of the session focused on why I was there, what I hoped to achieve and why I was seeking medicinal intervention.

You can fix me, right?

The biggest lesson I learned from my first evaluation was that there's no quick fix. For some reason, when we talk about mental health, we often have this idea that we lie on a couch, pour our heart out, cry a little bit and we're cured.

This is so not what really happens. When I found myself asking my psychiatrist, "So what's wrong with me?" she'd laugh and say, "It's not that simple." At that moment, I realized that I'd made a mistake I promised myself I would never make. I'd been expecting a diagnosis, like when I take my car to the mechanic, but instantly I knew there were no simple answers.

The idea that we can go to a psychiatrist, get medication and are magically cured is one of the biggest misconceptions in all of mental health.

I'd been expecting a diagnosis, like when I take my car to the mechanic, but instantly I knew there were no simple answers.

If we have heart issues, we see a cardiologist, and for reproductive issues, we see a gynecologist or urologist. So, if we are experiencing a mental illness, we should go see a psychiatrist.

Working with a psychiatrist, just like any other doctor, is a process, so managing your expectations is essential. While medicinal interventions are one part of treatment, there are many other options, such as psychotherapy, that your psychiatrist may recommend in conjunction with your other interventions.

The most important part of this process is to be open to these treatments and be completely honest with your doctor, so you can reach your mental health goals.