Posted by Racer on December 5, 2007, at 14:23:55
In reply to Re: First Psychiatrist Visit - Input Please!!! » torachan, posted by sonic_gb on December 5, 2007, at 9:52:10
First, the more honest you are, the better able the doctor will be to treat you. Often, in this sort of situation, the doctor will have a time limit, so less editorializing is better. Plus, doctors tend to tune out a lot of what patients say, so answer questions as briefly and to the I think point as you can. (I know, that really [emulates a Hoover], but it's the sad truth.)
As far as what you want to get out of it, the best case is another appointment, so that he can follow your treatment plan himself. Barring that, you want a treatment plan the psych nurse can follow.
Don't be surprised if MAOIs are not a first line option with this doctor. Sadly, many doctors want to try something they've had good results with in the past, with other patients, but the more calmly you can react to that, the better. Since you've already tried so many drugs, that gives you some ammunition to say, "Hey, tried that, didn't work. What else?" In my experience, the first time one sees a psychiatrist, it's best to offer up what other doctors have diagnosed, what medications you've tried, what symptoms are most problematic -- and only if the doctor seems open to it, offer up as questions any thoughts you have. Once you get a relationship formed with a doctor, then you can get a little more assertive.
Basically, what I tell people who ask me, is that the doctor's job is to make a diagnosis and prescribe medications. If you walk in with his job effectively done, the result won't be as good. (I even experienced this walking into a doctor's office and saying I had shingles and needed an anti-viral. The doctor just had to correct my diagnosis -- "Actually, you're having an outbreak of herpes zoster..." Um... Yeah, commonly known as shingles...) It's partly an ego thing, but it's also because so many people don't have the knowledge that we've gotten here, AND because even people with good knowledge of the disorders and medications for them won't necessarily have great insight into our own issues. (I denied for years that I had an anxiety disorder -- "It's not anxiety, it's just that I'm fueled mostly by adrenaline..." A doctor finally told me to stop and think about that -- it's almost a definition of anxiety...)
So, for instance, rather than saying you think you're suffering atypical depression -- which you probably are, since it's the most common type -- try walking in with symptoms. "I notice that I feel better when good things are happening to me, but I'm really crushed by even mild criticism. I sleep too much, and eat too much." Or whatever symptoms make you think it's atypical depression. And I always make a spreadsheet to take in, showing the medications I've taken, the side effects, the benefits -- if any -- dose, how long I took it, etc. That speeds things up, and saves a lot of the limited time you'll have.
I'm sorry it's taken me so long to get this to you. By now, you're probably already there, or even back home. Do give us an update, though, 'K?
And I very much hope it goes well today.
poster:Racer
thread:798905
URL: http://www.dr-bob.org/babble/20071204/msgs/798948.html