Why Can’t My Psychiatrist Be More Like My Therapist?
“My psychiatrist doesn’t listen to me!”
“I just walked out with 2 more prescriptions!”
“15 minute med checks…give me a break!”
These are some of the complaints I hear on a
weekly basis from clients who see psychiatrists
for psychotropic medications to help them manage
symptoms of anxiety, depression, OCD, and more.
This Is A No-Psychiatrist-Bashing Zone!
Lest you think this is going to be an all-out
Bash-the-Psychiatrists blog post, think again!
Psychiatrists provide a much-needed area of
medical expertise, and I rely on them to help
my clients when that expertise is required.
I hope to give you a little more information about
psychiatrists that may help you know what they do,
what they do best, what they don’t do, and what you
need to do if you are their patient to get the best help.
1. Psychiatrists are M.D.s
Psychiatrists go to medical school and get a medical
degree, with training mainly in the area of diagnosis
of mental disorders and psychopharmacology…the use
of psychotropic drugs to treat mental illness.
Very few psychiatrists get any training in talk therapy
anymore, so when you walk into their office, it will feel
more like walking into your cardiologist’s office than it
will your therapist’s office. What do I mean by that?
They will not be very “touchy-feely.” They will focus
on your symptoms, not your feelings. Being able
to communicate what you are experiencing
effectively will help your doctor to plan a better
medication treatment strategy.
2. Speak Their Language
Before you see your doctor, it would be helpful
for you to keep a record of symptoms you have been
experiencing. You will want to be able to answer
specific questions regarding your mood, energy,
sleep, appetite, sex drive, sociability, and daily
functioning. You can keep a record of symptoms
in a notebook or with a mobile app. There are
apps available to record symptoms for a variety
3. Have Reasonable Expectations
Your psychiatrist is not going to do therapy.
Your psychiatrist is not going to help you gain
insight into your problems or teach you better ways
to cope with your disorder. That’s what therapy is for.
Your psychiatrist is trained to know which
medications may provide some symptom relief
or management for your unique set of symptoms.
Your psychiatrist is going to prescribe medication.
That is what your psychiatrist is going to be good at.
If you expect your psychiatrist to be good at
something else, that may not be a reasonable
expectation. You might be disappointed.
4. Be An Active Part of the Treatment Team
In order for you to effectively manage whatever set
of symptoms you are experiencing, you have to take
an active role. You are not a passive patient being
“operated on.” Recovering or managing your disorder
requires that you, more than anyone else on your
treatment team, be active, assertive, and involved.
If you don’t understand why your doctor has chosen
a certain medication, ask for clarification.
If you don’t like the side effects and want to try a
different medication, tell your doctor what is and
is not acceptable to you. Be open to hearing what
your doctor has to say about the pros and cons of
various medications. There are no “miracle”drugs,
and medication compliance on your part is very
important in giving them a chance to help you.
Never forget that your psychiatrist and your therapist
need to work FOR you and WITH you.
If you don’t understand something or you are not okay
with something, be assertive and let them know.
Better communication can lead to better outcomes…
and who doesn’t want that?