How To Talk to Your Psychiatrist

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 the 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 of issues including Bipolar Disorder, PTSD, Anxiety, Depression, and OCD.

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?

Dr. Anita Sanz, PhD, Psychologist

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