“Should I Go to a Psychiatrist?” Frequently Asked Questions

As I subtly implied in my post “Feel Depressed A Lot? Please Go Get Medicated, You Jerk,” I tend to think that medication is a good idea if you’ve got mood or anxiety problems. I’d like to use this post to answer some questions about the whole process, maybe allay some fears, and possibly confirm some others. It’s a mixed bag, but I think that the eventual positives outweigh the negatives.

“Why should I bother getting medicated?”

If you’re chronically down in the dumps, or if you can’t act like yourself because you’re so damned stressed out, medicine can make you feel better. In fact (and this is the main reason for me), it can make you feel more like yourself.

I recently got on a new regimen (sometimes this shit stops working quite right, or you get new goals), and suddenly I can leave my house again. I can stand talking on the phone and answering emails. I’m no longer binging on sugar or booze, and my mood is just plain better.

I feel more like myself. Depressed Ian is still a good guy, but he’s always acting in ways to avoid stress or pain. His brain is always shrouded in a black fog. It’s not an easy way to live. When I’m feeling good, all of my endeavors just flow more easily. I find it easier to have enjoyable conversations, I can engage in hobbies that Depressed Ian stopped liking, and my motivation is back.

Am I a new man, 100% better? No. But this is pretty nice.

“How do I find a psychiatrist?”

The answer to this one kind of sucks if you’re in the U.S.: You will probably have to check with your insurance provider. Get a list of who’s in your network and bring it to your doctor. They should be able to refer you to someone who’s not a quack (and getting a doctor’s referral is a good way of getting in to see someone who is “not currently accepting new patients”). If you don’t have a doctor, try calling your insurance provider directly for a referral. If you don’t have insurance and you’re in the U.S., you can probably get it for cheap through www.healthcare.gov (it works now, by the way).

“How long until I feel better?”

Probably about a month, though it may be as little as two weeks for some medications. Most antidepressants take a while to do their trick. In fact, the first regimen they put you on might not quite work, or the side effects might be intolerable; this means starting over from scratch.

If you end up seeing a psychiatrist who can’t help you, you may have to try another one. Unfortunately, not every psychiatrist is created equal.

Just remember that the sooner you get this process started, the sooner you can see if this works for you. There will be tweaking involved, changes in dosage, and maybe even multiple kinds of meds, but it’s a process worth trying.

“Won’t there be side effects?”

Oh god yes. I mean, probably. Some people can take this stuff and just feel better, but that’s never been the case for me. Some of the side effects are just nuisances, like waking up with dry mouth a little more often, or having the occasional stomach problems. Others can be pretty damned annoying, like losing your sex drive.

The good news is that other medicines will affect you completely differently. One made me horribly constipated, so I called and got switched to something else. Several have had sexual side effects which I will not be describing because my mom reads this blog, so my psychiatrist put me on two medicines instead of one. It wasn’t perfect, but it helped.

So yes, there will probably be side effects, but this usually just means a little tinkering.

“Can’t I just exercise and meditate?”

Quite possibly. In fact, many studies have shown exercise and meditation to be just as effective as certain medications in the treatment of anxiety and mood disorders. In cases where heavy medication is needed, sometimes exercise can substitute for dosage.

That said, you can’t half-ass it. When scientists study things like meditation and exercise, they don’t have people sit quietly for ten minutes, or go on a short jog. No, you’re going to have to make one or the other (or both) a big part of your life. Joining groups can definitely help keep you on track.

So, why don’t I just exercise and meditate? I do. I just find myself much less likely to do so when I’m depressed. Vicious circle and all that. I’ve found that being properly medicated helps me engage in other wellness-promoting activities.

“Will I have to be medicated forever?”

Maybe. While many people have successfully scaled back on medicine as they improve or change other aspects of their lives, I’ve never had success with it. I consistently end up having strong anxiety symptoms when I go off my meds. A month or two later, I’m back to feeling how I felt when I was, oh, ages 4 through 18.

That said, If your depression or anxiety had a sudden onset, or if they’re due to extraordinary life circumstances, you may be able to undertake a short regimen and then go on as normal.

Some Last Words

As you can see above, the whole “getting medicated” process can be kind of a pain in the ass. You might not respond well to the medication, you might need to see more than one shrink, and sometimes your wiener stops working (sorry you had to read that, mom). Why would anyone go through this?

Because sometimes it’s all you need. If you’re on the proper regimen (which may just be a small dose of a single drug), sometimes you just stop feeling depressed or anxious. You get your life back, or maybe you realize that life doesn’t need to be all about avoiding pain and despair. Social stuff is easier, work stuff is easier, and you find yourself flourishing in ways that you didn’t think possible.

Maybe it won’t be that great; maybe you’ll just get a 50% improvement, or 25%. I gotta tell you: When you’re in a really bad place, 25% can be a godsend.

Let me know what you think. Got any stories about medicine helping? Got any about it seriously sucking? Hit up the comments section below.
Photo credit: Venturist, via flickr

8 thoughts on ““Should I Go to a Psychiatrist?” Frequently Asked Questions

  1. Excellent, excellent. Thorough.

    It’s hard for people to grasp (often hardest for the person affected) that major depression and other psychological disorders are still physiological. The brain is fantastically elastic, so you are generally more able to build new pathways that were neglected while your brain was growing than the equivalent wasting of say muscle and nervous tissue. But it doesn’t mean that it’s not an actual physical difference.

    My experience was to be completely terrified of taking antidepressants. I had been passively suicidal for years. The meds could make it worse before it got better. Honestly, I was most afraid of not being myself – no matter that I knew otherwise. I was terrified of the potential side effects.

    I didn’t have to go to a psychiatrist and in fact only tried SSRIs because my mother had some she gave to me. Dodgy. When I finally bit the bullet (after months – possibly more than a year – of thinking about it), I was totally amazed at the small-but-indescribably-huge difference it made. It’s not like I was happy. But I felt less dead inside and that is mind blowing. So I went to my family dr and asked for some more. I literally chose my own drug and dose rate. I have been to a couple of psychologists in the meantime, and am thinking of going again. But I’m getting there.

    I am on 40 mg citalopram – started on 20, possibly could have done with 60 at one point but studies don’t really support there being much improvement between 40 and 60. Citalopram (I don’t know the brand names sorry) is often what you’re started on, and it’s also commonly used for anxiety.

    Side effects I experienced: hideous nausea for one day (always with the nausea – thanks, body), probably increase in anxiety (it’s multifaceted but I’m sure it’s contributed: pretty much all brain drugs can cause what they are meant to help), probably affected my sex drive but again there were a lot of factors at play, and after about 3 years that’s improving.

    Most people do not need that long and I am thinking of weaning myself off soon. All signs point to me having depression since I was a young child so I went with the recommendations of 2 years or more. Grief related depression and suchlike often only needs six months or so. It’s very individual.

    I thoroughly recommend it. I cannot describe the months of fear followed by totally unspectacular working of drugs. No dramas. Just took the edge off. Magical.

    1. “small-but-indescribably-huge difference” <--- this! That's what I want to tell people about, what I wish I could beam into their brains. These aren't "happy pills" by any stretch of the imagination, but I'll be goddamned if I don't feel less terrible on them. It's like a stormy day becoming overcast... you can go on a walk when it's overcast. You can enjoy yourself. Speaking of, I've been out of commission for the last two weeks due to crippling depression. Been switching up my meds... and damn that sucked. But it's nice to be out of the woods again, and I think I came out ahead. Hell, I'm doing massage again! Anyway, thanks for the awesome comments as always 🙂 You kick ass.

      1. Oh man, I’m sorry to hear that. But glad you’ve got it fairly under control for now – the uncertainty about your ability to deal with doing your job sounds super frustrating.

        I hope 2014 is a year of positivity for you – I’m actually feeling pretty positive over here and that is an unusual state for me! 😀

  2. Hi Ian-Glad to hear that Celexa (citalopram) is working for you. That class of drugs didn’t work for me, at least the ones I’ve tried, Celexa not being one I’ve taken, mainly because I think I was misdiagnosed w/depression when my most prominent symptom was anxiety. I know that the symptoms of each often overlap, or are present in both. I now am doing well on a medication specific for anxiety (xanax). I see a NP (nurse practitioner) every 3 mo. with not much in the way of counseling involved, just med. refills. In the past, the things I’ve found most helpful were group counseling and as a part of that, learning various coping strategies like diaphramatic breathing, exercise, use of relaxation tapes and receiving feedback from others in the group. I’ve found the best therapists were those w/a masters degree in social work, substance abuse guides and nurse practitioners. They seem to encourage more active participation than a psychiatrist generally does. The 12 step program also wasn’t very effective for me, as it felt too much like a religion which i don’t relate to. Wishing you continued success.

    1. Hi Judith! I can’t agree more about the “active approach,” and how it doesn’t seem to be too high of a priority for many psychiatrists or psychologists. Movement, mindfulness, and creation are all so important.

      Thanks you for the kind comment!

  3. I’m sorry but the majority of individuals who express depression or anxiety typically have a fundamentally good reason for feeling that way. For example, many people who express such psychological effects are because they are struggling economically, they’re experiencing troubles in their personal lives/ relationships, are being somehow threatened, or perhaps are eating incredibly unhealthy foods and lack the appropriate nutrition for the appropriate mind, body, soul health.

    I have experienced depression and anxiety for years, over a decade really. During that time, I was fully employed pretty much the entire time. But at the beginning I was in closet and gay, I was being used by my friends and my society in ways that individuals should never be used, I was raped, I was beaten repeatedly, I was betrayed repeatedly, I quit jobs because my employers treated me like crap, I was fired from jobs because occasionally I self-medicated with boozes and what not and should up to work inconsistently. In every relationship I had, I was cheated on, betrayed, and thrown under the bus. Two years ago I tried to commit suicide. And since then, trust me my world is far from being better.

    But should I go and take a pill? Would being on a pill make my life better? Would it make people treat me better? Would it help make me more attractive to people so I could finally try to have a healthy relationship? Would it help me in work environments so that my coworkers and bosses treat me better? Would it help me pay my bills? Would it help me make a difference in the world?

    Absolutely not. If anything it would help me to accept the status quo of my life. My life wouldn’t get better, I would just be better owned by the environment and society around me.

    I disagree with the premise of medication for most diagnosis, isn’t necessary but because it’s over prescribed. Honestly, I feel that some shrinks should encourage their patients to learn mixed martial arts or kick boxing and then encourage them to kick reality ass when reality tries to kick your ass.

    As a concession, for almost two years I dependably and regularly took psychotropic medications. They made me fat, shaky, drool, experience echoing thoughts, experience insomnia, and made concentrating difficult. Because of my medications I had to quit a job.
    And I even went through the Social Security Disability process because my case was considered so severe by my psychiatrists, disability denied my claim.

    I know that for a handful of people, medications may be the best option and perhaps only option. But for the vast majority of other people, I would recommend the following,

    Look for a better paying job.
    Look for a healthier relationship with better or more frequent sex.
    Eat organic food and drink more water.
    Stay away from all nicotine substances.
    Avoid alcohol completely.
    Avoid all processed food completely.
    Exercise regularly.
    Have a regular sleeping schedule and pattern.
    Social more consistently.
    Volunteer and help your community and others.
    Stay away from all forms of caffeine.
    Watch comedies.
    Breathe deeper.
    Laugh louder.
    Takes naps as frequently as possible.
    Pray longer.
    Take more vacations, and if you can’t afford vacations, try stay-cations or go camping.
    Keep your apartment or house cleaner, have regular chores to stay busy.
    Reconnect with nature.
    Get a pet that interacts with you.

    When your environment is cleaner and healthier so are your moods.
    When your body is cleaner and healthier so are your moods.
    When your soul feels cleaner and healthier so are your moods.

    Remember your mind, body and soul connections.

    And most of all, believe in yourself. If everything around you is making you feel like shit and you’re sincerely trying to make a difference and being a genuinely great person, then it’s not your fault. It’s because your environment and your society is completely at shit!

    Don’t give up no matter what you do. And in the end, if you think a psychiatrist might help you, I wish you luck! And please remember if you’re no medications, you cannot drink alcohol and you shouldn’t be smoking cigarettes! Also medications don’t work immediately so keep that in mind. And medications don’t work if you don’t get into a good routine of regularly taking your medications.

    And in the end, I’m still skeptical of psychotropic medications, so if after a year or two the medications haven’t helped, if your circumstances are still the same from an external standpoint, and you’re still struggling with internal struggles, reevaluate your efforts. Have you sincerely and consistently tried to improve your life, see the recommendations previously mentioned. If you stopped trying to improve your life because you thought just taking a pill would instaneously improve it, get back on the horse and gallop away to a better life.

    Reality is a bitch, people suck, and we all eventually die. Remember that your own personal struggles are no different from anyone else’s. And ultimately the best way to help yourself is by helping others.

    Again, sorry if I’m a debby-downer, and as an aside I’d like to mention that although my life still sucks and I’m struggling as much as every before, I own my own struggles. By placing them into context, I can accept why I’m depressed, why I’m lonely, why I’m anxious. I can accept why I have internal struggles on and off at this present moment in my life. And the first step to overcoming the impossible is acceptance. So be honest with yourself, which for many individuals truly suffering from mental illness is difficult to say the least, but if you’re one of the vast hundreds of millions of people that are suffering in this reality on a daily basis, understand you’re not crazy and you’re not alone, reality sucks this much for the vast majority of us peon humans.

    1. I wish I could edit my last statement, I noticed a ton of grammatical mistakes. I apologize for the disruptions during your reading experience. Although I hope that you get the gist of what I was meaning.

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