How often will I have to return for visits?
The length of treatment will vary, depending on both the nature of the problem as well as whether you are seeing your psychiatrist both for psychotherapy and medication management versus strictly medication use.
If I start medication, how long do I have to stay on it?
Each clinical situation has to be evaluated separately to determine how long you need to stay on it. Although experience shows that some types of chronic or recurrent depression and other conditions do best with longer rather than shorter treatment, no one really knows for sure in an individual case whether medication will be required indefinitely. New medications and treatments are constantly being developed that will almost certainly transform the approach to psychiatric disorders in the next few decades. The important thing is to maintain good communication with your doctor and to make decisions about the length of medication use after thorough discussion. A not uncommon scenario is relapse of depression or other symptoms when medication is discontinued prematurely and without medical guidance.
What are the most common mental illnesses and how are they treated?
The most common mental illnesses are depression, bipolar disorder (manic depression), panic disorder, obsessive-compulsive disorder, other anxiety disorders, ADHD, substance abuse, schizophrenia, and eating disorders such as anorexia or bulimia. They are usually treated with a combination of medication and psychotherapy.
What is a psychiatrist?
A psychiatrist is a medical doctor who specializes in the diagnosis, treatment and prevention of mental illnesses, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of emotional problems. A psychiatrist has completed medical school (is an M.D. or D.O.) and an additional four or more years of residency training in psychiatry. To become a psychiatrist, a person must complete college, then medical school, and then a four-year residency program in psychiatry. Some psychiatrists also complete additional training after their four years of general psychiatry training. Newly graduated physicians must pass written and oral examinations for a state license to practice medicine. After graduation, doctors typically spend much of the first year of residency training in a hospital taking care of patients with a wide range of medical illnesses. The psychiatrist-in-training then spends at least three additional years in training learning the diagnosis and treatment of mental illnesses, gaining valuable skills in various forms of psychotherapy and in the use of psychiatric medicines and other treatments. After training is completed, most psychiatrists take a voluntary written and oral examination given by the American Board of Psychiatry and Neurology to become a “board certified” psychiatrist. Becoming “board certified” indicates that the psychiatrist has met the highest standard available to provide clinical care. A psychiatrist must be re-certified every 10 years.
What is the difference between a psychiatrist and a psychologist?
As noted above, a psychiatrist is a medical doctor with special training in psychiatry who is able to conduct psychotherapy and prescribe medications and other medical treatments. A psychologist usually has an advanced degree, most commonly in clinical psychology, and often has extensive training in research. Psychologists treat mental disorders with psychotherapy and some specialize in psychological testing and evaluation.
What kind of treatments are available?
Psychiatrists use a variety of treatments, including psychotherapy, medication, and other treatments. Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a therapist and patient. It can be used to treat a broad variety of mental disorders and emotional difficulties. The goal of psychotherapy is to eliminate or control disabling or troubling symptoms so you can function better. Depending on the extent of the problem, treatment may take just a few sessions over a week or two or may take many sessions over a period of years. There are many forms of psychotherapy and it can be done individually, with a family, or in a group. Some mental illnesses require limited but ongoing treatment in order to manage chronic conditions. Medications are used by psychiatrists in much the same way that medications are used to treat high blood pressure or diabetes. After medical and psychological evaluations, a psychiatrist can prescribe medications to help treat mental disorders. Psychiatric (also called psychotropic) medications can have an effect on brain chemicals (called neurotransmitters) that are thought to be involved in some mental disorders, but can be used for many different purposes. Psychiatrists often use medications in combination with psychotherapy. A patient on long-term medication treatment will need to meet with his or her psychiatrist periodically in order to monitor the effects of medications. These medications can include antidepressants, anti-anxiety medications, and mood stabilizers among others. Other treatments are also sometimes used by psychiatrists. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is used most often to treat severe depression that has not responded to other treatments. Deep brain stimulation, vagus nerve stimulation, and repetitive transcranial magnetic stimulation are a few of the newer therapies being used to treat some mental disorders. Light therapy can be used to treat seasonal depression.
What will the first visit be like?
When you visit the psychiatrist, the doctor will ask questions about your background, family, habits, as well as your general health, and will ask why you think you need treatment. Because they are physicians, psychiatrists can order or a full range of medical, laboratory, and psychological tests which, combined with interviews/discussions with you, help provide a picture of your physical and mental state. Your doctor’s education and years of clinical training and experience equip him or her with the understanding of the complex relationship between emotional and other medical illnesses, to evaluate medical and psychological data, to make a diagnosis, and to work with you to develop a treatment plan. If you are coming to see us, please bring all your prescriptions (even if they are for other problems) in their bottles so that we can see exactly how they were prescribed. If you have had previous treatment from a psychologist, counselor, or other psychiatrist, please bring those records. If you do not have any records, we may ask you to sign a release so we can talk to the other people who have worked with you, if this is OK with you. In this case, please bring the names and phone numbers of the people who have treated you in the past. It is also very helpful to fill out the initial intake forms available for each provider on the individual provider’s page. When you’ve found a psychiatrist with whom you are comfortable, you’ve finished the first part of the treatment process. The second part, which is working together with your psychiatrist to understand and manage your illness, is about to begin.
When do I know my problems are severe enough to see someone?
People seek psychiatric help for many reasons. We all have times when we feel blue or particularly stressed. Usually these times pass and we begin to feel like ourselves again. Sometimes these problems persist a long time or start to interfere with daily life. People may have trouble sleeping, may feel more irritable, or begin to have difficulty in their jobs and relationships. The problems can be sudden, such as a panic attack, or frightening hallucinations, thoughts of suicide, or hearing “voices.” They may be more long-term, such as feelings of sadness and hopelessness or anxious feelings that never seem to lift, causing everyday life to feel distorted or out of control. Some people simply have trouble coping with the many stresses of modern life. Others are already seeing a counselor who has suggested that medication might help them feel better. Most people who see a psychiatrist are simply trying to find ways to cope better with difficult feelings or behaviors and see psychiatric treatment as an opportunity to improve their lives. Under our forms page, we have a number of different clinical forms available to help you assess yourself. Many of the websites on our “Resources” page also have checklists that might help you decide if you need to see someone about your mental health. If you are unsure about whether you would benefit from treatment at HMG Psychiatric Associates, feel free to call us and describe your problems and we can help you make this decision.