Psychiatrist's couch for those with mental illness

One of the most difficult things with having a mental illness is actually getting help. I remember when I was very sick and my wife told me I had to get help, it really hit me hard. And, then, when I went to my counselor and he said had to get more help, in the form of a psychiatrist, I was reeling. It was really hard to hear that I was that sick. I did not know what to expect or, even, what to do. I was lost.

In light of this, I want to offer a few tips for someone who has not yet gone to see the psychiatrist and who may question if they should. I make the assumption, though, that your doctor or counselor recommended it or referred you and that this is something you need. I’m going to try and give you some insider information for how to approach the entire process. This is important because it is very easy to do things incorrectly or poorly and mess up your recovery from a mental illness.

Here’s my list.

1. It’s a doctor’s office…so there’s nothing to be ashamed of.

I like to sit in my psychiatrist’s office and watch people come in the door. I can always tell someone who is new or has not been there very much. They have a sheepish look and do not look comfortable. It is like they have something for which they should feel shame. And I know that look because I had that look: that look of being totally unsure and not wanting anyone to judge me. I felt shame that I had to be there.

However, it’s important to remember that this is just another doctor’s office and there’s nothing to be ashamed of. When I had two herniated discs in my back, I went to a specialist and felt no shame or even thought twice about it. I simply wanted to get better and was doing what I had to in order to accomplish that goal. This is the same thing that occurs with a psychiatrist: you want to get better and you are going to a doctor. There’s nothing to be ashamed of. Own the fact that you are actually trying to get better and be proud of that.

2. Make sure you get along with your psychiatrist

One thing that is essential is that you get along with your psychiatrist. I like to have a rapport with my psychiatrist. It does not mean that we are best friends or that we are a perfect match, because we’re not. But, the best psychiatrists are ones that build a relationship and have a vested interest in you and you have a similar interest in them. I mean, they want you to get better as that is their job. Further than that, though, you have to have some mutuality to the relationship.

Due to issues with my insurance, I had to switch psychiatrists three different times. This was quite unfortunate. Of those three, the one that I had the hardest time with and really had no relationship with (and dreaded seeing) was the one that made my recovery most difficult. And, it is hard to say what makes it so that you get along – there’s no surefire list – but it is important that you do get along and have some sort of mutual rapport.

3. Make sure your psychiatrist listens to you

One of the important things about developing a rapport with your psychiatrist is making sure that they listen to you. You are a patient and need to make your concerns and issues heard. You also need to detail how you feel and make sure that your psychiatrist understands what you mean. They are there to offer diagnoses and then prescribe medicine. The best way that a psychiatrist can do that is to listen to and hear what a patient says. So, make sure that you voice your concerns and make sure that the psychiatrist hears you.

One of the ways that this really comes into play with your psychiatrist is over medication. Oftentimes a psychiatrist will prescribe a medication that they believe will help you. But, it may not. You may have a rough time with the side effects of the medication and this makes it so that, in your eyes, it’s not worth taking. Voice this to your doctor. Similarly, make sure your doctor hears you when something works. Just make sure that you tell your psychiatrist what needs to be said, how your medications work and how you feel on them.

4. Listen to your psychiatrist 

In a different vein, it is important that you listen to your psychiatrist and actually try what they say.  Be patient and listen to what the psychiatrist tells you. It Is important that you hear why (and if not told, ask) you take certain medications or do certain things. The psychiatrist, for better or worse, is an expert and generally knows what they are doing. It is imperative to have an implicit trust in them and listen to what treatment plan they have you on. You should follow their directions.

5. Don’t expect to get all the answers right away

One of the most frustrating aspects of having a mental illness is that there are no “answers” right away. Things take time. It takes time to get a diagnosis. It takes time for many medications, especially antidepressants, to work. It takes time for talk therapy to begin taking effect. You cannot go into your psychiatrist’s office expecting to walk out with the perfect resolution to your mental illness. This just is not the reality. Rather, you walk into the psychiatrist’s office deciding to listen and then walk out with the beginning of a plan.

Let me share a brief example. My first appointment with my first psychiatrist was simply a chance to get to know one another and then to begin outlining what a treatment plan would look like. She decided that the antidepressant I was on was not helping and we began to wean me off that and onto another one. That was it. There was no diagnosis and not really a lot we planned to fix. We were simply going to take one step at a time and work a process to recovery. Eventually, I got a diagnosis (bipolar 2 and anxiety) and a good set of meds that help control my illness. But, it took a lot of time. And you have to be patient and realize that it takes time.

6. Be committed to your treatment

Oftentimes, people go into a psychiatrist with an attitude that says, “I don’t think this will help” or “I’m not sure about this.” They also walk into the office with an attitude that they are ashamed or embarrassed to be there. This causes people to not really commit to their treatment. Instead, they take the attitude of “Let’s see if this works.” That attitude will rarely lead to a positive outcome in your care for your mental illness. Rather, you have to actively commit to the treatment and, when it does not work out, change things. This means more than simply taking your meds; it means making the necessary lifestyle changes to ensure your recovery and that you are active in your recovery. Other people cannot recover for you: you have to perform the recovery yourself. And, at times, that sucks. But committing to your treatment with a psychiatrist from your first day is an absolutely imperative starting point.

There are a number of other things I could say. Honestly, there’s probably a book to be written. These are just some good tips to get you into the door and through your first session with a psychiatrist. It requires a lot of work on your part, which is really hard when in the throes of a mental illness, but it will be worth it in the long run. Good luck on your journey!