Some good advice.

[Hensley258]

I wish I could make this a sticky that would remain on the boards. Mostly for new members and those that suspect they may be suffering from clinical depression or anxiety dissorder.

I read way too many heart breaking stories of un-needed suffering by people that relied or are currently reling only on a regular Doctor or family MD to treat their severe depression or other mental illness. Very often this results in a disastorus outcome for both patient and doctor.

Pease people, for your own safty and good health, make the extra effort to get treated by a specialist in the feild of mental health such as a Boaed Certified Psychiatrist.

For people not in the know..... There is a huge difference between a Psychiatrist and an MD doctor. Regular doctors are experts at treating and diagnosing illnesses of the body, NOT THE BRAIN.

Psychiatrists are also doctors, except they have several more years of training in the art of treating mental illness with Psychotropic medications. It is VERY important to understand the difference.

Just as you would not go to a Neurologist for a heart condition, you should not go to a regular doctor to be treated for Major depression.

Can regular doctors prescribe powerful Psychotropic medications? You bet they can. And they often do with less than favorable results. There are literally hundreds of different Psychotropic medications on the market and each one is different from the other. You simply can not expect a regular doctor to understand all the variables involved with treating such a complex condition as Major depression or anxiety.

I'm not saying that your family doctor is "bad" for trying to help your symptoms of depression. They do so with the best intentions and a few (very few) do have some training in treating basic forms of mental illness. What I am saying is that your mental health is in many ways more important that even your physical health and to ensure better odds of a proper diagnosis and treatment it is best done by an absolute expert in his or her chosen feild.

I simply can not stress this enough. Even if you must pay more to see a Psychiatrist for treatment, do it because it's worth it.

Regards.

[bernie40]

I completely agree with Hensley regarding the fact that GP's will refer to other specialists without a by-your-leave yet trying to get a referral to a psychiatrist is like pulling teeth.  It can take years before a GP will consider a referral and only once they have tried every form of SSRI and appointments with counselling or psychologists.

Over here in the UK GPs cannot prescribe mood stabilizing drugs unless they have been authorized by a consultant specialist, which is one good thing I suppose.  My GP was telling me that the strongest she can prescribe off her own bat is Venlaflaxine.  Yet the scary thing is the side effects even of SSRI's can be truly horrific if you have not had a correct diagnosis.

I have actually been present at a consultation between a patient and their Dr regarding a reaction to venlaflaxine and the Drs answer was to increase the dose!!!!!  I was absolutly horrified and pointed out that the patient was literally "going out of her mind" after being on the start dose for less than a week and surely an increase would make matters worse.  The look of contempt the Dr gave me was incredible.  Needless to say this person got worse and was back in the surgery within a few days and taken off the medication completely.  

It is a sad fact that some Drs are not prepared to truly "listen" to their patients and have what i refer to as the "God complex".

Sorry, this ended up as a rant!!!!  I should add that there are of course a lot of very good Drs/Specialists out there, the trick is finding them!

[Hensley258]

You make a good point. It still is difficult for me to understand why a GP would attempt to treat Major Depression.

I find it odd that the FDA and AMA even give regular GP's the legal ability to write Prescriptons for Antidepressants and other Psychotropic medications. There are some (very few GP's that do complete very basic extra training regarding Psychiatry) but these GP's are uncommon and most choose not to take part in this additional training simply because there is no "real" financial benifit associated with doing so.

There are many Mental Health Nurse Practitioners that are actually very skilled at treating Mental Health conditions and can also write prescriptions. (In fact some are even better than some Psychiatrist as they have much the same training and experience as many Psychiatrists)

For people that can not afford to see a Psychiatrist then a good mental health Nurse Practitioner can also be a wise choice for treatment. Most are actually very skilled in Mental health and the proper usage of Psycotropic medications.

I would give my trust to one of them before a GP that has no experience or training in mental health.

Let me give you an example: I know people that have Very severe forms of depressive dissorders that are being treated by GP's and they are prescribing them 2MG bars of Xanax to take 4 times a day! How are they helping this person that is suffering cronic depression? Or the house wife that has a serious Bi-polar condition that her GP is simply treating with meds that EVEN I KNOW are dangerous for Bipolr 1 sufferers. The results (I have seen them) are horrid and end up with eventual hospitalization and all kinds of unfortunat things.

I see it on the forum here sometimes too. Post such as; "My GP has me taking Zoloft, Prozac and Celexa for my depression and I'm getting worse." I'm like OMG, dude no wonder! You really need a mental health specialist bad! Your going to get poisoned from that many different SSRI's all at one time!

It really breaks my heart to hear stuff like that. The GP's mean well, but as a whole they really have no clue about these meds and how to properly use them on their patients.

Yet the FDA allows this to be a free for all. I look at it like this; If I find out that I have inner ear problems that could cost me my hearing, I want and Ear and nose specialist working on my condition, not my family doctor!

If I get the flu or an infection, I go see a GP simply because they are experts that that kind of thing.

I just want to educate people on our forum about the importance of finding the proper care for their treatmet. Severe depression can be deadly if treated incorrectly and people need to know this.

[Lizz67]

Hensley258, you make a good point about regular doctors not referring pts to specialists.  I think this is true.  It makes me really angry when hear about someone getting psych meds from a GP.
(Excepting the very real problems people have all over with access or being able to afford it as mentioned above.)

Where I work I've met quite a few women on anti-anxiety and AD who don't see a psychiatrist or psychologist.  In this group people are insured (US). They would all be referred to a cardiologist or an orthopedist for related problems.  But mental illness is still different. (and usually the talk is about how meds aren't working and people stopping treatment).

I wonder if some of these people did not want to go due to the stigma.  I agree that many GPs probably don't take the treatment of mental illness seriously. And I wonder if some doctors don't refer because of concern about their patient's reputations.
I live in a small-town region and this possibility just occured to me.

This issue really angers me, so pardon me if I'm kind of rambling.

[Hensley258]

I understand what you mean about the long wait times in the UK to see such a specialist.

I have heard many stories from people in the UK waiting several months just to see a Psychiatrist. I know the health care system in both Europe and The US have their own seperate problems and getting prompt care is not always possible.

With no Appointment or refferal I can pick up the phone right now and get an appointment for evaluation by a new Psychiatrist in less than 72 hours. Problem is that we pay and pay big time for that luxury of option here in the States. ( I ment I can, but it would cost me hundreds.)

If your inclome here is very low, then there are mental health programs availible for you in the States that move pretty fast. Problem is that if your in the "middle income bracket" then you have to pay even with good insurance and many families in the middle income level are just scraping by as it is. It's always the person in the middle that gets screwed here.

Regardless of these facts I still see a lot of people that have the means to see a specialist, but never do because they figure a doctor is just a doctor and thay all have the same training. Often times these people suffer for long periods before getting specialized care.

We are fortunate in the US to have an abundance of Psychiatrist and I think this option should be looked at by more people that are getting less than good results thru a regular doctor.

What I have always found odd is that regular doctors do not hesitate to immidiatly refer a patient to a specialist, except for in matters of mental health. Often they are more inclined to attempt prescribing Psychotropic meds to see what works.
This can be bad news simply because in many cases they don't fully understand what their dealing with and what symptoms are best matched to specific drugs.

Another option can be a specialized Mental health Nurse Practitioner. These Nurses can prescribe medication and some of them are even better at it than some Psychiatrist.

As far as the (not all Psychiatrist are created equal) I agree 100%. I have been to a few in my life that I wouldn't trust to treat my dog, much less my condition.

It can take a bit off searching before you find one that is really good.

Regards.

[bernie40]

rliz raises a very important point - not everyone has a choice.  In the UK we have to be referred to a pyschiatrist by our general practitioner - we (the patient) are not able to make a direct appointment with a psychiatrist ourselves.  The waiting lists are long.  Also the fact that in countries where medical help is not free some people struggle to pay for their care and therefore have fewer options.

In an ideal world we would have complete control over who we see regardless of location or financial status, sadly this is not so.

[therese83]

I suffered very badly with psychotic depression which was not even recognised by the first psychiatrist, she just put me on antidepressants.  After one month of going downhill rapidly I went to a top psychiatrist and she had me sleeping that night, I mean the change was immediate.  I could have suffered on with the other doctor which may have led to death.
That is what I always say to people, you do not have to suffer, find the right help.  I have made a great recovery and lead a very happy life, mostly taking care of my four kids + I have a great job.  Get the right help.

[BEJ54]

It took me a long time to see a "specialist".  I should have done it years ago but it wasn't until this last year that I went.  I refused to see a therapist until last year this time when I showed up in my family doc's office in the fall last year this time.

However, I understood the reluctance a lot better when, in February, I told both my therapist and family doc about abuse I suffered from a psychologist who preyed on me. I needed to see both gynecologist and psychiatrist and was absolutely terrified.

Hence, I stayed with my family doc far longer than I should have, and he did suggest but did not push me on seeing a psychiatrist.  As soon as I blurted out about the abuse, everyone settled back and said, "that explains a lot".  So, with the support of my therapist, I've gotten gynecological issues resolved and am working on the brain chemistry issues.

My family doc remains very supportive and as he says he'll "take care of my body" and let my therapist take care of my support and psychiatrist take care of my brain.

The skills I learned to compartmentalize and survive were the same ones I've had to undo to get the care I needed.  There, I said it!