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Phobia/Fear of going to see a Psychiatrist!
Hi everyone!.
My primary care doctor wants me to see a Psychiatrist because of my severe anxiety and panic attacks. I was also recently diagnosed with (and am being treated for) Bi-Polar Disorder by a specialist (although not a P-Doc). I have been diagnosed with, treated for and have been dealing with GAD, OCD, Panic Disorder and Tourettes for many years by regular doctors and a few specialists but never a P-Doc (at least not since I was a kid) so this is something that is actually very scary to me.
I'm sure we have all seen various movies about people being committed to an insane asylum and they are never heard from again or being forced to take powerful anti-psychotic medications against their will. Even electro-convulsive therapy. I remember back in the 70's and 80's there were a lot of rumours about people being "kidnapped" off the streets and committed even though there was nothing wrong with them, patients being abused (both physically and sexually), medication being used as "punishment", even a number of deaths. At some point, I think there was a major investigation that resulted in lots of psychiatric hospitals being closed and many patients being released to outpatient care. New patient protection laws also came out.
Even recently however, I've read that psychiatric hospitals are a "highly competitive business" and that some "evaluators" are even paid a "commission" for each patient they can get committed and that all it takes is a "label" in order to get you committed for a 72 hour evaluation (just enough time to miss other appointments and obligations, pay your bills or lose work while your pets go hungry at home because your not there to take care of them!). I just don't want to be looked at as a big dollar sign walking through that door.
I've also read that there is a stigma attached to people with Bi-Polar disorder...that they can suddenly become "psychotic" and "go crazy" at any moment. All the recent violence in our society has people with mental issues under the microscope now as well and the public demanding new laws. Heck, I am about as timid as they come and have always been a very calm, meek, stable and friendly kind of person but still, I have apparently already been "labelled".
I've read all kinds of things online that really scare me about all the little tricks they supposedly use to get you committed, keep you there until your insurance runs out, etc. I also read some article that said that many insurance companies won't pay for outpatient care and so it's more "profitable" to just commit you. I've read a lot of other things that really creep me out (like how one of the criteria just by itself, is for you to be "diagnosed with a mental illness"). Like I said, I have Tourettes and the LAST thing I want to do in any Psychiatrist's office is be jerking and twisting all over the place and making loud screeching noises!.
I just want to sit down and talk and feel safe and comfortable and be honest about my problems without being seen as someone's $meal-ticket$. If I'm prescribed certain meds, I don't don't want to feel like I'm being forced to take them or get a "surprise" injection of something that stays in your system for two weeks and makes you walk around feeling dazed all the time or have my meds monitored/forced. I don't want to be told to continue taking something if it is causing side affects just to "give it time to work" or "until the side affects go away". This whole thing is a really grey area for me and I'm really not wanting to go this route because my main issues are (and have always been) anxiety, panic attacks and Tourettes and I am already being treated for these.
Can anyone here please shed some light on my fears?. I have nothing against Psychiatrists and I know there are probably a lot of good ones and many people benefit from seeing them but I just can't get the rumours and things I read out of my mind and now my doctor wants me to go see one and it really scares me!.
Thanks so much for your input/advice.
My primary care doctor wants me to see a Psychiatrist because of my severe anxiety and panic attacks. I was also recently diagnosed with (and am being treated for) Bi-Polar Disorder by a specialist (although not a P-Doc). I have been diagnosed with, treated for and have been dealing with GAD, OCD, Panic Disorder and Tourettes for many years by regular doctors and a few specialists but never a P-Doc (at least not since I was a kid) so this is something that is actually very scary to me.
I'm sure we have all seen various movies about people being committed to an insane asylum and they are never heard from again or being forced to take powerful anti-psychotic medications against their will. Even electro-convulsive therapy. I remember back in the 70's and 80's there were a lot of rumours about people being "kidnapped" off the streets and committed even though there was nothing wrong with them, patients being abused (both physically and sexually), medication being used as "punishment", even a number of deaths. At some point, I think there was a major investigation that resulted in lots of psychiatric hospitals being closed and many patients being released to outpatient care. New patient protection laws also came out.
Even recently however, I've read that psychiatric hospitals are a "highly competitive business" and that some "evaluators" are even paid a "commission" for each patient they can get committed and that all it takes is a "label" in order to get you committed for a 72 hour evaluation (just enough time to miss other appointments and obligations, pay your bills or lose work while your pets go hungry at home because your not there to take care of them!). I just don't want to be looked at as a big dollar sign walking through that door.
I've also read that there is a stigma attached to people with Bi-Polar disorder...that they can suddenly become "psychotic" and "go crazy" at any moment. All the recent violence in our society has people with mental issues under the microscope now as well and the public demanding new laws. Heck, I am about as timid as they come and have always been a very calm, meek, stable and friendly kind of person but still, I have apparently already been "labelled".
I've read all kinds of things online that really scare me about all the little tricks they supposedly use to get you committed, keep you there until your insurance runs out, etc. I also read some article that said that many insurance companies won't pay for outpatient care and so it's more "profitable" to just commit you. I've read a lot of other things that really creep me out (like how one of the criteria just by itself, is for you to be "diagnosed with a mental illness"). Like I said, I have Tourettes and the LAST thing I want to do in any Psychiatrist's office is be jerking and twisting all over the place and making loud screeching noises!.
I just want to sit down and talk and feel safe and comfortable and be honest about my problems without being seen as someone's $meal-ticket$. If I'm prescribed certain meds, I don't don't want to feel like I'm being forced to take them or get a "surprise" injection of something that stays in your system for two weeks and makes you walk around feeling dazed all the time or have my meds monitored/forced. I don't want to be told to continue taking something if it is causing side affects just to "give it time to work" or "until the side affects go away". This whole thing is a really grey area for me and I'm really not wanting to go this route because my main issues are (and have always been) anxiety, panic attacks and Tourettes and I am already being treated for these.
Can anyone here please shed some light on my fears?. I have nothing against Psychiatrists and I know there are probably a lot of good ones and many people benefit from seeing them but I just can't get the rumours and things I read out of my mind and now my doctor wants me to go see one and it really scares me!.
Thanks so much for your input/advice.
Oh dear. It sounds like you're having a really hard time, and would benefit from some sort of treatment. For this response, I'm assuming you're in the US.
I know you're scared about being committed, but it's now pretty difficult in most states to even get a 72 hour hold on someone. In most states, I think they have to have a good reason to think that you will harm yourself or someone else if you aren't seen inpatient. This website http://treatmentadvocacycenter.org/legal-resources/state-standards has information on commitment laws in various states. The page is somewhat geared toward families who are really concerned about their loved ones and want to get them help, but the legal resources are the same. So unless you're really clearly a threat to yourself or others, they can't force you into inpatient treatment, and you have the right to refuse any treatments you aren't comfortable with, even if they are strongly suggested. Being a psych patient doesn't mean you lose your rights. The thing with the insurance company having a criterion of "diagnosed with a mental illness" sounds to me like they're saying, "In addition to our other criteria, if we're going to pay for inpatient psych treatment, that person had better actually have a diagnosis of a mental illness". In other words, it sounds like they're protecting people from being pushed into inpatient treatment for no reason.
Any psychiatrist worth their salt shouldn't mistake Tourettes tics with psychosis, especially when you already have the Tourettes diagnosis in your file. And you won't get any surprise injections at a doctor's visit! At my first visit with my psychiatrist, I openly admitted having intrusive thoughts of suicide, but had no plans to carry it out (I was just scared), and she was very understanding and we discussed what meds we should go with (I knew going in that I needed meds, and did a lot of research so that I knew which ones I would prefer if the psychiatrist agreed with my choice). There weren't even mentions of inpatient treatment, and I was really obviously severely depressed.
Some doctors who work for hospitals are salaried, so they won't see you as a meal ticket. While I'm sure there exist doctors who order too many tests because, hey, the insurance company will pay for it, they are few and far between, and ordering an extra scan is a far cry from forcing inpatient psych treatment.
If you really can't stand the idea of seeing a psychiatrist, a psychologist is probably the best place to go. They can diagnose mental health problems, and give non-medical therapy treatments. Some of them also work with a psychiatrist, who will prescribe medications based on the psychologist's recommendation. You might still have to meet with the psychiatrist, but it would be after meeting with the psychologist and working out a course of treatment with them.
When it comes to medications, if you and your doctor decide it's the right course (and with your symptoms, it sounds like they would be a good idea), a lot of meds you do need 3 months or so to really tell if they're working or not. Some side effects only happen for a while and then go away. If you can't stand the side effects from a medication, you can tell your doctor you're stopping it and make them tell you how to stop safely, and try a different one (sometimes it is possible to add a medication to deal with a side effect, but you have the right to refuse that). For anxiety, SSRI antidepressants are sometimes used, which have a long term effect and can take a while to start working. On the other hand, benzos (like valium, xanax, etc.) are also sometimes used to deal with a panic attack you are having right now. Those you can probably tell within one use if you like them or not (just make sure you don't like them too much ;)).
I think the stigma you see with bipolar disorder is in the public, not the mental health community (keep in mind that there are assholes everywhere, and mental health is no exception, but you have every right to go to someone else if you aren't being treated well). What type of bipolar were you diagnosed with? (just curious)
Overall, I think you could really benefit from seeing someone, and maybe starting some medications. The most important thing is to remember that you still have the right to make decisions about your own treatment, and that people who take an active role in their treatment tend to do better. I know it can be scary to go to someone, but it has the potential to greatly improve your life. I really wish I had gone sooner.
Best of luck.
I know you're scared about being committed, but it's now pretty difficult in most states to even get a 72 hour hold on someone. In most states, I think they have to have a good reason to think that you will harm yourself or someone else if you aren't seen inpatient. This website http://treatmentadvocacycenter.org/legal-resources/state-standards has information on commitment laws in various states. The page is somewhat geared toward families who are really concerned about their loved ones and want to get them help, but the legal resources are the same. So unless you're really clearly a threat to yourself or others, they can't force you into inpatient treatment, and you have the right to refuse any treatments you aren't comfortable with, even if they are strongly suggested. Being a psych patient doesn't mean you lose your rights. The thing with the insurance company having a criterion of "diagnosed with a mental illness" sounds to me like they're saying, "In addition to our other criteria, if we're going to pay for inpatient psych treatment, that person had better actually have a diagnosis of a mental illness". In other words, it sounds like they're protecting people from being pushed into inpatient treatment for no reason.
Any psychiatrist worth their salt shouldn't mistake Tourettes tics with psychosis, especially when you already have the Tourettes diagnosis in your file. And you won't get any surprise injections at a doctor's visit! At my first visit with my psychiatrist, I openly admitted having intrusive thoughts of suicide, but had no plans to carry it out (I was just scared), and she was very understanding and we discussed what meds we should go with (I knew going in that I needed meds, and did a lot of research so that I knew which ones I would prefer if the psychiatrist agreed with my choice). There weren't even mentions of inpatient treatment, and I was really obviously severely depressed.
Some doctors who work for hospitals are salaried, so they won't see you as a meal ticket. While I'm sure there exist doctors who order too many tests because, hey, the insurance company will pay for it, they are few and far between, and ordering an extra scan is a far cry from forcing inpatient psych treatment.
If you really can't stand the idea of seeing a psychiatrist, a psychologist is probably the best place to go. They can diagnose mental health problems, and give non-medical therapy treatments. Some of them also work with a psychiatrist, who will prescribe medications based on the psychologist's recommendation. You might still have to meet with the psychiatrist, but it would be after meeting with the psychologist and working out a course of treatment with them.
When it comes to medications, if you and your doctor decide it's the right course (and with your symptoms, it sounds like they would be a good idea), a lot of meds you do need 3 months or so to really tell if they're working or not. Some side effects only happen for a while and then go away. If you can't stand the side effects from a medication, you can tell your doctor you're stopping it and make them tell you how to stop safely, and try a different one (sometimes it is possible to add a medication to deal with a side effect, but you have the right to refuse that). For anxiety, SSRI antidepressants are sometimes used, which have a long term effect and can take a while to start working. On the other hand, benzos (like valium, xanax, etc.) are also sometimes used to deal with a panic attack you are having right now. Those you can probably tell within one use if you like them or not (just make sure you don't like them too much ;)).
I think the stigma you see with bipolar disorder is in the public, not the mental health community (keep in mind that there are assholes everywhere, and mental health is no exception, but you have every right to go to someone else if you aren't being treated well). What type of bipolar were you diagnosed with? (just curious)
Overall, I think you could really benefit from seeing someone, and maybe starting some medications. The most important thing is to remember that you still have the right to make decisions about your own treatment, and that people who take an active role in their treatment tend to do better. I know it can be scary to go to someone, but it has the potential to greatly improve your life. I really wish I had gone sooner.
Best of luck.
Your fear of being taken advantage of is understandable. It will continue until you are able to be more assertive and reactive instead of proactive.
I also see therapists for many reasons. I see a therapist for my PTSD, a different one for my addicition, and I see a nurse practitioner for my bipolar and meds.
I also see therapists for many reasons. I see a therapist for my PTSD, a different one for my addicition, and I see a nurse practitioner for my bipolar and meds.
Wow, so much incredibly good (and constructive) information here, I hardly know where to begin [:)]
I guess one of the reasons I fear going to see a P-Doc with Tourettes is because I'm concerned that if I had one of my head-jerk tics, he or she might construe that as my "being a danger to myself" since sometimes the tics can be quite intense. I also have HUGE issues with opening up to people and sharing (I'm a very wary, suspicious and apprehensive person) and I am always that anything I say will be exploited in some way or that I will be taken advantage of.
I have also thought about keeping the two medical specialities separate from each other as a way to cope with my fears. For example, instead of going to see a Psychiatrist (basically a medical doctor+psychologist), I might see a regular doctor for my "body things" and a psychologist for my "mind things". I have read that most psychologists are not able to prescribe medications (or at least not in some states) but they can make diagnoses and provide therapy. Perhaps this would fall more within my "comfort zone".
One of my fears is that my insurance is gov. provided and I have the full range of coverage (inpatient and outpatient). Since inpatient pays more and since gov. coverage is very reliable, it might actually make me a more profitable patient and pay more if I was committed. I guess that was one thing that bothered me. I just want to be seen as a human being. Not another notch in someone's bottom line.
I also have to admit that I feel under pressure to see a psychiatrist. I already have a lot of stress, anxiety, responsibilities and pressure in my life and I feel like every time I see another specialist, it always results in my having to then see other specialists, have lots of tests done and then go back for a re-check - only to be told that I need to see tow more specialists which then results in even more appointments, tests, re-checks, overlapping medications being prescribed, etc. It reaches a point where I'm spending my life doing nothing more than just going from one appointment to the next with hardly any time to catch my breath and relax.
A few things I have found very helpful in coping are prayer, AC/mood stabilizers (like Keppra), finding distractions and trying to avoid things that are anxiety-inducing (especially at night). Thanks again for all the support and input. I really appreciate it a LOT!.
I guess one of the reasons I fear going to see a P-Doc with Tourettes is because I'm concerned that if I had one of my head-jerk tics, he or she might construe that as my "being a danger to myself" since sometimes the tics can be quite intense. I also have HUGE issues with opening up to people and sharing (I'm a very wary, suspicious and apprehensive person) and I am always that anything I say will be exploited in some way or that I will be taken advantage of.
I have also thought about keeping the two medical specialities separate from each other as a way to cope with my fears. For example, instead of going to see a Psychiatrist (basically a medical doctor+psychologist), I might see a regular doctor for my "body things" and a psychologist for my "mind things". I have read that most psychologists are not able to prescribe medications (or at least not in some states) but they can make diagnoses and provide therapy. Perhaps this would fall more within my "comfort zone".
One of my fears is that my insurance is gov. provided and I have the full range of coverage (inpatient and outpatient). Since inpatient pays more and since gov. coverage is very reliable, it might actually make me a more profitable patient and pay more if I was committed. I guess that was one thing that bothered me. I just want to be seen as a human being. Not another notch in someone's bottom line.
I also have to admit that I feel under pressure to see a psychiatrist. I already have a lot of stress, anxiety, responsibilities and pressure in my life and I feel like every time I see another specialist, it always results in my having to then see other specialists, have lots of tests done and then go back for a re-check - only to be told that I need to see tow more specialists which then results in even more appointments, tests, re-checks, overlapping medications being prescribed, etc. It reaches a point where I'm spending my life doing nothing more than just going from one appointment to the next with hardly any time to catch my breath and relax.
A few things I have found very helpful in coping are prayer, AC/mood stabilizers (like Keppra), finding distractions and trying to avoid things that are anxiety-inducing (especially at night). Thanks again for all the support and input. I really appreciate it a LOT!.
A pc doctor knows a lot about medicine but for treating mood disorders you are better off seeing a psych doctor. Your treatment is up to you. The doctor, if it is a good one, will give you full control of your recovery. Yes being inpatient in a psych hospital is scary. It is not like the movies. Also the thought of ECT is scary to me. It has a high success rate and I have been close to having to do it. Some patients are a little hurt because of the things a nurse may say to them or not say to them but as closely as you are monitored, the staff is monitored just as well. I am not saying that there is no abuse in treatment because there are exceptions to every rule but I have been in treatment several times in different places and I have never witnessed or heard rumors of this happening. If you get out of control, then yes they will get physical and you could get hurt physically but it is a precaution they have to take.
There is a lot of shady things going on these days in the health care field. Sometimes you just have to weigh the pros and the cons of being inpatient if it is even necessary for you to go. If you come in the drs office in an unstable manic episode they may try to get you to go to treatment. If you are arrested for the same thing, you will have no choice.
There are some of us that are a danger to society but I am an exception to the rule the same as you and most of the bipolar people I have met except two of them.
Yes a lot of them won't pay for outpatient.
Like I said you should have full control over your treatment. As long as you are not breaking laws you should be able to decide if it is time to go to treatment or not. In my case I know when it is time to go and I don't question it. I have been through a lot of manic and depression spells and I won't go into detail but they scare me sometimes, more than my fear of being uprooted from my life and admitting I can't handle it. This is my knowledge and perhaps someone else may say something different.
There is a lot of shady things going on these days in the health care field. Sometimes you just have to weigh the pros and the cons of being inpatient if it is even necessary for you to go. If you come in the drs office in an unstable manic episode they may try to get you to go to treatment. If you are arrested for the same thing, you will have no choice.
There are some of us that are a danger to society but I am an exception to the rule the same as you and most of the bipolar people I have met except two of them.
Yes a lot of them won't pay for outpatient.
Like I said you should have full control over your treatment. As long as you are not breaking laws you should be able to decide if it is time to go to treatment or not. In my case I know when it is time to go and I don't question it. I have been through a lot of manic and depression spells and I won't go into detail but they scare me sometimes, more than my fear of being uprooted from my life and admitting I can't handle it. This is my knowledge and perhaps someone else may say something different.
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