View Full Version : what to expect at 1st pyschiatrist appointment
nicola1980
11-02-12, 20:12
Hi, ive got my first pyschiatrist appointment on wed, doctor has requested a change in my medication for anxiety and panic attacks as currently on citalopram and it doesn't seem to be helping, i just wondered what to expect from my 1st appointment? doctor said to be aware that she will ask me alot of personal questions etc starting from my childhood, family etc, im really stressing myself out about going and could do with knowing a little of what to expect? apparantly she's not the most sympathetic pyschiastrist and holds no prisoners :ohmy: but is very good regarding treatment!! thanks :D
be totally honest is the best advice I would give and Im sure she will in turn very good treatment.
Ive found working against them at times causes problems and dont mention I googled this or that , and I think this med would suit me etc , remember they see people all day long they are in general very good with their diagnoses and treatments , as long as they have the correct symptoms that is
nicola1980
11-02-12, 20:36
Thankyou :) xx
Hi, don't worry, I think they have to be impartial and can appear cold and un-sympathetic (their job is not to give sympathy). They do ask lots of qu;s, it's only to get some background info so they can help to work out any 'triggers'. It's natural to feel stressed, I was, but I found it really helpful, I couldn't believe an hour had gone by on my first visit, and to be honest I could have answererd her questions all day. I had 10 sessions in total and it still helps me to cope better with my panic attacks...that was 5 years ago. Please go, it will be worth it. best of luck :hugs:
nicola1980
11-02-12, 20:53
Thankyou :D xx
I would think the psychiatrist will probably ask lots of questions about you and your difficulties, the purpose being to diagnose you, then they will probably suggest some medication to help with the problem you have.
A big misconception is that psychiatrists deliver therapy ('lie on the couch, and tell me of your childhhod', etc.,), when infact the majority are not trained in therapy, remember they are doctors not therapists, therefore they generally diagnose and prescribe medication, a few however may have some training in therapy, so it might be worth asking what they do deliver if any psychological intervention is offered.
thetube82
nicola1980
12-02-12, 07:57
Thankyou, i am currently having weekly councilling which is helping xx
Any update of how it went? I have one next wed, found out she is a trainee pyschiatrist which hasn't really filled me with confidence. I really want to try pregabalin but my GP said she isn't happy to prescribe it.
nicola1980
18-02-12, 12:58
Hi it went well but be warned they want to know everything from your childhood upwards, i found it very emotional but felt loads better when i came out, i was in there over an hour and a half and she changed my meds there and then to what she felt would benefit me better, have got a follow up appointment a wk on monday with her again, good luck x x
Great news Nicola. It can be a bit of an emotional rollercoaster but I think it's good to talk about things and they sure know the right questions to ask! I'm sure your next session will be positive for you too. :) Onwards & upwards!!
Hi it went well but be warned they want to know everything from your childhood upwards, i found it very emotional but felt loads better when i came out, i was in there over an hour and a half and she changed my meds there and then to what she felt would benefit me better, have got a follow up appointment a wk on monday with her again, good luck x x
Hi thanks for replying. What meds did she change you onto ? I've tried citalopram, amitriptlyine and prozac so far.
nicola1980
18-02-12, 15:17
I was on citalopram and shes changed me to mirtazapine, she said im suffering an anxiety disorder, citalopram was heightening my anxiety and panics and id persevered with it since sept so really was at the end of my tether!! xx
---------- Post added at 15:17 ---------- Previous post was at 15:15 ----------
Great news Nicola. It can be a bit of an emotional rollercoaster but I think it's good to talk about things and they sure know the right questions to ask! I'm sure your next session will be positive for you too. :) Onwards & upwards!!
Thanks, i was absoutley bricking it before i went in but ou just have to put your trust in them and apparantly mine is very clued up on meds so fingers crossed xx
I was on citalopram and shes changed me to mirtazapine, she said im suffering an anxiety disorder, citalopram was heightening my anxiety and panics and id persevered with it since sept so really was at the end of my tether!! xx
---------- Post added at 15:17 ---------- Previous post was at 15:15 ----------
Thanks, i was absoutley bricking it before i went in but ou just have to put your trust in them and apparantly mine is very clued up on meds so fingers crossed xx
Got my first appointment tomorrow :ohmy:
nicola1980
21-02-12, 15:47
Good luck you'll be fine, let me know how you get on x x
nicola1980
22-02-12, 08:55
Just wanted to wish you luck for today Dan x x
Thanks so much nicola,
Saw a trainee pyschiatrist today, had the assessment done today, because it is a complicated case she is speaking to a consultant. She is arranging for me to get CBT. Basically it was positive, but will take a couple of weeks till my meds are changed. Although I told her I will unwilling to take Prozac. She was surprised my GP prescribed diazepam ???
nicola1980
22-02-12, 12:25
These new docs etc are dead against diazepam but ive been told by my physchatrist to carry on using it until im stable mentally and medication wise, usually they prescribe meds there and then so hope you dont have to wait too long x x
Was good to read these posts as I have had 3 sessions of CBT but am seeing a consultant psychiatrist tomorrow to review my meds as I'm on citalopram but for various reasons my GP and therapist don't think it's right for me but don't know what to try. I was recommended pregabalin (by said consultant via GP over the phone) but was turned down by the Primary Trust (as it had to be ok'd) as they didn't feel I had tried enough of the more generally used medications. I am so anxious about the appt tomorrow incase they tell me just to stick with the Citalopram and I don't want too as it's been 5 months and I'm at my wits end with it all :-(
When will they invent the magic wand to wave anxiety away??
xx
nicola1980
22-02-12, 14:24
Was good to read these posts as I have had 3 sessions of CBT but am seeing a consultant psychiatrist tomorrow to review my meds as I'm on citalopram but for various reasons my GP and therapist don't think it's right for me but don't know what to try. I was recommended pregabalin (by said consultant via GP over the phone) but was turned down by the Primary Trust (as it had to be ok'd) as they didn't feel I had tried enough of the more generally used medications. I am so anxious about the appt tomorrow incase they tell me just to stick with the Citalopram and I don't want too as it's been 5 months and I'm at my wits end with it all :-(
When will they invent the magic wand to wave anxiety away??
xx
Good luck for tomo, i had the same problem with citalopram, i perservered with it since sept up until last wed when the physchatrist swapped me to mirtazapine, the cit just made me worse but now im going through withdrawal off the cit aswell as side effects off the mirtazapine :mad: but we have to go through this to get better xx
These new docs etc are dead against diazepam but ive been told by my physchatrist to carry on using it until im stable mentally and medication wise, usually they prescribe meds there and then so hope you dont have to wait too long x x
Only 1 yr difference between when they qualified. Maybe because she wasn't a fully qualified pyschiatrist yet she was being cautious. Just out of interest how much diazepam are you prescribed ? I've had 21 since sept and the GP has refused to give me more. Hopefully the consultant pyschiatrist will be more willing to prescribe them.
nicola1980
22-02-12, 14:41
im taking upto 10mg a day at the min, only been on that amount for 4 weeks and ill slowly been weened off it when im stable xx
Was good to read these posts as I have had 3 sessions of CBT but am seeing a consultant psychiatrist tomorrow to review my meds as I'm on citalopram but for various reasons my GP and therapist don't think it's right for me but don't know what to try. I was recommended pregabalin (by said consultant via GP over the phone) but was turned down by the Primary Trust (as it had to be ok'd) as they didn't feel I had tried enough of the more generally used medications. I am so anxious about the appt tomorrow incase they tell me just to stick with the Citalopram and I don't want too as it's been 5 months and I'm at my wits end with it all :-(
When will they invent the magic wand to wave anxiety away??
xx
I want to try pregabalin too. I've tried citalopram, prozac and amitriptyline and have propranolol and diazepam prn. My GP point black refused to prescribe it. Have you thought about venlafaxine or duloxetine ?
nicola1980
22-02-12, 14:50
I mentioned venlafaxine to my physcahtrist but she told me it wouldn't even be her 2nd choice of meds for me?? you really do just have to put your trust in them regarding meds and i know its hard as i find it hard trusting people but theses people are experts on mental health, did they diagnose you with anything today? i was told im suffering an anxiety disorder xx
I mentioned venlafaxine to my physcahtrist but she told me it wouldn't even be her 2nd choice of meds for me?? you really do just have to put your trust in them regarding meds and i know its hard as i find it hard trusting people but theses people are experts on mental health, did they diagnose you with anything today? i was told im suffering an anxiety disorder xx
Same Anxiety, but then I could have told her that from the start. I'm a bit annoyed that she didn't change my meds.
nicola1980
22-02-12, 15:57
I would have been aswel because thats the whole point of us going to see them because we need help, it really frustrates me at time :mad: are you on any meds at all at the min? X x
I would have been aswel because thats the whole point of us going to see them because we need help, it really frustrates me at time :mad: are you on any meds at all at the min? X x
I was on prozac but it made me aggressive and violent so I stopped it.
nicola1980
22-02-12, 16:00
Sorry just seen you take propranolol, ive tried them aswel and they didnt help me either x x
Sorry just seen you take propranolol, ive tried them aswel and they didnt help me either x x
Diazepam helps, but it is impossible to get my GP to prescribe them. I've explained to her I will only take them when the anxiety is unbearable and only a few 2mg ones. I'm hoping the consultant is a bit more understanding.
nicola1980
22-02-12, 18:18
Some gps are very reluctant to prescribe them could you maybe try another gp in your practise? I only get them as my gp knows i dont abuse them infact i hate taking them but ive been that bad anxiety and panic wise ive had too so i can function as a mum x x
Some gps are very reluctant to prescribe them could you maybe try another gp in your practise? I only get them as my gp knows i dont abuse them infact i hate taking them but ive been that bad anxiety and panic wise ive had too so i can function as a mum x x
I understand, she has prescribed me some. 3X7 so 21 2mg tablets since september. They lasted me about 5 months so not excessive at all.
nicola1980
22-02-12, 20:37
Well its obvious you dont abuse them so its a bit unfair that you cant get prescribed anymore especially as your meds arent sorted yet x x
Well its obvious you dont abuse them so its a bit unfair that you cant get prescribed anymore especially as your meds arent sorted yet x x
I can't force her to prescribe me them. She quotes the BNF which says it shouldn't be used for more than 3-4 weeks. Her point being 2mg a day for 3 weeks is 21 which I have had despite me taking that over months, not 3 weeks.
Not happy with the pyschiatrist at all, will ring tomorrow and ask how long I will need to wait to be seen by the consultant. Looked into going private but an initial assessment is £300 alone, and I think I would have to pay for meds on top.
nicola1980
22-02-12, 21:04
I looked into private aswel, my sister goes private as she has an eating disorder but fortunatly they have health insurance which covers it but she still just pays normal nhs perscription charges when they prescribed her meds x x
They ask you to sit in a chair facing a huge mirror , then they ask if you've been on holiday
They then fit you with a large apron and run there hands over you hair
Oh that's the hairdressers,So forget most of it apart from the chair bit
Good luck anyways
Thanks i'll let you know how I get on, I had been worrying myself about taking something different and having to come off the cit (withdrawals) and starting new meds (side effects) sometimes it feels like we're just going round and round in circles!!!!!! Still, we'll get there in the end and who knows may today the psychiatrist will have something amazing up his sleeze :-)
Hope you're doing ok xx
I have decided to go private, to speed things up. Got an appointment with a consultant pyschiatrist tomorrow, at a cost of £350 be best be good.
nicola1980
23-02-12, 14:21
good for you dan, i know its alot of money but hopefully it will be worth it, keep me posted how you get on good luck xx
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Thanks i'll let you know how I get on, I had been worrying myself about taking something different and having to come off the cit (withdrawals) and starting new meds (side effects) sometimes it feels like we're just going round and round in circles!!!!!! Still, we'll get there in the end and who knows may today the psychiatrist will have something amazing up his sleeze :-)
Hope you're doing ok xx
How did you get on? xx
good for you dan, i know its alot of money but hopefully it will be worth it, keep me posted how you get on good luck xx
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How did you get on? xx
Hopefully will be worth it. Will do. The idea is that the consultant will fax a prescription through to my GP who will then prescribe the medication so I don't end up paying silly prices.
Lol typical NHS, rang the trainee NHS pyschiatrist today, and she said that my case was discussed with her team and that they want to do a CBT assessment before discussing meds. This could take weeks. I am already at breaking point. Seeing a private consultant pysch this afternoon, I don't have a referral letter from my GP but if he decides meds are the right way forward he will liase with my GP. Hopefully he can issue me with a weeks supply of diazepam till he has spoken to my GP.
Before anyone tells me meds aren't the solution I understand but I have already tried CBT twice and want to combine meds and CBT.
nicola1980
24-02-12, 11:00
Good luck Dan, i totally agree with you that cbt isn't always just the answer and needs to be combined with meds, no meds aren't always the solution but for some people they are a life saver! make sure you tell this physchatrist everything, mine wrote nearly a 15 page essay on me when i saw her :blush: let me know how you get on xx
hi i see my pyschiatrist on monday, i have seen him before last year, but i am still nervous about going back.
i will write everything down, i think it is a good idea, as nerves take over xx
Good luck Dan, i totally agree with you that cbt isn't always just the answer and needs to be combined with meds, no meds aren't always the solution but for some people they are a life saver! make sure you tell this physchatrist everything, mine wrote nearly a 15 page essay on me when i saw her :blush: let me know how you get on xx
Thanks you have been really supportive :hugs:
I told the trainee pyschiatrist everything, she seemed disinterested, unsympathetic, had the people skills of a fish and I don't think she realised how badly it was affecting me. My GP is more supportive and willing to prescribe on a pyschiatrists say so hopefully should all go well.
Just wish I had private health insurance, but luckily my mum is paying for me... Thankfully she thinks my mental health is more important than her bank balance. Feel extremely let down by the NHS, but then again i'm sure others do too.
nicola1980
24-02-12, 11:44
If my physcahtrist appointment on the NHS didn't come through so quickly i was going to pay to go private and even tho it would of skinted us i didn't care my mental health is more important to me and my family xx
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hi i see my pyschiatrist on monday, i have seen him before last year, but i am still nervous about going back.
i will write everything down, i think it is a good idea, as nerves take over xx
Im back seeing mine again on Monday and even though i only saw her 2 weeks ago im still nervous about seeing her again, im going to write my feelings down i think as this week has been so hard for me that i think ill just break down sobbing pleading on my knees to her for help!! :ohmy: xx
If my physcahtrist appointment on the NHS didn't come through so quickly i was going to pay to go private and even tho it would of skinted us i didn't care my mental health is more important to me and my family xx
---------- Post added at 11:44 ---------- Previous post was at 11:31 ----------
Im back seeing mine again on Monday and even though i only saw her 2 weeks ago im still nervous about seeing her again, im going to write my feelings down i think as this week has been so hard for me that i think ill just break down sobbing pleading on my knees to her for help!! :ohmy: xx
Right ok, he was amazing. Listened fully to what I had to say, did a detailed examination. Prescribed me 50mg Pregabalin X3 daily. So 150mg, which will be increased to 300mg. Also prescribed me 30 diazepam 2mg tablets. Beats the 7 each time my GP was prescribing.
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Right ok, he was amazing. Listened fully to what I had to say, did a detailed examination. Prescribed me 50mg Pregabalin X3 daily. So 150mg, which will be increased to 300mg. Also prescribed me 30 diazepam 2mg tablets. Beats the 7 each time my GP was prescribing.
Forgot to say, he was a really funny guy. If anyone wants a recommendation, I am happy to PM you his name and number. He covers surrey and the London area but i'm sure its worth travelling a bit to see someone as good as him.
nicola1980
24-02-12, 16:00
Thats great that it went well and you actually got prescribed the meds you wanted :D have you got a follow up appointment with him? X x
Thats great that it went well and you actually got prescribed the meds you wanted :D have you got a follow up appointment with him? X x
He told me to ring in 2 weeks to see how I am doing. He has faxed a letter to my GP to prescribe me the next supply of medication on the NHS. Got a diagnosis of GAD + a fancy code. Cost me £72.50 for 14 days supply of pregabalin and £5.00 ( minimum dispensing fee) for 30 2mg diazepams. Cheapest was lloyds lol. He did say that in his experience pregabalin is a wonder drug, and that the NHS prescribe shitty antidepressants due to cost.
My advice would be to see a shrink if possible. They are very caring, have a lot more time to spend with you( 60-90mins vs 10 at GP) and are SPECIALISTS. They know a lot more than GPs.
If my physcahtrist appointment on the NHS didn't come through so quickly i was going to pay to go private and even tho it would of skinted us i didn't care my mental health is more important to me and my family xx
---------- Post added at 11:44 ---------- Previous post was at 11:31 ----------
Im back seeing mine again on Monday and even though i only saw her 2 weeks ago im still nervous about seeing her again, im going to write my feelings down i think as this week has been so hard for me that i think ill just break down sobbing pleading on my knees to her for help!! :ohmy: xx
If its this monday Nicola, i'm thinking of you. Hope it all goes well :bighug1:
nicola1980
27-02-12, 09:44
Thanks Dan, yep its today in an hour xx
nicola1980
27-02-12, 14:43
If its this monday Nicola, i'm thinking of you. Hope it all goes well :bighug1:
Hey, shes upped my mirtazapine to 30mg and got to go back in 3 weeks to see her again, was only in with her just over half an hour this time compared to the hour and half last time!! hows it going on the pregabalin? xx
Hey, shes upped my mirtazapine to 30mg and got to go back in 3 weeks to see her again, was only in with her just over half an hour this time compared to the hour and half last time!! hows it going on the pregabalin? xx
Is the mirtazapine helping you?
The pregabalin seems to be helping. Early days yet. No unbearable side effects. Went to tescos today to get my other medication and had no anxiety. Hope this continues :D
Dan, mind telling us what the mental health examination consisted of? talking or filling in multiple choice questions? what spectrum of mental health did the exam cover?
Dan, mind telling us what the mental health examination consisted of? talking or filling in multiple choice questions? what spectrum of mental health did the exam cover?
Well it basically consisted of a complete history. Imagine a time line of your life,you go through everything. they ask you lots of questions to find out your problems and how it effects you. They devise a care plan. No formal tests or sheets to fill in, as they are experts. Although dependent on the problem they might do it. Not sure really.
Its about an hour to 90 mins. You talk through possible treatments and meds and go from there really.
Well it basically consisted of a complete history. Imagine a time line of your life,you go through everything. they ask you lots of questions to find out your problems and how it effects you. They devise a care plan. No formal tests or sheets to fill in, as they are experts. Although dependent on the problem they might do it. Not sure really.
Its about an hour to 90 mins. You talk through possible treatments and meds and go from there really.
thankyou
that sounds good. Id need 3 to 5 hours at least though if not full day.
One hour flies by with me. I had alot to more to say to pscyhologist and i got my notes out, but as the hour was up, it was obvious they wanted me to stop. Slightly annoying. You cant be writing reports and making conclusions based on half the info......sigh.
guess it will be different for me, on NHS, i think i read you went private.
Do you get homework to do?
thankyou
that sounds good. Id need 3 to 5 hours at least though if not full day.
One hour flies by with me. I had alot to more to say to pscyhologist and i got my notes out, but as the hour was up, it was obvious they wanted me to stop. Slightly annoying. You cant be writing reports and making conclusions based on half the info......sigh.
guess it will be different for me, on NHS, i think i read you went private.
Do you get homework to do?
Well a psychiatrist is unlikely to cut you short, as they want the full info before making a diagnosis. They aren't going to sit 5 hours with you.
They are qualified docs, so are more concerned with making the diagnosis, prescribing and reviewing medication, and sending you for the right therapy such as CBT. They are unlikely to set homework, thats more the remit of your therapist.
I've been seen by a NHS psychiatrist, but she was useless and disinterested in me and my problems, so yes i went private. But my health is worth far more than his fees so it was a no brainer.
PM replied to aswell.
In my experience a first NHS psychiatrist appointment lasted about 30-45 mins. They generally ask all the questions and you answer them. To be fair, they are trained in psychiatry and know which questions to ask in order to get a good perspective of how you are feeling at the moment.
They tend to start by getting some background information, beginning with your childhood, your relationship with your parents, relationship with any siblings you may have etc. Who you live with...i.e. general questions about you. Then they will probably ask about your appetite, sleep patterns, suicidal thoughts. Things you used to enjoy but maybe don't enjoy anymore.
They seem to have standard questions that they ask all new patients and may ask you to elaborate on some of the answers if relevant.
Then more about you personally and how the way you are feeling affects you and your life. They sometimes ask to speak to a close relative or spouse to get their perspective on how you seem to feeling/acting.
Then, hopefully recommend some treatment, medication and/or psychology, hopefully both!
I've been under psychiatric care for twenty years now and have been under the care of three different psychiatrists.
Unfortunately, their time is limited and my usual psychiatrist appointments last about 15mins.
It's not like tv I'm afraid where they let talk as much as you want, but you are entitled to ask questions of course.
They're all different too. My current psychiatrist is very "straight to the point", some people find him abrupt, but he is very experienced, a Professor in psychiatry in fact and he really knows his stuff so I trust him. My boyfriends psychiatrist, whilst still a reputable consultant psychiatrist, takes a different approach, spends longer with her patients, but I still prefer mine because of his vast experience.
Hope this helps and good luck.
Do you have any idea how long you will have to wait for the appointment?
Haz. :)
---------- Post added at 23:06 ---------- Previous post was at 23:03 ----------
Sorry, I've posted this in the wrong thread! This reply was meant for "anybody".
Sorry Nicola for hijacking your thread. :)
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