One of the most challenging things for the mentally ill these days is to find a competent psychiatrist. As someone who has struggled in the past with a few bad psychiatrists, I have a few things that I want to discuss. Although you aren’t going to know whether a psychiatrist is good until you go in for a few sessions, it is pretty easy to get a general idea of whether or not they are good or not. If you have a good psychiatrist, you don’t really need to read this article because much of what I am about to say you likely already know.
My experience with a bad psychiatrist
My very first psychiatrist I thought would help me get my anxiety disorder under control and help me overcome my depression. I would go in every 6 weeks or so, report my side effects from the medication that I was on, and I never got relief. I tried about 10 different antidepressants and nothing worked. For most of the medications, all this guy did was try to up the dosage or keep pushing his sample packs on me with new medications.
Additionally he didn’t really pay close attention to the strong side effects I was having. He kept telling me to stick with the drug even though I reported a strong dislike for what I was experiencing. The funny thing is that in all the cases of strong side effects in the first month, not only did I feel worse, but in all of the cases the medication didn’t work – it made my depression and anxiety symptoms worse.
After trying a lot of antidepressants for my depression and having no success, he made the statement that I may have “premorbid schizophrenia.” After he said that, he prescribed an antipsychotic. I took the antipsychotic medication for 2 days before feeling so tired and literally screwed up to the point that I could barely walk.
When I realized it was having such a powerful effect I read about the medication, looked at the side effects, threw the pills away and said I’d rather deal with the severest depression than be on an antipsychotic medication. I stopped seeing this psychiatrist and have fortunately found a new one that doesn’t think I have any premorbid symptoms of schizophrenia.
What To Look for In A Good Psychiatrist
1. Experience – One good quality is experience. If the psychiatrist has a lot of experience, they have likely dealt with many patients and know what types of treatment options tend to have a higher success rate than others.
2. Up-to-date – Is the psychiatrist up-to-date with the latest research and literature? If not you may be prescribed medications that are less effective than current remedies. You want someone that knows any groundbreaking new studies and that is constantly checking for new solid research.
3. Aware of new treatments – Part of being up-to-date is having an awareness of newer treatments. For example, some psychiatrists may not be aware of the fact that stimulants may be an adjunctive treatment to an antidepressant in cases of treatment-resistant depression.
4. Willingness to work with you – Although the psychiatrist went to school to understand medications and treat mental illness, they need to be willing to work with you. If you are sick and tired of a certain class of medication, you should have some input as to the direction you go next. There needs to be some sort of give-and-take relationship between you and your psychiatrist for it to be successful. Otherwise you will feel like a helpless slave susceptible to getting drugged up.
5. Thinking outside of the box – You want a psychiatrist that thinks about your individual case and tries to come up with a better solution if nothing is working. My current psychiatrist thinks outside the box and has suggested alternative treatments that didn’t even involve medication. He then was able to cite research backing his train of thought; this is what you want.
6. Experimentation – If a certain class of drugs isn’t working, it may be time to experiment and try something new. For example, if you’ve tried all SSRI’s to treat depression and none seem to work, your psychiatrist should think about experimenting with a different class like MAOI’s, Tricyclics, or even stimulants.
7. Not mindlessly pushing drugs – Psychiatrists that push drugs without listening to your symptoms or the type of depression that you are dealing with are doing you a disservice. If you have severe anxiety that is causing you to be depressed, maybe it’s a better idea to consider an anti-anxiety medication instead of just something for depression.
8. Mindful of your side effects – If there are certain side effects that you are not willing to put up with, let your psychiatrist know right from the start. By letting them know, you can narrow your search down to certain drugs that have a low side effect profile for certain things like weight gain or decreased sex drive.
9. Changing the dosages to help – Psychiatrists that realize dosages totally depend on the individual are superior to those that assume 20 mg is going to work for everyone. Certain people may have an antidepressant effect lower than the standard therapeutic dose while others may need more. It is good to always start low and titrate upwards until you feel like the medication is working.
10. Realizing the dangers of medication – Most psychiatrists tend to believe that medications for the most part are good. To a certain extent, they are correct – most medications had to pass rigorous testing and get approved by the FDA. Although FDA approves medications, it doesn’t mean 10 years from now there won’t be thousands of lawsuits against the drug companies for dangerous side effects. You want a psychiatrist that knows some of the crazy side effects that aren’t typically reported by the mainstream media.