Do I Have to Continue Seeing a Pyshcatrist at the V a
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If you've been experiencing symptoms of depression, anxiety, and stress and you feel like medication might be helpful, you may want to find a psychiatrist. If you're unsure where to start, you're not alone. Below are some ways to support your journey.
There are several resources — online, in your community, and through a primary care doctor — that can help point you in the right direction.
Before you get started, it's important to point out that psychiatrists are different from other mental health professionals. Unlike psychologists and other therapists, psychiatrists are medical doctors; therefore, during your appointment, they will evaluate for any co-occuring medical diagnoses, and then can prescribe and monitor psychotropic medication.
Some psychiatrists specialize only in managing medication, while others offer comprehensive services that include:
- evaluations
- diagnosing mental health conditions
- prescribing and managing medication
- providing therapy
Plus, psychiatrists often have experience working with a wide array of medical diagnoses, making them equipped to diagnose any additional disorders that may be exacerbating symptoms.
With that in mind, here are some tips to help you continue your search.
Psychiatrists typically approach and treat mental health issues from a biological perspective, in addition to psychosocial approaches.
Psychiatrists need to have one of two medical degrees: an MD (doctor of medicine) or a DO (doctor of osteopathic medicine), along with advanced qualifications from their 4-year residency and a psychiatry specialty.
These types of doctors are trained in various areas, such as genetics, neurology, biochemistry, or psychology, among others.
Psychiatric specialty areas include:
- addiction medicine
- pain medicine
- geriatric psychiatry
- child and adolescent psychiatry
- forensic psychiatry
- sleep medicine
Psychiatrists vs. psychologists
Psychologists evaluate, diagnose, and treat mental health symptoms by reviewing the person's history and current challenges and identifying presenting symptoms. The psychologist will then identify a diagnosis and a treatment plan, which will include the recommended number of sessions, treatment goals, and action steps. This plan will be reviewed often by the psychologist and client to check in on progress.
Psychologists may provide interventions and education about ways to reduce negative thinking and identify unhelpful behavioral patterns. Often times, psychologists will work together with a psychiatrist (sometimes in the same office and sometimes in different practices) if the person needs to be evaluated for medication and subsequent medication management.
Psychologists must hold a doctoral degree and typically specialize in a certain area. For example, they might have a marriage and family therapy (MFT) license, which requires a master's degree, and doctorate-level psychology training, such as doctorate (PhD) and doctorate in psychology (PsyD) degrees. They also need the relevant state licensing and certifications for the treatments they offer.
Psychologists work in similar settings as psychiatrists, such as clinics, private practices, and schools.
Psychologists often use different types of therapy to help identify and treat mental health symptoms. Some types they may use include:
- talk therapy
- cognitive behavioral therapy (CBT)
- dialectical behavioral therapy (DBT)
- interpersonal therapy
- art therapy
Psychiatrists vs. therapists
A therapist focuses on learning the overall picture of your life and mental state and helping you express and address your feelings constructively. They walk you through helpful decision making processes and use talk therapy to provide support.
Therapists (sometimes called counselors) could have education and training in psychology. Or, they might study:
- sociology
- childhood development
- education
- social work
Therapists can be:
- licensed mental health counselors (LMHC)
- licensed clinical social workers (LCSW)
- psychologists (PhD or PsyD)
- psychiatric nurse practitioners (NP)
- psychiatrists (MD)
Ask a general physician or other healthcare professional
If this is your first time inquiring about mental health care, it's a good idea to have a conversation with a doctor or therapist. They may be able to recommend a psychiatrist or help you find one that focuses on your concerns.
Psychiatrists can provide comprehensive treatments, including psychotherapy and medication management. However, if you already have a therapist you like and want to remain with them, many psychiatrists can collaborate with your therapist.
But if you don't have a regular doctor or therapist, you can always go to a walk-in clinic and talk with a healthcare professional and ask for a referral.
Checking community clinics
If there's a community mental health facility in your area, a patient care coordinator may be available, and they can assist you.
Look for psychiatrists based on their specialties and areas of focus
When looking for a psychiatrist, it's important to find one specializing in the diagnosis or concern you're seeking help for.
It may also be important to you to find a psychiatrist who has worked with other people with a similar background to yours or who is easy to talk with about your perspectives.
If you're uninsured, the first step, according to Magavi, is to contact a local National Alliance on Mental Illness (NAMI) representative. They can help you find affordable mental health care in your area.
She also recommends contacting the Substance Abuse and Mental Health Services Administration (SAMHSA), which is a reliable resource you can use to find affordable mental health care, including psychiatrists and therapists who accept Medicaid.
Most regions also have federally funded health clinics, which you can visit or call.
Another resource for free clinics is the National Association of Free & Charitable Clinics, Magavi said.
"Additionally, some teaching and academic institutions offer discounted rates for various forms of treatment inclusive of pharmacotherapy and psychotherapy," she said.
For veterans, Magavi suggested checking out Give an Hour, a national nonprofit that provides free and confidential mental health care to those who are serving, veterans, and their families.
Finally, if your employer offers an employee assistance program, ask about the number of sessions covered under your plan.
Several health insurance plans cover mental health treatment. Your first step is to look over the description of your plan's benefits and determine whether you have coverage for behavioral health.
Next, figure out what's actually covered. Try to determine:
- how many sessions are covered
- the percentage of coverage
- in-network versus out-of-network costs
- whether you need a referral from a primary care doctor
- what your out-of-pocket deductible cost is prior to coverage
- any maximum amounts for out-of-network physicians
You have a couple of ways to find a psychiatrist based on your insurance.
If you haven't chosen a provider, you can call the insurance benefits office and ask about providers in your area. They should have a list of preferred medical professionals and facilities that accept your insurance. They can also answer any questions you might have about benefits and costs.
If you have a psychiatrist in mind, call the office and ask if that person takes your insurance.
The Department of Health and Human Services has an up-to-date
If you prefer to engage with a psychiatrist online, there are a number of quality telehealth networks that offer this service. Here are a couple of examples:
Doctor on Demand
Doctor on Demand offers a range of mental health support services through psychiatrists from various backgrounds and specialties. Appointments cost $299 for an initial consultation and $129 for each follow-up appointment.
Doctor on Demand psychiatrists can prescribe some medications at their discretion, as long as the medications do not have a Drug Enforcement Administration (DEA) Schedule I to V classification or require an in-person visit with a local psychiatrist in your area.
Lemonaid
Lemonaid offers a variety of mental health services, including those targeted to help with:
- anxiety
- depression
- health and wellness
The consultation fee is usually $25, which includes an evaluation and a prescription, but excludes the cost of your medication. Services like those for depression and anxiety are a flat monthly fee (contact Lemonaid to confirm this) that includes consultations and medications that they prescribe and ship.
Available prescriptions include:
- Sildenafil
- Viagra
- Cialis
- Cialis Daily
- Tadalafil
- Finasteride
- Sprintec
- Lexapro
- Zoloft
- Wellbutrin
- Prozac
- Amitriptyline
- Errin
- Ortho Tri-cyclen Lo
- Bupropion
- Escitalopram
- Fluoxetine
- Sertraline
Other resources to help you get started with teletherapy include:
- Amwell
- BetterHelp
- MDLive
- Online-Therapy.com
- ReGain
- Talkspace
Child and adolescent psychiatrists specialize in general psychiatry, but they also have additional training focused on mental health needs specific to children and adolescents.
In addition to diagnosing mental health conditions, they can also prescribe medication and provide psychotherapy.
The American Academy of Child and Adolescent Psychiatry (AACAP) has a tool on its website that allows you to locate psychiatrists who have reported to the AACAP that they provide psychiatric care for children and adolescents.
If locating a child and adolescent psychiatrist in your area is challenging, you may want to consider a child psychologist or a marriage and family therapist as they're also trained to work with kids and families. Taking this first step may assist in identifying other treatment sources for medication management.
Mental health experts specialize in treating certain conditions, as well as the type of therapy they provide. If you're seeking care for depression, you should ask about the techniques they use for treatment.
Some of the more common types of psychotherapy for depression include:
- behavioral therapy
- CBT
- dialectical behavior therapy
- interpersonal therapy
"One of the most important factors — besides being put on the correct medication — for depression prognosis is called a therapeutic alliance," said Julian Lagoy, MD, a psychiatrist with Mind Path.
Therapeutic alliance, he said, is essentially how well you get along and "click" with your psychiatrist.
Lagoy says some objective things to look for when choosing a psychiatrist for depression include:
- Looking at their reviews on the internet. But proceed with caution, because sometimes people write bad reviews for no rhyme or reason. Although, Lagoy did point out that consistent negative reviews can be a red flag.
- Asking a trusted family member or friend. It can be helpful if you have a trusted family member or friend who has experience working with a psychiatrist and can give a good recommendation based on their care.
- Finding a psychiatrist who combines therapy and medication. Lagoy recommended looking for a psychiatrist who likes to do therapy in addition to medication management. "This is an indicator that they have a good, caring personality, and you will most likely have a good therapeutic alliance," he said.
The only way you can honestly know if a psychiatrist is the right fit for you, said Lagoy, is to meet with them.
"Sometimes, a psychiatrist looks great on paper, but then when you meet them, they are simply not a great fit for you," he said.
However, the opposite can also be the case: A psychiatrist can look just OK on paper but feel like a strong fit because you click when you meet, he added.
The best you can do is try to find someone on paper who you think will be good for you, and then meet them in person to make a decision.
"You want to be able to build trust with a psychiatrist and get along with them, but you also want to have a psychiatrist who is intelligent and up to date with their knowledge," said Lagoy.
"You should feel heard and valued by your psychiatrist and feel comfortable voicing your concerns and feedback," said Magavi. For example, if a medication does not work for you, the psychiatrist should take in this feedback and make appropriate adjustments, according to Magavi.
Find a psychiatrist who can relate to you and understand your perspective.
Signs that it might be time to change mental health professionals, said Lagoy, include when someone:
- does not listen
- does not give good advice
- is incompetent, rude, arrogant, or disrespectful
Here are some tips and suggestions for making the most of working with a therapist:
How do I know when to see a psychiatrist?
If you're experiencing symptoms of depression, anxiety, or stress and feel that medication could help, you might want to explore the option of seeing a psychiatrist. This might be the case for you if you've been speaking with a therapist or psychologist already but don't feel that you're making enough progress.
How can I find a psychiatrist?
Ask your doctor or therapist for a referral (or walk-in clinic if you don't have one) or check your community mental health facility. You could also look online or in your community for psychiatrists based on their specialties and areas of focus. This means doing your research and asking questions about your particular circumstances so you can find a good match.
What can I expect when I see a psychiatrist for the first time?
At your initial psychiatry appointment, be prepared to discuss your medical history and answer questions about your past and what's going on currently. You'll talk through what you've been experiencing and create a plan for the future. Throughout all of this, remember that it's completely normal and OK to feel emotions of all sorts.
Finding a psychiatrist or therapist who's a good fit may take some time.
Consider asking your doctor for a referral or a trusted friend or family member for a recommendation.
Look online for resources that can match you with a mental health professional in your location. Also, consult your insurance company for information on coverage and costs.
Working with a mental health expert like a psychiatrist can provide you with a safe environment to work through concerns related to your mental and emotional well-being.
Source: https://www.healthline.com/health/how-to-find-a-psychiatrist
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