No more than meeting a therapist for the first time, meeting a psychiatrist can seem overwhelmingly daunting, not least because we’re conditioned to believe a number of things about psychiatry:
- It’s only for crazy people
- All they’ll do is prescribe drugs
- They’re in league with big pharma
- They’re quacks
And on and on it goes. When psychiatry was first mentioned to me I nearly lost my life, primarily because I firmly believed it must have meant there was something seriously wrong with my mind.
Four years ago I reached the point where I had no choice but to attend, and so began my adventures with the Galway Adult Mental Health Services.
As with every aspect of our health service, there is a gaping chasm in terms of provision between public and private. As I attend Galway as a public patient, and have done since my first admission in 2012, I can only comment on the public side of things.
The world of psychiatry for a public patient is a confusing one. As I understand it (and I’m open to correction on this) each patient is assigned to a team, with the team consisting of a consultant, registrars on rotation, psychologists, clinical nurse specialists, community mental health nurses and social workers. There may be others, but these are who I have encountered over the years.
During the time that I’ve been engaged with psychiatric services, I’ve lost count of the number of doctors I’ve met, albeit all under the management of one consultant. The majority I only saw once or twice before they rotated elsewhere.
One of the biggest challenges this created was that I believed every time I met a new doctor they knew nothing about me. It never occurred to me that my case may already have been discussed at team meetings, that they had the background necessary, and were simply trying to gauge how I was on any given day.
However, with hindsight I can appreciate that this perception was probably more than a little skewed. One of the many difficulties of being mentally unwell is that we tend to see the world through a very distorted filter. What I mean by this is I was hearing a group of words but interpreting it according to how I felt at the time, if I even managed to take anything from it at all.
If I wanted to believe they didn’t care and knew nothing about me, there’s not a force on this earth could have convinced me otherwise.
There’s one thing I cannot recommend highly enough – if at all possible take someone with you to these appointments, particularly the first one. When we’re feeling vulnerable, particularly in a crisis, it is really really hard to articulate what the problem is, especially as it’s most likely quite a complex situation.
It’s equally hard to comprehend what is being said to us, and having someone there who can ask questions, and maybe fill in any blanks we’ve left, can be invaluable. I know that I certainly came away from appointments with one version of events in my head, while my husband had another entirely. The reality was usually somewhere in the middle.
As for medication? Yes, psychiatrists tend to prescribe.
They’re doctors, and that’s what doctors do when the situation requires it. If I went to my GP with a strep throat, I’d expect to come away with a prescription for antibiotics. The only difference.. well ok, one of many, with psychiatric medication is that it’s long term and it can take a while to settle on something that works.
Medication is by no means a cure though. It simply gets us to a point where we can start to address the underlying issues that are the root cause of our distress. Insulin doesn’t cure diabetes, but it stabilizes diabetics so that they can make the necessary lifestyle changes to minimize the impact of their condition. This is the same.
It has taken a long time, and certainly the nature of the public mental health service hasn’t helped, but I finally trust my consultant, and I do believe she has my best interests at heart.
For a long time, I fought and railed against medication, but now I understand that she knows a hell of a lot more about this than I do, and I trust her judgement. As long as I feel I’m being heard, I’m willing to listen.
Whether you meet a psychiatrist publicly or privately, being able to trust that person is absolutely crucial.
Try to leave preconceived ideas about what they’re going to say or do at the door. Take someone with you. Make notes ahead of time if you’re afraid you’ll forget something, and don’t be afraid to take notes either. Ask questions, as many as you need.
This is their job, but it’s completely alien to most of us. Having a good understanding of why they’re treating us with a particular medication or therapy will make a huge difference in accepting and hopefully improving the situation.
Last but not least – psychiatry, like therapy, is not a quick fix. It’s a stepping stone – one the vast majority will hopefully never need to use – but if you do, there’s no shame in it.
They are simply doctors trained to work with a specific area of the body, in this case, our mind. It will be ok.
Fiona Kennedy writes regularly about mental health issues on her blog sunnyspellsandscatteredsh