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Ask A Therapist: What Should I Expect On First Psychiatrist Visit?

I have suffered with severe depression for about 25 years now. At last someone has listened to me and I have been referred to see a psychiatrist as i feel that maybe there is more going on than just depression. I feel very suicidal, I self harm, I hear voices that no one else can here and I’m also seeing things. I am a bit worried about seeing the psychiatrist as I don’t know what to expect. I was told that they would assess me, what does this involve and will they be able to tell on the first visit what is going on.

A: I’m so glad that you’re going to meet with a psychiatrist for an evaluation. You’re describing serious symptoms that need to be addressed immediately. Watch the video below for my complete answer…

Take good care of yourself!
Julie Hanks, LCSW

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Ask A Therapist: How Often Should I Meet With My Psychiatrist?

Q: I have been seeing my therapist for almost 2 years, and I just had my first psychiatrist appointment 2 weeks ago (per my therapist’s referral). The psychiatrist wants me to come back every month, but I would much rather see my therapist more often. I think some insurance companies count the number of overall mental health visits per year and I don’t want to “waste” them. I am “real” around my therapist and I know that it will take a long time for me to open up to my psychiatrist. Can I mention this to my therapist next week or is that a bad idea since they communicate with each other? I guess my thoughts are every 2-3 months would be sufficient and my therapist could certainly tell him if my status changes for me. I know I shouldn’t, but I do put up a fake “front” in front of the psychiatrist. Any suggestions on what to do? This is all new to me!!

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Ask A Therapist: Depressed, Anxious, and Socially Awkward

Q: I don’t remember a time in my life where I’ve been totally happy but for the past approximately 2 years i have been extremely depressed as a result of my social anxiety and loneliness. I have always found social situations ‘awkward’, in fact the last time I remember frequently leaving my house for social reasons was when I was about 13. I then became more and more of a recluse from there on, i went out with my friends less and less outside of school, then upon leaving school i stopped doing things with my friends more and more until the point where i have not left my house for social reasons for about 2/3 years. I no longer have any friends and although my family is nice and supportive they cannot provide me with what I need. I have not spoken to anyone in person about my problems, I simply can’t. My parents will just tell me to go to a doctor. Doctors will just prescribe me with a drug that I don’t want. I don’t feel a psychiatrist can help me. I’ve become extremely lonely and depressed. My self esteem is extremely low and although I’m not a bad looking person I simply cannot accept my imperfections, no matter how hard I’ve tried. I feel I am in so deep that I cannot make a recovery. I cannot throw myself into social activities to make friends because of my social anxiety. I no longer find anything enjoyable and nothing at all interests me, this leaves me with the motivation to try nothing. I feel like I’m in a corner with no way out, every possible path I need to take to fix myself, I cant bring myself to walk down whether its my self esteem, depression or social anxiety stopping me. I hate it and I hate the person I am, I’m so sad it hurts. I feel so lost and lonely I cry randomly, its pathetic. There is no reason why I should feel like this, I’ve had a very normal life without any trauma, this only makes me feel guilty for the way I am. Guilt I don’t deserve to feel when there’s so many more out there in far worse situations.

I just want to live my life and be happy, but I truly believe I will never get there. Sometimes I feel like giving my life and donating what i have to give someone else a shot at life. Someone who can appreciate life.

I have read a lot of advice online about people in similar situations to myself but what are my options when the things I need to do to fix myself, I simply cannot bring myself to do?

A: Thanks so much for writing in and reaching out for help. I have seen many clients in my therapy office who express similar feelings of hopelessness, worthlessness, focus on their own imperfections, and have extreme guilt for feeling so sad and lonely because they’ve had a “pretty normal life.” It sounds to me like you are suffering from severe depression and anxiety that are keeping you in a downward spiral, unable to reach out for help. The good news is you have reached out on this forum, so I am very hopeful that you can reach out in other areas.

I urge you to talk to your parents and ask them for help. You said you haven’t talked to your parents because they will tell you to go to a doctor. If they love and care about you they will tell you to go to a doctor or a therapist because that’s the right thing to do when a family member is ill. I suggest that you keep an open mind about medication. While it doesn’t need to be the first course of treatment, it can definitely be a helpful tool in treatment. Ask your doctor for a psychotherapist referral as individual psychotherapy can be very effective. Often, a combination of medication and psychotherapy can be effective in treating depression and anxiety.

In order to experience some change in your life and find happiness you will need to take some action, even if you don’t want to, and even if it’s a small one – like talking to your parents about how hopeless you feel. You can do it. It sounds to me like what you’re experiencing isn’t really “you” but is mental illness clouding your thoughts and feelings. You can have more satisfaction and joy in living than what you’re experiencing.

Take good care of yourself!

Julie Hanks, LCSW

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Ask The Therapist: Psychiatrist Talks To Mom And Ignores Me

Q: I have bipolar disorder, along with ADHD and OCD. Recently, I have started going to see a psychiatrist about my issue. But when I go to her, I feel as though she doesn’t ask ME how I am, she asks my mother. There are so many issues I need to tell her, but I simply do not feel like I can. I am worried about myself. All I want to do is lay in bed. Please, tell me what I need to do to tell her about my issues. I tried writing them down to tell her, but I did  get the chance, because she only had a 2min session with me, after talking to my mother. Help!

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Ask A Therapist: My Best Friend Is Suicidal

Q: My best friend is suicidal and I want to know if there is anything I can do to help her. She has already told her parents but they really aren’t doing anything to stop her. I have told a teacher at our school and the counselor but all they do is recommend seeing a psychiatrist. I am really worried about her she almost always has cuts all over her body arms, legs, and stomach. Her mother has been in and out of prison even before she was born. Her mother is also in right now and has been since she was 7. In the past few years she has had a lot happen, she lost her grandmother on her dad’s side two days before Christmas in 2008. Right after that she moved from a big house to a small one and in the process lost connection with her former best friend. Many of her animals outside died and she sat with one of her cats and had to watch it die after it got attacked by a dog. This past year she had her aunt on her dad’s side die and lost a lot of her friends. She also found out that her mother was diagnosed with bipolar disorder by four different psychiatrists and borderline personality disorder by one or two. We were in seventh grade this year and for most of the second semester she was labeled a whore because of how she dresses and who hangs out with. This past summer is also when the cutting started it started off pretty bad but not frequent. It then went to minor burns and small scratches and then blew up again to bad cuts and they were very frequent. At the current moment she only has scars but is thinking about cutting herself again. I would just like an idea of what I could say to her to get her not to cut anymore. Thank you for taking the time to read this (and respond if you do).

A: First of all, your friend is lucky to have such a mature and concerned friend like you. For 13 years old, you are wise to get some advice on how to handle this serious situation. You mentioned that your friend is suicidal. Has she told you that she has plans to end her life or are you suspecting that she is suicidal because of her cutting behavior? Often intentional self-harm, or parasuicidal behavior, is a cry for help without an intention to die. The two are related but don’t necessarily go together.

Does your friend acknowledge that she needs help to address her cutting? If so, she may want to ask her parents to take her to their family doctor. Sometimes parents are more willing to take their child to get “medical” help than “mental” help. Also, have you talked to your parents or guardian about this situation and asked for their help and advice? It may be a good idea to sit down with your friend and both sets of parents and express your love and concern and see how you and your parents can support your friend.  Another possible resource is Childhelp national hotline. You can tell them about your concerns with your friend and they will identify resources in your area.

If your friend’s parents are fully aware that their daughter is cutting and in need of psychological intervention and they refuse to get their daughter the treatment she needs, then this may be a case of medical neglect requiring or your parents to report the situation to child protective services. I hope it doesn’t come to that. Thank you again for writing in to Ask the Therapist.

Take good care of yourself.

Julie Hanks, LCSW

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