There are times when medication needs to be considered as part of an overall treatment plan for mental disorders. A primary care physician may be able to do the job, but if the situation needs more frequent or specialized attention, a psychiatrist may be needed.
A psychiatrist is a medical doctor who specializes in the treatment of mental disorders. The right match between doctor and patient is extremely important and increases the likelihood of finding the right medication . A positive initial experience, with the doctor, helps forge a working relationship that is necessary for a successful treatment outcome. Patients need to feel that they are being listened to and know that their feedback is necessary and essential.
Sometimes finding the right medications and dosages requires trial and error. Without teamwork a patient may not stick to the treatment plan. A negative first impression may completely turn the patient off to medication altogether. It is important to be prepared to educate the doctor about the problems and issues and ask questions that will ease the anxiety that is normal when considering medication. Cooperation between patient and doctor will expedite the fine tuning that is needed to reduce side effects and prevent negative outcomes. The outcome will be more positive if the patient takes responsibility for making sure they are satisfied with how the appointment progresses.
Too often I hear that the first appointment with the psychiatrist was too short. Frequently the patient has not prepared for the appointment and assumes a passive role. I think it can be very helpful to prepare some questions ahead of time. When should I expect to feel an effect? What are the potential side effects? What should I do if I have a problem? How will they interact with my other medications? When and how would I stop the medication safely? Is medication even appropriate for me? What about my medical issues?
A written outline of the problem and a time line, along with a list of questions, will create a structure for the appointment that will help meet the needs of the patient and give the doctor more pertinent information. If the patient can assertively and concisely describe the problem symptoms and ask questions, the doctor will get more information quicker and be able to efficiently make a needs assessment.
It is extremely important that the patient leaves the appointment feeling comfortable and reassured that he or she was heard. All medications have side effects and should be considered carefully. The right medication can mean feeling better and functioning normally again versus the wrong medication which could be dangerous. In some cases, certain antidepressants called selective serotonin re-uptake inhibitors, when given to someone who has an underlying bipolar condition, can cause a manic episode. Another medication can cause a rare but sometimes fatal rash. It is important for patients to know what they are taking and the potential side effects.
While it sometimes differs by state, in California, a split model of treatment is normally used. This means a therapist provides the psychotherapy, sometimes referred to as talk therapy and a psychiatrist provides medication management. A patient's first contact may be with a qualified therapist. This could be a licensed psychologist, a licensed marriage and family therapist or a licensed clinical social worker. Any of them can conduct an evaluation and make an assessment of the problem. After the evaluation they will formulate a treatment plan specific to the needs of the patient and make recommendations. Psychological or neurological testing may be needed to identify illnesses that are deep-seated and difficult to narrow down. This is normally done by a psychologist. If it is decided that a psychiatrist should be consulted to determine the appropriateness of medication, a referral will be made. It is important for all of the providers that are involved to communicate and coordinate care so that no one is working at cross purposes.
Most providers, in the medical and mental health field are conscientious, ethical people who want to help their patients get better. However, if the patient will take an active role and express his or her needs in an assertive way, the help they receive will be better and faster. After all, they are the most important member of the team.