choosing a psychiatrist

[Ms 45]

I realize that this forum is for poker psychology, but I haven’t been able to find a more appropriate place to ask this question, so here goes…

I have decided that I would like to see a mental health professional, but I have a series of questions that I would like to have answered before I go.

First, how do I go about picking one? I don’t have a physician who can recommend one for me. In fact, since I’m new to the area I don’t know anyone at all who can recommend one to me. I would like to do something more advanced than just picking a name out of a directory, but I'm not sure how to go about this.

Should I see a psychologist or a psychiatrist, or doesn’t it matter? I strongly suspect I am manic/depressive, so I don’t know if this should influence my decision on which to see.

Since I don’t have insurance and make lower/middle income, will I be able to afford long-term treatment?

Are there more appropriate places on the web to ask these sorts of questions? I’m sure there are, but I haven’t been able to find any browsing the internet.

Thanks in advance.

[pc in NM]

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Should I see a psychologist or a psychiatrist, or doesn’t it matter? I strongly suspect I am manic/depressive, so I don’t know if this should influence my decision on which to see.

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The primary difference between a psychiatrist and a psychologist is that the former is a MD, and can prescribe meds (psychologists can do some prescribing in some states). If you are bipolar (current term for "manic depression", medication would be likely, so that would predispose towards a psychiatrist. Both will be at the high end of the cost continuum, however, so getting counselling from either might be expensive....

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Since I don’t have insurance and make lower/middle income, will I be able to afford long-term treatment?

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Community Mental Health Centers typically have fee adjustment schedules, and are more likely to offer an array of services such as counseling and education, in addition to "just meds". You want to go to a place that will perform a good assessment, including for substance use issues, and ask for counseling, not just medications.

Remember that you are the "customer", and don't hesitate to ask for what you want, and to assert your interests and preferences throughout the process....

[chesspain]

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I have decided that I would like to see a mental health professional, but I have a series of questions that I would like to have answered before I go.

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I am a clinical psychologist, and I'll try to answer the following questions for you:


[ QUOTE ]
First, how do I go about picking one? I don’t have a physician who can recommend one for me. In fact, since I’m new to the area I don’t know anyone at all who can recommend one to me. I would like to do something more advanced than just picking a name out of a directory, but I'm not sure how to go about this.

[/ QUOTE ]

Even if you think you are in good health, I would recommened that you first try to find a primary care physician. This individual will perform at least a basic screening physical to rule-out possible medical reasons for your symptoms, and can help you to find an an appropriate mental health professional.



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Should I see a psychologist or a psychiatrist, or doesn’t it matter? I strongly suspect I am manic/depressive, so I don’t know if this should influence my decision on which to see.

[/ QUOTE ]

If you actually have Bipolar Disorder (i.e. manic-depression), it will be helpful to have a psychiatrist or psychiatric nurse-practitioner for medications, since psychologists can't prescribe medications, and most primary care physicians aren't trained in the nuances of managing patients on medications for Bipolar Disorder.



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Since I don’t have insurance and make lower/middle income, will I be able to afford long-term treatment?

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Treatment should be available to you at a local mental health center, which will likely have a sliding scale based on income.

Good luck to you.

[Shaman]

How can you expect people to give you a recommendation when you're not telling them which city or state you're from?

[Kopefire]

In addition, many private practitioners will have income adjusted scales. A lot of this depends on the state you reside in -- in some states, if a private clnician accepts any state insurance, they are required to offer income adjusted rates to all patients.

[Ms 45]

I was looking more for heuristics for choosing someone rather than the name of a specific doctor.

[MRBAA]

You will almost certainly want a psychiatrist. Drugs like Prozac have been truly life-changing for many depressives and manic/depressives. I'd advise finding hospitals that offer residencies in psychiatry in your areas (seek out the best know private or esteemed public ones) and see if you can get recommendations from the staff psychiatrists. I'd advise meeting at least two or three. Be prepared to invest $1,000 in 6-8 sessions (rates vary by city). There's nothing wrong with letting the psychiatrist know upfront that you have limited resources. However, "full price" is usually from $125-$250 for a 45-minute session, so even a cut-rate will be costly. However, investing a few thousand to find an effective drug and get your dosage working could be a great investment. And along the way, you may also find that discussion your issues with a professional will help you to organize your life in a way that will help you avoid problems.

[bdypdx]

I ran across this book:

Shrink to Fit: Answers to Your Questions About Therapy
by Dale A. Masi, Robin Masi, Robin Masi Kuettel

Seems to have decent advice.

See if your library has it.

[Shaman]

I just sent you a private message.

[skibum]

No matter the reason, go get help. In the early 90's I went through extensive therapy with a psychologist because my world came crashing down. I cried a river of tears while spilling my fears, and I've never been the same since. Thank God. And Lou. Especially Lou. Because I was able to share this experience with certain friends through the years, they also were able to get the guidance they needed without feeling alone, or stigmatized, or weak. For me, it was Amazing Grace. And hard work. Lots of hard work.

I personally would prefer a psychologist, but I don't know if this is just a predjudice, and I certainly know nothing about manic depression. My intuition is they have better counseling skills. If you need meds, he or she will refer you to a MD for a prescription. I was only able to pay a small percentage of what were normal fees due to my financial circumstance at that time. There is help available. I truely thank God I'll never be normal again. And Lou. Especially Lou.

Good luck, and God bless you for reaching out. I wish I could be of more help, but you will be in my prayers.