When you go to a psychiatrist appointment, a general practitioner appointment, or a therapist appointment to address your mental health issues it can be scary, especially if it’s your first time. I was terrified the first time I decided to see a therapist when I was 20 years old. I was alone, I had no support, I didn’t know anyone who had seen a therapist, and I had stress diarrhea for weeks. The first time I brought up my depression with my general practitioner was scary also because I was terrified that he wouldn’t take me seriously. The first psychiatrist appointment ever was daunting because I didn’t want to believe that I needed a psychiatrist.
I imagine I’m not alone in my fears because living with mental illness is scary. We are up against a stigma that spreads through almost all parts of our lives. Even when we ask for help, things can go wrong. But when things go like they’re supposed to, there is progress. I have been to many therapists, may psychiatrists, many GP’s for mental health, and I’ve seen good ones and bad ones, and ones that have just not worked for me. Here are a few things that I wish I could have known when I started treatment. If you are considering getting help for your mental health, I applaud you and hope this helps.
Q: What will a therapist do on my first visit?
A: They will introduce themselves, and they will ask you why you came in. This is not a judgement, they want you there, and they want to know how to help you. Even if you aren’t able to be articulate why you’re there, do the best you can. They will ask you questions and lead the conversation when you’re not able to.
Q: What if I’m embarrassed by something I need to talk about with my therapist.
A: Your therapist will never judge you. The truth is that they’ve probably seen it all. I tend to seek out older therapists who have been practicing for a long time because there is literally nothing you can say that will surprise them. Being honest is the only way to make true changes in your life. You’ll get out what you put into therapy.
Q: What if I don’t like my therapist?
A: The best thing you can do is be honest with your therapist and yourself. It’s okay to discuss this with the therapist. If you can’t work it out, find another therapist you can work with. It takes some trial and error sometimes, and there is absolutely nothing wrong with leaving a therapist you’re not comfortable with. This applies to all doctors and psychiatrists as well. Trust is a big part of mental health treatment.
Q: What could a general practitioner possibly know about mental health?
A: Enough to help point you in the right direction when you need help. Sometimes a GP is all we have available to us, and there’s nothing wrong with that either. They can prescribe medications and refer you to a psychiatrist or therapist if they think you need it. Go to who you trust as your first step.
Q: Is it as interesting to sit in a psychiatrist’s waiting room as you’d imagine?
A: Waiting rooms are always professionally discreet. No one is even paying attention to you much less trying to guess why you’re there. I’ve never felt unsafe in a psychiatrist waiting room.
Q: What is the difference between seeing a psychiatrist and a general practitioner?
A: A psychiatrist specializes in only mental illnesses and mental illness medications. They will be more up to date on specific medications and specific diagnoses and can provide a more in depth mental illness treatment. Generally, the philosophy is that if it works, keep doing it. I mean that if your GP prescribes you some medications that make you feel better, then keep taking them. If your GP has tried everything they know to try (like in my case) they may say go to a psychiatrist to try something different.
Q: What is the difference between a psychologist and a psychiatrist?
A: A psychologist will be your therapist and cannot prescribe medications. A psychiatrist will prescribe your medications. Most psychiatrists don’t do therapy, but there are some who do. I’ve never been to one who does, but it sounds like it could be a nice simple “one stop shop.”
Q: What’s the deal with medications? Are they pills that make you happy? Are they just a crutch?
A: Mental illness is much more complex than happy/sad. The hardest part of getting mental health treatment is that there is still so much that even the experts don’t know about it. They don’t know exactly why some medications work and some don’t, or why it’s different from person to person. While mental illness is a real, diagnosable medical condition, just like diabetes, or a broken arm, the treatment is different for each person. A doctor will pretty much treat a broken arm the same way for each person, because if they do, it will heal. Unfortunately depression and other mental illnesses are not so linear. We use medications as a way to stimulate our brain chemistry to do what it should be doing anyway. Just like a diabetic gives insulin because it’s what their pancreas is supposed to be doing anyway. Medications are not happy pills. They are not a crutch. They help clean up your thought processes and clear pathways so that you can function as yourself, just like when you clean out the hallways of a house so you can get around the house with less stress. I was prescribed medications for the first time at age 20, and I carried the bottle around, unopened, until I was 22. I was afraid of the stigma. I was afraid that they would give me a false perception of the world. I wish I had been more open minded sooner though, because it was the depression that was giving me the false perception. The meds helped me see more truth.
Q: Is it possible that medications won’t work?
A: Unfortunately there’s always that possibility. Sometimes it takes trying a few medications that don’t work before finding ones that do. It can be a frustrating system because often you have to take the medications for several weeks before you know if they’re helping. It can be so time consuming. It’s an imperfect system, but it’s the best one we have right now. There’s so much research being done about treating mental illness, learning why it happens, and learning what the symptoms mean that there are new options available all the time.
Q: Can insurance be a pain in the ass when it comes to mental health?
A: Sometimes. Mental healthcare is still a completely separate section of insurance from healthcare (guess what, it’s all healthcare!) and it can have its own rules. The issues I’ve run into over the years are that insurance can sometimes dictate how many therapy sessions you get per year, and they can limit the options for doctors you can see. The staff at therapist and doctors’ offices are pros at dealing with insurance, and will work the system if they need to to get you what you need.
Q: Is it okay to be scared?
A: Absolutely. Getting help is supposed to be the greatest thing you can ever do, and there are supposed to be circles of cheerleaders following you around wherever you go, and everything is supposed to be perfect and amazing and rainbows and smiles. Well, getting help is a great thing, but more than that it’s a brave thing. We’re still in a world where it’s often an uphill battle to get help for mental illness. I wish to god it wasn’t. I wish that mental health was treated like the rest of healthcare, and that people didn’t have to be afraid and anxious to seek help or even avoid seeking help because they’re afraid they won’t get it. I’m going to be real with you – getting help can be hard work. I will cheer for you and assure you that you’re not alone, I will share everything I’ve been through in hopes that it helps, but I can’t tell you that it will be smooth sailing. I do think you’re worth the fight. I also believe that you can be strong and brave and terrified all at the same time. And I think it’s worth asking for help, even if it looks like just showing up in a doctor’s office, not making eye contact, and saying the word “Help.”
These questions and answers are based on my own experiences, and my own fears before I got into treatment. I have not had a smooth ride with mental illness or its treatments, but I have met some really good people along the way who have helped me a lot. I’ve met some good people who haven’t helped me too. And I’ve met some idiots. But so far I haven’t given up on myself, and I don’t think you should either. I hope that at least some of this is helpful.
If you have any other questions, or if you have any other insights from your own experience that you think might be helpful to someone else, leave them in the comments or you can e-mail me. I don’t claim to be an expert, but between all of us I bet there’s a lot of really good information out there.