Finding a Psychiatrist in New Jersey

July 13, 2007 11:56 AM

The meds the GP gives me don't work. How do I find a psychiatrist who's actually able to see me?

I've been fighting depression all my life. In high school it manifested as mood swings, insomnia and crying jags, but I never got diagnosed until college. I spent a few weeks hospitalized (long enough to learn I don't belong in a mental institution) and wound up on Zoloft and Serzone and seeing a therapist, which worked out moderately well. I had enough trouble with side effects that I moved to Wellbutrin, which was somewhat less effective, but low enough on side effects that I'd actually take it. After some time, both my medical benefits and savings ran out and I stopped both meds and therapy.

With my new job, I have some coverage again, and my General Practitioner put me back on Wellbutrin, because it was the last thing I was on that worked. This spring, though, I've been feeling just wrong. I have a deep feeling of unease and that there's something wrong with me but I don't know what it is. I've started having crying jags again and I flip between sleeping to much and not sleeping. I figure I need a psychiatrist to either adjust the meds or work out what to do instead.

In May, I tried to find a doctor. I went to my insurance website and got a list of doctors on my plan and even called to confirm I'm eligible. According to my insurance plan, any doctor on the list should be able to see me within two weeks. In practice, two of the doctors I called don't take my insurance anymore, most of the rest never answered my voicemails, and the only one that I did hear back from couldn't see me for two months. I gave up.

I prefer a female doctor, but don't insist on it. I also prefer evening or weekend appointments, but I'll use up my vacation time if I have to. At this point, I'll even pay out of pocket for a doctor who's not on my plan. I just need this to stop. I'm in Central Jersey (exact location in my profile). Anyone know a decent shrink in the area? Or how to find someone who'll actually see me?

posted by Karmakaze to health & fitness (9 answers total)

Have you asked your GP for a referral to a pyschiatrist? (Your insurance will surely insist on your getting a referral before you see a shrink.)
posted by Carol Anne at 12:17 PM on July 13, 2007

Insurance does not always require a referral. (Mine doesn't). It's a good idea to get a referral cause your MD might know who is accepting patients. Plus your MD might have more drugs in his/her arsenal than you think. At least you will get something to help you get some sleep already in the interim.
posted by crazycanuck at 12:24 PM on July 13, 2007

The nice lady at my insurance helpline told me I do not need a referral for mental health services. (There is a limit to the number of visits/year, but I am not worried about that yet.) My GP is part of one of those walk-in storefront arrangements, and I don't always wind up seeing the same guy. It's fine for routine stuff, but I didn't really feel he's up on the latest in psychiatry.
posted by Karmakaze at 12:31 PM on July 13, 2007

I could not find a good psychiatrist, until I found a good psychologist.

My good psychologist was recommended to me by another psychologist - on behalf of my mom, no less, who was concerned about my depression.

Anyway, he psychologist works in conjunction with this psychiatrist, and I love her and she's awesome.

The moral of this story, I guess, is that it seems like a lot of it depends on blind luck.

Before my mom actually asked her shrink for a recommendation, I felt like I was navigating a maze in the dark with my eyes closed with cement on my feet with regard to finding someone I actually liked.
posted by kbanas at 12:34 PM on July 13, 2007 [1 favorite]

A referral will help you jump the queue. Even a recommendation from the random GP at the Kwik-E-Health. It's part of their job. Tell them what you told us about your preferences.
posted by Ookseer at 12:53 PM on July 13, 2007

Try the New Jersey Psychiatric Association?

If it makes you feel any less worse, it's very common for shrinks NOT to return calls even to tell you they're booked up or they don't take your insurance. To me this is inexcusable, but at least it's a quick way to find out that it's someone you don't want to waste time with.
posted by scratch at 1:18 PM on July 13, 2007

try the psychiatry department at your local hospital. the schedulers can tell you if they take your insurance and should be able to run through all the docs on staff and get you in to see the first available. that person might not meet your exact needs, but i think it seems more important for you to get help quickly. good luck.
posted by thinkingwoman at 1:28 PM on July 13, 2007

Any one who turns out you down, ask them if they recommend someone else. If they will see but not for a while, ask if you can be put on a waiting list in case of cancellation.

I think you are right to want a real psychiatrist - you need someone who understands the full range of options and their pros and cons. The other possiblitiy in some areas is a psychopharmacologist - they specialize in just med management.

Also, are you looking for a therapist? Evidence shows that you are less likely to relapse if you have had therapy as well as medication. Around here, a psychiatrist will charge as much for 20 minutes as a therapist charges for a full hour. Again, if you get someone on the phone nad they can't do it, ask them who they would recommend (therapist and psychiatrist)

I did this when I urgently needed to set up care for a family member. I spent two days on the phone and got lucky - we ended up with people that we have been really happy with. (Although the psychiatrist was an especially lucky break - a cancellation created an opening the day after I called.) It helped that I started with some good people - good people tend to know who else is good. Also, if it doesn't feel right, don't be afraid to change - especially therapists - there needs to be good chemistry for it to work.
posted by metahawk at 2:11 PM on July 13, 2007

Do you have any friends or family who are seeing a psychotherapist? They don't have to be near you -- most therapists will agree to a phone consultation and then make referrals to local practitioners.

Otherwise, I'd try Rutgers, which has a sliding-scale psych program, with degree candidates practicing under supervision. You'll be able to hook up with a prescribing psychiatrist through them.

I'd also encourage you to undertake talk therapy in tandem with the meds. I know you're just looking for a way to make it* stop, and effective meds will go a long way towards that. But you've been dealing with depression for a long time, and you've developed lots of coping mechanisms. Some of those mechanisms are still useful; some have become destructive. A good therapist will help you sort all of that out, while the meds will enable you take on and enact those insights.

*I feel it as "razory hate-wheels in my head," but of course your it is different. And now I'm morbidly curious about how you do describe it.
posted by vetiver at 6:52 PM on July 13, 2007 [1 favorite]