What kind of doctor do I need?
September 14, 2011 2:37 PM Subscribe
What kind of mental health doctor do I need to see?
I'm a 28 year old married man with two children. I live in Northern Virginia. I am finally accepting that I have been suffering from anxiety/depression/panic attacks/something for at least a year (probably longer). I need to get some help. What kind of doctor/professional do I need?
I don't want to get out of bed in the morning. I have trouble falling asleep in the evenings. I have horrible GI problems - at least 3 or 4 trips to the toilet every day, with varying levels of "success" - but all painful and lengthy. I hardly eat - never breakfast because it upsets my stomach, and usually just a sandwich for lunch and then half a plate of dinner. I am only about 20% productive at work (and people are starting to notice) because I'm too worried about doing the wrong thing and so I don't do anything and then it all builds up and I become overwhelemed and even more stressed out. This last weekend my anxiety about doing anything spilled over into my personal life - I couldnt leave the house on Sunday to go out on a day trip with my wife and kids. I can't explain why except that I didn't want to get up off the couch....
I am not really keen on just starting a pill regimen (both of my parents started taking anti-depressants when I was in high school and it was awful to see them become a zombie when he took them and a slave to her pills), but at this point I feel desperate enough to.
Do i need to see a therapist? A psychatrist? I need to see someone soon, and I've called around and all the psychs have like 3-4 week waiting lists. The Loudon county mental health department has an emergency mental health services thing, but when i called the lady explained it was just like a nurse doing "crisis stabilization" and then you get on the 3-4 week waiting list. Maybe thats what I need? it doesnt feel like a crisis, but i cant wait a month to start fixing things.
If anyone has any suggestions or advice please help.
I'm a 28 year old married man with two children. I live in Northern Virginia. I am finally accepting that I have been suffering from anxiety/depression/panic attacks/something for at least a year (probably longer). I need to get some help. What kind of doctor/professional do I need?
I don't want to get out of bed in the morning. I have trouble falling asleep in the evenings. I have horrible GI problems - at least 3 or 4 trips to the toilet every day, with varying levels of "success" - but all painful and lengthy. I hardly eat - never breakfast because it upsets my stomach, and usually just a sandwich for lunch and then half a plate of dinner. I am only about 20% productive at work (and people are starting to notice) because I'm too worried about doing the wrong thing and so I don't do anything and then it all builds up and I become overwhelemed and even more stressed out. This last weekend my anxiety about doing anything spilled over into my personal life - I couldnt leave the house on Sunday to go out on a day trip with my wife and kids. I can't explain why except that I didn't want to get up off the couch....
I am not really keen on just starting a pill regimen (both of my parents started taking anti-depressants when I was in high school and it was awful to see them become a zombie when he took them and a slave to her pills), but at this point I feel desperate enough to.
Do i need to see a therapist? A psychatrist? I need to see someone soon, and I've called around and all the psychs have like 3-4 week waiting lists. The Loudon county mental health department has an emergency mental health services thing, but when i called the lady explained it was just like a nurse doing "crisis stabilization" and then you get on the 3-4 week waiting list. Maybe thats what I need? it doesnt feel like a crisis, but i cant wait a month to start fixing things.
If anyone has any suggestions or advice please help.
Start with a therapist. Try the search tool on Psychology Today. Don't worry about education level -- I have an MSW and he is fantastic. Just talk to as many as possible -- the vast majority of them will do a phone consult or even sometimes one free session for free. Go and talk talk talk to all of them. It will feel draining to go through it all over and over again, but that's how you find someone who will work and who's the best fit for you.
Also, about the medication -- I don't know what went on with your parents, but I've taken them and I know many other people who have, but I don't know anyone who acts like a zombie or doesn't have a personality any more or anything like that, at least with standard anti depressant anti anxiety type stuff. That said, discuss this first with your therapist and see if they think you should do therapy with meds, or therapy first then meds later, or no meds -- but definitely no meds without therapy!
Good luck -- this is highly treatable and your family needs you to get through this for their sake and yours.
posted by sweetkid at 2:51 PM on September 14, 2011
Also, about the medication -- I don't know what went on with your parents, but I've taken them and I know many other people who have, but I don't know anyone who acts like a zombie or doesn't have a personality any more or anything like that, at least with standard anti depressant anti anxiety type stuff. That said, discuss this first with your therapist and see if they think you should do therapy with meds, or therapy first then meds later, or no meds -- but definitely no meds without therapy!
Good luck -- this is highly treatable and your family needs you to get through this for their sake and yours.
posted by sweetkid at 2:51 PM on September 14, 2011
Go see your GP, for starters. He/she can start the process of testing to see what is causing your gastro issues (could be mostly anxiety, or you could have anxiety AND a gastro disorder that needs to be treated), will refer you to a gastro specialist if need be, and could also prescribe something like klonopin that could help you get through the next month until you can get in to see a shrink.
posted by Serene Empress Dork at 2:54 PM on September 14, 2011 [5 favorites]
posted by Serene Empress Dork at 2:54 PM on September 14, 2011 [5 favorites]
The folks at the emergency health services unit should be able to get you hooked up with an initial prescription, put you in touch with a psychiatrist who's currently taking clients, and also get you in touch with a therapist. Therapy is really important for this stuff.
Also, if you really are having such trouble that you can't leave the house, you might qualify for the kind of program I'm in. The social worker at the health department should be able to say for sure. Definitely bring a printout of all the stuff that you say up there, so you don't start minimizing when you get there.
Another option for an immediate prescription is the ER, though truthfully I don't know what they do if you come in with something on the not-quite suicidal side of the coin.
Oh, and look into the possibility of using a nurse practitioner for medication management, instead of a full-blown psychiatrist. If you can get an appointment with a therapist they could be able to hook you up. I think, looking at the UVa website, that they may be allowed to prescribe in VA.
(I got started on the path I'm on by talking with an EAP counselor at work, by the way. She's a social worker and got me an appointment with a therapist in under two weeks, and medication management in a week and a half.)
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 2:57 PM on September 14, 2011
Also, if you really are having such trouble that you can't leave the house, you might qualify for the kind of program I'm in. The social worker at the health department should be able to say for sure. Definitely bring a printout of all the stuff that you say up there, so you don't start minimizing when you get there.
Another option for an immediate prescription is the ER, though truthfully I don't know what they do if you come in with something on the not-quite suicidal side of the coin.
Oh, and look into the possibility of using a nurse practitioner for medication management, instead of a full-blown psychiatrist. If you can get an appointment with a therapist they could be able to hook you up. I think, looking at the UVa website, that they may be allowed to prescribe in VA.
(I got started on the path I'm on by talking with an EAP counselor at work, by the way. She's a social worker and got me an appointment with a therapist in under two weeks, and medication management in a week and a half.)
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 2:57 PM on September 14, 2011
I suggest starting with your family practitioner.
Prior to the rise of SSRIs and other modern drugs, anti-depressants usually meant tricyclics, which are little used today; I'd suggest not judging psychiatric medication in the general case on your parents' experience.
posted by Zed at 3:10 PM on September 14, 2011 [1 favorite]
Prior to the rise of SSRIs and other modern drugs, anti-depressants usually meant tricyclics, which are little used today; I'd suggest not judging psychiatric medication in the general case on your parents' experience.
posted by Zed at 3:10 PM on September 14, 2011 [1 favorite]
Does your workplace have an Employee Assistance Program or something similar? Many large employers do, and can sometimes get you seen relatively quickly.
Can you get an appointment soon with your primary care physician? He or she might be able to get you an appointment with a psychologist/therapist (not exactly sure what the difference is here) or psychiatrist more quickly than calling one directly, and may also prescribe some shorter-term anxiety medication until you can be seen by a mental health practitioner.
posted by Juffo-Wup at 4:06 PM on September 14, 2011
Can you get an appointment soon with your primary care physician? He or she might be able to get you an appointment with a psychologist/therapist (not exactly sure what the difference is here) or psychiatrist more quickly than calling one directly, and may also prescribe some shorter-term anxiety medication until you can be seen by a mental health practitioner.
posted by Juffo-Wup at 4:06 PM on September 14, 2011
I would start with a psychiatrist. Good suggestion from Juffo-Wup to see if you can use your PCP to get a faster appointment. Keep in mind, at least in the US, psychiatrists normally do the medication evaluation and management. Other professionals do the therapy. You may need both.
posted by tuesdayschild at 4:14 PM on September 14, 2011
posted by tuesdayschild at 4:14 PM on September 14, 2011
in the US, psychiatrists normally do the medication evaluation and management
In the U.S., family practitioners are the ones writing most of the psychiatric drug prescriptions.
posted by Zed at 4:25 PM on September 14, 2011
In the U.S., family practitioners are the ones writing most of the psychiatric drug prescriptions.
posted by Zed at 4:25 PM on September 14, 2011
These kinds of drugs, as well as our understanding of them, have come a long way since the time you were in high school. Please try to remember that.
posted by hermitosis at 5:01 PM on September 14, 2011 [1 favorite]
posted by hermitosis at 5:01 PM on September 14, 2011 [1 favorite]
One thing to consider: gastro distress can cause depression, anxiety, and fatigue--these are listed in the symptoms of many food intolerance and inflammatory diseases, like Celiac Disease or IBD. Your immune system is so busy in your gut that you just don't have anything left over. I have an inflammatory disease and it wrecks havoc on my moods when I don't manage my diet properly.
Might oughta work that angle, too, in addition to therapy. Good luck. This is tough, tough stuff.
posted by hotelechozulu at 5:18 PM on September 14, 2011
Might oughta work that angle, too, in addition to therapy. Good luck. This is tough, tough stuff.
posted by hotelechozulu at 5:18 PM on September 14, 2011
Check out crazymeds and its forums to get a) consumer-oriented information on neuropsychiatric meds (antidepressants, anti-anxiety drugs, etc.), and b) other people's stories about their experiences with depression, anxiety, panic attacks, etc., and with the meds, the side effects, the health care system, the docs, and the insurance industry.
The site doesn't push meds as the be-all and end-all. It deplores the Big Pharma-influenced prescribing of neuropsychiatric meds to people who just want to tweak their lives a little bit.
But you are genuinely hurting and struggling. Several people have urged you to see your primary care provider -- nthing this as the best route to evaluation of your physical symptoms and referrals to folks who can evaluate your mental symptoms and help you decide how best to treat those symptoms. I wish you well and hope things get better for you.
posted by virago at 5:30 PM on September 14, 2011 [1 favorite]
The site doesn't push meds as the be-all and end-all. It deplores the Big Pharma-influenced prescribing of neuropsychiatric meds to people who just want to tweak their lives a little bit.
But you are genuinely hurting and struggling. Several people have urged you to see your primary care provider -- nthing this as the best route to evaluation of your physical symptoms and referrals to folks who can evaluate your mental symptoms and help you decide how best to treat those symptoms. I wish you well and hope things get better for you.
posted by virago at 5:30 PM on September 14, 2011 [1 favorite]
Find a Vipassana meditation center and do a ten day course - no unpleasant side effects, usually free. Anti-depressants have horrible side effects, and most therapists are just guessing - they don't have real tests to diagnose. You can cure yourself, and Vipassana is one way to find out how to do that.
posted by nickji at 1:17 AM on September 15, 2011
posted by nickji at 1:17 AM on September 15, 2011
If your parents were taking pre-SSRI antidepressants there is a world of difference between those and what is prescribed today. Back then it was often a choice between which was worse, the depression or the medication.
posted by Carbolic at 1:36 PM on September 15, 2011
posted by Carbolic at 1:36 PM on September 15, 2011
nickji, I agree that meditation can have many physical, psychological, and spiritual benefits. I have depression, ADHD, and epilepsy, so I am all in favor of becoming aware of how to quiet one's own mind. It's an empowering experience.
But when I was so depressed that I was hiding under the covers every hour of the day except when I was at work, I was in no condition to fold my own laundry, let alone cure myself of a mood disorder.
And to dismiss psychiatric medications as an option with the statement "anti-depressants usually have horrible side effects" overlooks that depression/anxiety/panic attacks, etc., are pretty horrible experiences, too.
As crazymeds' Jerod Poore says:
1. Keep it Simple
One of the core philosophies of Crazy Meds is a very simple calculus you’re faced with when it comes to side effects (and many other things in life):
Which sucks less?
Take all the symptoms of your condition(s) and all of the side effects you’re most afraid of, annoyed with, sick of, etc. Write them down, type them up, imagine them in your hands. Extrapolate into the future, keeping in mind that your condition(s) will keep getting worse if left untreated, while almost all of the side effects will go away, or diminish, or you’ll acclimate to them, or you’ll find a way to mitigate them. Then ask yourself, “Which situation sucks less?”
posted by virago at 6:44 PM on September 15, 2011
But when I was so depressed that I was hiding under the covers every hour of the day except when I was at work, I was in no condition to fold my own laundry, let alone cure myself of a mood disorder.
And to dismiss psychiatric medications as an option with the statement "anti-depressants usually have horrible side effects" overlooks that depression/anxiety/panic attacks, etc., are pretty horrible experiences, too.
As crazymeds' Jerod Poore says:
1. Keep it Simple
One of the core philosophies of Crazy Meds is a very simple calculus you’re faced with when it comes to side effects (and many other things in life):
Which sucks less?
Take all the symptoms of your condition(s) and all of the side effects you’re most afraid of, annoyed with, sick of, etc. Write them down, type them up, imagine them in your hands. Extrapolate into the future, keeping in mind that your condition(s) will keep getting worse if left untreated, while almost all of the side effects will go away, or diminish, or you’ll acclimate to them, or you’ll find a way to mitigate them. Then ask yourself, “Which situation sucks less?”
posted by virago at 6:44 PM on September 15, 2011
This thread is closed to new comments.
If you can't get into a psychiatrist immediately, can you get into a therapist or some other kind of counselor?
Whether it's a crisis is up to you, but taking whatever steps (however small) that make you feel empowered may make a huge impact. It's feeling stuck that exacerbates all these symptoms. Don't give up!
posted by Enneking at 2:44 PM on September 14, 2011