An Appointment with the Psychiatrist – What is it like?
Many people are unsure as to what an appointment with a psychiatrist is like. In extreme cases, it can prevent people from actually seeking the help they need. Fear of the unknown and all that. However, the nature of mental illness too makes it more difficult. Someone with social anxiety, for example, could find it difficult to go and see someone for help. It is an extreme and vicious cycle, and a barrier to care.
Thinking about the above got me thinking about my own appointments with psychiatrists. My first appointment came almost a year ago now. I was going on long, unexplained walks at dangerous times at night, and my GP decided to refer me to see one. I remember the feeling of unease. After all, we have preconceived notions of what these appointments are like from things like the media. Sadly, the media often portrays these appointments in a negative light. We don’t get to experience any psychiatry until 5th year of Medical School either, so I had very little idea of what it was actually like.
I therefore thought I would write a blog post about what an appointment is actually like, from my perspective.
Arriving to the Mental Health centre
My Mental Health centre is located in the hospital where I actually have most of my teaching is. It is literally 5 minutes away from the lecture theatre and anatomy laboratories (i.e. dissection rooms). The good thing about this is that if I forget about an appointment, I get a phone call and can often say: “Ooooh crap, sorry, I forgot. I’m in x hospital right now though, so I’ll be down in 5 minutes!”
Unfortunately, it isn’t all good having these appointments near my place of teaching. For starters, many other Medical Students live near the hospital as a result – and some live right outside the mental health centre. It means that I often have to go quickly and briskly into the centre, to make sure no one else sees me. I am all for being open about mental health, but the stigma that exists makes it difficult in the current climate. I have to enter in a James Bond type of way – minus all the guns, explosions and fancy suits.
The waiting room
A ‘good’ thing about mental health care is that it goes on for a long time. Well, it’s not really good as it takes a while to recover, but it does mean that the staff there get to know you. All the receptionists there greet me by name when I arrive, and it’s funny how small things like that can make a difference. It helps relax the mood a little, and allows you to have a quick chat with them.
The media again portrays mental health patients to be unstable, to the point that they are dangerous. The waiting room tells a different story. Everyone there is waiting patiently for their appointment, just like they would in most other specialities. Of course, you occasionally get some patients who seem a bit loud or rude who you want to sit away from – but isn’t that true of all specialities? I’ve never seen anything break out in the waiting room in all my appointments. This is in contrast to my A&E experiences – but even there, it is rare and the staff are bloody good at dealing with it.
The start of the appointment
Eventually, when my name is called, it is my care coordinator who comes to get me. The appointment is carried out by both of them. It seems as though the psychiatrist has more of a leading role, but I know my care coordinator better so feel more comfortable around him.
The start of the appointment is like any other appointment. The usual, “Hi, how are you?”‘s and “Did you have a good weekend?” and so on. Depending on my mood, I either answer it in a generic way or use it as an opportunity to tell them what’s bothering me. If it’s the former, the psychiatrist may go on to ask me more directly how things have been in terms of my mental health. If it’s the latter, we take some time to discuss what’s been happening. It’s like talking to a trusted friend about your problems, and them simply listening.
Talking about my problems
Talking about problems with the psychiatrist can be very different for many people. It depends on:
- How willing you are to open up to your psychiatrist.
- How good your psychiatrist is at responding to you.
The two are interlinked. If your psychiatrist is good, it is likely you will be more willing to open up to them. This, in turn, will make them better at responding to you and so on.
In my case, I am lucky that I have a good relationship with my psychiatrist. More often than not, she helps give me a different perspective on my problems but she can sometimes give advice if necessary. For example, if I talk about how I’m feeling stressed about exams, she may go on to tell me that the stress is showing that I’m taking it seriously. I may then go on to mention that I’ve been having trouble sleeping recently as a result, and she may go on to suggest strategies to tackle that or, if appropriate, medication.
It is important to remember that psychiatrists are doctors. They too can prescribe medications. In my case, she often just asks about how they have been going. By that, she means if I’ve noticed any positive improvements at all, or if I’ve noticed any negative side effects.
If I have been noticing bad side effects, she can review my medication or even offer other medications to help alleviate other symptoms. At times, the side effects get so bad that I become unwilling to take them. This is where we both need to talk together and give our point of views on things to decide what the next step would be. Sometimes it may be to stop the medication for the time being; at others, it may be suggested that I just be patient and let them wear off.
End of the appointments
At the end, we often discuss what the next steps would be in my care. I often see my psychiatrist once a month, and my care coordinator weekly. Plans can include things like:
- Booking more appointments with the psychologist.
- Making sure I continue with my medications.
- Coming off my medications slowly.
- Blood tests to see how well the medication is working/if it’s disrupting anything else.
None of this stuff sounds too exciting. And it’s not. For me, the appointments are kept as calm as possible and that is very helpful. It is important to remember that seeing a psychiatrist will not magically solve you of any mental health issues that you have. Sadly, it is a much longer process than that. However, seeing one is – more often than not – not as scary as people think.