Are Your Prepared for Your Psychiatric Consultation?

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Almost all of us experience some anxiety when we go to the doctor. We worry about what our symptoms mean, if and how they can be treated, and whether we will be okay. Anxiety is even more prominent in psychiatric settings. Psychiatric conditions, like Major Depression, eating disorders, phobias, and bipolar disorder, have anxiety as a key component.

Being Your Own Best Health Advocate

Preparing for your mental health evaluation—knowing what to expect, what important information to share, and what questions to ask—can help alleviate your fears. It can also make all the difference in whether or not your mental health consultation and, ultimately, your treatment, are successful.

At a time when many doctors and nurse practitioners work in large clinics where they are required to see a high volume of patients, we each need to be our own best advocates. We must be active partners in our own treatment. For those who are severely depressed, it can be helpful to bring along a spouse or adult child to the consultation to provide support in this process.

Getting Ready for Your Mental Health Evaluation

A comprehensive consultation is key to getting an accurate diagnosis and appropriate treatment. Preparing for your initial visit with your psychiatrist or other health provider will ensure that you’ll cover all the key information, even if you feel nervous. Major Depression can manifest with many varied symptoms. There is a vast array of psychiatric drugs that can be tailored to specific symptoms. Keep in mind that the more details you provide, the more customized your medication treatment can be if a pharmacological approach is appropriate.

To make the most of your consultation, write down answers to the questions listed below in advance and bring your responses to your appointment. If your physician doesn’t address some of the issues noted here, be sure to raise them yourself. Your role is to be honest and open so that you can be helped. Be ready to speak about the following:

• Your presenting problem–What brought you into treatment?
• The onset of symptoms–When did you first experience symptoms? Can you think of anything that triggered your symptoms?
• Type of symptoms–Is your sleep, appetite, mood, focus, energy, sex life, work, relationships, and anything else affected? Have you had any obsessional or ruminating thoughts? All symptoms and their intensity will be tracked during treatment so that progress can be monitored.
• Alleviating or aggravating factors–When are your symptoms better or worse? What exacerbates your symptoms?
• History of your mental health–Have you ever experienced such symptoms before? Have you ever been hospitalized for a mental health disorder?
• Associated symptoms–Are there any other symptoms you're experiencing besides your main complaint?
• Treatments tried–What has helped you and what hasn't worked? Have you tried psychiatric medications in the past, and at what doses? Have you experienced negative side effects from these medications?
• Other health issues–Do you have any chronic or acute medical conditions? Have you had gastro-intestinal, heart, circulatory, neurological, pulmonary, hormonal, or other medical problems? Have you suffered from other medical problems in the past?
• Substance use–Do you currently use or do you have a history of using alcohol, marijuana, or other “recreational” substances?
• Medication history–What medications are you currently taking? Are there any medications to which you have had negative side effects?
• Family history–What medical and psychiatric conditions have your parents, grandparents, siblings, or other close relatives had?
• Social environment–What is your home life like? How is your work life going?
• Suicidal or violent ideation–Do you ever think of doing something to end it all?" If so, “do you have a plan?” "Have you thought of hurting anyone else?"
• Hallucinations–When you’re awake, has anything ever happened where you thought you were experiencing, or maybe you were even sure you were experiencing, hearing, or seeing things that other people could not?
• Trauma–Have you suffered any trauma in your childhood or adulthood?

When interviewing a new patient, I typically ask one additional open-ended question, like, "How did you get to be you?" It's telling to hear what comes to people's minds:

• "My parents were older when they had me."
• "I had a brother who died when I was five."
• "I moved around a lot as a child."
• "My parents got divorced when I was 14."
• "I have a special needs child."
• "I am divorced and a single parent."

These quick snapshots of patients' lives hint at dynamics that may be key to the root of depression or provide "gems" to be mined later in psychotherapy.

Tying It All Together

As you share your symptoms and medical, medication, and family history, your doctor will determine a diagnosis and discuss a treatment plan. If medication is recommended, be prepared to ask questions about the treatment process, possible side effects, how to prevent and/or manage side effects, and how long it will take until treatment takes effect. In other words, find out what you should expect...and when.

Psychoeducation is an important part of mental health treatment. Be sure to ask questions so you understand your diagnosis and condition and have a plan for follow up. There isn't one instant cure-all for depression or just about any mental health problem. You'll need to work with your health practitioner to track your progress, make tweaks in your treatment, and integrate psychotherapy and mind-body practices that can help regulate mood and promote well-being.

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Building a Patient-Doctor Relationship

Hopefully, during the consultation, you will begin to relax and develop a trusting rapport with your health provider. The patient-doctor relationship is an unappreciated but vital ingredient in successful treatment for depression. Knowing you can share your concerns, questions, and anxieties becomes especially important if you run into roadblocks during treatment.

Assess if your doctor is a good listener, empathic to your situation, and takes time to answer questions. Being depressed can be somewhat traumatic and make you feel vulnerable. Having a doctor who is a good partner in your treatment will make your journey to recovery much easier.

To find a therapist near you, visit the Psychology Today Therapy Directory.