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Psychiatry

Are Your Prepared for Your Psychiatric Consultation?

What you need as you begin your journey.

Key points

  • The more details you provide during your consultation, the more tailored your treatment can be to your condition.
  • Reviewing the answers to these questions in advance will help ensure you'll provide key information even if you are anxious.
  • A comprehensive consultation is the key to getting an accurate diagnosis, appropriate treatment plan, and positive outcomes.
Simon Berger/Unsplash
Source: Simon Berger/Unsplash

None of us can afford to be passive recipients of health care. In our time-pressured medical system, in which many physicians are required to see a high volume of patients, it is incumbent upon all of us to be our own best advocates and make the most of our time with our health providers.

This is especially true if you seek help for a mental health problem. 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 depression, eating disorders, phobias, and bipolar disorder, have anxiety as a key component.

Preparation Pointers

Preparing for your consultation will ensure that you’ll cover all the key information, even if you feel nervous. Depression can manifest with various symptoms, and psychiatric drugs can be tailored to specific ones. The more details you provide, the more customized your medication treatment can be if a pharmacological approach is appropriate.

Write down answers to the questions below and bring your notes to your medical appointment. If your physician doesn’t address some of the issues noted here, be sure to raise them yourself. As we mentioned in our post “Driving Out Depression: A Comprehensive Consultation,” the initial four-part consultation is the foundation for successful treatment. Your role is to be as 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 also typically ask one general 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 their lives hint at dynamics that may be key to the root of depression or provide "gems" to be mined later in psychotherapy.

Putting It All Together

As you share your symptoms and story, your doctor will use all of this information to determine your diagnosis—a diagnosis that can often be illuminating for patients. All of the details you've described may seem disparate and unconnected, but everyone contributes to the picture of what is going on with you—and how you can be helped. From this assessment will flow treatment options and a plan of action.

Building a Rapport

Hopefully, during the consultation, you will begin to relax and develop a trusting rapport with your health provider. The doctor-patient 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.

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