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[Owlbread]

Hello, I thought based on past experiences here that this would be a good place to seek some advice regarding something I'm dealing with at the moment. People here have always come across to me as very non-judgemental and with a lot of experience of these kinds of problems. I have been going through a somewhat difficult period over the last few months and I wasn't really sure what was wrong - it seemed like a whole cluster of issues coming together, and I felt at times like I was just diagnosing myself with everything under the sun. I am currently taking SSRIs and receiving private psychotherapy, but I am debating about whether that is actually enough and whether I should see a psychiatrist.

The problem is it's quite difficult for me to actually see a specialist and get a diagnosis through the NHS (national health service) which will take a lot of time and effort. I feel like I already have enough information to know roughly what I'm dealing with and I don't know how helpful a diagnosis would actually be - it's not like I can get treatment that is unavailable to me currently. I have a concern that I will just receive a diagnosis that will be potentially debilitating in the future and I will have to continue as I am now with the course of treatment I am on.

I'm also concerned that if I see a psychiatrist, I'll have to be very careful because they don't like self diagnosis (as I have found with my GP) so it's not like I can say "Okay, I think I have BPD/borderline personality disorder and god knows what, can you prove it?" in which case I worry stuff will get missed. I don't really know what to do.

[ChairmanPoo]

:/ can't your GP refer you if you're not coping well.

[Owlbread]

:/ can't your GP refer you if you're not coping well.

My impression is that I would need to ask my GP to refer me in order to see an NHS psychiatrist but I also think that would involve long waiting lists and difficulty in actually seeing them. This begs the question I had in mind when I posted the thread; is it even worth it?

[ChairmanPoo]

If you're not coping well then maybe. You should probably ask your GP

[Owlbread]

If you're not coping well then maybe. You should probably ask your GP

I did ask her last time I saw her, but she said that she would be reluctant to seek that kind of service at this stage because I've only been receiving treatment for a month or so. My psychotherapist also questioned how useful it would really be, though she also said it was really my decision to make.

[ChairmanPoo]

it might be a bit soon because antidepressants take time to have their effects felt. maybe inquire about her referral criteria?

I think it would be something to follow if the treatment you're receiving at your GP is unsuccessful. Otherwise you can continue at primary care without trouble.

[inteuniso]

As someone who deals with a genetic polymorphism affecting their brain chemistry, it's unlikely even a specialist could help you with your problem. We simply don't have the tools (gene therapy) required to actually fix these problems with ourselves yet. The previous three generations of my family on my mothers side and I have to deal with an ever present flow of dopamine in the brain and the ever-increasing tolerance to it. This means my grandmother is morbidly obese and in permanent rehab and my mother is also on SSRIs or whatever they prescribe for "bipolar disorder." Cannabis helps control it slightly but I will need to do more research on the most effective way to ingest it; even then, it's not going to change my genes.

I think you should be fine as long as you recognize that your thinking is colored by your chemistry. You won't feel good, but few people really do in this world. Far more just scrape by, dragging along their aches, maladies, and pains with them.

[TheBiggerFish]

I think you should talk with your doctors more, as ChairmanPoo (actual doctor, though not in that field) said.

That said, I really wish you the best of luck with this.

[Sappho]

I don't think you need a psychiatrist to get diagnosed with anything. A psychologist is usually the one who does the diagnosing. Psychiatrists are more for prescribing medications. Unless the whole system works differently in the UK?

I have similar trouble trying to get psychiatric care (my insurance doesn't pay for it at all and there are precious few English-speaking doctors in this country, most of whom are just awful), so I feel your pain. If you're not satisfied with your current therapist, I encourage you to take steps to find a new one, as that makes a HUGE difference. There are so many different schools of therapy, and none of them works for everyone. If you think your current medication isn't helping, it's true that you should give it a little time, as SSRIs take a long time to start working. But it's also true that no medication works for most people, so if you think you've waited long enough and you're not seeing results, it's perfectly reasonable to want to try something different.

I know what you mean about self-diagnosis, too. Doctors, especially older doctors, really hate it when their patient knows what they're talking about. They see too many people who found the name of a condition online and ran to the doctor even though they clearly don't have that problem, so they tend to immediately dismiss anything we suggest. They have to come up with the diagnosis on their own, or they won't help you. I once had a psychiatrist give me medication that could have killed me because he didn't believe what I told him. However, you deserve to have a doctor who BELIEVES you and respects your intelligence. If your current doctor is refusing to consider anything you suggest, then it may indeed be time to find a new one. They're not ALL like that. At the very least, a doctor should listen to everything you have to say and at least consider it as a possibility, looking for proof that you are wrong before dismissing your self-diagnosis. You know what's going on in your head a lot better than they do. It may be that you're mistaken about what's wrong, but the doctor needs to explain why in a respectful way, not just dismiss your suggestion outright.

You can try a trick I sometimes use to soften the "self-diagnosis": tell them you have a friend with [the problem you think you have], and when they describe their problem, it all sounds exactly like what you're going through now. Do you think I might have the same problem, doc? (I'm very uncomfortable lying, but sometimes it's the only way to get the doctor to seriously consider my suggestion.)

[Fenrir]

I don't think you need a psychiatrist to get diagnosed with anything. A psychologist is usually the one who does the diagnosing. Psychiatrists are more for prescribing medications. Unless the whole system works differently in the UK?

I want to second this.

Psychiatrists seem to vary highly in quality, and I can only guess it's because they're multi-classing – they have some psychology training but they're primarily doctors. Psychologists (not therapists, mind!) are the ones with the PhDs in psychology. Psychiatrists, in my experience, are keys to the medicine cabinet, put there to advise you on what to try next and answer any questions you have about the drugs, while also making sure you don't take the wrong dose of the wrong thing and die to death.

[ChairmanPoo]

I don't think you need a psychiatrist to get diagnosed with anything. A psychologist is usually the one who does the diagnosing. Psychiatrists are more for prescribing medications. Unless the whole system works differently in the UK?

I want to second this.

Psychiatrists seem to vary highly in quality, and I can only guess it's because they're multi-classing – they have some psychology training but they're primarily doctors. Psychologists (not therapists, mind!) are the ones with the PhDs in psychology. Psychiatrists, in my experience, are keys to the medicine cabinet, put there to advise you on what to try next and answer any questions you have about the drugs, while also making sure you don't take the wrong dose of the wrong thing and die to death.

You're tragically wrong of course. Psychiatrists are doctora who have undergone specialization in psychiatry, and will be the ones actually diagnosing psychiatric pathology, and treating it for the most part.