I've had several different psychiatrists, and a couple of therapists in my lifetime. The first one wanted to be my daddy. BLEH! He hated my father, and told me so, many, many times. He kept me on the hook, now I think intentionally, because he wanted me to be dependent on him. I got really screwed up while I was in his "care". I was a teen-ager when I started with him, so I was more vulnerable than I am now.

The 2nd one I loved like a brother, had very warm feelings toward him. When I moved away, I didn't have any trouble moving on. I had a good relationship with him, but dont' feel I gained much. I was an older teen at the time.

The third was short lived, and boy was he weird! I was also a late teen then. I'd be in the waiting room, and he'd jump when he saw me, like I was a ghost! LMAO! He told me there was nothing wrong with me, which was SO nice to hear.

Anyway, none of these did me a whole hell of a lot of good. I've also had two psychologists, both were great, and provided a lot more insight into my problems, and how to deal with life in general. They were both women. I had no feeling for them whatsoever except that they were there to help me, they did, and I went on when I'd garnered as much as I thought I could.

I hadn't been in therapy for over 20 years, and now, it seems you have to have a psychiatrist for meds, and a therapist for therapy. Is that the general consensus? Doesn't that seem redundant?

The doctor I go to now is male. He's nice, very calm, very logical, not judgemental, but it's frustrating because I feel like he tries to assign feelings or neurotic tendencies to me which don't fit, and this happens because they diagnose you in a couple of appts., then they Rx meds, then they see you every couple of months. How can that work, how can he possibly know me? Do they get to know you over time? Is this a good way to do things or not? I'm frustrated by all of this, is this normal?

Jazzper,

You had written:
The doctor I go to now is male. He's nice, very calm, very logical, not judgemental, but it's frustrating because I feel like he tries to assign feelings or neurotic tendencies to me which don't fit, and this happens because they diagnose you in a couple of appts., then they Rx meds, then they see you every couple of months. How can that work, how can he possibly know me? Do they get to know you over time? Is this a good way to do things or not? I'm frustrated by all of this, is this normal?

I don't go to a pdoc but do go to a psychologist. From what I've heard from other people the pdocs don't spend much time w/ patients. I am not familiar with their approach but have found my therapist to be helpful. I feel like he really knows me and has helped me make some lasting changes in my life. <!-- / message -->

I guess I need to get a therapist too, so that I can get some counseling. Our problem right now is that 3 of us need counseling, and I don't want us to go to the same person because of conflicts of interest. My daughter and son have anxiety and a bit of depression, I'm just trying to deal with 5 of us having ADD, and one with behavior problems. Makes it tough, and expensive with the psychiatrist, meds, and counseling!
Gotta nip these problems in the bud.

jazzper,

It is also my understanding that psychiatrists have little or no training in working with people outside the medical realm. Personally, I have found www.flylady.net (http://www.flylady.net) helpful for my own symptoms and to gain structure in my life. You have to choose your therapist carefully because, as you have found, not all of them are good. You also have to set your own goals for what you want out of treatment, and if they are not being met, you have to reevaluate what's happening.

It's not necessarily true that psychiatrists don't have training in psychotherapy. Mostly, the reason people have to see separate practitioners for therapy and meds is due to managed care. Insurance companies have figured out that therapists, not being medical doctors, charge less per hour than psychiatrists.

Just as an example, one of my previous psychiatrists went to work for the Veteran's Administration so he could actually do therapy with his patients in addition to prescribing meds.

It's not necessarily true that psychiatrists don't have training in psychotherapy. Mostly, the reason people have to see separate practitioners for therapy and meds is due to managed care. Insurance companies have figured out that therapists, not being medical doctors, charge less per hour than psychiatrists.



Yep, that's what my psychiatrist told me, it's because of managed care. My guess is that most of the older psychiatrists used to do therapy and Rx meds. The psychiatrists are gonna be screwed as they pass the laws allowing psychologists to prescribe meds.

It gets expensive now though because you have to pay for the med consult. appts every month, and then the weekly or every other week, or monthly therapy. With managed care, you only get so many appts per year, so you get less out of therapy.

Not perfect, that's for sure. Hope it doesn't get worse for our kids. Hopefully, by the time they're our adults, they'll have the theraputic system perfected, not annihilated. I'm doubtful though because of the CBT and scripted therapies. Scary.

Hello. This is my first post.
I have always tried to have women pdoc and theropists. I find that it is alot easier when the opposit sex thing is not there. I have had four theropist that I love. I stay with them as long as I am growing in my theropy. Then we hug happaly and part ways. I am paying throught he nose to get better and if that is not happening then I move on. My average stay is about two years. My pdoc I will only stay with if they are willing to listen to what I have to say and agree the my sessions are a joint effert.

Personally I see a neuro-phychiatrist( specilizes in the brain chemisrty part of mental difference) for my medication management. I have seen the same doctor for the better part of 12 years. He was the one who diagnosed me in 1993. He is a wonderful man and has gone above and beyond to help me.

Although his primary role is to regulate my medications, however I have gone through some very difficult times and he has done some "counseling". Should I require "formal" lengthy counsling I would see a phychologist (therpist)!!!!!!

I do not have a problem with this arrangement.

My doctor (Dr. Hankin) is a wonderful man whom I would highly recommend for those in the west Texas area!!!!!

Personally I see a neuro-phychiatrist( specilizes in the brain chemisrty part of mental difference) for my medication management. I have seen the same doctor for the better part of 12 years. He was the one who diagnosed me in 1993. He is a wonderful man and has gone above and beyond to help me.

Although his primary role is to regulate my medications, however I have gone through some very difficult times and he has done some "counseling". Should I require "formal" lengthy counsling I would see a phychologist (therpist)!!!!!!

I do not have a problem with this arrangement.

My doctor (Dr. Hankin) is a wonderful man whom I would highly recommend for those in the west Texas area!!!!!
Wow, sounds like a perfect situation! You're very lucky.

Wow, sounds like a perfect situation! You're very lucky.

I do feel lucky in finding a good doctor.

I saw a psychiatrist once and was not too fond of him. He didn't seem like someone who worked with people. Now, I go to a family practice where a psychologist consults a doctor about my medication. The psychologist really got to know my behavior and how to modify it.

I really don't trust psychiarists with counseling and would never have him/her as my only practicioner. Their training as a psychologist is only a part taged on at the end of medical school. I'm sure there are some good ones out there, but it seems that the bad outnumber the good. I read in a textbook this past semester that many child psychiatrists still use many Freudian, psychodynamic techniques :rolleyes: IMO, psychiatrists live up to their bad reputation.

I really don't trust psychiarists with counseling and would never have him/her as my only practicioner. Their training as a psychologist is only a part taged on at the end of medical school. I'm sure there are some good ones out there, but it seems that the bad outnumber the good. I read in a textbook this past semester that many child psychiatrists still use many Freudian, psychodynamic techniques :rolleyes: IMO, psychiatrists live up to their bad reputation.
A psychiatrist's medical residency is no more a "part tagged on at the end of medical school" than a surgeon's, or your family doctor's. Residency in psychiatry is a 4 year program, in addition to medical school, and may be more if the doctor chooses to persue a subspecialty or fellowship. For example, child psychiatry is a minimum 5 year program. Not all psychiatrists are Freudians, either. :P

My post doesn't say all psychiatrists were Freudians. I acknowledged that their are good ones out there, didn't I? I'm not trying to say that their training is insignificant, I'd just rather see someone separate from a psychiatrist who's sole, primary interest was psychology and counseling- and psychologists fit that bill more than psychiatrists. It's my preference and i would recommend it to others.

My post doesn't say all psychiatrists were Freudians. I acknowledged that their are good ones out there, didn't I? I'm not trying to say that their training is insignificant, I'd just rather see someone separate from a psychiatrist who's sole, primary interest was psychology and counseling- and psychologists fit that bill more than psychiatrists. It's my preference and i would recommend it to others.
Sure, it's a valid preference. All I was trying to point out myself was that psychiatrists do have significant training beyond the MD. Many programs out there do incorporate psychotherapy into the training as well. A quick google search on "psychiatry residency psychotherapy" shows this to be the case.

Hi there -- I'm new here and I have a couple questions about docs/meds.

A little background: I have 3 kids, 2 of whom are clearly ADD. One is on Concerta, the other on Adderall. (They've repeatedly gotten the classic ADD report cards -- "A pleasure to have in class. Doesn't do the work.") I've always thought they got it from their dad, who I'm pretty sure has it but has developed enough coping mechanisms that it doesn't really affect him too negatively.

Then I started looking at my own behavior. I'd been seeing a therapist for mild depression/grief counseling/family issues, etc., and mentioned to her that I'd been doing some reading and thought I might also have ADD, though I don't fit the typical mold. I've been pretty successful in my career, got good grades in school, didn't run with scissors. But I'd been feeling really overwhelmed lately. Shtold me that sometimes, if your life situation changes (have a child, change jobs, whatever), the coping mechanisms that worked previously may no longer be enough. So just being fairly successful doesn't mean you don't have ADD. She set me up with the clinic's psychiatrist to see about meds, and I've now seen him a couple times. I have to go see him again next Wednesday and here's the thing: he irritates the crap out of me.

At my first appointment, he asked why I thought I had ADD. It was very open-ended. I scrambled for examples and apparently didn't come up with the right ones (duh, brain freeze would be part of the ADD, would it not?). He first responded that he didn't think I had ADD at all, but we could try a medication anyway. Later in the conversation, he made some comment about "if you'd said you drink a lot of caffeinated drinks or something ..." -- at which point I just stared at him and said, "I chain-drink Diet Coke -- does that count?" And then he backpedaled and said maybe I did have it. He put me on Strattera. It didn't seem to do anything but keep me awake all night (for which I eventually got a sleeping pill Rx).

The I tried Adderall. After 3 days on it, I woke up with what I now think was most likely a full-fledge migraine (never had one before). Worst headache I'd ever had and I was throwing up. Hadn't even taken the Rx that day. I went to an "urgent clinic" and called the psych's office to let them know, in case it was a reaction. They said to stop taking it and set me up to come in in a couple days. So, at my 2nd appt., he walks in and says, "what are we going to do with you?" I explained what had happened and that the urgent doc had said it could've been a reaction, a regular old migraine, a virus, whatever. Again, he told me, "I don't think you are ADD." I said, "What exactly makes you think I'm not?" Now, I totally understand about docs not wanting to "lead" patients into a diagnosis, especially with so much hype about people abusing the prescriptions, etc. But I really resent the "Desperate Housewives" implication. I'm an intelligent, well-read person (at least on this subject ;-) I know I've been successful, but for me, the process of producing that success is completely exhausting and overwhelming -- and so is the process of pretending that it's not!

Anyway, I tried a week of Ritalin and then went back on the Adderall, and now I have this follow-up appt. I think the Adderall helps, but I also think it might need to be increased (I'm on 15mg of the XR). I'm scared to even bring that up, because I am positive he'll take the "if it's not working, you're obviously not ADD" approach. I intend to take with me Sari Solden's Women with ADD book -- with a boatload of places highlighted in green -- and tell him he really needs to read it. It totally describes my life.

Sorry for the long-winded post, but my questions are -- has anyone else had this sort of experience with a doc, and how did you deal with it? And what's a reasonable dosage of Adderall?

Thanks for any advice/feedback you can give. I'm really glad I found this forum, just to read the posts and feel "okay" if for no other reason!

fiji4me,

I cannot answer your questions, but I totally know how you feel. When I was living in Georgia, I tried twice with 2 different therapists (both supposedly specialized in ADD/ADHD) and both kept focusing on my anxiety and depression and not on my absolutely disorganized life, my inability to stay focused, my lack of follow-thru, etc. I got VERY frustrated and just quit trying. Now that I am living someplace new and my husband is deployed to Iraq and all my carefully placed coping strategies have gone out the window I am once again going to pursue therapy and try for a dx. I, too, have read Solden's book and it felt as though she had written the story of my life. I intend to take the book with me along with a few different checklists that I have filled out and a letter from husband when I go to my first appointment next week. I just can't cope on my own anymore and I feel that meds with therapy would help a great deal.

GOOD LUCK to you!

#5 Some Psychiatrists are trained in Psychotherapy. Depends on the University where they do their Residency. Similarly, some Surgeons are trained in 'GI Surgery', whereas some specialise in 'Plastics' (burn repairs, birth defects, fixing hands, etc.)

#12 Some Residency Programs are 5 years, too.

A little background: I have 3 kids, 2 of whom are clearly ADD. One is on Concerta, the other on Adderall.

Then I started looking at my own behavior. I'd been seeing a therapist for mild depression/grief counseling/family issues, etc., and mentioned to her that I'd been doing some reading and thought I might also have ADD, though I don't fit the typical mold. I've been pretty successful in my career, got good grades in school, didn't run with scissors. But I'd been feeling really overwhelmed lately. Shtold me that sometimes, if your life situation changes (have a child, change jobs, whatever), the coping mechanisms that worked previously may no longer be enough. So just being fairly successful doesn't mean you don't have ADD. She set me up with the clinic's psychiatrist to see about meds, and I've now seen him a couple times. I have to go see him again next Wednesday and here's the thing: he irritates the crap out of me.


There's no reason why you have to see the p-doc in this clinic. If I saw a doc like that, I'd run the other way! I've been through several meds, this hasn't been an easy road for me either, but I also have ADD kids, 3 inattentive, 1 hyper. The more kids you have that have been diagnosed with ADD, the more likely you or your husband or both are ADD. Mine hasn't been diagnosed, but I'm sure he is. Why don't you find a p-doc who specializes in ADD instead of this guy who is so antagonistic? I'd also mention to your therapist the way the doc treats you. Who needs that? We have enough stress just trying to deal with day to day life, don't we?

Jazz

Thanks for the votes of confidence!

Stacey, I'll be thinking of you this week and wondering how your appointment went, too. I'm so ready to quit doing the "girl thing" (nodding politely and smiling) Where did you find the "different checklists" you mentioned? Those might come in handy, along with the book. Good luck, and may the force be with you!

Ishtar, I totally agree with trying to find female docs. Only trouble is that they're scarce in this area -- at least ones that come highly recommended. I had a new female GP for about two months last summer; then she did something unimaginably rude and I vowed to never go back. Found a nice male doc for the routine stuff and a female doc for the "girlie" stuff.

Jazz, thanks for the moral support. I actually have told my therapist about the Rx doc. I'm going ahead with this Wednesday's appointment, and if he gives me any grief, I'll be talking to my therapist again pronto -- and getting switched to another Rx doc.

I feel more confident now. By going in with backup information, I will hopefully have all my ducks in a row (though that's difficult for those of us with ADD -- the little buggers always seem to waddle off in about ten different directions at once!)

fiji4me,

I cannot answer your questions, but I totally know how you feel. When I was living in Georgia, I tried twice with 2 different therapists (both supposedly specialized in ADD/ADHD) and both kept focusing on my anxiety and depression and not on my absolutely disorganized life, my inability to stay focused, my lack of follow-thru, etc. I got VERY frustrated and just quit trying. Now that I am living someplace new and my husband is deployed to Iraq and all my carefully placed coping strategies have gone out the window I am once again going to pursue therapy and try for a dx. I, too, have read Solden's book and it felt as though she had written the story of my life. I intend to take the book with me along with a few different checklists that I have filled out and a letter from husband when I go to my first appointment next week. I just can't cope on my own anymore and I feel that meds with therapy would help a great deal.

GOOD LUCK to you!

Hi Stacy, if you haven't already found a specialist for your ADD, try this site:
http://www.addreferral.com/
Good luck!
Jazz

[QUOTE=fiji4me]
Jazz, thanks for the moral support. I actually have told my therapist about the Rx doc. I'm going ahead with this Wednesday's appointment, and if he gives me any grief, I'll be talking to my therapist again pronto -- and getting switched to another Rx doc.

QUOTE]

You are very welcome. We have to stick together! Like I told Stacy, you might check out www.addreferral.com (http://www.addreferral.com) if you don't find another doc for the meds.
Good luck!
Jazz

Retail Therapy? (in the profile, for those who wonder what in the heck I'm talking about!) Oh Fiji, you are too funny! LMAO I wish I were that creative!

Jazz