Well I know they are not completely useless they are able to write the script for the drugs.

I was recently diagnoised with mild ADD, that is what my Psychiatrist said I had.

It seems like when I go into there (30 min appt) he doesn't listen to me, its more of a try Ritalin, Dexadrine, Adderall. Experiment with the dosage and see what works with you.

He said is all trial and error so just be liberal in taking the drugs to see what works for you. I'm thinking why does he need a Doctorate to tell me that.

I am now taking Dexadrine and Adderall and it seems to be working ok since I can focus better, but wondering if I could be doing better if the psychiatrist could ask me the right questions to find out what dose I need to take.

Usually at the appt it is just how did you feel? then it is ok take less or more and see me again in a few weeks, and my wallet is a 250.00 dollars lighter (I don't have insurance)

Just wondering is this how all Psychiatrist are or do I just have a lazy one, who is more interested in getting more clients and handing out meds (to make money off of the office visits) then in helping his clients treat their ADD.

The whole trial and error thing just seems so unprofessional. I could buy something off the street and do trial and error to see if it works, so what is my psychiatrist for besides giving me a way to legally buy mediacation?

Thanks in advance for your responses

Hrmph.... mine is like that, too...

It seems like you'd be better off finding a PCP to treat your ADHD if just doing trial and error with meds. In my experience they'll set you back about $100, and sometimes much less if they know you are paying cash. A specialist should be good for something beyond that, and I think that's why they charge more. At least that's the theory...

I contacted a psychiatrist for job stress. You know, the job roulette game. Anyway, the doctor was really odd. $600 and 3 sessions later, I left.

She thought I had OCD, because

1. I have too many bags and shoes. She tried calculating how often I can wear the same pair of shoes in a month. who cares?

2. I stack dog food cans by color --- to make it easier to reorder. Her brilliant suggestion was to order less food and only one flavor.

Since she said I was OCD and "irritable" - she prescribed Zoloft. Well, that made things 10X worse.

And the "job stress" that I initially went to see her for? She said I had too much work. really? wow, amazing diagnosis.

The good thing is that we talked about my childhood and school and that's when I started wondering if there was a connection. Reading online I started wondering about ADHD.

My psych refused to discuss it. She said I wasn't hyper. She said I should get tested for a learning disability that would explain my daydreaming/inattention/forgetfulness/impatience ... etc.

I found a highly recommended therapist who said .. wow, you sound Inattentive ADD and referred me to an MD who specializes in ADHD (he's one himself).

So yeah, I'm still getting over the miserable experience.

Wow, my psychiatrist charges $125 an hour.

It seems like you'd be better off finding a PCP to treat your ADHD if just doing trial and error with meds. In my experience they'll set you back about $100, and sometimes much less if they know you are paying cash. A specialist should be good for something beyond that, and I think that's why they charge more. At least that's the theory...

Whats a PCP? Are you talking about a Primary Care Physician, I don't have health insurance and when I did the co-pay was like 75 bucks so it really didn't pay to go see a doctor. Plus ADHD wasn't a covered expense under the plan seems like they just covered severe depression and mental illness dealing with bulmina and anorexia, but no ADHD.

225 seems extreme. I only pay 90, though the first appt was 270.

I guess the short answer is they are less likely to kill you, because they know a lot more about psych meds than a GP. They should also be able to observe you and tell you are doing ok on that basis.

I do almost wish we had deregulation of prescriptions, though. I've basically diagnosed myself anyhow and made all the decisions. The problem is people would use the drugs in stupid ways and kill themselves and those few people would cause an outcry and then we'd be riht back where we are.

I don't think it would just be a few people. You probably did your research before concluding that you most likely have ADHD. Many people out there would take the strongest anti-biotic they could at the slightest cough, mix drugs without knowing what they are doing, etc. It would be chaos.

I just wish there was some sort of regulation of doctors. Lawyers have the BAR exam and a lawyer that graduates at the bottom of his class is unemployed. Furthermore, lawyers have to constantly read up on changes in law in order to know the game. A doctor who graduates at the bottom of his class is free to charge in a private clinic, do a half-assed job, and never be bothered by anybody telling him to learn the newest research and findings.

They're strictly for management of psychiatric meds

fyi, Psychiatry is one of the least lucrative ( lowest paid) of all medical specialties


tc

mctavish23

(Robert)

Strange, my relationship with my doctor feels quite different.

My physician and I speak very frankly about treatment options, and he admits openly (to me) what he does and does not know about how these medications work. If I tell him I want to try a specific medication, he is open to my suggestions and willing to prescribe the medication (I am sure this is only within reason, but my suggestions have been entirely reasonable!).

Strangely enough, it was his idea to try the methamphetamine (Desoxyn), which is a drug I had not previously considered. He even said that if I could somehow import pemoline, he would make sure I had the prescription to back it up to customs. I asked him about pyrovalerone, but (after having to read what it was!) he said that it be virtually impossible to find at any pharmacy.

Believe it or not, I have had a number of psychiatrists with whom I had similar relationships, with the exception of one (when I was in my early teens).

Present yourself well, but do not come across as a "know-it-all". Once you have developed a good report with the physician, you can then discuss things at a higher level.

Don't be too serious. Frequently, we will comment on the hot sales rep in his office or argue about politics!

I believe he bills at $275/hr, which is actually a bit less than my old physician. But fortunately, my new doctor accepts insurance, as my old physician did not (I had to write a $300 check each session!).

As in any field, some physicians are much better than others...

Personally, I think psychiatry is the last form of medicine I would like to go into, but I suppose it was a bit more of a "hot" field in the 1970's...

what are you wanting from your doctor?

try stating to him your expectations clearly.

NB They don't have a Doctorate (PhD), as you say. They are Medical Doctors first (MD).

you seem to be confusing a (PhD/Doctorate) Psychologist with a Psychiatrist (MD).

*snip*

See, my problem is I come to the doc's office and he kind of rushes me through. I have questions and observations I've made, but he doesn't really ask about any of that and before I remember I wanted to talk about it I'm out the door already.

See, my problem is I come to the doc's office and he kind of rushes me through. I have questions and observations I've made, but he doesn't really ask about any of that and before I remember I wanted to talk about it I'm out the door already.

This is exactly how it is with my psychiatrist, you hit it right on the head. He is open to me saying what drugs I might want to try and he will prescribe them to me to see if they work.

I told him I want to be able to focus better and concentrate while I study. He knows these are my expectations.

I guess I might be expecting too much from the psychiatrist, maybe psychiatrists are just meant for prescribing drugs and if you want talk therapy you have to go to a psychologist.

Just like you warphalange I have questions and observations that I have noticed from my previous visit which could be anywhere from 2-3 months ago.

I wish I had a good relationship with him like some of the previous posters said they had with their psychiatrists but seems like I'm just a number, and its in and out so he can get to his next patient. The lack of personalization is what bothers me the most. I'm wondering if he doesn't get to know me how is he going to be able to personalize my doses to fit me.

But guess that is the reality of psychiatry it is not an exact science so they just generalize the dosage basically take this and increase your dose everyday until you start to have side effects once that happen lower the dose and that is your optimum dose.

I actually had a few visits with a therapist some years back for depression and that's what he said, that therapists are for talking to and psychiatrists are for getting your pills. It just sucked having to repeat my story to 2 people instead of just talking to one person.

Now I still have the depression periods and the doc thinks the ADD might be causing it since they come on pretty fast and leave pretty fast (as in, not months on end, which is what clinical depression needs), but when I want to tell him that "hey, I don't feel like doing anything anymore, I don't have any hobbies, and all I do is wait for the day to end" he doesn't let me and just says "Okay, take this more potent medicine now."

Well, now I've hit the top of the ladder with Adderall so we'll see how it goes. I doubt it will be enough by itself and I think I have something besides ADD or maybe it's not ADD at all and the symptoms are just caused by something else. Then again, that's what I'm paying him to figure out, so that I know I'm not just making stuff up or making excuses for myself. Gahh...

[...]
I doubt it will be enough by itself and I think I have something besides ADD or maybe it's not ADD at all and the symptoms are just caused by something else. Then again, that's what I'm paying him to figure out, so that I know I'm not just making stuff up or making excuses for myself. Gahh...

That's funny in a way because it makes me think of my first experience going to see the doc for depression/anxiety. I thought that they would run some specific tests on my brain and figure out exactly what was wrong. Actually they don't know what the hell is going on, nor do they have any real tests. And the symptoms have so much overlap for so many disorders. Like in my case, ADHD could lead to poor job performance and anxiety, especially with all of these thoughts going through my head. If I took something for the anxiety I would probably be much worse off as that would probably do little for ADHD or job performance, if not hurt performance.

The tests are standarized questions from the DSM. Psychiatry isnt an exact science and relies a lot on interaction with the patient and experience of the doctor. Of course they dont ask you the questions in a normal format because that isnt a very good way of getting a valid answer due to how people view themselves because of illness. Psychiatry and psychology require a certain level of manipulation even if they dont exactly view it that way.

Most of them arent as slow as they seem.

Most psychiatrists are like that: abrupt, to the point, here's your prescription, see you in a month. They often see 4 or 5 patients in an hour. In fact, my psychiatrist is so rushed that she didn't even shake my hand when we met for the first time. She introduced herself to the desk, rather than to me. My sessions with her last about 3-4 minutes, and she might glance at me once during that time. She asks me questions while she's still writing down my answer to the last one. It's a very "in, out, on with life" type of process.

Psychologists are the ones who sit down with you and talk about your emotions for 50 minutes each week. I was in therapy for awhile and found it helpful for some things. I really liked my therapist, but she did have to refer me to a psychiatrist for meds, as psychologists only have a PhD and cannot prescribe meds.

I have yet to meet a psychiatrist who I like as a person. I find the abrupt attitude to be very rude and obnoxious, to be honest. But I know most of them are like that and I get what I need (my meds), so I try not to take it personally. There are some who are not like that, of course, but they are becoming more and more rare. Most psychs are not much more than prescription writers. You just have to learn to speak quickly, and it might help to go in with a list of questions written down, so you don't get rushed out of the office before you have a chance to ask them.

Just as each person is different, so is each psychiatrist. I've seen 2 and they were quite different. But I've had the same kind of experience with "regular doctors" in my life. I've gone from the extreme of the guy who just writes prescriptions, to others who actually sit at a desk with you and discusses things before your temp is even taken.

So far I've had 3 appointments with the p-doc I'm seeing now for ADHD. The first appointment was lengthy (at least an hour but that's a guess) -- I didn't feel rushed. The second one was very brief. The last one felt like maybe 15 minutes. But I'm not checking the times at all.

I took a tip from someone on here: I'm writing a document to take with me. Next time, I'll take a copy for myself AND one for my p-doc. That way I can stay with my agenda and he can see what's on my agenda.

Now that I think about it, I don't actually know how much time they're allotting me. It could very well be that the first appointment is supposed to be long, and subsequent ones aren't intended to be. I'll have to ask ahead of time on the next one, so that my expectations aren't different than theirs.

psychiatrists are extremely educated dope dealers.
.....that TRY to customize your dope for you, since we didn't go to school for drug taking.

that's the service they provide.
.....since everyone is different, and everyone has different effects from different drugs.

it's no more than an educated guess, and a game of trial and error.

.....Basically, they wanna know if you are happier on the meds you got last, or if you wanna try another cocktail.

so, in order to find out what the meds are doing to you, they have to ask you how your life, relationships, and work, are going, on the drugs.

but they are'nt there to listen to your life story, like a therapist, but sometimes they
NEED to know the highlights, to tell what kind of mind set you have.

It would be nice if they could separate what is and is not reasonable for meds. Maybe all you need is psychotherapy or someone to help you cope with something. Instead it seems like they are more than willing to give you meds to mask the symptoms and tell you to GTFO.

For something like ADD all you can do is mask the symptoms, but having someone help you out in adjusting to the condition would be nice.