How to Handle Your First Psychiatric Appointment

Tuesday, July 21 2015 Natasha Tracy

Recently, someone wrote me and asked how to best handle a first psychiatric appointment. This is a good question because, essentially, people are walking into the vast unknown. If you’ve never seen a psychiatrist before, how could you possibly know what to expect? And, the kicker of that is, the doctor will be asking you why you’re there. So you’re supposed to know what to say when he says that. So how do you handle your first psychiatric appointment?

Write Down What Concerns You Before Your Psychiatric Appointment

Many people get in front of a psychiatrist a freeze, completely forgetting all the issues that brought them there in the first place. This is extremely common. So, before you head off for your first psychiatric appointment write down all your concerns. Everything that has been odd and everything that you think might be odd should go down on the list, with examples.

For example, “I find I obsessively count things. I can’t leave a room without counting all of the ceiling tiles.”

It doesn’t matter what your concerns are, believe me, the psychiatrist has heard them all before.

Bring a Loved One to Your First Psychiatric Appointment

Your first psychiatric appointment can be scary but you can get through it. Here's how to handle your first psychiatric appointment successfully.It can be really difficult to sit in front of a stranger and pour out your heart and admit to things you’d likely prefer to forget. But you have to, so bring a loved one to your first psychiatric appointment to make it easier. This person will be on your side and be able to fill in any blanks you might forget. Plus, this person can offer a perspective on what symptoms he or she has personally seen and that can be very helpful for a doctor. (Your loved one can also write down concerns before the appointment too. They may freeze under the stress of being there as well.)

Be Open and Honest In All Psychiatric Appointments

Honestly, it’s natural to want to hide stuff, even from a psychiatrist, but he can’t help you if you don’t give him the full picture so it’s critical to be honest with your psychiatrist. If you’re experiencing sexual dysfunction – say so. If you’re raging in out of character ways – say so. If you just bought five, $5,000 handbags that you can’t afford – say so. All of this is important stuff even if you’d prefer it not be.

Also try to answer the psychiatrist’s questions with as much honesty as possible. Don’t try to shape your answers into a diagnosis, just be honest. Really, you’ll be a more accurate diagnosis that way. You don’t’ know what is important so don’t try to do your psychiatrist’s job for him.

Write Down Everything the Doctor Says in Your First Psychiatric Appointment

Chances are there will be a lot of information flying your way in your first psychiatric appointment so write it down for reference later. This can be the job of your loved one.

Ask Questions at Your First Psychiatric Appointment

What matters in any psychiatric appointment is that you understand what is going on and you can’t do that without questions. No questions is a dumb question. Trust me. I’ve heard them all and I’ve probably asked them all and they’re all important. Don’t leave the room without an understanding of what is going on and what is happening next. Again, your loved one may be able to do some of this for you if you’re feeling overwhelmed, which would be natural. Likely you won’t have a complete understanding of your illness at your first appointment but your doctor may be able to recommend resources (like HealthyPlace) where you can learn more.

Your First Psychiatrist Appointment Should End with a Plan

You may or may not leave your first psychiatric appointment with a prescription, but you should leave with a plan for next steps. Will you be seeing someone else? Do you need any tests run? When can a diagnosis be made if not now? That sort of thing.

You Should Understand Any Prescriptions from Your First Psychiatric Appointment

If you do get a prescription, make sure you understand what it is, what it’s for and what the common side effects are. You should also know if there are any special dosing instruction (like, take with food (and how much food)) and if there are any interactions to worry about.

Again, you may want to write down what you want to know about a prescription before you get there so you know that when you walk out, you have all the information you need.

Your First Psychiatric Appointment Is Worth It

I think, in short, it is scary meeting a stranger that has so much power to help you, or not, but it’s worth it because, honestly, most doctors just want to see you get better. Yes, there are bad apples and if you get one, you’ll have to see about changing doctors, but most really do want to help. So try to go in with a positive attitude, with the backup of a loved one and start getting the help you need to get better.

You can find Natasha Tracy on Facebook or Google+ or @Natasha_Tracy on Twitter or at Bipolar Burble, her blog.

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar BurbleTwitterGoogle+ and Facebook.

View all posts by Natasha Tracy.

How to Handle Your First Psychiatric Appointment

lee
says:
May, 25 2018 at 9:21 pm
I am new blogger. I have had bipolar along time and thought I could help someone that has just found out that they were diagnosed with bipolar.
Sarah
says:
May, 25 2018 at 9:21 pm
My first psychiatric appointment was in the middle of a psychotic episode. I was hospitalised and still in my pajamas, seated in front of about ten people.

Can't get much worse than that.
Paula
says:
May, 25 2018 at 9:21 pm
Great idea Lee. And Sarah, that must have been just awful for you. I hope that you both are doing well now. xx
Paula
says:
May, 25 2018 at 9:21 pm
Natasha, I do this list thing whenever I have an appointment, not just with medics, but other meetings too. Saves you getting out of the room and a forgotten thought coming to you!
Debra
says:
May, 25 2018 at 9:21 pm
My husband has depression, social anxiety, and is a recluse.

I have my own issues with the d word the a work, but I try to go to work each day and handle the household chores.

I am very sad that he can't see his way clear to reaching out to other people.

I am involved with www.recoveryinternational.org. It is a fine organization that helps people to help themselves with cognitive behavioral training.
Tammy
says:
May, 25 2018 at 9:21 pm
I just had my very first psychiatric appointment Friday. I took my betrothed with me. I needed that support. He offered a lot of commentary (that was really hard for me to hear, but necessary). He filled in so many blanks, because I don't see things the way he does about me.

I am still trying to come to terms that I have bipolar, let alone bipolar I with psychosis. I feel things touching me that aren't there, I think people follow me when I drive, and sometimes I hear and smell things that are not there. I am always suspicious of everyone and their motives.

And writing this makes me feel like I am a nutcase. Maybe I am. All I know is that I am committed to my mental health and psychiatric care has been my 2nd step. I have just started Lithium and I am in day 2 and although I am still manic, I can already feel that my mind has changed or at least the moods.

I look forward to blogging more. I need this.
Kelli
says:
May, 25 2018 at 9:21 pm
I have my first psych eval tomorrow.
It has taken me two years to get this far because of my anxiety.... Right now it is very amped up and I will be throwing up by morning. I can't even drive myself to the appointment! I feel like I will 'Fail' the evaluation and make a fool out of myself!!!
Intellectually, HOW can anyone 'mess up' a visit with a psychiatrist?? This is what I battle with daily.....Dread and Fear! Along with heart palps, nausea, shortness of breath, shaking and fatigue.....all the time! I will post the outcome tomorrow.....wish me luck!
Melanie Overy
says:
May, 25 2018 at 9:21 pm
I was originally posting for myself, but having reread the last comment I have to offer my sympathy Kelli! I have also taken two years to finally convince myself to get an appointment, and it's also because of anxiety it's taken so long but I have never thrown up so I really hope you found the help you needed! Was ringing up today and getting racing pulse/shortness of breath but wasn't able to get through today so I have to call them up next week. The appointment will mainly be about possible bipolar which I think the anxiety's a part of but since I've reorganised my wardrobe and cleaned/restrung my violin and practised it's easing off. And the concept of failing is never far from my mind. For me it's been more the idea that I'm attention seeking(how, when I hid my thoughts and feelings from everyone, is that even possible) and when I tell someone how I'm feeling they'll see through it and call me a fraud(in fact I know now what really happens is I break down completely). But it still feels like a test I have to pass.
Mel
says:
May, 25 2018 at 9:21 pm
Kelli and Melanie,

I found it to be comforting to read about your common anxieties regarding your visit. I don't mean that I take comfort in your pain! I have been putting off visiting a psychiatrist for 10 years, and I finally went in today.
I had the same thoughts that both of you do, and Kelli I really felt like k had to vomit, before and after the appointment. It was hours ago, but I still feel strung up with anxiety. I wish I had read this article before my appointment, it would have been so helpful to have things written down considering how I was in a state of terror through the whole appointment. How can one even fail a psych appt, but my mind still insisted that's what would happen.

Instead I received compassion and understanding. When my anxiety and nervous tension wears off (hopefully soon) I think I will feel relief as well as somewhat proud that I FINALLY took the first step.

I wish the best of luck to both of you! When I left I kept thinking "I wish I did this 10 years ago, I've had so much unnecessary suffering!"

I hope everything goes well for both of you.
KIM
says:
May, 25 2018 at 9:21 pm
HI...SO I HAVE BEEN PUTTING OFF GOING TO SEE A DR. TOO, AND I HAVE AN APPT. AT 10 THIS AM. IM ALREADY FEELING SOME ANXIETY, AND IT WILL GET WORSE WHEN I OPEN MY FRONT DOOR TO WALK OUT. PRAYERS PLEASE ;)
Jay
says:
May, 25 2018 at 9:21 pm
This is how crazy I am... I'm putting off Dr. Visit in fear that when they refer me to see a psychiatrist or something similar that I show up to the appointment and end up knowing them or one of their work colleagues. That would actually tip me over the edge for sure!
Melanie
says:
May, 25 2018 at 9:21 pm
Thanks to Kelli, Melanie and Mel (the last two my name also and my nickname lol)! I have my first Psych appt tomorrow and I have anxiety as well. I have been sitting here watching a show trying to get into it and "wind down" but I too think that I'm going to "fail" the appt, or that they will find several things wrong with me and think I'm so completely crazy that I will end up in the hospital involuntarily, or that they will be like "tough love" and be like just mediate (which I already do or try to do). I already have Dr. anxiety about going to any appt., so much so that my last primary care thought I had high blood pressure when I don't. I guess if I can't sleep and my appt. is in 5 1/2 hours I might as well work on a list, since that will focus my brain some and hopefully stop the thoughts that this appt. will be the ruin of me.

Thanks again so much for all the comments here! <3
Nikki
says:
May, 25 2018 at 9:21 pm
hi I haven't been to my psychiatrist in 10 years maybe plus. I am bipolar and I am not functioning well right now . My family is sick of me, by the way 38 year old mother of 3 married, I've worn them out. My mind is completely against me and I know j need help and I want help so much . I just can't make the call or don't know how . Please help me , just tell me a number or something to call . I don't know where to start anymore . Thank you for any advice
Nikki
says:
May, 25 2018 at 9:21 pm
Oh my gosh , I just posted a comment and forgot that I'm supposed to go on a vacation with family and In laws too. In the same beach house ! I can't do that because they don't know how I really am . I know they know j don't go to a lot of things and that I'm always late , very late , but they don't know how I really do things . They haven't seen me get upset if something goes wrong ( wrong to me, no one else usually) , they don't know how I stay up almost all night doing things in my house . Which I don't know what I'm gonna do there at night? I can't sleep but maybe 2/3 hours at a time before I'm up .sometimes I go back to sleep after doing something , most of the time I don't go a chance. They don't know what my skin looks like right now under my clothes and at the beach they will see how I claw myself to stay calm . I feel like such a loser and I'm so embarrassed , ashamed . I don't even want to go. What if we go eat and the place feels dangerous to me , I can't force us all to leave ? Please somebody what can I do ? I'm sorry to be so needy
Kay
says:
May, 25 2018 at 9:21 pm
DID I DO SOMETHING WRONG?..........I have an appointment coming up that I am very nervous about since the last time I tried to seek help didn't go so well. My severe depression and anxiety can no longer go untreated. I can't take SSRIs ((I tried one for a couple months and it made me completely pass out. One minute I'm standing the next minute I was on the floor completely out and it kept happening. I passed out in the shower and was on the bathroom floor having hit my head. My PCP had me stay on it for a while longer but finally weened me off in two weeks after continuing passing out issues. I now continue to suffer dizzy spells since and I had never had any issues like that before the medication. It's been very hard to get any Dr believe that it was from the medication.)) I am searching for anything to see If I did something wrong the last time I tried to see a psychologist. I did my best and was very well mannered but nervous. It was my first visit to a counselor of any kind in a long time. I was greeted by very rude staff. The Dr seamed ok at first and I was willing to do anything to get help. I was in crisis. The Dr asked me about sexual abuse only 20 minutes into the session. I said I wasn't comfortable talking about that yet. He persisted and wanted to know if I was abused and I said yes but I wasn't comfortable enough yet to talk about it. The dr persisted and asked me If I masturbated while thinking about the abuse. I WAS SHOCKED. He persisted after I said I wasn't comfortable and made me feel vulnerable in just 20 minutes. He then said I had to take the same SSRi that I reacted poorly to so he can see the results. I said no, that I wouldn't put myself in that kind of danger again. He said to me "You will take the medication and you will behave!". I couldn't get out of there fast enough... Now I have tried to explain to a few doctors what happened with the psychologist but they don't believe it or don't want to get involved. Now because of this I am soo scared of my upcoming visit to this new therapist. Is it me? Did I do something wrong in the visit? Is that standard procedure to be so aggressive with a patient? I don't want to go through that again.
Follow Your Intuition
says:
May, 25 2018 at 9:21 pm
No Kay, that's not normal procedure. Good for you for standing up for yourself and not going back to him!

Follow your intuition. If something feels wrong, it probably is.
Follow Your Intuition
says:
May, 25 2018 at 9:21 pm
and Kay please also keep in mind that you are the client and he is the service provider. In essence you are his employer. If you don't like the service he is providing fire him and don't go back. Don't settle for less because you are desperate for help. Shop around. You are worth the effort. So many people who have been abused in the past have unwittingly been conditioned to accept more of the same. Stick to your guns. Learn to put your foot down and stand up for yourself. If you are not comfortable talking about something, then don't!
"First Do No Harm"
says:
May, 25 2018 at 9:21 pm
Kay, for any psychiatrist, psychologist, or counsellor to repeatedly cross your boundary like that is extremely unprofessional and well, just plain WRONG and shame on them for doing it. They are trained to know better!!!

Here's A Guide I Found On The Net That May Be Helpful With Regards To Psychology And It's Practice, A Special Emphasis On Boundaries

http://guidetopsychology.com/boundaries.htm

I once read an autobiography, that was too disturbing to finish, by a young girl in my community who had been kidnapped by a neighbour and held in a tiny underground bunker (no light, no toilet, etc) for over a year where he repeatedly sexually assaulted her and nearly starved her to death. He even took part in a public search for her with the police, now how sick is that! Eventually he was caught, charged and died in prison.

When she was eventually rescued by the police her mother took her to a local hospital to see a counsellor that kept insisting she come and sit on his lap! She didn't want to because it made her feel uncomfortable. Her childlike trust had already been broken and her boundaries severely violated by her original abuser. She was not ready and that "counsellor" should have known better than to insist on any type of "closeness". When they left she told her mother she was never going back and she didn't. She had already been traumatized enough!

A doctor's hypocratic oath is said to be "first do no harm"... A true healer will abide by that. A true healer is sensitive to the needs of their client and will act appropriately!
Marie
says:
May, 25 2018 at 9:21 pm
I have my first appt tomorrow and I can't think.
Alllllllll summer I was in my head. And now nothing. I don't know where to start. It's too much. I don't even know how to start here.. what if I don't say enough. I hate this..
Clayton
says:
May, 25 2018 at 9:21 pm
Hi everyone,

I'm so happy I found this website that will help me understand my 1st visit to see a psychiatrist. I've never been diagnosed but I'm scared as hell to what I've been going through the last 15-20 years. I've all the symptoms for being bipolar and want to know can any of you give me some helpful advice to keep calm. My head doesn't slow down a bit to even think or sleep and do get sick as well from the anxiety I've. I'm finally getting up the courage to get some much needed help cause I can't live like this anymore. I appreciate any help one can give
Clayton
says:
May, 25 2018 at 9:21 pm
Hi everyone,

I'm so happy I found this site to read about everyone's advice and experiences with their first visit cause I'm scared as hell right now. I've been living like this for 15-20 years and finally getting up the courage to get the help I'm really needing. I've never been diagnosed but I've all the symptoms as being bipolar. My head races so much that I can't think straight then get so much anxiety because of it and can't get it too stop and much less I worry about people hurting me all day and night. It's crazy and maybe I'm crazy but it's time. Can anyone give me some helpful advice to keep calm or to try and help me before my first visit. I had to leave my last job because it became too much to handle and always thought my workers under me were going to hurt me in some kind of way and I can't live like this anymore

Thanks for any help and great website and pray you all will keep updating it to help myself and others that may be going through same thing

Clayton
Chrissy
says:
May, 25 2018 at 9:21 pm
Hi everyone! I had a visit to a more public affordable place that deals with mental illness when i didn't have health insurance. I was told to fill out a long packet and was asked so many questions. I was diagnosed by a nurse practitioner and was told i was bipolar. She prescribed me something that was awful and made me hallucinate so then she prescribed me something else which i wasn't comfortable taking either. I don't take anything currently as I am skeptical that I even have bipolar disorder. She wasn't the least bit detailed about my specific case. Like, she never said if I was bipolar I or II...so i have an upcoming visit at a better psychiatrist office (hopefully). I hope they will be able to tell me exactly what is going on. Im looking forward to finally getting things sorted out but still a little nervous
amber
says:
May, 25 2018 at 9:21 pm
I have my first appointment with a psychiatrist tomorrow. When I spoke to my doctor about my symptoms he seemed very concerned. He referred me straight away and they got back to me very quickly. He thinks I have bipolar disorder or a personality disorder but of course has to send me to the psychiatrist. I was scared about what to expect. This post has helped
Irene
says:
May, 25 2018 at 9:21 pm
I'm 26 and have been dealing with often crippling mental issues by myself with no diagnosis or treatment for thirteen years, always too poor or too terrified to seek help, but I finally reached out to a psychiatrist today. I hope to get a diagnosis of what's wrong with me just to validate to myself that there's a reason and a name for why I've suffered so much.
Maria Byrne
says:
May, 25 2018 at 9:21 pm
I got my first sycyatrist appointment money. I'm really worried
Mandy
says:
May, 25 2018 at 9:21 pm
How did it go? I'm going to see someone next week for similar issues.
TD
says:
May, 25 2018 at 9:21 pm
I wish I would've read your article before my first psych appointment. It was horrible! The doctor was very rude and sarcastic. At the beginning of the appointment, he asked me if I had ever seen a therapist or psychiatrist before. I answered that I've seen a therapist before but it was not for me, we ended up talking more about her family and it really didn't help me. I explained that was not looking for drugs but just needed to know what was wrong with me. Maybe a diagnosis. Immediately, he did a Dr. Jekyll/Mr. Hyde and kept repeating, "I am not a therapist, I am a psychiatrist." I sat there in shock because he kept escalating his voice. I wanted to run out the office. I thought maybe I was imagining this reaction until he called his nurse, put her on speaker and started blasting her in front of me. It was very uncomfortable and unprofessional. Needless to say, I'm not going back. I left there with no resolve and medication which I am afraid to take.
Danny
says:
May, 25 2018 at 9:21 pm
Do I really need a psychiatrist? I don't seem to have any special concerns about my life that I want to share with anyone, but I'm sure if I saw a psychiatrist, he or she would likely be able to pull a lot of repressed memories out of me. I also don't have a doctor's recommendation to go see a psychiatrist; this is something I have been thinking of doing for quite some time, just to see if I'm really sane. What should I expect to pay for my first hour? How long does the first session last? Is it just an evaluation session or will he or she prescribe future visits in the hundreds of dollars per visit? Thank you for reading.
Barbara
says:
May, 25 2018 at 9:21 pm
I have my first appointment tomorrow morning with a thearpist. I am scared about it. I am going because i havent been able to eat whole food in three months due to being scared i will choke on it. I just had my throat stretched and a test done to test the strength of the muscles in my throat. The tests show i am good to go. But i still have a fear due to almost choking on a bone. I just hope they are able to help me.:(
anne
says:
May, 25 2018 at 9:21 pm
We cannot trust Psychiatrists, they are paid huge bonuses to push drugs. Read books or watch video's by by Peter Breggin and Joanna Moncrieff.; and especially read 'cracked -Why Psychiatry is Doing More Harm than Good' by James Davies.
Dkey
says:
May, 25 2018 at 9:21 pm
I want to meet a psychiatrist, buy i'm scared.. But, at the same time, if possible I want to meet psychiatrist alone, withouy family members, without friends or partner.. I want to keep this thing from everyone..
Natasha Tracy
says:
May, 25 2018 at 9:21 pm
Hi Dkey,

I understand the desire to want to keep this from everyone but I don't recommend this. This is a hard road and it's even harder if you walk it alone. Certainly, you don't have to tell anyone, but if you trust at least one person, that support can be invaluable.

- Natasha Tracy
Steven
says:
May, 25 2018 at 9:21 pm
I've been depressed and suicidal since the age of 10. I've been to several psychiatrists but they did not help me. I've never actually attempted suicide but once came close. I [was going to when] when my dog started licking my face. I am convinced that my dog knew that I wasn't well. I was concerned who would take care of my dog if I died and could not go thru with killing myself. I finally found a doctor, not a therapist who attributed my suicidal tendencies to a bad reaction of a medication. All I can say is don't waste your money on psychiatrists. If you don't have a dog, get one and check all medications for side effects. Without a doubt the dog saved my life.
Harish Ravi
says:
May, 25 2018 at 9:21 pm
Some doctors prefer a patient to come with a caregiver to get a complete picture, some prefer alone. The patient usually expects or requests something. Yes the doctors need to heed their requests too.
Harish Ravi
says:
May, 25 2018 at 9:21 pm
Hey, a person feels bad if he isnt getting something or there is no hope. Just accept let go and bow to life and you will be able to overcome!
Cindy
says:
May, 25 2018 at 9:21 pm
I hope things ended up helping you
Jennifer Burns
says:
May, 25 2018 at 9:21 pm
That is such a accurate statement, I've got 2 dogs and if I hadn't I wouldn't be here.They keep me outside even when its cold rainy and dismall. Thank you. Going for a walk, just left new psychiatrist whom hasn't a clue..
Burt Silver
says:
May, 25 2018 at 9:21 pm
I like what you said about being open and honest in all of your psychiatric appointments. This is something that I've been nervous about is sharing details about my life and my thoughts. I'm looking into meeting with a psychiatrist soon and although I hate drugs, I think at least seeing what they have to say would be a good idea and maybe the most beneficial option for someone as unstable as me.

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