If you are contemplating seeing a psychiatrist, or you have an upcoming appointment, chances are you’re a little nervous, or at least apprehensive. Choosing a psychiatrist is a personal and important decision. You’re trying to enhance your life by meeting a complete stranger and explaining your inner most emotions to them. Sounds simple right? Unfortunately, not so much. Most people don’t know how or where to start, or what to expect. It’s no wonder that thinking about it feels awkward and uncomfortable. Here’s the scoop.
Being unbiased and honest is the key to starting off right.
During your first visit, the psychiatrist will perform a psychiatric evaluation. This may sound intimidating and clinical, but it’s really just a way of saying “getting to know a person.” The psychiatrist will ask you about your medical and family history. They’ll also try to get a sense of your main concerns and goals.
It’s important to remember not to overanalyze what the psychiatrist is asking. It’s easy to misinterpret or read into the intent of a question, and that can alter your response. Answers that aren’t completely straightforward make proper diagnosis and treatment harder, as the doctor ends up basing your assessment on false pretenses. It’s best to be as honest as possible. Don’t worry about how your answers sound or could be interpreted. Try not to be shy about your life, even if you’re worried that what you’re saying sounds embarrassing or silly. An open minded and honest approach will set a solid foundation for future visits, and ultimately for success.
Do not compromise on care.
There are certain things that should be expected when you see a psychiatrist, and others that should not be tolerated. If you feel uncomfortable or misunderstood, you may not have found the right psychiatrist for you. You should always be treated with respect. The psychiatrist should be focused on trying to understand you and your struggles. They should be polite, compassionate, and a good listener. If your clinician is not making eye contact and is overly focused on documenting what you’re saying or writing a prescription, it could be a red flag.
Medications will be discussed but should not be the sole focus.
For better or worse, medications are at the core of what psychiatrists do. We’re experts in psychotropic medications, so it’s inevitable that the topic of medications will come up. Still, despite being a major element of psychiatric care, medications should never be the ONLY component of the conversation. People are more than walking chemical imbalances. There are psychological, social, and interpersonal dynamics at play. Focusing exclusively on medications would be oversimplifying what it means to be a human being.
You should be an active participant in your treatment
By the end of the first visit you should be provided with a diagnosis and given an overall assessment and plan for treatment. All of your questions should be completely answered. Medication risks, benefits, indications, and alternatives should all have been discussed. Most importantly, you should be given the opportunity to express what is helpful (or not helpful) for you. Patients have the right to refuse treatments and express their opinion as it relates to their treatment. Leaving your first session without a clear understanding of your medication or treatment goals makes improvement less likely. Though you may not leave your session completely perfect, you should certainly leave feeling confident in the next steps to achieving happiness.
Seeing a psychiatrist, particularly for the first time, can be intimidating. Seeking help can mean confronting the unknowns, like a possible diagnosis. Moreover, trusting a practitioner with your mental and emotional well-being puts you in a vulnerable position. While your loved ones can support you, they can’t treat you — thus, your psychiatrist holds a powerful position in your treatment.
A little preparation before your appointment, however, can go a long way. This begins with finding the confidence to self-advocate, as you are the expert in yourself. Only you can best express your goals, values and preferences, and you have the right to take an active role in your care. In fact, new research suggests that active involvement of patients in their health care may significantly enhance outcomes.
With that in mind, here’s how you can best prepare yourself for seeing a psychiatrist.
Do Your Research
One of the best ways to find a qualified psychiatrist is often through referrals from a talk therapist, primary care doctor or member of your support system. If you’d prefer to do your own search, you can use online directories available through mental health publications and websites like Psychology Today. Make sure to research the background and specialties of all psychiatrists you are considering to ensure that they fit your needs. Before scheduling an appointment, ask about insurance coverage.
Know Your Medical History
Before meeting with a psychiatrist, you may want to assemble your complete medical history. Be familiar with and ready to share any prior diagnosis, symptoms and a summary of current and past medication regimens (including doses, time periods taken and side effects). If you are unsure about your medical history, you can obtain this information from the clinician who prescribed past medications or your pharmacist.
Educate Yourself on the Basics
A little at-home education on mental health conditions can be extremely helpful. Read up on your condition, symptoms and possible treatment options. You won’t become an expert, but you can learn enough to ask more targeted questions.
Advocate for a Shared Decision-Making Treatment Approach
Shared decision-making (SDM) is a collaborative approach to making decisions about your care. SDM requires that psychiatrists, chosen family members and patients come to mutual agreement about plans for treatment. Ultimately, this approach assumes “two experts” in the room: The psychiatrist with specialized medical knowledge and the person with the expertise of their lived experience, values, preferences and goals.
You can ask your provider if they are familiar with shared decision-making and determine if they will include your thoughts and expertise when deciding about your treatment plan. Knowing up front how you will be involved in your treatment plan will help you decide whether this is the best provider for you.
Assess the Relationship Fit
Most likely, you do not feel comfortable with every person you meet. The same applies to working with mental health professionals. It often takes a few meetings to figure out whether you feel comfortable enough to work with someone. Connecting with your mental health professional is key — researchers have found that the quality of the therapeutic relationship (including their warmth, interest and responsiveness to your needs) has been shown to improve outcomes in psychotherapy.
After the first few appointments, it is important to consider whether you connect with your psychiatrist. Ask yourself:
- Did you feel you comfortable talking to them?
- Did you feel like they cared about what was important to you?
- Did you feel like you could express what was important to you?
Difficulties in these areas could suggest that this may not be the right psychiatrist for you. Talk about your concerns with your psychiatrist and decide whether switching to someone else would better support your needs.
Ask Questions
An effective psychiatrist should be willing to answer any questions you have — respectfully. Dismissing your questions may be a sign that they may limit your involvement in your care. Some possible questions to pose are:
- What is your treatment approach?
- How can I be involved in my care?
- I would like to be treated to achieve my life goals rather than to address symptoms. What do you think of this approach?
- What are my medication options? Can you thoroughly explain each one, including what symptoms they will treat?
- Can you carefully explain any side effects, including physical impacts, such as sedation or weight gain or activity restrictions such as alcohol consumption?
- How can side effects be addressed? Are there any adverse impacts with the other medications I am on (if applicable)?
- Are you available outside appointments to address medication and other concerns, such as refills and emergencies? What’s the best way to reach you?
- Are you able to recommend additional resources that might be helpful for me?
Keep Records
In between appointments, it can be helpful to keep a log of your moods, triggers, symptoms, medication observations and any self-care practices. These trends can be useful data to evaluate with your doctor, including progress between appointments. You can also use this information to make a list of discussion points for your next appointment.
A meaningful relationship with your psychiatrist is critical to receiving the best care possible. Your psychiatrist’s role is to share their expertise to guide you on your journey, but for the best results, this relationship requires your effort and preparation as well.
Katherine Ponte is happily living in recovery from severe bipolar I disorder. She’s the Founder of ForLikeMinds’ mental illness peer support community, BipolarThriving: Recovery Coaching and Psych Ward Greeting Cards. Katherine is also a faculty member of the Yale University Program for Recovery and Community Health and has authored ForLikeMinds: Mental Illness Recovery Insights.
Mark Costa, M.D., MPH, is a psychiatrist and an Associate Research Scientist at the Yale University Program for Recovery and Community Health. He is the project coordinator of the Yale Post-Doctoral Research Training Program to Advance Competitive Integrated Employment for People with Psychiatric Disabilities.
Anthony J. Pavlo, Ph.D., is a clinical psychologist and an Associate Research Scientist at the Yale University Program for Recovery and Community Health. His research focuses on recovery-oriented and person-centered practices in mental health care, therapeutic relationships and shared decision-making for persons who are diagnosed with serious mental illnesses.