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Psychiatrist or Therapist
Old 04-21-2016, 08:48 PM   #1
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Psychiatrist or Therapist

For anyone with experience or training in the area, how do you find a good and appropriate psychiatrist or therapist?

Basically, I have been suffering from OMY syndrome a very long time; and, I am considering TMY (Two, or Three, More Years) for a new opportunity. So, I think I need my head examined. But, I don't know where to start. Enough stigma still exists that I am reluctant to pose this question to people in my physical social circle, family, etc.

Seriously, this is not urgent; but, (not even pretending this is for a friend) more that one person has mentioned to me the possibility that I may be mildly depressed. And, I have had some mild symptoms that could be related to stress or anxiety if not depression.

While nothing is sever or debilitating, I would like to try to find out if this stems from j*b related stress (staying or retiring), family stress, andropause or other chemical imbalance, etc.
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Old 04-21-2016, 09:00 PM   #2
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It may be (probably is) covered under your health insurance - so you want to find a therapist/Dr. who's in your plan.

If your employer offers an employee assistance program (EAP) then you might be able to get some FREE (my favorite price) counseling. That's what I did when work stress/pressure led me to depression. I used the free 6 sessions - we determined I needed a bit more so the therapist helped me find a therapist in my insurance plan.

If it is depression or anxiety you're likely to need a psychiatrist as well, at some point, to provide meds.

I was dead set against any meds at the time - talk therapy helped - but not enough... so I did the SRI meds for a period. Statistics show that talk therapy alone helps some percentage... meds alone help some percentage... and a combination of both helps a higher percentage.

FWIW - I'm really glad I did the therapy and meds....it helped me get out of my depression and I've been fine since.
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Old 04-21-2016, 09:23 PM   #3
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In general, most of the time nowadays, psychiatrists provide medication management rather than therapy. Also, in some cases a psychiatrist can be a good overview person. For example, with our ADHD child we have used the same psychiatrist for 12 years. He did medication management but also made recommendations for therapists and helped us find an appropriate school for our child.

The psychiatrist we use is good because he is part of a multi-disciplinary practice. He handles the medication management and overview and there are several therapists who work in the same practice. Most of the time there has been someone there who had the expertise for the therapy aspect. There was one time where a specialized program was needed and we were referred to another therapy practice for that.

As for finding someone who is in your insurance plan, honestly, I wouldn't count on it and wouldn't even choose someone based upon that. Many psychiatrists -- particularly the ones who are really good -- don't join insurance plans. That hasn't been a big deal because medication management is not that expensive.

And, frankly, I have always tried to find the best therapist and not really cared if they were in network or not. Usually the ones in network are very, very limited.

I did awhile ago want to find a therapist for myself to deal with a very specific issue. This therapist needed to have knowledge regarding the therapy method that was being used with a family member. This is a specialized method that requires specific training. In this case, I actually went to the Psychology Today website and searched for someone in my area who had expertise with the specific method and went to her website to see that it was prominent there that she used the method, and talked about her training, etc. I ended up going to see her and it worked out well because she had the knowledge I needed her to have.
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Old 04-21-2016, 09:42 PM   #4
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My experience. Psychiatrist now days, give prescriptions. Which they always do. Therapists, talk therapy, can be very helpful.

I would see a Therapist first. After maximum 7 sessions, if you are not
getting results. Change Therapists. Therapy is more "art" than science.

If you do see a Psychiatrist, be prepared, for meds.
Psychiatrist's tend to trip the symptoms, (with meds), not the cause of the anxiety/depression.

Now the hard part. Finding a good Therapist / Psychiatrist is very, very, very,
difficult. Best recommendations are family and friends.

Professionals, never give a bad recommendation.

Insurance. Can be very expensive if you go out of network. Therapy can be a long process.

Good luck.
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Old 04-22-2016, 09:10 AM   #5
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There are still some psychiatrists who do psychotherapy as opposed to solely medication management (psychopharmacology). Some people prefer to have the person prescribing their medication and the person doing their therapy be the same person. Of course, the time of a psychiatrist is often (though not always) more expensive than the time of a non-MD therapist.

I agree with others that in-network is hard. Probably harder than any other form of medical care. The insurance reimbursement rate for therapy tends to be very low, so the therapists try to be private pay. As a general matter, only the ones who cannot get enough private pay business sign on as in network.

Also not all psychotherapy is long term. For example, Cognitive Behavioral Therapy (CBT) tends to be short term, and can be very effective. For that, it is worth finding a therapist who specializes in CBT.
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Old 04-22-2016, 09:35 AM   #6
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Thank You

Many thanks for not only taking the time to help but also for sharing a bit of your personal experiences.

It sounds like I want to start with a therapist. While I understand the need for medications in some cases, they do frighten me. I would like to avoid taking anything if possible.

Quote:
Originally Posted by rodi View Post
....
If your employer offers an employee assistance program (EAP) then you might be able to get some FREE (my favorite price) counseling. That's what I did when work stress/pressure led me to depression...
I need to look into this again. My benefits seem to change dramatically every year; I have not really looked into what is available this year.

Quote:
Originally Posted by Katsmeow View Post
In general, most of the time nowadays, psychiatrists provide medication management rather than therapy...

I did awhile ago want to find a therapist for myself to deal with a very specific issue. This therapist needed to have knowledge regarding the therapy method that was being used with a family member. This is a specialized method that requires specific training. In this case, I actually went to the Psychology Today website and searched for someone in my area who had expertise with the specific method and went to her website to see that it was prominent there that she used the method, and talked about her training, etc. I ended up going to see her and it worked out well because she had the knowledge I needed her to have.
I have a high deductible plan; so, the only insurance benefit I would likely get is a negotiated rate, if that.

I used the approach you outlined to find a dentist and was happy with that result, not sure why I did not think of it for this situation.

Quote:
Originally Posted by wolf View Post
....
Best recommendations are family and friends.
....
I actually do have a friend who I do feel comfortable speaking with about this who may be able to provide a recommendation.

Quote:
Originally Posted by medved View Post
There are still some psychiatrists who do psychotherapy as opposed to solely medication management (psychopharmacology). Some people prefer to have the person prescribing their medication and the person doing their therapy be the same person. Of course, the time of a psychiatrist is often (though not always) more expensive than the time of a non-MD therapist....
This was my original thought; but, I am definitely open to the idea of starting with a therapist.

Quote:
Originally Posted by medved View Post
....
Also not all psychotherapy is long term. For example, Cognitive Behavioral Therapy (CBT) tends to be short term, and can be very effective. For that, it is worth finding a therapist who specializes in CBT.
I find this very reassuring.
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Old 04-22-2016, 10:40 AM   #7
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My sister is suffering from this syndrome. She is back to work for at least 5 years to get a small pension. Not only that she is a hoarder. I'm sure she can get some help but no more medicine fore her, since she is taking lots of medicine already. Her kidney might shut down.


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Old 04-22-2016, 10:55 AM   #8
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i am not clear why this is defined as a problem, let alone as a mental health issue. OP has not said that he is miserable, just that he self diagnoses as OMY syndrome, something that I have never heard of anywhere but on early retirement websites.

A younger person who does not want to work has a problem, a heavy drinker has a problem, someone who is suffering torment definitely has a problem.

What would this be if it were somehow in the DSM? "Wishes to continue his career?" "Doesn't need to move to Florida issues?" "No golf attraction problem?"

Someone may show up here unhappy, frequent advice is to volunteer, on occasion even adopt or foster a child. Hello, are we expert at micromanaging everyone's life, or should we all perhaps just chill?
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Old 04-22-2016, 10:59 AM   #9
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Originally Posted by haha View Post
Someone may show up here unhappy, frequent advice is to volunteer, on occasion even adopt or foster a child. Hello, are we expert at micromanaging everyone's life, or should we all perhaps just chill?
You forget this forum also functions as an online Dear Abby column. Posters want answers, we offer them up - warts and all.
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Old 04-22-2016, 11:38 AM   #10
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I'd ask my Doc since I have a good long history with him. If he had a recommendation, I'd ask why he would recommend this professional over others.
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Old 04-22-2016, 11:56 AM   #11
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CoolChange:

While I am not a therapist, I offer advice on a wide range of topics. As I see it, pretty much everyone is entitled to my opinion.

So ask away, And I or the group here will set you straight.
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Old 04-22-2016, 12:38 PM   #12
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Sounds like you need to start with a therapist, either a psychologist or a LCSW. Should you need medication, the therapist can always refer you to a psychiatrist. I'm a retired primary care doc and I always had a pretty good idea about who the good therapists and psychiatrists were, so you might try asking your PCP for a referral. If you don't click with the first therapist, then don't hesitate to try a different one. EAP is a good option too.
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Not miserable, but...
Old 04-22-2016, 01:52 PM   #13
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Not miserable, but...

Quote:
Originally Posted by haha View Post
i am not clear why this is defined as a problem, let alone as a mental health issue. OP has not said that he is miserable....
Definitely not miserable but probably not as content as I could be, definitely not where I would like to be. Some specifics for anyone who is interested:
  • Significant desire for free time of ER but significant anxiety as well
  • Occasional but recurring sleep issues
  • Recurring skin issues
  • Both lack of interest in and anxiety about career
  • General irritability/cantankerousness

As I read this, I think I should probably go back to see my primary care physician again. It has been well over a year.

Many thanks again to all who have offered suggestions and insights.
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Old 04-22-2016, 02:30 PM   #14
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Late to the discussion.

While working, I once was under extreme stress managing others' expectations and my own, with a background of family illness at a distance. I availed of the confidential EAP program for online counnselling and several visits to a Psychologist. I learnt valuable counnselling strategies and how to say "No!"
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Psychiatrist or Therapist
Old 04-22-2016, 06:42 PM   #15
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Psychiatrist or Therapist

Quote:
Originally Posted by CoolChange View Post
Definitely not miserable but probably not as content as I could be, definitely not where I would like to be. Some specifics for anyone who is interested:
  • Significant desire for free time of ER but significant anxiety as well
  • Occasional but recurring sleep issues
  • Recurring skin issues
  • Both lack of interest in and anxiety about career
  • General irritability/cantankerousness



As I read this, I think I should probably go back to see my primary care physician again. It has been well over a year.



Many thanks again to all who have offered suggestions and insights.

I shared some of those specifics, but not so much the anxiety. But I have general anxiety problem, like I had to take anxiety medicine after 9/11. But I stopped after 3 months. I think anxiety comes from my arthritis. But it's been a while so nothing new. The skin issue is nothing serious, I think I've developed allergy to cheese from what I've read. I also must eat more vegetables. I tend to snack more than having a full meal.


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Old 04-23-2016, 09:38 AM   #16
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Quote:
Originally Posted by CoolChange View Post
  • Significant desire for free time of ER but significant anxiety as well
As I read this, I think I should probably go back to see my primary care physician again.
Get a recommendation for a psychiatrist who is diagnostic and not looking to build up their practice. One or two visits should do it. All the other issues are symptoms. Good luck. I was cured in 2 visits. Different issue but more debilitating.
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Old 04-25-2016, 10:42 AM   #17
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Quote:
Originally Posted by CoolChange View Post
Definitely not miserable but probably not as content as I could be, definitely not where I would like to be. Some specifics for anyone who is interested:
  • Significant desire for free time of ER but significant anxiety as well
  • Occasional but recurring sleep issues
  • Recurring skin issues
  • Both lack of interest in and anxiety about career
  • General irritability/cantankerousness

As I read this, I think I should probably go back to see my primary care physician again. It has been well over a year.

Many thanks again to all who have offered suggestions and insights.
Seeing the above list, I would suggest starting with your PCP. Some of these things could be due to other medical causes (eg hormone, or some other deficiency). Once other medical issues are ruled out, the PCP should be able to recommend the next appropriate step.
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Old 04-25-2016, 06:06 PM   #18
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To add another tool to your search for clarity, I highly recommend seeking out a Mindfulness Based Stress Reduction (MBSR) course. They are usually 8 weeks in length and have a profound effect on stress-related illness including chronic pain, anxiety, depression, etc. I have read about it for about 10 years and incorporated the associated meditation practices for some noticeable results. It was only after I attended the 8 week course that the process became profoundly transformative. It was developed at UMass and has some deeply researched roots to its efficacy.

More info here... Mindfulness Based Stress Reduction

The handbook to the MBSR process... http://www.amazon.com/gp/product/B00C4BA3UK

A free online version of the course (not as good as attending a class but better than nothing)... MBSR Introduction
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Mindfulness Based Stress Reduction (MBSR)
Old 04-26-2016, 01:52 PM   #19
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Mindfulness Based Stress Reduction (MBSR)

Thank you for sharing your experience with MBSR. I have started down this road in the past but apparently never followed the road far enough: I have read literature based on this research and attempted to implement my own meditation practice. But, I have never been able to keep it going for some reason.

Hopefully a formal class, even if it is online, will help me maintain a practice. Thanks for the pointer to the online free course; this seems like a great starting point in my current situation (still significant travel).

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To add another tool to your search for clarity, I highly recommend seeking out a Mindfulness Based Stress Reduction (MBSR) course. They are usually 8 weeks in length and have a profound effect on stress-related illness including chronic pain, anxiety, depression, etc. I have read about it for about 10 years and incorporated the associated meditation practices for some noticeable results. It was only after I attended the 8 week course that the process became profoundly transformative. It was developed at UMass and has some deeply researched roots to its efficacy.

More info here... Mindfulness Based Stress Reduction

The handbook to the MBSR process... http://www.amazon.com/gp/product/B00C4BA3UK

A free online version of the course (not as good as attending a class but better than nothing)... MBSR Introduction
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Old 04-26-2016, 06:56 PM   #20
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Quote:
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Thank you for sharing your experience with MBSR. I have started down this road in the past but apparently never followed the road far enough: I have read literature based on this research and attempted to implement my own meditation practice. But, I have never been able to keep it going for some reason.

Hopefully a formal class, even if it is online, will help me maintain a practice. Thanks for the pointer to the online free course; this seems like a great starting point in my current situation (still significant travel).
I was in a similar boat to yours and never took the practice further than what my schedule would allow. Pushing past that point of convenience made all the difference. A great way to immerse yourself in the practice is to become familiar with the MBSR meditation exercises and then find a 1-3 day silent, instructor-led retreat to attend. The time spent in meditation practice and silence in a retreat goes a long way in processing stress and the effects of it (anxiety, depression, etc). Message me if you need any more information, and I'll be more than happy to provide anything else that I can. Best of luck to you.
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