Beyond Blue

Beyond Blue


How Do I Find a Good Psychiatrist? Some Rules for Getting the Proper Treatment for Your Mood Disorder

posted by Beyond Blue

finding a good psychiatrist.jpeg
This month Guideposts magazine published my story about the morning I met Dr. Smith at the Johns Hopkins Mood Disorders Center. It read a little bit like a fairy tale … as soon as I met the right psychiatrist, I was fixed for good! And I never, ever cried again.

 

I didn’t have room to give all the details … like that it took a few months to feel good again … and there was a lot of work being done on my end … and that even today I have plenty of bad days. I suspect that because the story was so simplistic and ended with glass slippers fitting perfectly on my dainty feet that it has been generating a lot of mail for me, most of the notes asking this question: “How do I get myself one of those good doctors who can fix me?”

Dr. Smith told me during one session that it can be as long as 10 years before someone with depression or bipolar disorder seeks care. Treatment is often successful pretty quickly, but not always. It is more common for someone to have a delay in getting the correct diagnosis if they have bipolar disorder rather than unipolar depression, and especially if their illness presents mainly, or almost exclusively, as depression, as mine did. I am certainly not the only depressive who has had to shop around for the right psychiatrist like a working mother does a suitable nanny, and who has tried on a few too many misdiagnoses.

Have I learned anything in my psychiatric odyssey that could be useful information for the depressed Joe?

Yes, actually, I have. 

I’ll spare you all of the details and get to the point:

1. Go to a teaching hospital to get a psychiatric consultation

Try the psychiatry department of a large university or college. Because the psychiatrists there will be less likely to take the samples from the cute pharmaceutical reps and be lazy about reading all the research today on which drugs work and why. Like my doctor, these psychiatrist will probably be more willing to stick with the older, dependable, well-researched drugs like lithium and the older tricyclic antidepressants that won’t get them rich but that have an impressive track record.

2. I found the right treatment at the Johns Hopkins Mood Disorders Center. You could start there too. Because they have a list of referrals–trained psychiatrists all over the country.

3. Also, you might consider some of the other steps in my recovery program that I describe in my post “The Lessons of Depression,” like paying attention to diet, sleep, and exercise. I would advise anyone struggling with depression to start there. Sometimes those three adjustments are enough.

4. And if you are having a hard time hanging on, you might want to read “12 Ways to Keep Going” or watch my video called “I WILL Get Better.”

5. Many of you may need some support. I urge you to join a support group. I formed Group Beyond Blue about two years ago as a place where depressives and persons suffering from all kinds of mood disorders could exchange information on doctors, med side-effects, insurance hassles, work situations, and relationship complications. You may want to start there to find out about other support groups that people are involved in.

6. Keep these hotlines handy, and call them if you are experiencing suicidal thoughts:

  • Suicide Prevention Lifeline 1-800-273-TALK
  • Suicide & Crisis Hotline 1-800-999-9999
  • Panic Disorder Information Hotline 800-64-PANI

Other helpful numbers:

  • Mental Health InfoSource 1-800-447-4474
  • National Alliance on Mental Illness (NAMI) 1-800-950-NAMI (6264)

7. Whatever you do, do not lose hope. The right psychiatric care is available. 

I want all of you who have written to me to know that I keep you in my prayers, that I am rooting for you, and that I wish you peace and serenity.

Click here to subscribe to Beyond Blue and click here to follow Therese on Twitter and click here to join Group Beyond Blue, a depression support group. Now stop clicking.



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Tony

posted January 27, 2010 at 10:53 am


If I may add: tell your psychiatrist ALL of your symptoms, even if they don’t fit the DSM description of depression or bipolar disorder, even if they seem silly or are embarrassing. Those symptoms may help your doctor tailor the right combination of medications. Psychotic symptoms are hard to divulge: it took me about 7 years before I mentioned them to my doctor. I shouldn’t have delayed. They can be a very serious component to mood disorders. Sometimes they have to be addressed directly. When they are, remission of symptoms can be quicker.



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JOHN

posted January 27, 2010 at 11:07 am


GREAT CLIP, I AM A RECOVERING ADDICT, 18 DAYS CLEAN, AND I HAVE MORE COBWEBS THEN I CAN COUNT, OR WANT TO COUNT, I DO KNOW THERE ARE MANY WAYS TO FIND THE RIGHT PERSON, OR PERSON’S, HOWEVER SOMETIMES YOU MUST CLEAR THE COB WEBS BEFORE THE RIGHT CAN BE FOUND.
AS FAR AS FINDING THE ONE THAT WORKS RIGHT AWAY I DID, ITS CALLED NA, AND IT HAS GIVEN ME INSTANT RELIEF, INSTANT HELP, INSTANT SUPPORT, AND I HAVE TRUE FRIENDS, NOT FAKES.
I HAVE LOST ” MY LOVE OF A LIFETIME ” RIGHT NOW BECAUSE OF DRUGS, BUT I CAN SEE IF I HOLD ON TO WHAT I HAVE, A CLEAN AND SOBER ME, I CAN MAKE IT.
I WANT TO THANK BLUE, YOU ARE HERE IN THE MORNING AND AT NIGHT, YOU HAVE KEPT ME SOBER WHEN I COULD HAVE USED , THANK YOU, GOD BLESS, I AM YOURS, I LOVE THIS STUFF.
CAN YOU DO SOME MORE ON ADDICTION…..PLEASE…..FOR THAT LATE NIGHT READING I HAVE !!!!!



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The Barking Unicorn, Denver, CO

posted January 27, 2010 at 4:29 pm


“If you want happiness, help someone,” said the Buddha.
Even my psychiatrist agreed with this prescription; read what she said in the post linked above.



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Sari

posted January 27, 2010 at 4:50 pm


Therese, I do not know if you remember me but I wrote you several months ago. I was at a complete shut down point.
Your response was so tender and I thank you for it. But you also told me that you would include me and my family in your prayers and that was more than I could have hoped for.
I have suffered from depression for several years now – a combination of miscarriages, infertility treatments, a child born after a very difficult labor and with special needs, a husband who traveled much…
We hit rock bottom last Fall when my husband and I separated.
The climb for me , to accept that I was depressed, and find a therapist ( it took 3), medication that I have stayed on now for months (and taking on a regular basis instead of jumping back and forth), prayer, your blog and advise, support groups – it has all led me here.
7 months later and people around me can see the difference. Life has dark and painful and now I see the sun again.. I really do. Even on a cloudy day.
I love life again.
Thank you. Thank you for taking away the fear of discussing it, being honest about it, leading me to keep at getting better and never losing hope. Fighting to feel like me again.
My husband is not home yet, but my faith is strong and I have the energy and capability to give to others again. My children have their Mom again…
My prayers are with you as you share with us so generously and fight your way through your days as well.
God bless you,
Sari Farrell



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barb quester

posted January 28, 2010 at 8:40 am


hi therese, my journey actually began with a good dr who knew meds for mood disorders, a Godsend of a therapist weekly, and then a psychiatrist who took over my meds and is very understanding and easy to talk to. i personally don’t like group therapy, although for many it is a key, but one on one works for me. i have been blessed with a therapist that i have been with for 13 years. she has saved my life numerous times, and has picked me up, dusted me off, and kept me going. i am truly blessed to have this support system, your website and prayers from more people than i probably know about. thanks for all you do, i appreciate it. take care, barb



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Mary

posted January 28, 2010 at 10:06 am


I have had one psychiatrist for many years – almost twenty years. He is perhaps the most important person in my life. He diagnosed me correctly (bipolar disorder) and knows perhaps everything there is to know about me. I feel like the luckiest person in the world.
How did I find him? Through a recommendation from a psych nurse at my HMO. She was an angel.



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monica

posted January 28, 2010 at 11:28 am


HI TREESA,MY NAME IS MONICA AND I HAVE SUFFERED FROM BIPOLAR/MANIC FOR ALOT OF YEARS.I HAD NO IDEA WHY I WAS SO DIFFERANT FROM EVERYBODY ELSE “AT LEAST I THOUGHT SO AT THE TIME”I WAS A VERY SAD CHILD AND YOUNG TEEN AND EVEN THROUGH MY ADULT HOOD.I HAD TRIED ALL KINDS OF DOCTORS,THERAPIST YOU NAME IT.I AM NOW 42 YEARS OLD AND IT TOOK UNTIL THE YEAR 2000 BEFORE I WAS PROPERLY DIAGNOSED.I LOVE READING THE THINGS THAT YOU PUT OUT THERE FOR PEOPLE LIKE MYSELF.IT TOOK A LONG TIME BEFORE I RELIZED THAT I HAD A ILLNESS.(OR WANTED TO EXCEPT IT)I JUST WANT TO THANK YOU AND LET YOU KNOW THAT I THANK GOD EVERYDAY THAT THERE ARE PEOPLE LIKE YOU OUT THERE THAT ARE WILLING TO HELP SOMEONE LIKE ME! AWSOME TIPS….. GOD BLESS! MONICA



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Your Name

posted January 28, 2010 at 11:30 am


The battle inside me which is if i am alone or not makes me feel like
i am somewhat experiencing depression,i am not sure,though i wasn’t
ever diagnosed having bipolar disorder or is in a depression state.I
know when i am going to a psychiatrist,that’s the time when my faith
got me really crushed to the ground level,lol.but what i am doing to keep myself safe and depression proof is maintaining a prayerful life,
eating healthy foods,exercise and keeping close connection with my dad
who is always there everyday 24/7 giving me kind messages when i am feeling at my lowest.I am blessed knowing and having person like my dad,he’s like a hand of God reaching me out giving me sustainance and grace to embrace the dawn in a way that it’s a spitual food that i eat
that is far better and greater theraphy more than anything.I will always be thankful and grateful as long as i live to my dad,and most of all to God who sent and made my dad for many purposes not just being my dad but many more.He’s my angel i suppose,lol.



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Darcy

posted January 28, 2010 at 5:25 pm


Your story is very inspiring. But what do you do when you are stuck in a rut with no health insurance and can’t find a job because your depression intrudes on everything in your life? I sit at home with a Bachelor’s Degree because I can’t seem to keep a job and don’t have much desire to even get out of bed anymore. I have been trying to “fix” my depression for almost twenty years and have not found a solution yet. I have been to more than twenty psychiatrists over the years and have been on almost every depression medication on the market. I feel hopeless at this point. I pay for minimum monthly health insurance which does not cover the one thing I need the most, Mental Health. What is wrong with society? Is mental health ever going to be treated with the same seriousness as physical health? I am beyond frustrated.



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Jill

posted January 28, 2010 at 10:48 pm


I feel the same way as you Therese, in that I “never cried again”.
My doctor is absolutely wonderful. I’ve done so much better…considering that I have been on meds on and off since high school and always was depressed even as a child.
I will miss him when we move to Las Vegas (I was kind of worrying last night about finding a good doctor down there) but I’m sure I will and as long I stay on my meds and all that I will be fine.



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Jill

posted January 28, 2010 at 11:16 pm


I just wanted to add that I read your article on the Guideposts site and loved it. :)



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Diana Molino

posted February 1, 2010 at 12:50 pm


I need a psychiatrist and I have been trying to get one for 4 months.
I got two recommends from my primary care physician. One wasn’t taking any new patients and the other wouldn’t return my phone calls. I am on SSA and SSI. My health plan is Care 1st. I am running out of my psychiatric medications. HELP!!!



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Bridgette Torre

posted February 14, 2010 at 11:29 pm


Millions of Americans suffer from a misdiagnosed or undiagnosed mental illness. Silver Hill Hospital has clinicians trained in evaluation, diagnosis and adult and adolescent psychiatric treatment and provides hope for people who may not have been getting the right care.



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Jordan Sneakers

posted May 26, 2010 at 8:39 pm


This blog makes me realize the energy of words and pictures. I am grateful that you let us look in! Keep coming up with ideas.



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Nike Shox R4

posted June 26, 2010 at 2:40 am


Extremely delight in your material, my fantastic fortune to explore your weblog.



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Dawn

posted September 20, 2010 at 9:48 am


I too was diagnosed bipolar. Along with watching my exercise,
food and sleep…I saw the importance to aligning myself with the
life desires in me, to live the life I truly desired to life. I also
went to school, to gain mental focus, knowledge, and a supporting environment to develop in. It was amazing, as I aligned myself with the life I wanted to live…all the balance returned. I used drugs like lithium, wellbutrin, etc while I adjusted to living my life…but, then as balance in all life areas were created through my living the life I truly desired…I no longer needed them. I am happy, balanced and successful in every area now.



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Carol Kaplan

posted September 20, 2010 at 10:46 am


Sadly there is rarely a good psychiatrist. Psychiatrist’s ruined my life. They are pill pushers and get kick back from drug companies. They have a ugly and shocking history. Have a look at the history of psychiatry,
everything from putting people into dungeons (snake pits) to blowing out people’s brains with shock therapy.
It has evolved into a profession where they can do their damage by giving you 15 minutes, thumbing through the DSM-IV and picking a diagnosis out of some now 300 to chose from. Many of the new so called diagnosis’ are simply made-up. They then chose a drug which may harm you forever. Stay away from Psychiatrists… they are dangerous. Try to find a GOOD psychologist, sadly this too is difficult as there are many out there but few good ones. Many are ethically shaky and often break basic rules, Others are trained poorly as the training itself is flawed. My entire family has been destroyed by shrinks of various degrees ad names. Form your own support group. examine your life the chances are very high that you are not “ill” at all but simply not able to cope temporarily. Love and support from family and friends is what is most important. If you do see a shrink you may find you no longer have a family and or friends. DO NOT allow a label to be put on you. This could affect the rest of your life and cause you to be outcast in our society.



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Della Menechella

posted September 20, 2010 at 11:38 am


I agee that it is critically important to find the right psychiatrist who you can wholeheartedly trust. My son was diagnosed with biploar disorder when he was 17. We found a wonderful doctor at a major medical center/school. She worked with my son for 5 years, first at the medical center, and then in her own private practice.
During this time she provided him with meds and also self-help ideas such as meditation, getting enough sleep, exercise, and being involved in a spiritual community in order to help his with illness. She viewed him as a complete person, not just a diagnosis. We absolutely adored her.
However, last year, it became increasingly obvious to this doctor that my son could no longer be treated in an outpaptient setting, where he would see her monthly and see his therapist weekly. My son was rapidly becoming more and more unstable with 2 hospitalizations within 2 1/2 months. She told us that he needed more extensive treatment than an outpatient setting could provide. Although it was difficult to hear this news, my son and I knew we could trust her judgment. Not only did we work with her for 5 years, but this doctor is also one of the screeners for our county to determine if individuals needs to be hospitalized. She knows what she is talking about.
My son left her care and went into a 6 month acute partial hospitalization program, which probably saved his life. He is now in an extended partial hospitalization program where he is continuing to learn how to manage his disease. He is doing very well and has even started back at college part-time.
I think it is absolutely critical to find a psychiatrist whose skill you can trust, and who is also caring and compassionate. Mood disorders can be devastating to a person’s life. My advice is if you don’t feel comfortable with your doctor, then find another one who is right for you. It will probably be one of the best decisions you will ever make.



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Shelley

posted September 20, 2010 at 11:50 am


Great topic Therese. My input? For those who are depressed, if you go to your regular doctor, get a referral for a psychiatrist. So many GPs give out the meds but don’t follow up on whether they work or not. Do you need a higher dose, etc. They are not trained.
First psychiatrist I had was just there to push the drugs. He rarely asked anything past,”How are you feeling?” Extra questions were up to the therapist. He left and his replacement was not much better. She had studied and did her residency at John Hopkins. She left when I was in the middle of my worst depressive episode. Along come the next one to replace her. He studied in Iowa. He asked about me, my family,etc. He did more research to see if I could actually get better. He found a medication that augmented my antidepressants and mad me feel better than I had in years. Yes, it can take awhile to find a decent doctor but don’t give up. I live in a rural are where psychiatrists are in short supply but I did find one that cares about me as a person, not a patient.



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Bill

posted September 20, 2010 at 12:51 pm


A very good article, one I’ll bookmark and read again.
I do have another comment though, and that is listing NAMI but not the equally helpful DBSA. In this area, according to some bipolar people I’ve spoken with, have had poor results with NAMI, saying NAMI was more family oriented than individuals.
A friend and I maintain a DBSA group in our area, and since we are both Bipolar 1 we know the score. Our experience is that the more support you have with your disorder the higher you achieve on your journey to a better life, so friends and family are more than welcome. Don’t get the wrong idea, I have nothing against NAMI. I think they are a premier organization. but DBSA is right beside them.
Check out the link for where and when our DBSA group meets. We are glad to take calls and emails, though for me afternoons and evenings are better as I also have what amounts to sleep deprivation.



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