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Seeing a psychiatrist for the first time...What to expect?
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Frustrated84 posted:
I'm having my first appointment with a psychiatrist in a couple weeks and I'm already extremely nervous to the point where I was feeling sick to my stomach today. This is all new to me and I'm not sure what to expect. How long does an initial appointment typically last? Will I have to fill out paperwork/questionaires? What kinds of questions will be asked? I have such a huge fear of people judging me and I'm afraid the psychiatrist will think I'm totally crazy. Everyday I question whether I'm losing my mind or not. I've had 3 sessions with a professional counselor and she is referring me to a psychiatrist for medication purposes. She thought it would be best for me to go to a psychiatrist instead of my primary care physician. My PCP prescribed Zoloft, 25 mg once daily, for the past 5 weeks - it is not helping at all. I'm battling issues with anxiety and depression. Everything is bothering me right now and I just feel as though I'm destined to be alone and miserable for the rest of my life.
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Patricia Farrell, PhD responded:
Psychiatrists, unlike psychologists, don't usually use any type of formal questionnaire/tests. It's usually just an interview that can be as long as one hour or as short as 15 minutes. This can be an indication of nothing really and, depending on where you go, it can be an indication of how long the patient waiting list currently happens to be.

Of course, you have problems and the psychiatrist expects you to have them because you're being referred by someone. So, that's a given. The fact that your med hasn't worked in 5 weeks may indicate that it's too low a dose or isn't the med for you. All of this depends on the psychiatrist's experience and training.

It will be okay.
 
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Frustrated84 replied to Patricia Farrell, PhD's response:
Dr. Farrell, thanks for taking time to respond. I'm still so incredibly nervous about going to the psychiatrist, it's all I can think about. It's difficult and embarassing to open up to a complete stranger about my thoughts and feelings. I've spent years trying to hide my true feeling from everyone including my family and even myself. I'm just so unhappy with my life currently. When I'm not having anxiety and totally freaking over one thing or another, I'm thinking about every seemingly wrong choice I've made, to get to the point I am, which makes me depressed. Even my emotions feel out of whack though as even when I feel like I want to cry, the tears won't come. I can't even having an emotion or thought without questioning it to the point that I don't even know what I really think or feel. I'm never going to lead a normal life like most people. Something is wrong with me and I don't even think it's fixable. I'm stuck like this and that's the only thing I feel sure of currently.
 
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Patricia Farrell, PhD replied to Frustrated84's response:
The psychiatrist is there to help and believe me that there is really little concern for you. Take someone with you, if you'd like and say that you want that person to remain with you during the interview. There is no law that prohibits this.

I think you should also be referred to a psychologist for on-going therapy so that the two of you can work toward a better life for you.
 
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hibernation responded:
No worries here. You are doing the right thing by visiting a psychiatrist. It's really OK; you have nothing to lose. The psych may be able to help & that should give you Hope. After many years I recently found a local Dr. that really understands and cares, & that has made a big difference. Remember, you are interviewing the Dr. for the proper fit. Keep searching until you find the right match - this is very important. Usually they will give U a Free consultation.

Great quote to live by which I paraphrase below:

"Slay all fear, doubt, and worry, as those thoughts never helped anyone achieve anything."

This was taken from a Robert Allen book which I refer to frequently.

At the end of the day, Just Go for It! Best wishes.
 
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An_190135 replied to Frustrated84's response:
Opening up about the things I tend to keep to myself is always scary. For short periods of time I have seen two psychiatrists and two psychologists in my life and before each first visit I've just wanted to run away. I don't think that is an uncommon feeling. With the two therapists I saw when I wanted help I felt a good level of trust and my fears vanished after the first visit (as opposed to being a surly teenager not wanting help with the other two).

Two things that for me helped to develop that trust were (1) starting with an easy topic such as my fear about the appointment in order to get me to start opening up and (2) if there were any boundaries I wanted set to make that clear from the beginning. As an example, there are some topics about my life that tend to ruin my day when I discuss them. I'll only talk about them when I know I can take a couple hours after the appointment to calm down and get back to where I can deal with daily life again. I had to make sure my therapist understood that we can talk about those topics, but that I'd need extra time to myself afterwards.

I think you are making moves in the right direction and you should be proud of that. That is a healthy choice. Psychiatrists and psychologists are professionals who go through years and years of training and care about the wellbeing of their patients. Since they also prescribe meds, ask about the beneits and risks of what they prescribe for you and what plan they have for seeing if they are working properly. Not every medicine will work for any given patient, and you may find you'll have to try out a few before finding one that works for you. That is just the nature of medicine.

And please remember that not every psychiatrist is a good match for every patient. It is okay to try others if you can't get comfortable with the one you have an appointment with.

You'll be okay if you give yourself the chance, and asking for help can be the hardest part of that to do (and you've already done that!).

By the way - the "normal life" most people lead have problems like yours at some point in life. You are not alone.
 
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dmward10 responded:
Hey,
Expect to fill out ALOT of paperwork. They ask tons of questions. They may suggest you take a MMPI test. This one takes a good hour to take, it judges you mental state basically. The psych. is not there to judge but to observe your "state of mind" when you come in. There is a check list they look at your attire, your cleaniness, etc.

I started out on meds that did not work, it is trial and error with what meds work with which people. So, if they change your prescription alot do not be concerned. They are trying to get the one that will help you the most!

Good luck and don't be scared, they are the best people to help you!
 
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dmward10 replied to Patricia Farrell, PhD's response:
On my first visit, I was there a couple of hours. I had to fill out a MMPI, questionaires and a give detailed descriptions of what is going on with my life, in my dreams, etc.

There was alot of paperwork. There was alot of changing my meds to see which one would do the best job.
 
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Boyzmomee responded:
Expect to fill out lots of paperwork and questions regarding symptoms, previous treatment and family history.

Your therapist did well in referring you to a psychiatrist.

I've worked in an impatient child and adolescent psychiatric unit and with a local child psychiatrist in his office.

Psychiatrists are not scary and are there to help. Don't hold back from being afraid to be labeled "crazy." The psychiatrist needs to know all of your symptoms to best help you and to prescribe the most suitable medications if needed.
 
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Boyzmomee replied to Patricia Farrell, PhD's response:
Actually they may have "questionnaires" (but not formal testing) depending on the situation and why you are coming.

The initial visit does not last 15 minutes. A 15 minute visit will likely occur after a patient is stable on medication. The psychiatrist allows more time for the initial psychiatric evaluation. The waiting list does not determine the length of the first appointment but it determines the wait time to get an initial appointment.

Medications may be started at a very low doses and then increased. Multiple medications may need to be tried to find the right one or combination to treat the individual patient no matter what the psychiatrist's length of experience.
 
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grammyrenee replied to Frustrated84's response:
Frustrated84 please consider why you are going to a psychiatrist. You feel helpless about your mental situation and you feel hopeless that it will change. These are excellent reasons for going to a psychiatrist. Your psychiatrist is not there to judge you - your feelings or actions. Neither is your therapist. Your psychiatrist is interested in getting you the medication you need that will help you get your emotions and thoughts back on the path that will lead you to feel good about yourself. We have all made bad choices. I believe we all think some of our bad choices are the worst ever made. These feelings of emotional chaos are NORMAL for someone in need of medicine and therapy to gain perspective on their life choices. When I first went to my psychiatrist, I had a one page form to fill out. The questions were like - rate how you feel you are doing in the following areas. 1 meaning no problems and 5 meaning severe problem. Then the questions were how do you feel you are doing - as a spouse, can you dress yourself, can you maintain your friendships - those type of questions. Very simple to fill out and not in need of a lot of thought and NO WRONG ANSWERS. You must also have a list of any medications you are currently on. I am diabetic, so I had meds for that and for acid reflux that I indicated. About getting your meds from you PCP, for years I was treated by my PCP for depression. When I finally went to see a psychiatrist, after a session of talking for about 50 minutes about how I was feeling and a couple of things I was comfortable talking about that happened in the past, she said she thought I was Bi-Polar. It used to be called manic-depressive. She started me on the lowest dosage of two meds for Bi-Polar disorder. Continuing therapy with one of the therapists on her staff helped the therapist and the doctor to see that indeed I am Bi-Polar. Getting the exact dosage for the 4 meds I now take took two years. During that time I continued to feel better and better about myself, my life situation and my future possibilities. I was a very tough case, suicidal when I first started. Now I am sooooo much better and I credit that to my being brave enough to see a psychiatrist to be able to get the right medication in addition to seeing a great therapist. WARNING - if you feel that your psychiatrist is judging you, find another. Psychiatrists and therapists have heard it all, many times over. They know we are all human, make mistakes and wouldn't be seeing them unless we wanted to feel better about ourselves and our situations. I know you will do well with this for you have taken the first step and won't chicken out. It's your life that you want to take back.
 
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psychic3 replied to Patricia Farrell, PhD's response:
Yeah, i have been feelin this way months ago, but thank to god theres way to combat this..People who go to psychiatrist is not abou that they are crazy, they just need the help of a proffesional to get through this...
 
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Frustrated84 responded:
Thank you all for taking time to respond. I'm starting to feel a little better about going. Don't get me wrong, I'll be totally freaking out the day of the appointment for sure. When I initially started this topic I didn't even think going to the psychiatrist was even worth the stress it was causing me. Now, I'm just really hoping that he is able to help me. My moods are so up and down - one minute I feel like I'm doing the right thing by going to the psychiatrist and that everything is going to be okay. Next thing you know I'm back to why am I doing this to myself, it's pointless and no one is going to be able to help me.

I am going to go to the appointment though, no matter how uncomfortable it is going to make me feel, just on the off chance that just maybe I can be helped. Even typing out this message I can't decide whether I feel more optimistic or pessimistic about that decision. Tomorrow I have my 4th session with the counselor I've been speaking with. She has helped me a lot and I'm sure will ease some of my concerns about speaking with the psychiatrist.

dmward10 - You said that there is a checklist and that the psychiatrist will be looking at how present yourself, including what you are wearing? Now I won't know what to wear the day of, haha! If I go in with my hair fixed, makeup, and dressed decent will that count against me? I mean, will he look at me and say she must be fine since she doesn't look horribly? See, I overthink everything!

Filling out paperwork might even be a challenge for me as well. If I have to rate how I'm feeling, grammyrenee mentioned this, I'll start overthinking things. I'll be paranoid that I'll makes my symptoms sound more severe than they are or the other way around. Making decisions, even simple ones, are something I'm struggling with currently. Example, my PCP did prescribe a really low dosage of Clonazepam, .25mg, to be taken twice a day "as needed." Well, I couldn't decide when I actually "needed" it. Ridiculous, I know, but I haven't been taking it because of that as well as a I'm afraid of getting addicted to it.

Again, thanks to everyone for your advice and support. It means a great deal to me. Knowing more of what to expect does make me feel more at ease and not as anxious. Still incredibly nervous about it but you all honestly have helped me feel better about it. Hope you all have a good day. Take care!
 
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Frustrated84 responded:
Three days to my appointment, yikes! Still quite nervous even though my counselor tried to address my concerns about the appointment. She assured me he is not going to be judging me or paying much attention to me at all for that matter. She said basically he will just be hearing the symptoms I'm describing and figuring out what to do based on what I tell him. She suggested that I write down symptoms and what I'm going through and take it to him. That way, since I'll be really nervous when there, I'll have that so I won't forget anything.

During, and for a short while after speaking with my counselor, I felt more at ease about the psychiatrist appointment. Of course now, I've been obsessing over it and making myself nervous again. How can I use words to describe how I really feel? It seems so complicated to me! When she said he'll ask me to describe symptoms, what exactly does that mean?...Physical?...Is that also what I'm feeling emotionally? Please someone respond and help me out!


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