What to Expect at Your Appointment
A psychiatrist is a physician who is trained to diagnose and treat people with a wide variety of concerns, such as difficulties with mood, anxiety, memory, concentration, and clarity of thought. Often, an appointment to a psychiatrist is prompted by difficulties at work or school, or in relationships at home or with friends. Sometimes these problems are a result of external causes, such as stressors in life or medical issues, but they can also arise spontaneously, without any obvious source. A psychiatrist receives extensive education, in medical school and later in a residency training program, to learn to evaluate and treat these disorders.
On your first visit with the psychiatrist, you will be asked about the problem that brings you into treatment, what we call the “chief complaint.” In particular, you might be asked about when your problem started, how it has developed over time and how much it has impacted your daily life. It might be useful to think about these questions prior to your appointment, or to write a timeline of how your symptoms have progressed. You might also be asked about what you have tried already to cope with your difficulties. Along with asking about the symptoms you have experienced, your psychiatrist will ask about any past treatment you’ve received, such as past medication or psychotherapy. It is sometimes helpful to make a list of all the medicines you can remember trying in the past, how long you took them, any side effects you can recall, and whether they were tried alone or in combination.
Your psychiatrist will also want to know about your family history. You might spend some time before the appointment thinking about any blood relatives (especially parents and siblings, but also aunts, uncles and grandparents) who may have been treated for a mental health condition. Even if you aren’t certain if they were diagnosed or treated, are there any blood relatives who you think might have had mental health issues? In addition,you may be asked about any blood relative who’s had a substance abuse problem, such as alcohol or other drug use.
Your psychiatrist will also ask about current medical problems. Please bring a list of your current medications, including the dosage and instructions, such as how many times a day, and at what time of day you take them. You will also want to bring a list of current medical conditions you are treated for as well as a list of any past medical events, such as a surgery, heart attack, stroke, or a concussion. If you have access to any reports from the hospital, such as laboratory data or radiology reports, it is useful to bring those along as well.
After discussing your symptoms, past psychiatric history, family history and medical history, your psychiatrist will likely discuss with you a range of options that you could consider. These might include further work-up, such as laboratory tests or referral to a specialist, psychotherapy (talk therapy), or possibly a medication. Some patients will choose to start the proposed treatment plan right away, while some may choose to think about the suggestions made and return to discuss them further before moving ahead with treatment. In either case, you and your psychiatrist will likely plan a follow-up visit at some point in the future to discuss how your symptoms are responding and how to move forward. It is very important to ask questions about anything you’re not sure you understand, or why you are being prescribed a given medication or psychotherapy. If you decide to start a medication and have problems, such as side effects, it is essential that you contact your psychiatrist and discuss these on the phone or return to be seenearlier, rather than stopping the medication on your own. Your psychiatrist will be happy to answer your questions and explain things in more detail.