Understanding Psychiatry Part 3: First visit to a psychiatrist & what to expect

In the previous articles, we talked about identifying the need for help, and the difference between a psychiatrist, neurologist and clinical psychologist.

In this segment of Understanding Psychiatry with Dr Sucheta Tiwari, we share a brief checklist of information that we could consider keeping ready before our visit to a psychiatrist, especially the first. We also talk about the possible discussions about our condition and medication that may happen in the first visit.

When we go for the first visit, we don’t have to have all of this information, but can try and put together whatever we can without adding to our discomfort.

We can of course go and speak based on whatever comes to our minds in the doctor’s office, but given that visits can be anxiety provoking and rushed, it’s not a bad idea to go in with some preparedness. We can simply note all this in our minds, or take it with us in writing.

Here we go. If possible:

  • Make a list of the most pressing concerns
  • A brief summary of our life circumstances at the moment, especially if there were any major life events or anniversaries – trying to identify any triggers
  • It can be helpful to have significant family history jotted down, to provide the psychiatrist with some background information – this can involve circumstances as well as a psychological history (if close family members have had diagnosed or suspected mental illness)
  • Note any previous psychiatric or psychological help we have taken (or were recommended)
  • Note other medical conditions, such as thyroid, blood sugar, or blood pressure, however irrelevant we might think they are
  • Also note all other medication we’re on – names and dosages.

It’s a good idea to keep a journal for a week or longer, with details about our daily routine, amount of sleep and time, etc. if possible.

Will I be prescribed medication on my first visit?

The psychiatrist is there to aid in our recovery/ illness management when we are unwell.

A good psychiatrist will always ask us about what we need help with and listen to our concerns.

There is a big misconception that people who visit psychiatrists always get medicated, or get addicted to the medication prescribed.

Instead, the first visit might more likely involve –

  • A detailed history where you will be asked to share a lot of the information from the checklist above
  • A deep probe to ascertain the cause(s) for our distress, including understanding our life circumstances and triggers.
  • A search for what’s changed, and what’s brought us to visit the psychiatrist
  • A probe into what we’ve been doing to manage our distress ourselves – what’s worked, what’s not
  • An indication of some blood work and general medical check ups to rule out other health conditions that might be influencing our mental state
  • A discussion of both general medical and non-medical solutions, like if its possible to manage our distress by a change in our environment, and what you expect from psychotropic medication.

For instance, we cannot expect medication to resolve our circumstances or issues, but only alleviate certain forms of psychological distress.

So there will ideally be a detailed discussion on the need for medication, and expectations from it. It is most likely that before any prescription, the results of other medical check ups will be reviewed.

Only after weighing everything in a holistic manner will medication be prescribed.

Please read ahead about psychotropic medication, the way it works and some of the issues we may encounter when taking these. We also talk about different psychotropic medications and things we should all know if we choose to use them. In the last segment, we examine the principles and shared process by which diagnosis are formed and psychotropic medication delivered. .

If you have particular questions or concerns and we’ll do our best to help you resolve them. writein@theshrinkingcouch.com
This article has information only. Please do not consider this to be a substitute for medical advice.

sucheta tiwari
Dr. Sucheta Tiwari is in the final year of her psychiatry residency. She has received her medical education from the University of Delhi and also has a masters degree in Global Health from the University of Oxford, UK. She hopes to work with mental health issues both with individuals as well as the communities they live in.