>Do You Need Me?

>I’m often asked the question, “When should somebody go to see a psychiatrist?”

There are a few broad brush types of situations in which a trained mental health professional like a psychiatrist may be able to help you. Now, before I go any further, I need to make a couple of things clear to you, since a lot of people also ask about these issues as well.

A psychologist is a mental health professional who is trained to assess and treat psychological problems and issues, as well as do certain types of testing, diagnostic interviews, and therapies. Psychologists are often called “Dr.” and often have higher level degrees such as PhDs. This of course stands for Doctor of Philosophy, from the Latin. Psychologists have done higher level training, but have not attended medical school.

Psychiatrists are also trained mental health professionals who also happen to be medical doctors. That is, they have attended medical school and have either an MD or a DO degree. They usually have a four year college degree, have gone to medical school for another four years, and then have completed a residency in psychiatry that is an additional four years of training.

Of course, there are many other trained professionals such as pastoral counselors, nurses, nurse practitioners, masters level therapists and others who are more than willing and able to help you with a wide variety of emotional issues and problems. We all work as a team, and each of us brings a different set of skills to the table when assessing, diagnosing and treating mental health issues.

Now, back to the original point of this post. When do you need to, or when should you, seek the help of a psychiatrist?

Your family doctor, who knows you well and treats you for a variety of ailments from colds to heart attacks, is often the perfect person to help you assess your need for psychiatric help. If he has diagnosed a major depressive disorder, for instance, he may have prescribed an antidepressant medication such as Zoloft or Pristiq or Wellbutrin to help your symptoms. If you take this medication, see the doctor back for follow up, and things are better, great! If not, your doctor may try another medication or two that he is familiar with to help you. If things simply do not get better, he may speak with you about a referral to a counselor or a psychiatrist or both to step up the intensity of the treatment a bit. That is a perfectly appropriate time to go see a psychiatrist. Your family doctor may have certain psychiatrists that he likes to refer to, or he may simply help you find the right person to see.

Another time that you may need to see a psychiatrist is if you are feeling suicidal. Anxiety and depression are common, but not everyone’s illness progresses to the point that they are seriously contemplating killing themselves. When it gets to that point, you don’t want to bide your time and hope that things get better. They might, but again they might get worse, and then it may be even harder for you to take the steps you need to get help. If you are feeling hopeless, helpless, sad, and are thinking that taking your own life is the only way out for you, then you need to seek help immediately. Go to your own doctor for a referral, call a psychiatrist directly, or go to the local emergency department for help. Don’t wait. Your life may depend on it.

Lastly, if there is ever a time when you feel that things are looking strange, odd, out of context, or if you just feel you are not distinguishing between what’s real and what’s not, then you may be experiencing psychotic symptoms or psychosis. (From the Greek for “giving life to animation”). This can be a terrifying time when you feel that other people are watching you, that you are being threatened, or that others can read your thoughts. You may think that a television show has special messages embedded in it that are directed towards you. You may have terrifying auditory or visual hallucinations where you hear voices speaking to you or see things that are not really there. Obviously, this can be a true psychiatric emergency, just as feeling suicidal can. In this case as well, seeking help as soon as possible will enable a professional to assess the problem, make a diagnosis and start appropriate treatment right away.

These situations (severe worsening depression, suicidal ideation and psychosis) are only three of the issues that a psychiatrist may be able to help you with. If you experience any of them, please seek help immediately and get the treatment you need.