Shy Person Seeking Help; Apply Within

[SharonDee]

Yeah. So. I really hate cold calling. I mean, really-really-really hate cold calling.

I've known for over two weeks that it's time to call a psychiatrist. The three names my therapist gave me--it took me months to get up the guts to call her--turn out to not be covered by my insurance. I'm perusing the list of physicians that are covered and I have no idea who to call.

I finally picked one at random, then slammed down the phone before it was answered because I suddenly realized I didn't know what to say. What does one say besides, "Hello. I'm not suicidal but I think I need help, anyway."

A little advice? Please?

This is so embarrassing... :(

[viscousmemories]

Poor Sharon, I'm sorry. :(

I've seen many different counselors, social workers, psychologists and psychiatrists, and unfortunately I don't think there's any way you can figure out who's a good one until you find out for yourself. In my experience even those who come most highly recommended may not click with you.

Just call any one on the list and say "Hi, I've been feeling unusually X (depressed?) for X amount of time, and I'd like to make an appointment."

Good luck. :hug:

[livius drusus]

Good phrase, vm. Sharon, how about writing it down and then just reciting it as soon as you hear a voice? That might help counter the hang up reaction.

[freemonkey]

Hi Sharon, have you told your therapist that the names she gave you aren't covered by your insurance? Would she be willing to help you find someone who is, or at least help you make a list of questions you could ask? :smilehug:

[LadyShea]

I would just say "I would like to set up an appointment for a consultation". I should think you may want to meet with several to see who you're comfortable with for this area of care.

[SharonDee]

Just call any one on the list and say "Hi, I've been feeling unusually X (depressed?) for X amount of time, and I'd like to make an appointment."
Ah, this looks like the ticket. Thanks, Tom!

have you told your therapist that the names she gave you aren't covered by your insurance? Would she be willing to help you find someone who is, or at least help you make a list of questions you could ask?
I've only been to her the one time and my opening line was, "My doctor thinks I shouldn't be taking antidepressants by themselves anymore and wants me to look into counseling." I made it sound all businesslike and stuff. I hesitate to bother her again when I'm not sure we really clicked.

Thanks for the hug, though. :)

I'll just try vm's suggestion (with special thanks to liv for reinforcing it) tomorrow.

I should think you may want to meet with several to see who you're comfortable with for this area of care.
Repeat that same mantra for more than one prospect? :eek:

[Goliath]

Setting up an appointment is hard...I just set up a counseling appointment today...in person! :eek:

Good Luck, SharonDee.

[SharonDee]

Setting up an appointment is hard...I just set up a counseling appointment today...in person! :eek:
Ack! You're a better man than I am.

Good Luck, SharonDee.
Thanks. You, too! :wave:

[Goliath]

Ack! You're a better man than I am.

Not too bad for a baby, huh? :P :D

And I'm sure you're a much better woman than I..I'd look horrible in drag. :D


Thanks. You, too! :wave:

Thanks...I hope Monday will go okay...

/me crosses his fingers..

[LadyShea]

I should think you may want to meet with several to see who you're comfortable with for this area of care.
Repeat that same mantra for more than one prospect? :eek:

I know, it sucks, but it's better than getting all through the initial barriers only to find out he/she is an asshole that makes you feel worse.

When I needed antidepressants, my insurance company had this incredibly convoluted system. I had to go to an enormous mental health "triage" center, where a doctor talked to me to see if my situation warranted seeing the REAL doctor. She then gave me HIS name, and set the appointment for me at his office on the other side of town. I had no choices. So I get there and, though this is my first and only bout of depression and there was a specific situation causing it, he insists I am having problems because I didn't go to college and got married too young :whup: . So's, I said "Can I have something non-habit forming without sexual side effects to get me over the hump and leave the talking to my therapist?"

What a dick he was.

[Ex-zombie]

:bow: to SharonDee and Goliath. It takes courage to seek counseling. I like Lady Shea's suggestion about simply asking for a consultation.

[wildernesse]

:cheer:

Good luck to both of you, and for being brave enough to start the search for help!

I totally hate calling people up in this way too--it makes me all writhy inside. No, I don't know if writhy is a word. But I write a script for myself and just go from there. Of course, it always takes forever for me to figure out exactly what I want to say--but I think there are great suggestions here.

[Dingfod]

SharonDee, when I first decided to seek therapy, I called my company's help line, the person on the line was very good at drawing out of me what it was that was bothering me. They also made the appointment for therapy for me. You might try one of those depression hotlines or something, I'd bet they'd be easier to talk to than just cold-calling a therapist's receptionist.

Here's a site that will find one for you. (http://www.hopeline.com/ries.asp)

[SharonDee]

Ack! You're a better man than I am.

Not too bad for a baby, huh? :P :D
Huh? I don't know what you're talking about. :blush2: :giggle:

So I get there and, though this is my first and only bout of depression and there was a specific situation causing it, he insists I am having problems because I didn't go to college and got married too young.
Oh, geez. Nothing about how you secretly hated your mother? :rolleye1: Okay, I see your point. I'll treat this like a series of consultations. I don't look forward to that. :deepsigh:

when I first decided to seek therapy, I called my company's help line...
Yeah, I did that, too. That's how I got hooked up with the psychiatrist-recommending therapist. I just got stuck while trying to take the next step. But thanks for the link.

And thanks to Ex-zombie and wildernesse for your help and encouragement, too.

[Blake]

Good luck, Sharon. I had to find a therapist a couple of years ago by cold-calling. I picked some names on my insurer's list and asked them a few questions (picked after consulting with a bunch of helpful friends):

1. What is your approach to therapy?
2. Do you have an area(s) of specialization?
3. What role (if any) does spirituality play in your life?
4. What is your training; your professional affiliations; your experience?
5. How soon can I make an appointment? How soon can I schedule a followup?

Aside from the helpful details like the heaviness of their schedule that this reveals, mostly in the end it just got them talking, and based on listening to their manner (as well as substance) of conversing I got a feel for them and picked one that worked just fine.

I feared it greatly, but in the end it wasn't that hard and worked great. I managed to play the stern, sceptical consumer even while racked with depression and acute grief. ;)

[HelenM]

Setting up an appointment is hard...I just set up a counseling appointment today...in person! :eek:

I hope the appointment goes ok, Goliath. Based on my experience, I'd suggest not expecting too much in the way of 'results' from the first session - but hopefully you can get a good sense from the first session of whether you think this particular counselor has the potential to help you in whatever ways you need help.

Helen

[seebs]

Man, that's tough. My wife finally got started counseling, but I think I actually had to set it up for her. One solution (which a couple of people I know are using) is to get involved with someone who's not afraid of the phone, and make him do all your phone calls for you.

[HelenM]

Yeah. So. I really hate cold calling. I mean, really-really-really hate cold calling.

I've known for over two weeks that it's time to call a psychiatrist. The three names my therapist gave me--it took me months to get up the guts to call her--turn out to not be covered by my insurance. I'm perusing the list of physicians that are covered and I have no idea who to call.

I finally picked one at random, then slammed down the phone before it was answered because I suddenly realized I didn't know what to say. What does one say besides, "Hello. I'm not suicidal but I think I need help, anyway."

A little advice? Please?

This is so embarrassing... :(

Hi Sharon,

I think you could say "I have been seeing a therapist and she recommended that I make an appointment with a psychiatrist". If they ask what it's in connection with for you can say "depression" or "anxiety" or whatever your main symptoms relate to.

Even though it may feel embarrassing to you, bear in mind that it's what the psychiatrist sees every day.

Perhaps you know this but anyway - psychiatrists are doctors specializing in mental health who can prescribe medication. Counselors talk to you and generally aren't qualified to prescribe meds. The conventional medical wisdom is that seeing both a psychiatrist and a counselor is the most effective way to treat mental health problems. The counselor can help you assess whether your meds are working and help you with what to say to the psychiatrist on the next visit. If appropriate the counselor might provide feedback directly to the psychiatrist, who hopefully is glad that you are in counseling as well as having him/her help you with medication.

Visits with psychiatrists are usually just a few minutes long; they are focused on assessing whether you have symptoms that medication can treat and if you are on medication, whether it is helping, whether it has problematic side-effects, etc. There isn't time to go into details about your life with a psychiatrist (unless you are seeing them for counseling, which is rather expensive and not a good idea unless they are qualified to do counseling as well as diagnose mental health problems and prescribe meds).

You can get mental health medication from an internal medicine/family practice doctor - you don't have to see a psychiatrist - but it's rather hit-and-miss whether the doctor you see has detailed knowledge about the latest psych meds. Some do; some don't - it probably depends in part on how many people come to them for help with mental health problems. Some people are quite happy to have their depression treated by the same doctor who treats their physical illnesses.

I guess what I'm saying is - don't expect a psychiatrist to spend a lot of time with you listening to you talk about your life, or to necessarily be skilled in responding as a counselor would. Expect he/she to offer you meds unless he/she is convinced your symptoms don't justify medication, because what they do is prescribe meds.

One other thing, Sharon: if you don't feel that your counselor related to you well, maybe you could search for another one.

Helen

[Cool Hand]

Yeah. So. I really hate cold calling. I mean, really-really-really hate cold calling.


Yeah, me too. I know that dreaded feeling well. My sympathies, Sharon.


I've known for over two weeks that it's time to call a psychiatrist. The three names my therapist gave me--it took me months to get up the guts to call her--turn out to not be covered by my insurance. I'm perusing the list of physicians that are covered and I have no idea who to call.

I finally picked one at random, then slammed down the phone before it was answered because I suddenly realized I didn't know what to say. What does one say besides, "Hello. I'm not suicidal but I think I need help, anyway."

A little advice? Please?

This is so embarrassing... :(

[edit: Cross post. Helen's post above has a much better and more practical explanation of what I was trying to say below. Some of my post is still relevant, but I prefer Helen's post. Upon re-reading, mine sounds detached, academic, and condescending. I didn't mean it that way. Helen's is more helpful, I suspect.]

I note that you said "psychiatrist," not "therapist." I trust that you know there is quite a difference. A psychiatist is an M.D., a medical doctor. As an M.D., the psychiatrist has the legal authority to issue prescriptions for pharmaceutical medications. In all likelihood, this is the typical primary approach to treating mood disorders and other mental illnesses a psychiatrist will take. Some believe a combination of medication and "talk therapy" works better.

A therapist might be a licensed counselor, a psychologist, or simply a self-proclaimed counselor, depending on the laws in your state. In other words, it is possible that a therapist might have little formal training and no professional license by the state or federal authorities. Yours, of course, might well be a fully trained and licensed professional, but "therapist" is sometimes a broad term.

The best way to get in to see a psychiatrist is by way of referral from your regular family doctor. A family doctor is a primary care physician, meaning that except in cases of emergency, you go to him or her first. If the matter is beyond his or her expertise, the primary care physician usually makes a professional referral to a specialist. The primary care physician often stays informed about the treatment of the patient by way of written updates from the specialist, assuming the patient remains under the care of the primary care physician.

Psychiatrists are specialists, of course. Because of that, it may be difficult simply to call around and make an appointment with one yourself. It is usually easier to get in to see one by way of referral from another doctor.

I recommend that you make an appointment with your regular doctor, tell him or her what is bothering you, and ask for a referral to a psychiatrist. In all likelihood, if you do that and ask, you will get a referral and an appointment. There is nothing wrong with asking for 3 or 4 different referrals and making appointments with each. Payment for 3 or 4 different consultations might be another matter.

Private insurance coverage in the U.S. of treatment for mental and emotional disorders is spotty. I recommend inquiring into your own coverage. You are likely to be unpleasantly surprised at its limitations. It is tragic that so much psychiatric care in the U.S. is not covered by insurance. Of course, you probably already know whether you are covered under TennCare. My state has no state health care program, so I have no experience with it.

Good luck. Please follow up with your care should you and your doctor(s) determine that you need it. Seeking it and not needing it is far better than needing it and not seeking it.

Cool Hand

[ApostateAbe]

1. What is your approach to therapy?
2. Do you have an area(s) of specialization?
3. What role (if any) does spirituality play in your life?
4. What is your training; your professional affiliations; your experience?
5. How soon can I make an appointment? How soon can I schedule a followup? Excellent set of questions. That is needed because some counselors are better and more suited than others. The first counselor I had did nothing for me. She would ask a sparse set of questions while I talked for an hour and she took notes. My mother met her through the church. Big waste of money.

My second counselor was with the college, and the sessions were free. That paid off. They prescribed medication (Effexor). I took it for a few weeks, and it seemed to help. I stopped taking it when I did some research on the Internet, and I found a message board with about a hundred posts telling stories of serious side effects and withdrawal effects after taking the drug. I got in an argument with my counselor about this. She defended the drug by saying that the FDA tested it with a six-week study with only minor results. But I said that six weeks wasn't nearly long enough. As a compromise, I suggested that she recommend to her patients that they do research before they take the drug, and that is what she did.

The lesson is that you are in charge of your life, you make all the decisions, and nobody cares about your health and your well-being more than you do yourself, not even your doctors and counselors. I go to doctors for their knowledge and treatment, but I trust my own judgment when it comes to my health over the doctors--they care most about staying in business.

[HelenM]

[edit: Cross post. Helen's post above has a much better and more practical explanation of what I was trying to say below. Some of my post is still relevant, but I prefer Helen's post. Upon re-reading, mine sounds detached, academic, and condescending. I didn't mean it that way. Helen's is more helpful, I suspect.]

Thanks, but to me, yours seems as helpful as what I wrote and more informative in some ways also.

I note that you said "psychiatrist," not "therapist." I trust that you know there is quite a difference. A psychiatist is an M.D., a medical doctor. As an M.D., the psychiatrist has the legal authority to issue prescriptions for pharmaceutical medications. In all likelihood, this is the typical primary approach to treating mood disorders and other mental illnesses a psychiatrist will take. Some believe a combination of medication and "talk therapy" works better.

A therapist might be a licensed counselor, a psychologist, or simply a self-proclaimed counselor, depending on the laws in your state. In other words, it is possible that a therapist might have little formal training and no professional license by the state or federal authorities. Yours, of course, might well be a fully trained and licensed professional, but "therapist" is sometimes a broad term.

Good point - where I live there are a number of different ways counselors can be certified. I once had insurance which paid 50% for counseling (therapy - I use the words synonymously) if the counselor had a PhD. The trouble is, counselors with PhDs charge more per hour so that's not as much of a benefit as it may seem. And I don't see reason to think a PhD is necessary, since being certified in my state doesn't require it.

The best way to get in to see a psychiatrist is by way of referral from your regular family doctor. A family doctor is a primary care physician, meaning that except in cases of emergency, you go to him or her first. If the matter is beyond his or her expertise, the primary care physician usually makes a professional referral to a specialist. The primary care physician often stays informed about the treatment of the patient by way of written updates from the specialist, assuming the patient remains under the care of the primary care physician.

Psychiatrists are specialists, of course. Because of that, it may be difficult simply to call around and make an appointment with one yourself. It is usually easier to get in to see one by way of referral from another doctor.

If you have a primary care doctor I think he/she is a good place to start. Apart from anything, if he/she is covered by your insurance, the specialists he/she refers you to may well be also. And it's wise to have a physical check-up anyway just in case you have a physical reason for depression (physical health problems can cause depression).

On the other hand, whether you need a referral is probably more to do with insurance than anything else - insurance companies may look for that as justification for covering the expense of it. My experience has been that it's as easy to go see a psychiatrist at his/her office as it is to see a primary care physician.

I recommend that you make an appointment with your regular doctor, tell him or her what is bothering you, and ask for a referral to a psychiatrist. In all likelihood, if you do that and ask, you will get a referral and an appointment. There is nothing wrong with asking for 3 or 4 different referrals and making appointments with each. Payment for 3 or 4 different consultations might be another matter.

There are reasons for seeing your regular doctor first, as I mentioned, and it might help you with insurance coverage. And as I said in my other post, he/she may have quite a bit of experience treating depression. But if you want to go straight to a psychiatrist, I don't think you'll have any trouble making an appointment without a formal referral.

I highly doubt that insurance would pay for multiple consultations and I'm not convinced you would need that with a psychiatrist unless you have some strong reason for not accepting his/her medical advice. It's not that complex; he/she assesses your symptoms and then, if warranted, he/she prescribes one or more medications out of the list of what are currently available for depression (or whatever your symptoms suggest). Please bear in mind that being treated with psychiatric meds is often a trial-and-error business; you try one, you wait 6-8 weeks; if problematic side effects are present at that point and/or it doesn't seem to be helping you try something else. This doesn't mean the psychiatrist is incompetent; it's simply that no-one can know beforehand exactly what will work best for your own mind and body.

Anyway, I think 'fit' is a much more of an issue with the counselor because that is the person with whom you need a relationship in which you are comfortable enough to open up about yourself and you also need confidence that his/her methods of counseling can help you personally.

Private insurance coverage in the U.S. of treatment for mental and emotional disorders is spotty. I recommend inquiring into your own coverage. You are likely to be unpleasantly surprised at its limitations. It is tragic that so much psychiatric care in the U.S. is not covered by insurance. Of course, you probably already know whether you are covered under TennCare. My state has no state health care program, so I have no experience with it.

Yes, this is a good point. With my husband's latest job change, I'm in a health plan that covers my counseling completely for the first time (although there is an annual limit on number of visits which wouldn't be enough if I went every week). I was in one once that paid 50% if I saw a PhD, and many of them are not; then I was in one that didn't pay anything towards counseling and only paid 50% of office visits to psychiatrists. If you have insurance that pays almost the entire cost of visits to your primary care physician and 50% or less of visits to a psychiatrist, that's a financial reason to see your primary care physician first. If you see a psychiatrist who finds you a medication that works, your visits will space out and become simply maintenance med checks. But while you're looking for one that works, you may see him frequently.

Good luck. Please follow up with your care should you and your doctor(s) determine that you need it. Seeking it and not needing it is far better than needing it and not seeking it.

Absolutely. And if you see a doctor or psychiatrist who says "I hear you, but I don't think meds are warranted" you'll only be paying for one visit.

Helen

[SharonDee]

Thanks for the advice, Helen & Cool Hand. I do understand the differences between therapists/counselors and psychiatrists. And I have been taking Celexa at my medical doctor's prescription after she determined there was no physical cause behind my depression. But she's told me that two years is long enough for taking the meds without therapy and has stopped prescribing, advising me to use my insurance to find someone qualified to address my mental health. (I have managed to squirrel away some Celexa, which is why I haven't self-destructed yet.)

That's when I went through my job's service to find a therapist, who then recommended some psychiatrists because it was her opinion that I needed to stay on the meds for a little bit longer. (I went to her in the middle of withdrawal and I was a complete mess, physically and mentally.)

So here I am, trying to find a psychiatrist because it seems to be the next logical step.

But it's a good idea to make sure people know these mental health professional distinctions and I'm glad you guys laid it out there, just in case. :)

The lesson is that you are in charge of your life, you make all the decisions, and nobody cares about your health and your well-being more than you do yourself, not even your doctors and counselors. I go to doctors for their knowledge and treatment, but I trust my own judgment when it comes to my health over the doctors--they care most about staying in business.

Exactly. :yup:

[HelenM]

Yeah. So. I really hate cold calling. I mean, really-really-really hate cold calling.

I've known for over two weeks that it's time to call a psychiatrist. The three names my therapist gave me--it took me months to get up the guts to call her--turn out to not be covered by my insurance. I'm perusing the list of physicians that are covered and I have no idea who to call.

I finally picked one at random, then slammed down the phone before it was answered because I suddenly realized I didn't know what to say. What does one say besides, "Hello. I'm not suicidal but I think I need help, anyway."

A little advice? Please?

This is so embarrassing... :(

I just had another thought - if you had a therapist who was a good fit for you, you'd be discussing your fears about calling a psychiatrist with him/her. And he/she would help you deal with them. That you came to us instead of going to her is a sad sign that she's not effectively helping you in the ways you really need help :(

Helen

[SharonDee]

I just had another thought - if you had a therapist who was a good fit for you, you'd be discussing your fears about calling a psychiatrist with him/her. And he/she would help you deal with them. That you came to us instead of going to her is a sad sign that she's not effectively helping you in the ways you really need help :(
To be fair, Helen, I only went to this person the one time. My company's contract with this service calls for six sessions (per "incident") at no cost to me. During that one session we talked about all the life situations I'm going through at present; there was no time left in the hour to discuss my reticence to phone. Hell, I hadn't thought I would lack that courage until it happened.

I suck. :(

[Godless Dave]

I finally picked one at random, then slammed down the phone before it was answered because I suddenly realized I didn't know what to say. What does one say besides, "Hello. I'm not suicidal but I think I need help, anyway."
That's pretty much what I said when I first called the mental health clinic I go to now. "I'm depressed and I'd like to see a therapist and a psychiatrist." I rehearsed for several hours before picking up the phone.

Good luck. Been there, done that, bought the t-shirt.

[Godless Dave]

Speaking of my clinic, I really like it because it has both therapists and psychiatrists on staff. My therapist and psychiatrist know each other and share notes on their patients.

[Dingfod]

Setting up an appointment is hard...I just set up a counseling appointment today...in person! :eek:

I hope the appointment goes ok, Goliath. Based on my experience, I'd suggest not expecting too much in the way of 'results' from the first session - but hopefully you can get a good sense from the first session of whether you think this particular counselor has the potential to help you in whatever ways you need help.

HelenThis was true for me. The first session was almost entirely taken up getting acquainted and filling Judy in on my personal situation. After three sessions I decided I needed medication for my condition and that I was actually handling my situational depression quite well, but I was still down in the dumps and teared up frequently. I went to my regular physician for the meds, we're working on getting the right one and the right dosage. Right now, it appears I need to be taking a higher dosage, especially when I'm on night shift.

I'm lucky in the out-of-pocket costs though, my company pays for up to six sessions of mental health therapy or counselling 100%, then it drops to the usual 50% under my health care plan.

[HelenM]

I just had another thought - if you had a therapist who was a good fit for you, you'd be discussing your fears about calling a psychiatrist with him/her. And he/she would help you deal with them. That you came to us instead of going to her is a sad sign that she's not effectively helping you in the ways you really need help :(
To be fair, Helen, I only went to this person the one time.

Ok, fair enough.

My company's contract with this service calls for six sessions (per "incident") at no cost to me. During that one session we talked about all the life situations I'm going through at present; there was no time left in the hour to discuss my reticence to phone. Hell, I hadn't thought I would lack that courage until it happened.

Well, how could you know that you would?

In my experience, initiating making a phone call to a stranger gets way harder when you're feeling anxious/depressed.

I suck. :(

No - it's more that the difficulty you're having making the call is a symptom in itself.

One thing cognitive types of therapy address is how we interpret what's happening in our life - helping us not to generalize what turns out to be personally challenging into "I suck".

Helen

[JoeP]

Courage and kudos to Sharon and Goliath. Hope it goes well. I will be back with some of my own experiences when I have the time to post.

joe

[seebs]

Heh. Going in for marriage counseling is arguably even more embarassing, because everyone sees you together in the waiting room.