Where to Get Help?
Should I see a psychologist/therapist? What should I look for in a doctor or therapist? What kind of therapy is best for me? I’ve been asked this question more than once. I wish I had a definitive, simple answer. I don’t, but I can tell you what I know from my own experiences.
A general consensus among mental health professionals is that a combination of medication and therapy is the best approach for most mental illnesses. However, different doctors, both psychiatrists and psychologists, have different personalities and methods that they prefer. It can be tricky to find the ones who are right for you.
Psychiatrists Come in Different Flavors
I have been through multiple psychiatrists and therapists. My stories should give you an idea of what to expect. Expect differences.
My first, in my late teens, was very cool and distant. He did not explain himself, and this was very frightening. I felt lost and threatened.
I saw one doctor a few times who frustrated me with his “Don’t worry. Be happy.” approach. He told me to avoid caffeine, eat a balanced diet, and exercise. I felt his approach was overly simplistic and almost insulting because he seemed to imply my condition was the result of laziness and a bad attitude.
Another doctor had a very brusque manner and did not ask many questions at all before prescribing medication. I only saw him once because my internal radar started flashing red. How do you prescribe without examining the patient?
One doctor that I saw for many years helped me a great deal, but toward the end of our relationship, she was having some personal problems of her own, and her manner changed. She began to insist on hospitalization and encouraging ECT (Electro Convulsive Therapy) over my protestation. She tried to force me, but another doctor intervened. I later found out she was overdosing me, and I had developed Serotonin Syndrome as a result, a condition that causes unpleasant side effects like facial ticks and is potentially dangerous. Nevertheless, she helped get me through some very dark days, perhaps the worst parts of my illness. I believe she thought that level of medication was necessary given my mental state at that time.
Finally, I met my current doctor, who I will refer to as Doc. Doc is a match made in heaven. He may not think of himself this way, but I see him as a fellow Geek. His intelligence and skill are apparent. He’s a bit eccentric, a former military veteran who loves history and has a set of Roman armor in his office along with a display of figurines in battle and lots of science fiction books, mostly dealing with alternate timelines. He will distract me with humor, but I have learned that he is always observing. Probably what I love best though is his honesty. He is open about the fact that psychiatry contains a good bit of educated guesswork, and he always elaborates on why he is giving me a particular medicine, including its benefits and side effects. Some people find him abrasive. I find his candor refreshing.
Finding a therapist is just as tricky
One psychologist told me from the first session that we were going to have a personality conflict because she was a female, and because of my background, I don’t get along with women very well. She was about the same age as my mother, and as a “mother figure,” I suspect she thought I would project some of the negative emotions I associated with my childhood onto her. Her methodology primarily involved delving into my childhood and discussing my dreams. She helped me connect my current behavior to what happened to me as a child. In the end, she was right. We did end up with a personality conflict although I learned a great deal from her and am grateful.
My current therapist is also a good one. He has primarily focused on my struggle with philosophy and spirituality in an effort to make meaning from my life and encouraged my blogging. He has an undergraduate degree in philosophy, and our conversations are almost fun, really. He seems to allow the patient to dictate what direction therapy should go unless he sees a specific problem to be addressed.
I also have an unofficial therapists, a friends who keep my spirits up. I can’t stress enough the importance of a support network. These people are your safety net. Finding some sort of spiritual practice that speaks to your soul can also be a life saver.
Okay, Here’s my advice
As you can see in my story, while medication and therapy is basic, treatment varies greatly. Here are the pearls of wisdom I will give you in deciding if a doctor or therapist is right for you:
- I think it’s important, if you can muster the will and energy, to do a bit of research on your own. That way when you see your doctor, you can ask intelligent questions, so that you can better understand what his or her objective is with a specific treatment. At minimum, use your common sense and your “gut instinct.” If the situation doesn’t feel right to you, it probably won’t be. If you can’t do this, let your partner or someone you trust be your advocate.
- I think it’s important to keep in my mind that mental illness is not static. It falls on a continuum. At the “normal” end, you might have “The Blues” from life event like a recent breakup. Unlike mental illness, you will hurt for a while and then move on with your life. At the other end, there is the almost catatonic state I found myself in for a long time. Just a walking, breathing shell. You are still a person who grows and changes. You will get better. You will get worse. The kind of doctor/therapist you need during one phase of your life may not be the one you need a few years later.
- I think it’s important to understand that no doctor or therapist is going to be perfect. They are not omniscient. They are not magicians. They are trained in medicine, specifically psychiatry, but they are just people like you and me. Also, unlike other fields, the doctor primarily has only a description and observation of symptoms for a diagnosis. While tests for different mental illnesses such as depression are being developed, they are still at the expensive, out of reach stage for most people. The brain is still a mystery. Plus, everyone’s body chemistry is different. Add all that up, and you can expect some trial and error. Don’t get discouraged.
20 Years of Searching
Most importantly, be an active participant in your journey to wellness. Just a year ago, that would have been impossible for me. As I said, I was a walking zombie incapable of rational thought and introspection. If you can get yourself to the point where you can become a seeker to find your own way, I encourage it. Medication and therapy help get you to that point, but eventually you will need to ask the big, hard questions like, “Why am I alive? What do I want my life to mean?”
My biggest frustration is that I have been working on my mental health for about 20 years now. If you count my years in an abusive environment that helped create and/or trigger those problems, then I have been struggling my entire life. My doctors say that I will get better. I wouldn’t expect a different answer from them.
I have come to terms with the fact that my illness is difficult to cure but not impossible to manage. I see my doctors as helpers, resources, and guides. I am ultimately responsible for doing the work. The important thing is not to give up. Your “dark night of the soul” may last a long time, but you must remember and hope for the dawn.
Notes from the Author
The picture above is the very famous Sigmund Freud, whose theories are now considered outdated (lots of fun as a tool to analyze literature), but he is still an iconic figure in psychiatric medicine.
Speaking of doctors. Dr. Deb has an excellent mental health blog. I enjoyed her latest post on Therapy Service Dogs. Pets are wonderful therapy. I have 6 cats, each with their own unique personality. Sometimes it seems like they take turns doing guard duty. One of them is near me all the time.