Should I go to a psychiatrist or psychologist?

[Rocky53]

Mid 50's. came here cause I now find myself refereed to a psychologist by my GP. Have been on Efexxor for 5 years up and down doses but still feel tired and down most of the time. Seldom happy about things (what is that)

Had first session last week and just spent the time giving a life overview.

Does it really help to go to a psychologist?

 

[Halo]

Re: Genesis

Welcome to Psychlinks Rocky :welcome2:

It is nice to meet you :wave:

As for your question about whether seeing a psychologist really does help, I can say that for years all I ever saw were psychiatrists and it wasn't until about a year ago that I switched and decided to try a psychologist and for me the world of difference was once I made that switch. I have made more progress in therapy in the last year with a psychologist than I had the previous 10 with psychiatrists.

Of course this is only my experience but I would say to keep an open mind and give it a try, it may just be what you need.

Take care

 

[sister-ray]

Re: Genesis

Just wanted to say hello and welcome:hello:

 

[Retired]

Re: Genesis

Welcome to Psychlinks, Rocky! Thanks for joining us.

If you care to share, what is the diagnosis for which you are being treated, and what dose of Effexor are you taking now?

Sometimes having a psychologist work with you as an adjunctive therapy with your physician can provide the kind of support and insight your physician may not have the skills to provide, plus your psychologist can help you with strategies to overcome some of the issues you might be dealing with.

IMO your doctor has your best interests at heart, and the combined therapy should benefit you in the long run.

Feel free to join in any ongoing discussion or start as many as you wish.

Hope you will enjoy Psychlinks!

:welcome:

 

[Daniel E.]

Re: Genesis

Had first session last week and just spent the time giving a life overview.

Yeah, that's typical of the first session.

Does it really help to go to a psychologist?

Yes, and there are tons of clinical studies that show the effectiveness of cognitive behavioral therapy in both the short and long term.

Personally, I still benefit from the therapy I had 2 years ago. At the time, it got me out of the slump I was in. In both the short and long term, it improved by ability to identify and challenge my negative thought patterns, such as all-or-nothing thinking.

Do you do self-care methods like socializing, exercising, listening to music, etc. ?

 

[ThatLady]

Re: Genesis

:welcome: , Rocky.

Yes, going to a psychologist does help. It helps to have someone to talk to who is educated in how we "tick" as human beings. I will say this: You'll get out of therapy what you put into it, and the going isn't always easy. It doesn't work overnight to make you happy, but you'll find improvement comes with time and effort. Good luck to you!

 

[Rocky53]

Re: Genesis

Do you do self-care methods like socializing, exercising, listening to music, etc. ?

Well I am not very social but OK...I have been exercising 5 days a week and quit drinking for 5 months although the last two weeks it has been creeping back.

Yes I read and listen to music

If you care to share, what is the diagnosis for which you are being treated, and what dose of Effexor are you taking now?

Sometimes having a psychologist work with you as an adjunctive therapy with your physician can provide the kind of support and insight your physician may not have the skills to provide, plus your psychologist can help you with strategies to overcome some of the issues you might be dealing with.

IMO your doctor has your best interests at heart, and the combined therapy should benefit you in the long run.

Feel free to join in any ongoing discussion or start as many as you wish.

Hope you will enjoy Psychlinks!

:welcome:

diagnosis: Depression/anxiety....

currently on 75mg but my GP wants to increase it

 

[Retired]

Re: Genesis

Rocky,

Is your GP working in conjunction with a Psychiatrist to treat your depression?

Here is information with regard to dosing Effexor, taken from the Canadian product monograph. Source alternate= U.S Monograph Here

Be sure to advise your doctor of any liver or kidney dysfunction you might have, if any. Many doctors adjust the dose for elderly patients; and the most important information to discuss with your doctor is how to discontinue Effexor, if and when that becomes an option.

Discontnuation must be accomplished gradually by tapering the dosage over several weeks to avoid adverse side effects.

Have you experienced any relief from your symptoms of depression since beginning your Effexor therapy? Is this the first anti depressant you have taken, or have you switched from something else?

Dosage
Adults:
The recommended treatment dose is 75 mg per day, administered in two or three divided doses, taken with food. If the expected clinical improvement does not occur after a few weeks, a gradual dose increase to 150 mg/day may be considered. If needed, the dose may be further increased up to 225 mg/day. Increments of up to 75 mg/day should be made at intervals of no less than 4 days. In outpatient settings there was no evidence of the usefulness of doses greater than 225 mg/day for moderately depressed patients. More severely depressed inpatients have responded to higher doses, between 350 and 375 mg/day, given in 3 divided doses.

Maximum:
The maximum dose recommended is 375 mg per day (in an inpatient setting).

Patients With Hepatic (liver) Impairment:
Given the decrease in clearance and increase in elimination half-life for both venlafaxine and ODV that is observed in patients with hepatic cirrhosis compared to normal subjects (see Pharmacology), it is recommended that the total daily dose be reduced by about 50% in patients with moderate hepatic impairment. Since there was much individual variability in clearance between patients with cirrhosis, it may be necessary to reduce the dose even more than 50%, and individualization of dosing may be desirable in some patients.

Patients with Renal (kidney) Impairment:
Given the decrease in clearance for venlafaxine and increase in elimination half-life for both venlafaxine and ODV that is observed in patients with renal impairment (GFR = 10 to 70 mL/min) compared to normals (see Pharmacology), it is recommended that the total daily dose be decreased by 25% in patients with mild to moderate renal impairment. It is recommended that the total daily dose be reduced by 50% and the dose be withheld until the dialysis treatment is completed (4 hrs) in patients undergoing hemodialysis. Since there was so much individual variability in clearance between patients with renal impairment, individualization of dosing may be desirable in some patients.

Geriatrics:
No dose adjustment is recommended for elderly patients on the basis of their age. As with any antidepressant, however, caution should be exercised in treating the elderly. When individualizing the dosage, extra care should be taken when increasing the dose.

Discontinuing Venlafaxine:
When venlafaxine therapy that has been administered for more than 1 week is stopped, it is generally recommended that the dose be tapered gradually to minimize the risk of discontinuation symptoms. Patients who have received venlafaxine for 6 weeks or more should have their dose tapered gradually over a 2-week period.

 

[ladylore]

Re: Genesis

:welcome:

Hope you enjoy your stay. I personally see both a counsellor and recently had a couple of visits with a new psychiatrist. The first visit was a bit scary as he went over my history but they need the background.

For me its feels like it will be a good balance as my counsellor knows me already and is more of a "friend", but not in the traditional sense. My pschiatrist comes highly recommended and knows what is going on with my brain and I need that kind of information myself. It is a personal journey and unfortunately changes don't take place over night.

I also find this forum to be very helpful. So read all you can as there is loads of information.

Ladylore

 

[Rocky53]

Re: Genesis

Rocky,

Is your GP working in conjunction with a Psychiatrist to treat your depression?

Have you experienced any relief from your symptoms of depression since beginning your Effexor therapy? Is this the first anti depressant you have taken, or have you switched from something else?

Steve,

I'm not sure how much in conjunction they are yet as My GP just gave me a referral to go see a Psychologist (though I wonder if it should not be a Psychiatrist instead)... I have only had the one initial session so far in which I gave a life overview and the only remarks he made was "well you have certainly suffered several significant losses..."

I had been on effexor for about 5 years. Initially I was put on it because I was highly agitated easily. The least little confrontation would cause me to loose my temper or get very anxious and upset. The medicine worked like a charm to cut that agitation in half at least. Last summer I collapsed while riding in my car (my wife was driving) She called 911 and I went through a battery of tests but nothing was determined. They decided it was most likely a seizor. and recommended I get off effexor. When I reduce to 35mg I slowly get agitated and go back to 75. My GP thinks I need to increase it and I just do not know. I have gained weight which makes me more depressed and yes I suppose the losses I have had cause an underling condition of depression, dread, and unhappiness.

I did try to go off effexor a few years ago and switch to wellbrim but it did not seem to work at all (but the GP...I'm not sure we made that change in the right way)

 

[Rocky53]

should I go to a psychiatrist or psychologist?

I have had 2 appointments to a psychologist.

The first appointment I just gave a life overview
The second apt (today) I just talked a little more about some of those things.
he said "well you have had some multiple losses, you have hurt, pain, anger you are afraid of loss and you are generally down emotionally"...

So What now? I knew that.... so what will talking more about this do to help?

How do I know I have an effective psychologist?

Is it worth my time and money?

 

[Daniel E.]

Re: should I go to a psychiatrist or psychologist?

How do I know I have an effective psychologist?

Hmmmmm...

On the one hand, you've only had 2 sessions.

On the other hand, some therapists are better than others.

A big factor is compatibility:

http://forum.psychlinks.ca/showthread.php?t=4441

Personally, I've liked every therapist I've seen except one, who was just a college mental health counselor.

 

[Retired]

Have you asked you GP for a referral to a Psychiatrist? Since there are medication issues, you may just ask for a referral to a specialist.

As you know, in most jurisdictions Psychologists do not prescribe medications, so the Psychiatrist would be able to perhaps better tailor your medication therapy.

In many cases, by working with both a Psychiatrist and Psychologist, you can have a well rounded therapy as they would be working together.

If you choose to stick with the Psychologist, then I would propose you need to have a conversation with the psychologist to determine what is the therapeutic plan. You could ask how many sessions are anticipated, what will you be doing in each of the sessions and what can you expect as an outcome.

Once you have that information, you can decide if that therapist's plan fits in with your expectations.

Perhaps by having such a discussion, your therapist will have a better understanding about your needs and expectations.

 

[Halo]

Rocky,

I agree with Steve in that speaking with your psychologist about what the plan is for your future session are is a great idea.

I do want to say that in my own personal experience and that for years I saw a psychiatrist and only recently did I switch to a psychologist and for me the switch was great. I find that I like the approach that a psychologist takes with a lot of issues which seems to be quite different from that of a psychiatrist and for me personally it just seems to work better. When I was with my psychiatrist a lot of the talk was around medications and while that is important, the real therapy and dealing with my issues for me comes from seeing a psychologist.

Take care and good luck.

 

[HA]

Re: should I go to a psychiatrist or psychologist?

Is it worth my time and money?

Yes.

From my personal experience most psychiatrists in Canada don't do psychotherapy. There are some that do psychotherapy but you need to ask if they do and what kind of therapy they use. We also have psychotherapist GP's in Canada who are able to both prescribe meds and/or do therapy.

I agree with the "fit" being very important. If you are not comfortable with the therapist then it's not a good fit for you.

 

[Jesse910]

Personally, I fired my shrink last year in favor of my psychologist who knows me loads better. I get my meds through regular doctor. You have to go with what works for you. After 25 years, I figured that I knew what was best for me. Think of it this way, it depends how where your shrink operates - outside a hospital environment or in one. If they're inside of a medical environment, they only have so much time and their more interested in your meds and moods. If the dr works outside, you may get a bit more. From my view, therapists pay attention to what's going on with you. They also know when the meds aren't working because again, they know you.