Meghan Tells It

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Psychiatrist or Psychologist or Other Counselor? March 8, 2012

Filed under: Uncategorized — Meghan Hamilton @ 7:08 pm
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Mr. Man has been to approximately ten mental health professionals (excluding hospital staff) since his first major Manic Episode in college. Yesterday and today he has had appointments with two of those people. All in all he has four professionals guiding him on this life journey.

First is his psychiatrist. For those of you who are confused about the differences the various titles connote, I will try to explain. A psychiatrist is a doctor in the traditional sense of the word. He/she went to med school, completed their M.D. training, then decided to specialize in psychiatry the way some docs specialize in obstetrics. As such, many of these people are very talented at diagnosing disorders and are interested in getting the body in good working order. Mr. Man’s mother found his psychiatrist a number of years ago and he has been a Godsend. This man finally correctly diagnosed him with Bipolar. As an M.D., he can prescribe medications. Additionaly he ran many other tests (bloodwork and rEEG among others) to determine Mr. Man’s general state of health. This doc discovered his food allergies and intolerances as well as other non brain things that were affecting his brain’s ability to function. He got him on a good medicine regimen. He brought Mr. Man to a better state of health in his body. But like many psychiatrists, he is less adept at counseling and helping his patients actually deal with their lives – and often lives are a mess in the wake of mental illness. Being a very intelligent and caring man, this doctor has people on his staff that are very good at counseling.

Here is where a number of other titles come in. A psychiatrist has a Master’s degree or a Doctorate in psychology. A Licensed Social Worker also has an advanced degree. Before seeing their first patient, they should be certified to counsel patients. These people are qualified to diagnose psychiatric disorders. But because they do not have an M.D. they can not prescribe medications. Thus they often partner with a psychiatrist or with the patient’s primary care doctor if the patient needs medication. These professionals are generally adept at helping people live their lives. You can’t talk someone out of a mental illness, but you can equip him/her to live with it. They can also help family members know how to deal with the illness. For example, Mr. Man has anger management issues as a result of his illness. His psychologist has really helped him learn how to deal with anger in a more constructive way. If I have a concern, he hears me out and then works with both of us to resolve it. He doesn’t take sides. If he thinks I am overreacting, he lets me know. If he thinks Mr. Man needs to change something, he lets him know. He wants our lives to work.

The third Professional in Mr. Man’s life is a Nurse Practitioner who also is a licensed counselor. This man works for his psychiatrist. An NP has an advanced degree in nursing (often a doctorate) and can prescribe most medications. But he/she must work under the supervision of an MD. For Mr. Man, the NP he sees provides the best of both worlds. Mr. Man can get meds refilled/changed and get counseling at the same appointment. He is also good at helping us smooth out the bumps in the road of our marriage.

The 4th person on the team is Mr. Man’s primary care physician. When the NP suspected a sleep disorder was making the bipolar worse, he sent him to the PCP to get a sleep study. Sure enough – sleep apnea was keeping him awake and making him crazy. His PCP also helps keep an eye on his general health which becomes even more important when taking medications that can be very harsh on the body. He also evaluates Mr. Man’s state of mind at appointments and communicates with the psych people as needed.

In all of this, the doctors and nurses ask both of us how Mr. Man is doing. They want to know what family sees as well as what he feels.

If you are looking at a mental illness in yourself or a loved one, keep looking for professionals that you feel comfortable with. They will be in your life for a long time. Two qualified people will have different styles and fortes. Find the ones that work with your personality and give them time to build trust.


4 Responses to “Psychiatrist or Psychologist or Other Counselor?”

  1. It’s good to see it all laid out plainly sometimes. While my own illness is different than your husband’s I find the “team” of doctors really only includes one or two that get me. The others are there for certain skills only. It’s a constant game…and I’ve only just started playing.

    • I must say that the most helpful person on that team is the Nurse Practitioner. The man truly understands both of us and is able to talk both of us down from our respective trees when either of us is freaking out. He is has that rare combination of knowledge and sensitivity that make you want to go see him. He is the first person I contact when there is a problem. Sooner or later any person dealing with a chronic illness needs to find that one doctor or nurse they can call. I feel for the people that spend years and years drifting through our medical system with no one they can depend upon.

  2. I adore my LPC, who has helped teach me the skills I need to cope with my MI and who also has shown me great compassion as she helped me unravel the causes of my chronic PTSD. The psychiatrists are necessary but gosh, so lacking in empathy most of the time. Good blog–enjoyed reading it!

    • Thank you El! Indeed, the psychiatrists often do lack empathy. My husband was so much happier once he started seeing the NP/Counselor. It literally makes swallowing the pills easier for him because he feels like someone has taken the time to truly listen to how he is feeling. I do believe the psychiatrist cares, but he is so embedded in the clinical end of things that he doesn’t always know how to show it beyond doing his best to make sure his patients eat right, get the right meds, etc…

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