# Psychiatrist vs Psychologist



## Hunter (Feb 29, 2012)

Long story short - 

I have had a life long of abuse - you name it, physical, mental, sexual

I was molested by my brother for years at the age of 12 my mother allowed it -she had her own mental health problems, but she was not aware of them - I have read enough books to know that she had severe borderline personality disorder 

I was physically and mentally abused by my mom every since I can remember proably started at the age of 6 as she did not want me, I was the accident.

At the age of 17 ran away to live in the big city and met up with a man who said he loved me, yeah so then why for the next 8 years did he abuse me in every sense of the word,

he allowed his friends to rape me to pay off his drug debts, when I tried to fight back I was beaten and then drugged so that I could not move - this went on for years, and for some reason never could get up the nerve to leave, in 1994 when I did leave him, he left me to die at the side of the road in -40 below weather. Someone found me lying in the ditch and called a ambulance. It was then at the age or 25 that in the hospital I was told that I was pregnant, so after screaming at them to get it out of me, a abortion was performed.  I have so much trauma and triggers and nightmares from this whole ordeal called my life. I cared for both my elderly parents, until they passed away in 2009 and then everything seemed to hit me all at once. I had what you would call a breakdown, and went to see a doctor who turned out to be a savior for me. He put me on some coping meds and for the most part they are helping me. My psychologist who I cared for deeply because he helped me so much passed away from cancer in 2010. I have been trying to cope ever since then on my own. 

Every day is a struggle to get up and put on a happy face and go to work, when under the facade you are hurting so bad emotionally and physically that all you want to do is stay in bed.

I started _{self-injuring}_. I am not sure as to why I am doing this, most times I dont even know that I am doing it. I just see the aftermath and think my god what have I done to myself. My medical doctor now wants me to see a psychiatrist and I am so scared, he must think I am more screwed up than I think that I am. I dont know why he wants me to see one. I thought the only difference between a psychiatrist and psychologist is that the psychiatrist can prescribe meds - but my medical doc has already gave me meds,so why does he want me to see a psychiatrist. 

I need some answers. Most days I am confused - I try to sleep at night and this is when the triggers and nightmares come back to haunt me, I used to wake up so many times during the night and was not able to get back to sleep, now i just take sleeping pills to knock me out cold to get some reprieve from my pain.  This is something that even my medical doctor does not know of.

I am undertaking a online panic disorder program, it is 12 weeks, and I am into week 5. I have so much panic in me all the time, I am always on the verge of a panic attack, so I keep a large supply of ativan near by. They come in with no sign of any warning and within minutes I am ready to do the fight or flight response.  I am on edge all the time, and full of so much tension, at least that is what I am learning in my panic program.

And to top it off I also suffer from chronic pain - from severe motor vehicle accidents, I have two fractures, one in my tailbone, the other in my neck shoulder area. I am on two oxycontin narcotic pills which sure help me with the pain, but for the most part I am in a fog and constant grogginess. I also have been diagnosed with rheumatoid arthritis again take more oxycontin for that.

Some days it would be so much easier to just give up, but for some reason I keep plugging away at this journey called life, because in my heart someday somewhere somehow I know that one day I can be happy, and feel better, emotionally and physically.  I guess I just want someone to reach out and say hey I care about you and that I matter here on this earth.

well just wanted to see if anyone had any comments for me

Dr. Baxter - I would really like to hear from you.
thank you


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## Cat Dancer (Feb 29, 2012)

Seeing a psychiatrist doesn't mean you're "screwed up." It sounds like your doctor wants you to consult with someone who might be able to help you manage your medications better? Also, if I were you, I'd consider therapy/a psychologist as well. 

Welcome to Psychlinks!!


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## Dragonfly (Feb 29, 2012)

Hunter - your drive to survive is an indication of your strength.  Even though it may not feel like it at times.    To answer your question - a psychiatrist is a physician.  All psychiatrists have gone to medical school and then done specialty training on human behavior.   As we all have at least some specialty training in medications and we all have at least some specialty training in psychological matters, we (psychiatrists) are in a unique position to help with medications and maybe supplement or be a primary therapist.

I can't know for sure, but it sounds like your primary doc wants some help with your psychological needs - because your insomnia, panic, pain, maybe depression and maybe anger ..... All impact each other and will impact which meds will help the most - or cause the most problems.   In short Hunter, your doc is saying you are worth the time and effort to see a specialist - you deserve an outstanding level of care.

Take care.  Victoria Harris MD


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## suewatters1 (Feb 29, 2012)

A family DR is ok to give you psychiatric medication but a Psychiatrist would know more which medication is the right one for you.  They trained more in that area.

Also Psychiatrist will be able to help you deal with all the trauma you went through especially since it affects you so much.
My family DR tells me when I ask him for some meds to help me sleep or for anxiety he tells me if it to help me with my mental health to ask my Psychiatrist for them.

You have been through lots in your life time and a Psychiatrist could help you deal with that.

I see a Psychiatrist, a Canadian Mental Health worker, and a psychotherapist and I enjoy seeing all 3. I know my Psychiatrist knows more about the medication and any interaction that a combination might have.

Think of him like you did your psychologist.  You have to get to know the DR and after a few visit you might know if this DR is for you if you click so to speak.

Welcome

Sue


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## forgetmenot (Mar 1, 2012)

You open every avenue and you get all the help you need you deserve hun.

   I find talking to a psychologist easier because they deal with people  mine deals with trauma specializes in it. I did go to a psychiatrist just to make sure my meds were correct  because they deal with meds mostly.

    You take all the help you can get okay. Each person you  come in contact with is another hope for help    take each one what they have to give you and use it okay to move forward.

I know it is hard  but you take your time and seeing this doctor is no different then seeing another specialist hun    

You are not crazy  you have been beat up by the very people who were to love  you   that all  now it time to help YOU okay


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## Daniel (Mar 1, 2012)

Hunter said:
			
		

> And to top it off I also suffer from chronic pain - from severe motor vehicle accidents, I have two fractures, one in my tailbone, the other in my neck shoulder area. I am on two oxycontin narcotic pills which sure help me with the pain, but for the most part I am in a fog and constant grogginess. I also have been diagnosed with rheumatoid arthritis again take more oxycontin for that.


Are you on a SSRI as well? As you may know, they are prescribed for chronic pain as well, not just generic depression and anxiety. CBT (cognitive behavior therapy) can also help with chronic pain as can MBSR (mindfulness-based stress reduction) and physical therapy such as prescribed exercises and aquatic therapy.  



			
				Hunter said:
			
		

> I thought the only difference between a psychiatrist and psychologist is that the psychiatrist can prescribe meds - but my medical doc has already gave me meds,so why does he want me to see a psychiatrist.



Regarding the differences between psychiatrists and psychologists, psychologist/therapist visits are usually 50 minutes each, with the frequency usually being every week or every other week in the beginning, sometimes more.  Psychiatry visits are generally less frequent and shorter in duration (e.g. 15-to-20-minute followup visits every month or two after an initial 1-hour evaluation). There are a some psychiatrists who still offer longer visits, including a minority who offer something like the typical 50-minute therapist appointment:



> The 45-minute hour in psychiatry is giving way to shorter patient visits as increasing numbers of psychiatrists turn to medication management. Whereas 47% of respondents reported visits of 25 minutes or longer, the remaining saw patients for less than 25 minutes. A very small percentage (2%) spend fewer than 9 minutes with each patient.
> 
> Medscape: Medscape Access





> Like many of the nation’s 48,000 psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. So Dr. Levin sent the man away with a referral to a less costly therapist and a personal crisis unexplored and unresolved...
> 
> Like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names...
> 
> ...



OTOH, the actual duration of a visit is not as important for things like ongoing behavior therapy after being in therapy for a while. And over the years, I tend to stay longer with the same psychiatrist than with the same therapist.

So for most people with chronic mental health issues, including myself, seeing both a therapist and a psychiatrist is often the ideal unless you find a psychiatrist who also does therapy. I personally have never had a psychiatrist who does therapy per se -- more like counseling (which can be just as helpful at times as a "booster" since it is more to the point).

---------- Post added at 02:35 PM ---------- Previous post was at 01:57 PM ----------

More info regarding chronic pain:

http://forum.psychlinks.ca/medical-...-books-on-pain-chronic-pain-and-migraine.html

http://forum.psychlinks.ca/medical-...exercise-takes-the-edge-off-chronic-pain.html

http://forum.psychlinks.ca/health-a...pport-forum-for-people-with-chronic-pain.html



> *Should I See a Pain Management Psychiatrist, Psychologist or Therapist?*
> 
> You may be referred to a psychiatrist, psychologist or social worker to help you cope with chronic pain.  Before you run the other way, read on…
> 
> ...



​


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## JonDoe (Mar 2, 2012)

we have had a similar expirence hunter
except i got to a point where id panic / survival mechanism would kick in, i soon realised what felt was andrenalin which i channelled through deep vocal screams . your doctor has faith in you and has a route for you to start the journey to peace .

just remember your brain has infinate amount of space to stack up your fears , when your need a smaller think space with limited room and destroyable after 

Grab a piece of paper and bare your soul dont critisize or judge your self just be honest and civil to your burnden and write what seem logical hope ive helped  and not offend really new to this


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## artladymel40 (Mar 16, 2012)

Hi Hunter  just read your story about horrific abuse and how that has left you , just want to encourage you to hang in there and  find things your happy to do   to distract yourself with from these traumatic memories . I have suffered emotion abuse and know what it does to you . take care artladymel40


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## adaptive1 (Dec 2, 2012)

I was looking this up as well, I found my first psychiatrist visit strange, I much prefer a psychologist and my own doctor. Does a psychiatrist explain things to you or are they supposed to? The one I went to didn't say anything to me, they just mailed in a report that said everything I said word for word to my doctor. it Making note my nervous habit of hair twirling and things that I never expected to be written down. I was shocked I had to read it all I. I read The report and I am left to try and figure out what the hell it means, I am surprised they would write as though I would never see the report, do you normally just read about it like this in this manner. I thought someone would explain it but the doctor said he knows nothing about it.

If this is normal that's fine, but I am not sure. I guess I was thinking it would be more like a visit to a doctor where you felt they were working with you.

Shouldn't the psychiatrist meet with someone and explain why they came to the conclusions they did or is this just normal not to say anything and just let you read it on a report. It seems kind of mean in my opinion.


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## Banned (Dec 2, 2012)

I never had anything mailed to me so that is interesting.  Will you see this doctor on an ongoing basis for medication?  I see my psychiatrist twice a year or as needed for meds and my psychologist once a week for therapy.  My psychiatrist has diagnosed me and won't change her diagnosis but my psychologist and I aren't sure anymore if that diagnosis should still stand or be added to or removed or what.  

Did the psychiatrist mail a copy of the report to anyone else besides yourself?  We're you given a definitive diagnosis and if so what is being done on a go-forward basis for meds and/or counselling?  Do you have a follow-up appointment with the psychiatrist?


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## adaptive1 (Dec 3, 2012)

Thanks Turtle, it Wasnt mailed to me, it was sent to my doctor and I read the entire report when I was there  I don't know if that's normal, but that's how I got the summary of it all. Maybe that's normal but I don't know, but I couldn't understand a lot of it. There is no talk of going back to the psychiatrist at all in the report and I don't think I would anyway.  I am supposed to go for cbt, take Prozac and read some books and listen to mindfulness CDs.

I didn't know everything I said would be in the report. Naive I guess on my part. Not that I was hiding nothing, but even nervous jokes I made that mention nothing were recorded,


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## Banned (Dec 3, 2012)

Well I guess the psychiatrist is thorough if nothing else.  It is normal for a report to be sent back to the referring physician and I apologize I misunderstood - I thought a copy was mailed to you.

If you don't feel a need to go back to a psychiatrist at this point then certainly there's no obligation to.  In my area they keep our file open for one year at which point you need a new referral.  If you do feel ou could benefit in the future from revisiting you could ask for a referral to someone different which I have also done, so if you didn't feel good about this one please don't let it discourage you in the future from seeking out someone else.


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## forgetmenot (Dec 3, 2012)

I do not thing you should have received a report like that without having someone there like your psychologist or doctor to explain it to you.


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## adaptive1 (Dec 3, 2012)

Thanks you guys. I wasn't sure how it worked, but maybe it's normal. Definitely makes me prefer a psychologist. At least they don't give you a piece of paper showing all the dumb things that you say at the end of your meeting, which only makes me feel stupid. It definitely makes me feel guarded and that I better be careful what I say in the future.


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