There are four components that make up a successful team for mental illness recovery. 1) The mentally ill person; 2) Supportive family and partners; 3) Psychiatrist; and 4) Psychologist. This is your four-legged stool.
Today, I want to focus this post on the difference between items three and four. The biggest difference between psychiatrists and psychologists is the ability to prescribe medication. Psychiatrists CAN prescribe medication. Psychologists CANNOT prescribe medication.
When an individual has acknowledged that maybe he or she needs more help than what the spouse or parents can provide, often they are confused as to where to start or who to go see. They may think to themselves, 'I don't think I need to be on medication' or 'I don't want medication'. On the other hand they could think 'I don't want to talk about my problems with someone else. I don't even like listening to my own thoughts let alone say them out loud in an enclosed room with a stranger I don't even know. Why would I ever want to do something like that?'
Turn your attention to psychiatrists for just a moment. Psychiatrists prescribe medication. Psychiatrists don't talk as much as one would think. A psychiatrist appointment can go several ways but the two main ways are either: your medication is working or it isn't working. How is this determined? Through a series of questions between the patient and the doctor:
Doctor: How are you doing?
Patient: Fine
Doctor: Any bad thoughts?
Patient: Nope
Doctor: Anything bothering you?
Patient: Nope
Doctor: Any thoughts of suicide?
Patient: Nope
Doctor: Any medication concerns?
Patient: Nope
Doctor: Okay, lets keep your dose the same and I'll see you in three months. Call me if you have any problems or anything comes up.
Scenario #2:
Doctor: How are you doing?
Patient: Tired
Doctor: Feelings of depression?
Patient: Ya
Doctor: Thoughts of suicide?
Patient: Sometimes
Doctor: Are you feeling suicidal now?
Patient: No
Doctor: Lets adjust this medication dose, remove this medication and add this medication. Common side effects are lethargy and weight gain or loss. I can write a note for your employer while you get used to this medication for the first few days if you want.
Patient: Okay
Doctor: Let's schedule you for next week. If you have problems, call my office or after hours on-call number.
Patient: Okay
Now, obviously there is more to it than this, but you get the idea. Psychiatrists are not really heavy talkers. Yes, these appointments are this sterile and clinical. The number one priority of a psychiatrist is to find the right cocktail of medication that will help a disabled mentally ill, often suicidal, person come full circle to a fully functioning, main streamed community member engaged and contributing to his life, family, employer and society. It is the priority of the psychiatrist to create chemical stability within the brain through means of pharmaceutical synthetic medication.
Often people can and are offended at the lack of sympathy and compassion expressed by psychiatrists. Sometimes you can get a good psychiatrist who is both attentive and clinical, but they can be harder to find. Some people walk away thinking 'well that was a waste! He didn't even care about what is going on in my life or what makes me feel suicidal. I don't like him!' The things that need to be focused on in this type of treatment is 'does the doctor know his medications?', 'Is this knowledge strong enough to protect me?', 'can I call my doctor in a medical emergency?', 'is the treatment regimen he prescribed helping me be better now than I was last week?'
So far we are at a three-legged stool. It cannot stand upright at this point. We have the mentally ill individual actively seeking treatment, we have the supportive spouse or parents (which is assumed in this post), and we have a prescribing treating psychiatrist.
The fourth leg to this treatment formula: a psychologist. Psychologists can come in varying degrees of academic merit, the highest of them having their Ph.Ds and doctorate degrees. Medication can only take you so far. There are gaps in healing the mind and there is no magic happy pill that will make everything better. Psychologists help bridge that gap. Psychologists are the ones who ask the probing questions that so many are hesitant to answer to a complete stranger. It is important to shop around and find a psychologist that you like and that you connect with. Psychologists want responsive clients. If you don't feel you will be responsive to the first psychologist you see, you will be doing both of you a favor in seeing someone who will create a cohesive and healing environment for your specific treatment.
Good psychologists have a plethora of resources in which they can teach you life long techniques and skills to cope, manage and maintain your life. Medication will not get you to the end goal by itself. Once you learn and incorporate life skills of dealing with panic attacks, mood swings, feelings saturated with depression, suicidal thoughts and tendencies, anxiety and stress, you are on the road to recovery. Telling yourself that 'I'll just deal with it when it comes' usually ends up in explosive situations and things usually end up worse than they were before. Psychologists are not shrinks trying to take your money and get into your head. They are life skill workers who have based their career around helping others learn and apply the skills they have learned and know to legitimately work for you in your life.
Good psychologists will include your partner or family members in specific sessions and will educate them as well. Good psychologists know that the treatment doesn't start and end in the 50 minute session while you are in the office. These are not cortisone injections, people. Positive, successful treatment hinges on the support and encouragement of family and loved ones. How can the mentally ill person apply this stuff if they are the only ones who know how to apply the techniques outside of the office? Loved ones must be willing and available to help talk the mentally ill person through the disabling mood at the moment the mood hits. Education in life skills of mental functionality is the way to complete positive treatment for lifelong success and happiness.
Thus, the four-legged stool is complete. An individual willing to seek treatment to become a fully functional individual in society, a supportive spouse and family, a psychiatrist and a psychologist. Each one of these legs can hold a whole slew of resistance and difficulty. Patience must be exercised when seeking treatment and sometimes that patience is extremely hard to find.
The foundation upon which this stool stands is God. Take care of your spiritual foundation. Make sure one of the legs of your stool is not stuck in a pothole creating a wobbling imbalance. Turn to our Spiritual Maker for guidance, love, understanding, acceptance and most of all patience. No matter how may times the stool falls, it will always fall on the foundation of God. Connect spiritually and nurture your spiritual health. It will not be easy and it hurts every time the stool loses balance and falls. Choose the landing upon which you will fall and create stability for this stool you are trying so hard to build. Fall on your God and you will always be able to stand again.
~Elizabeth~
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