Help What do psychiatrists want to hear?

[BleedingHeart]

Headed to psychiatrist this morning. I've only been seeing her for like 2 months-ish. I've switched medications and was last put on sertraline (Zoloft) but only took it for 2 weeks and stopped myself but haven't told her yet. I personally stopped to avoid interactions with meto. Today I have to tell her I stopped them and I'm going to say I've just been conflicted with taking medications (this is true)- but the last two months I was working with her with meds and she knew I had suicidal "thoughts" but no plans. I'm afraid she may feel sketchy about me switching a bunch of meds and then stopping all together. I'm taking the meds in to turn them over to her so she doesn't think I was saving meds for an OD, but she might feel sketchy that suddenly I'm not having suicidal thoughts (that's a lie and I have a plan). So what could I say to ease any concerns she might have? Do I just say I'm all better? Lol

 

[Thisisjustadream]

Make shit up thats what id do

 

[BleedingHeart]

Make shit up thats what id do

That's just it, I'm not sure what to say.

 

[SawItOnce]

From the way most (I suppose) mental health workers approach patients, I'd say that they work on a basis that one *could* just snap out of depression and whatnot, with a little bit of pills or talking or you name it, hence the retarded simplistic approach. As long as you back up an "I'm feeling ok now" with appropriate body language (observe what body language you have when talking about neutral obvious things), they'll readily munch it. There are sharp psyhiatrists though, based on a couple of posts that I've read here...

I find that taking your meds back is a very good way to support your statement.

 

[KiraLittleOwl]

Mine is strange, she always ask what medication I want..
And why I didn't kill myself yet when I mention suicide ideations.
But I like her because she doesn't judge nor push anything on me.
But it's really useless waste of time.
She probably want to hear that I got better.

 

[hypo666]

Talk about positive plans you have for the future. Career goals/relationships / travel are good ones. Talk positive about yourself. But as someone else mentioned there are a few psychiatrists who aren't anyones fool so don't lay it on too thick with the positivity. It's always good to make a 'confession' as well. So talk about a difficult period ,even mention the suicidal thinking but then talk about how you 'self soothed' or practiced 'mindfulness' {thats the fashion these days, personally I don't get anything from mindfulness'. Mental health workers love 'confessions'.

 

[I'm exhausted]

Can you just say you're still taking them?

 

[PDAnnie2610]

I usually am upfront about how I feel but not upfront about stockpiling lol. When I used to see one, that is.

 

[Sensei]

In my experience, it's best to be honest. However, I tone down my suicidal tendencies to avoid fuss.

 

[SawItOnce]

Talk about positive plans you have for the future. Career goals/relationships / travel are good ones. Talk positive about yourself. But as someone else mentioned there are a few psychiatrists who aren't anyones fool so don't lay it on too thick with the positivity. It's always good to make a 'confession' as well. So talk about a difficult period ,even mention the suicidal thinking but then talk about how you 'self soothed' or practiced 'mindfulness' {thats the fashion these days, personally I don't get anything from mindfulness'. Mental health workers love 'confessions'.

This made me think of another element that makes an approximately sudden change believable: a slight mentioning of the "how" the change happened. Not to go into it as a separate topic, bc it risks to be obvious, but mentioning some events with supposed positive effect among other things. One example would be, when asked about how have you been, to say the standard response plus a couple of positive events with a comforted tone of voice.

And later when the topic arises to not explain unless asked how so. And then you can basically call up in your mind whatever period in your pastwhen you felt better after a low and base your response on that memory.

 

[Santiago]

Make shit up thats what id do

Then what's the point of going at all?

OP tell the truth

 

[Thisisjustadream]

Then what's the point of going at all?

OP tell the truth

Sometimes the truth wont do any good

 

[Santiago]

Sometimes the truth wont do any good

That's irrelevant. You don't go there to do good. You go there to get help.

 

[ScorpiusDragon]

I will take my pills, blindly agree with everything you say, and show up to our next $200 session<--what many psychiatrists hope you do

 

[k75]

With something like Zoloft, they don't test you or anyting so you really don't even need to say you're not taking it. The psychiatrist will never know.
But if you want to say you're not taking it, all you really have to do is say it made me feel funny and I didn't like it or it wasn't working.

As for what they want to hear... they want to know the truth. They want to know if you have any side effects and if the medication you're taking is working or not. That's the only way they know whether they need to try prescribing you something else or if you're good. 90% of what a psychiatrist knows is what you tell them. And contrary to what people seem to believe, they really aren't the enemies.

 

[Lethe]

I just told mine that I'm still taking them, there's no way for them to know that I've stopped.

 

[SoupSnakes]

From the way most (I suppose) mental health workers approach patients, I'd say that they work on a basis that one *could* just snap out of depression and whatnot, with a little bit of pills or talking or you name it, hence the retarded simplistic approach.

This is a load of rubbish. No mental health worker, psychiatrist or otherwise believes you just 'snap' out of depression because they know better. It's also not possible. They also know all the tricks in the book and they know when to believe what you're saying and when to know you're lying, even if it's very subtle. They're not idiots.

If you went in there all happy guns blazing, you'd raise the red flag immediately. As @hypo666 said, just trickle the information in. Better yet, like others have said, why are you being honest about not taking the medication? Why are you even still going if you're only going to lie? Maybe on some level you want to be honest in the hope you get the help you need.

Just some food for thought.

 

[BleedingHeart]

From the way most (I suppose) mental health workers approach patients, I'd say that they work on a basis that one *could* just snap out of depression and whatnot, with a little bit of pills or talking or you name it, hence the retarded simplistic approach. As long as you back up an "I'm feeling ok now" with appropriate body language (observe what body language you have when talking about neutral obvious things), they'll readily munch it. There are sharp psyhiatrists though, based on a couple of posts that I've read here...

I find that taking your meds back is a very good way to support your statement.

Thank you for the advice. It went fine.

Talk about positive plans you have for the future. Career goals/relationships / travel are good ones. Talk positive about yourself. But as someone else mentioned there are a few psychiatrists who aren't anyones fool so don't lay it on too thick with the positivity. It's always good to make a 'confession' as well. So talk about a difficult period ,even mention the suicidal thinking but then talk about how you 'self soothed' or practiced 'mindfulness' {thats the fashion these days, personally I don't get anything from mindfulness'. Mental health workers love 'confessions'.

I don't think I could fake overly positive anyway, but I was able to be neutral and it went fine. Good advice; thanks.

Can you just say you're still taking them?

Well, I had picked up a refill script of it early the other week even though I wasn't taking them anymore and hadn't finished the last bottle. I basically picked it up 2 weeks early (I was kind of on autopilot when I picked it up and basically just picked it up because she bothered to put in the refill at our last visit right before I quit taking them)- The pharmacist acted a little weird and I later realized they might think I was stockpiling or something and I was afraid she would alert my psychiatrist that I already had picked it up early. But I couldn't for the life of me even handle simple math in my mental strain and couldn't figure out how I would calculate how far I would be into the prescription in order to feign still being on it. I guess I could have simply Said I was fine on it and have it keep refilling and just not use it since I want to use meto for CTB without reactions. Anyway, it's confusing because I'm confused and paranoid and I'm a mess.
It's all fine though; the appt went fine and I just said I'm doing therapy and don't want to continue meds.

 

[SawItOnce]

No mental health worker, psychiatrist or otherwise believes you just 'snap' out of depression because they know better.

While overall your message does sound grounded, you'd be surprised to find out that there are indeed mental health workers who are quite delusional with their expectations. I've personally met a few. So maybe I give the whole bunch less credit with my impression than they deserve, but you seem to give them too much.

And yeah, after a couple of sessions I had two of the mentioned therapists almost ecstatic at how well their technique works. They wouldn't have been so full of themselves if they didn't believe at some level that it's all a matter of approach, that a nice and clean solution is possible, but there are patients "who don't want to do the work".

I said I 'suppose' 'most' of them feel like that. Your rubbish comment fell uncomfortably.

P.S. They do think they know better, otherwise they would quit, because why.

 

[SoupSnakes]

While overall your message does sound grounded, you'd be surprised to find out that there are indeed mental health workers who are quite delusional with their expectations. I've personally met a few. So maybe I give the whole bunch less credit with my impression than they deserve, but you seem to give them too much.

And yeah, after a couple of sessions I had two of the mentioned therapists almost ecstatic at how well their technique works. They wouldn't have been so full of themselves if they didn't believe at some level that it's all a matter of approach, that a nice and clean solution is possible, but there are patients "who don't want to do the work".

I said I 'suppose' 'most' of them feel like that. Your rubbish comment fell uncomfortably.

P.S. They do think they know better, otherwise they would quit, because why.

I've dealt with a lot of mental health professionals both personally and professionally, I was saying in my experience.

I still disagree they think they know better, there is a reason they train. I'm a nurse but I don't treat people because I think I know better, I treat them with the theory I've learnt and experience I've gained. But I'm not here to argue the point with you.

 

[k75]

I must have amazing psychiatrists, because mine are always competent, have realistic expectations, and want to help. And they only prescribe things that they think will help me based on what I'm saying is happening.

Anyway, @BleedingHeart, don't worry about filling early. They won't give you the prescription if it's too early and probably didn't think anything of it. Zoloft really isn't something most people stockpile, and I doubt they were thinking that. Also they don't really communicate like that. They're not going to report you to your psychiatrist. But if you're not going to bother taking it, there's no point in even filling it. Nobody's going to check to see if you're picking up your pills or not; your doctor will never know and the pharmacy doesn't care.

But what I don't understand is why you're even bothering with this charade. It doesn't sound like you've got someone else breathing down your neck to comply. Why not try taking your medications and see if they actually help you? Since you've bothered to get them and all. The only thing you have to lose is your depression. Maybe it'll work? And if it doesn't work at least you tried and can go on with whatever you have planned anyway.

Edit: I just noticed where you said you told them you wanted to discontinue, what I said before still stands anyway.

 

[JoeFailure]

I would say be honest up to the point of saying you have a plan or that you're stockpiling meds if that's what you're doing.

I think if the psych is smart, they're going to be more suspicious if you just out of the blue say everything's better and you're "cured".

 

[BleedingHeart]

I must have amazing psychiatrists, because mine are always competent, have realistic expectations, and want to help. And they only prescribe things that they think will help me based on what I'm saying is happening.

Anyway, @BleedingHeart, don't worry about filling early. They won't give you the prescription if it's too early and probably didn't think anything of it. Zoloft really isn't something most people stockpile, and I doubt they were thinking that. Also they don't really communicate like that. They're not going to report you to your psychiatrist. But if you're not going to bother taking it, there's no point in even filling it. Nobody's going to check to see if you're picking up your pills or not; your doctor will never know and the pharmacy doesn't care.

But what I don't understand is why you're even bothering with this charade. It doesn't sound like you've got someone else breathing down your neck to comply. Why not try taking your medications and see if they actually help you? Since you've bothered to get them and all. The only thing you have to lose is your depression. Maybe it'll work? And if it doesn't work at least you tried and can go on with whatever you have planned anyway.

Edit: I just noticed where you said you told them you wanted to discontinue, what I said before still stands anyway.

it's more than depression. I was normal-ish last year. Then got some sort of marijuana psychosis which in between there led me to make a mistake that hurt my marriage. Then I started having perceptual disturbances. Not voices, but actual things I would hear or see in my environment would feel like it was directed at me. I feel like I'm realizing I'm a covert narcissist and ocd (also anxiety and depression is in there too) and ever since then it feels like it's becoming more apparent now with me trying to sneak around getting my supplies for CTB, that I fear I only care about myself. My husband was sick yesterday and all I could think about was hoping he wouldn't be home today if meto arrived. I was never like this and it feels like it's gaining momentum. I can't keep emotionally damaging people without realizing it or feeling like I have no emotional or mental control over it even if I know and do realize something is wrong with me. My marriage is now ruined and I'm heartbroken. Among other things. My kids will suffer from me CTBing but I also fear they'll have an emotionally disturbed and detached mother who is prone to fits of rage emotionally. I can't handle my emotions and they trigger me. I know it's selfish sounding and I want to be able to be a good mom to them but everything feels so hard and beyond my abilities anymore mentally and emotionally. I feel like on one hand me CTBing will devastating them and alter their lives of course but then I feel like it's better for everyone that I die. I worry about failure of that too and making things way worse. Ugh. So hard to articulate pieces of the story without full context that would take forever to explain when I don't even know why or how I became this person in the first place. My marriage is basically over and I have no prospects for job or anything in life and can't function most days. I'm constantly thinking of CTBing while also fearing the shit out of it and the aftermath. I don't have endless time to figure it all out either. Okay, I got way way off track here, but I feel I'm at the point of extended psych stay and losing my husband and kids and being pumped full of drugs forever with no real life ahead of me, or CTB and get it over with.

 

[k75]

it's more than depression. I was normal-ish last year. Then got some sort of marijuana psychosis which in between there led me to make a mistake that hurt my marriage. Then I started having perceptual disturbances. Not voices, but actual things I would hear or see in my environment would feel like it was directed at me. I feel like I'm realizing I'm a covert narcissist and ocd (also anxiety and depression is in there too) and ever since then it feels like it's becoming more apparent now with me trying to sneak around getting my supplies for CTB, that I fear I only care about myself. My husband was sick yesterday and all I could think about was hoping he wouldn't be home today if meto arrived. I was never like this and it feels like it's gaining momentum. I can't keep emotionally damaging people without realizing it or feeling like I have no emotional or mental control over it even if I know and do realize something is wrong with me. My marriage is now ruined and I'm heartbroken. Among other things. My kids will suffer from me CTBing but I also fear they'll have an emotionally disturbed and detached mother who is prone to fits of rage emotionally. I can't handle my emotions and they trigger me. I know it's selfish sounding and I want to be able to be a good mom to them but everything feels so hard and beyond my abilities anymore mentally and emotionally. I feel like on one hand me CTBing will devastating them and alter their lives of course but then I feel like it's better for everyone that I die. I worry about failure of that too and making things way worse. Ugh. So hard to articulate pieces of the story without full context that would take forever to explain when I don't even know why or how I became this person in the first place. My marriage is basically over and I have no prospects for job or anything in life and can't function most days. I'm constantly thinking of CTBing while also fearing the shit out of it and the aftermath. I don't have endless time to figure it all out either. Okay, I got way way off track here, but I feel I'm at the point of extended psych stay and losing my husband and kids and being pumped full of drugs forever with no real life ahead of me, or CTB and get it over with.

I get it now. I'm very sorry all of that has happened to you. I hope you don't think I was being judgemental, because I wasn't. Really was just curious why you were going to such lengths but not actually following through.

 

[azucaramargo]

Then what's the point of going at all?

OP tell the truth

I totally agree with Santiago's statement. Be honest. Get the help you need.

I must have amazing psychiatrists, because mine are always competent, have realistic expectations, and want to help. And they only prescribe things that they think will help me based on what I'm saying is happening.

Anyway, @BleedingHeart, don't worry about filling early. They won't give you the prescription if it's too early and probably didn't think anything of it. Zoloft really isn't something most people stockpile, and I doubt they were thinking that. Also they don't really communicate like that. They're not going to report you to your psychiatrist. But if you're not going to bother taking it, there's no point in even filling it. Nobody's going to check to see if you're picking up your pills or not; your doctor will never know and the pharmacy doesn't care.

But what I don't understand is why you're even bothering with this charade. It doesn't sound like you've got someone else breathing down your neck to comply. Why not try taking your medications and see if they actually help you? Since you've bothered to get them and all. The only thing you have to lose is your depression. Maybe it'll work? And if it doesn't work at least you tried and can go on with whatever you have planned anyway.

Edit: I just noticed where you said you told them you wanted to discontinue, what I said before still stands anyway.

I'm just curious, are you in Europe, k75? Just wondering where I could find such wonderful shrinks.

 

[k75]

I'm just curious, are you in Europe, k75? Just wondering where I could find such wonderful shrinks.

Haha, US here. I've always been very fortunate on that front. Therapists... not so much. I've been through 13, and all but maybe one of them have been dreadful.

 

[PDAnnie2610]

I've dealt with a lot of mental health professionals both personally and professionally, I was saying in my experience.

I still disagree they think they know better, there is a reason they train. I'm a nurse but I don't treat people because I think I know better, I treat them with the theory I've learnt and experience I've gained. But I'm not here to argue the point with you.

You are quite right - a trained and skilled mental health clinician do observe the most subtle behaviour, though they may not point out their observation to you..

 

[BleedingHeart]

I get it now. I'm very sorry all of that has happened to you. I hope you don't think I was being judgemental, because I wasn't. Really was just curious why you were going to such lengths but not actually following through.

I had intended to follow through on meds at first even though I was conflicted about taking them. That's when my husband was trying to help me through it

I must have amazing psychiatrists, because mine are always competent, have realistic expectations, and want to help. And they only prescribe things that they think will help me based on what I'm saying is happening.

Anyway, @BleedingHeart, don't worry about filling early. They won't give you the prescription if it's too early and probably didn't think anything of it. Zoloft really isn't something most people stockpile, and I doubt they were thinking that. Also they don't really communicate like that. They're not going to report you to your psychiatrist. But if you're not going to bother taking it, there's no point in even filling it. Nobody's going to check to see if you're picking up your pills or not; your doctor will never know and the pharmacy doesn't care.

But what I don't understand is why you're even bothering with this charade. It doesn't sound like you've got someone else breathing down your neck to comply. Why not try taking your medications and see if they actually help you? Since you've bothered to get them and all. The only thing you have to lose is your depression. Maybe it'll work? And if it doesn't work at least you tried and can go on with whatever you have planned anyway.

Edit: I just noticed where you said you told them you wanted to discontinue, what I said before still stands anyway.

also, want to say I'm glad you have good psychiatrists and I hope things stay good or are going good for you.

 

[BridgeJumper]

This is a load of rubbish. No mental health worker, psychiatrist or otherwise believes you just 'snap' out of depression because they know better. It's also not possible. They also know all the tricks in the book and they know when to believe what you're saying and when to know you're lying, even if it's very subtle. They're not idiots.

No they dont! They have the audacity to tell me Im making up shit when I havent leftmy bed or showered in weeks, and eat or drink water every 4 days.
Personally. I just bullshit them about how the meds work great (if Im stable enough to pull it off) to avoid medication switch and then stockpile the pills.
I have long ago learned nothing they do will be of help, and nothing I will say will be of help.

 

[k75]

I had intended to follow through on meds at first even though I was conflicted about taking them. That's when my husband was trying to help me through it

also, want to say I'm glad you have good psychiatrists and I hope things stay good or are going good for you.

Thank you. I'm really, really struggling despite the meds, but I'm trying. I'm better on them than off them is all I can say.