Whom should I see - psychologist or psychiatrist? Any advise.

Discussion in 'Fibromyalgia Main Forum' started by rasyte, Aug 20, 2003.

  1. rasyte

    rasyte New Member

    I am so depressed all the time and afraid that all my pains, anxieties and neuro symptoms are not simple FM. I am so afraid that there is something more serious. I had MRIs, blood work, extensive thyroid testing, saw tens of doctors - all normal except sinus infection, no one knows what is going on. I am seeing neuro doc now. He is going to do EMG and NCV testing next month to see if there are no underlying problems with my nerves. My hands have hyper reflexes and stiffness all day long which made him concerned :( and left me devastated. I am ready to get some counseling to help me deal with all this mess, but not sure what to go and see - psychologist or psychiatrist. What should I expect from them? Thanks for sharing your experiences.
  2. beh43

    beh43 New Member

    Hi rasyte,

    A psychiatrist would be best. Get an evaluation and then see if you need therapy or medication. Tricyclics are best if you have Fibro or CFS. Some people get relief with norepinephrine. It isn't a cure but it helps with sleep, pain and stiffness. Elavil is recommended in the latest literature in very low doses. 10mg is usually enough to level things out so your not miserable all of the time. If you have other issues standard therapy or CBT (cognitive behavoral therapy) may help but it is costly.

    I hope this helps in some way. With this illness I think you would be abnormal if you didn't get a little depressed. Negative test results are normal for this illness but it doesn't mean it is all in your head. They just don't know what the problem is or how to fix it at this time.

    beh
  3. sandy10seven

    sandy10seven New Member

    Sorry you are having such a difficult time. Sounds like you are getting thoroughly checked out by MD's. I do not have FM, but there are many people here who do and they can give much good advice on treatments that many doctors don't seem to be aware of.

    Depression is very common side effect of being ill, and it's good that you are aware that you might need help in this area. Many of us do.

    I have seen both psychologists and psychiatrists for post-traumatic stress for 8 years and will share what I know. A psychologist has a PhD and when seeing a patient that needs medication (many do) she will refer them to a psychiatrist, who is also an MD. The psychologist will continue counseling with you, and you'll also see the psychiatrist for medication purposes only (probably once a month for 15 or 30 mins).

    Having done this both ways, I would see the psychiatrist first. Most importantly, whoever you see has to be someone you can establish a rapport with and have trust in. If you don't feel comfortable with the first one you see, try someone else. Plus many of the meds that psychiatrists prescribe also help with FM symptoms.

    I also can tell you, that I would NOT have survived without their help. Before the PTSD, I could not imagine ever needing a psych doctor. Now I know why they're there and I'm so thankful.

    Best wishes, Sandy
    [This Message was Edited on 08/20/2003]
  4. Mikie

    Mikie Moderator

    If there is a possibility of drugs being pescribed, it is best to see a psychiatrist who can prescribe. If therapy is all that is needed, a psychologist or therapist with a Master's Degree is often all that is needed. I've seen all three types and each one was gifted and helped me.

    Good luck.

    Love, Mikie
  5. klutzo

    klutzo New Member

    I am Psychiatric Social Worker. I am prejudiced, due to my personal experience in working with both psychiatrists and psychologists, but will give you my opinion, for whatever it's worth.
    If you need drugs, you need a psychiatrist. Due to the discoveries that most "mental" illness is biochemical, psychologists are lobbying to be able to prescribe certain types of drugs, in order to keep their clientele. I don't think this legislation has passed yet, but may be wrong, since I am now out of the loop (On disability for my Fibro).
    I personally prefer psychologists. I have known too many psychiatrists who needed one themselves. You could also go to a licensed therapist. Even if drugs are needed, they can work with your doctor and have him/her prescribe them.
    However, I think the most important thing is to ask the doctor if he knows anything about FMS, and don't just take "yes" for an answer. Ask what his/her theory is on FMS and how it should be treated. If they tell you it is a psychological problem, drop them like a hot potato and find someone else.
    I have also studied Naturopathic medicine.... I wonder about your "normal" test results. Get a copy of your thyroid test results and look to see what your TSH is. If it is higher than 2.0, I would advise you to see a holistic doctor for proper treatment of your thryoid before you assume you are clinically depressed. Most conventional docs do not know about the new thyroid normal ranges and do not know how to prescribe the natural Armour Thyroid that corrects the problem. I believe about half of all people diagnosed with depression actually are hypothyroid, and even more than half of those with fibro.
    You can learn more about this at the website of Dr. Bruce Rind, or Dr. Lowe. We can't post URL's here, but they are easy to find by putting their names plus thyroid into a search engine.
    Klutzo
  6. MiahRoo

    MiahRoo New Member

    If you see a psychologist and he/she feels you need medication he/she will refer you to a psychiatrist for medication. It's a matter of finding a PERSON who you feel comfortable with. I'd seen some people in the past and never found anybody I felt I could talk to. I did the bull&%#$ "yeah things are hard but i'm doing okay" thing because I felt I could not go any further than that. Now I finally found that amazing person to talk to. The person who feels like a dear friend as well as my doctor. The person who I feel I can be open and honest with, even though it did take quite some time to get to the point that I'm at right now...which is still with me having walls up that I won't allow to come down. But I cried two weeks ago during therapy which is a huge thing for me. I let all the walls come down and just cried over everything that I feel. To find a person that I can do that in front of, and allow her to comfort me is a gift that can not be measured by any means.

    She works from a wholistic health center because she is a very spiritual person (not in a religious sense...just a pure spiritual person) She left the hosptial she had been at and came to the wholistic health center where her personality fits best.

    So my advice is to search around for a person you feel suits your personality. Give a few doctors a try for a few appointments and if you feel they just won't be that person that can help...move on. The wrong doc can do damage so make sure you find a person you feel you can be completely honest with. A person you feel you can trust and respect as a doctor as well as a friend. That is where the best help will be. Seems complicated, I know, but I just found from my own experience that when you are with the wrong doctor things can go downhill instead of uphill. *hugs to you* I hope you find somebody like my doctor. She is supportive of me. She calls me on my bull at times when I need her to. She speaks to me as a friend, not as an authority figure as many doctors seem to do. She cares, truly cares about me. I wish the best for you and that you are lucky enough to find the same.
  7. rasyte

    rasyte New Member

    Thanks to all if you for advices. You are so great and I am so happy that I found this site. I was on elavil 10mg - didn't make a difference. I was on buspar for anxiety - didn't make a difference. Maybe I should try other medications? My PCP and neuro write prescriptions so far with no problems. But what I really need is counseling on how to deal with this. I guess I need to talk to someone trained more than medication at this point.

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