How to get referred to a psychiatrist

First of all, I’m writing from a Canadian health care perspective but it should be similar in western countries where the health system utilizes General Physicians and Specialists.  I believe in th US, it’s got a similar referral system.   I’ve been through the system so I will explain as much detail as possible and provide you with some tips so you can seek help and start recovering.

If you are in an emergency situation, PLEASE go to your nearest emergency hospital for prompt treatment.  I know in major cities, there are emergency mental health hospitals that have psychiatrists onsite to deal with patients. Don’t be afraid of the mental health care system, it’s not what the internet perceives it to be.

General Physicans would be what we called family doctors, it’s usually the first point of contact in the health care system, they are like the handymen.  Psychiatrists are known as specialists because they specialize in mental health issues so you can’t just walk into a specialist’s clinic and expect the doctor to see you.  It just doesn’t work that way.  I know in Asia, at least in China, you normally would see a specialist directly but that’s a whole different health care system over there.

The first step is getting an appointment with your family doctor or physician.  This should be pretty fast, from a day to couple weeks.  Now this is very important especially with mental health issues, I know people tend to tell doctors about symptoms in a way that sounds less crazy because they do not want to be labeled “crazy” and they want the doctors to tell them they are fine.  This is wrong!  You have to be genuine and tell them everything that you are experiencing.  There is no shame and do not afraid, you are there to seek help.  If you want a referral to a psychiatrist, you have to be truthful with your doctors, do not hide any problems.  Some family doctors do overlook mental health issues so if they tell you “oh you’re fine, take some rest”, insist that they refer you to a psychiatrist if you feel like you need to.  Usually they will also perform some basic tests like blood test to make sure no physical issues in your case.

The next step in the process is wait….. a long wait… it took me almost a year and I think that’s the average for psychiatrists.  It’s very unfortunate that the wait time is so long but it is what it is.  The more awareness we raised about mental health issues, the more doctors the system will put into this field.

After months of waiting, you’re finally and excited to see the specialist(psychiatrist).  Same tip again, be genuine and tell him exactly what you are experiencing, don’t hide anything from him.  Remember, he is a doctor, he is trying to help you.  Mental diagnosis is just a label, what difference does it make if he diagnoses you with this or that?  There is no difference, you are still suffering and you will still need treatment.  Label is just a label, remember that.  Don’t read all the horror stories on the internet about how psychiatrists just stuffs you with medication, I’ve never experienced that.  Every one of them I met were nice and understandable.  They never pushed medication on me in any way.

Remember that mental health issues require longer term treatment so it’s important to find a doctor especially when you’re prescribed medication, to follow you up through the whole treatment process.  It’s not like a cold where you see a doctor once and the next time is god knows when.

I hope this helps all of you!

DP/DR My experience with psychiatrists

After DP/DR, my first visit with psychiatrist was at this place called CAMH, a hospital that specializes in mental health and drug addictions.  I was dealing with a particular symptom that was really bugging me. Thank god that I no longer suffer from that, it could just be that my mind was hypersensitive to everything around me.  But I was scared that I might develop psychosis because of it.  My symptom was that I could see faces in objects, not talking about actual faces but something that looks like face, my mind would perceive it.  The other thing was that I was ultra sensitive to things that I see from my peripheral vision. For example, walking down the street and walking by something that looks like a person, my mind would perceive it as a person for a split second.  This whole experience scared the hell out of me, I thought this could be an onset of psychosis.  I think some of you may be able to relate to this as I’ve seen people complaining about this on forums.  I also told the doctor about my DP/DR symptoms, I wrote everything down on the paper so I didn’t miss anything.  It was a residence doctor that I was seeing and he asked a bunch of questions during the initial assessment. As I was reading off the paper that I wrote down,  he asked to see it, I believe it was to see if there is any anything unusual that would indicate something.  He never asked me about the DP/DR part that I wrote down, I should have asked him more about it but I was too nervous.  My intent that night was more about the face symptom so I didn’t ask much about DP/DR.  After about one hour of questioning, he went to speak with his supervisor and I was given the diagnosis of OCD and Anxiety.  I was let go and went home for the night.  I felt better at least that he didn’t think that I was psychotic but at the same time I didn’t get much new information.

From the nuerologist after I cleared physicals, I was referred to a psychiatrist and I finally met him after a whole year waiting.  The previous doctor was more like a walk-in clinic and this one is more of a long term psychiatrist. I was really curious and  I wanted to find out if he had seen any patients with similar symptoms.  I reached a point where I no longer fight the condition but I wanted to know what was the cause behind this.  I thought I was the only one in the world with these symptoms if not extremely rare.  That’s in the mind of most DP/DR sufferers because the symptoms are so bizarre.

Like usual, we started with a full assessment because you can’t just go in and tell them you have DP/DR and expect some medication,  It just doesn’t work that way.  As matter of fact from my research a lot of psychiatrists don’t even recognize DP/DR as an disorder.  Like I said I waited a full year from the time of the referral to the appointment date, ya that’s how the Canadian health care system is.  I feel sorry for those who have to wait so long to get help, it is very unfortunate.  I was actually looking forward to this appointment, expecting to find some magic answer or magic pill.  It’s like you broke your arm and you’re finally going to see someone that’s going to fix it.

After a bunch of asssement questions, He agreed with my self diagnosis on DPDR and he mentioned that DP/DR is usually a secondary symptom of something else like anxiety or depression or other psychiatric illness.  As a primary disorder is extremely rare but he has seen few cases during his career.  He said medication would not help me, he said that medications sometimes make derealization worst.  Then he mentioned he doesn’t have much experience with dissociation and he has a colleague that specializes in dissociation and would bring my case up with him.  I was so glad when I heard that, maybe there is a magic cure now.  After about an hour of assessment and the final diagnosis, he said I should get some CBT which I did for couple months when I first got hit with DPDR.  He referred me to his preferred psychologist and I went home that day.

I met him again two months back, excited this time to see what his colleague who specializes in dissociation had to say.  I was disappointed that he said his colleague wouldn’t be able to help as mainly he deals with dissociative disorder like PTSD.  We chatted about OCD and DP/DR casually, a very nice and honest psychiatrist. I told him that I’m doing better but if there is more help available I will be willing to go after.  He still insisted that medication won’t do any good for my condition but one thing that he said that really hit me was that

“Sam I’m sorry I won’t be able to help you, I wish there was a brain scan to tell your what’s going on but we don’t.  We are not trained in these disorders.”

It’s unfortunate that he wasn’t be able to help me but at least he was honest and did not push me with medications like many do.  I told him that I was doing CBT for my OCD and he said continue and let’s book a follow up meeting and off I went.

I’m a little disappointed with this whole experience but I believe this is the limitation of psychiatry.  There is really no magic medication, either it’s long term therapy and recovery or we are limited by research specifically DP/DR.  However I’m only speaking for my case so please as I said these are just my opinions.

Please go seek help if you need it, you do not need to suffer in silence.  Also please DO NOT self diagnose yourself, go see a psychiatrist!  Even though it was not helpful to me but it might help you. Find another one if you do not like the current one. There are some good and honest psychiatrists out there.   Keep in mind, if you are afraid of medication(I do), they are optional, they will not lock you up. 

Stay strong guys!

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Brain Defect?

Why did I call my site “Brain Defect”?  I don’t like the term mental illness because it’s not the mind that’s not working properly, it’s the defect of the phsyical brain that causes the behaviors or symptoms that we called “Mental Illness”.  Everything mentally is caused by some physical reactions with billions of neurons in our brain.  *JOKE*. Please do not blame your parents for your gene, when something extraordinarily complicated forms through natural process, defects will occur. 

In my opinion, mental illness shouldn’t be in its own category on the far side of the spectrum.  Take any mental illness for example, it is no different than let say someone with diabetes.  Diabetes is something physical because it can be detected by looking at blood sugar level and causes a bunch of symptoms due to lack of insulin the body makes.  On the other side of the spectrum,   anxiety, I believe it’s a part or or multiple parts of the brain not working properly physically that causes us to feel anxiety and many other symptoms associated with anxiety.  So as you can see mental illness and physical illness are really the same in nature.  It’s that we haven’t reached a point where we can do physical tests for mental illness.

Unfortunately the current psychiatric health care system still relies on symptom grouping diagnosis using DSM instead of pinpointing to physical causes in the brain.  But I believe this is the best we can do right now and I believe it has helped tremendous number of people.  My aunt’s husband suffers from schizophrenia and is functional most of the time with the help of medication.  Many mental illnesses are somehow related, you can’t have 100% separation between two mental illnesses so until we have brain scan diagnose, we can only reply on symptom grouping and medication treatment based on those symptoms.

I visited this very honest psychiatrist and he said “I wish I have a brain scan for you to tell you exactly what is physically going on in your brain that causes what you feel, if we have that, then people wouldn’t be given multiple labels  like OCD, Anxiety and Depression etc.”. 

BUT, I believe researchers are working towards that.  A lot of imagine technologies that weren’t even available decades ago are now being used for brain imaging to look at the phsyicall process of the brain for mental illness.  But like I stated before the brain is so complicated that I believe it’s not matter of pinpointing the area in the brain,it’s matter of how to study the brain in relative to our mind and consciousness.

Let’s hope one day, we can go to our doctors and be sent for brain scan and be given one diagnose label and be treated the same as any other phsyical illness and have effective treatment designed for that particular condition.

That’s it for now, stay strong people.

Love you all!