hey everybody thanks for checking back
today I'm sitting down with my friend
Barry Lieberman who is a psychiatrist
and we are answering your questions
about psychiatry medication and more so
stay tuned if someone makes an
appointment to see a psychiatrist what
do they expect what how long do you see
them is there a ton of paperwork to fill
out all of that jazz what kind of
questions are you going to ask well the
difference is what they expect is and
what they actually get is often
different people often expect some
little man in a white coat is just stare
at them like a fish and a psychiatrist
wearing a white coat in all of my years
maybe in the hospital I kept one here
for years just for the fun to take one
out and to intimidate somebody who's
already here on a second appointment I
need to wear this now very good
but in fact most people go to a
psychiatrist yes they will often fill
out a form and their medical history I
don't do that because I'd rather ask the
questions myself and I do a more focused
personal interview but you usually want
to know about the person the history of
their problem and you want to know about
their medical conditions and stuff like
that but but typically a first session
should and always should be at least
nearly an hour to really get to know
what's going on with that person yeah
and I agree I think that I'm sure you
feel this way but sometimes especially
first appointments an hour goes by like
no and I can barely get a full history
of you know if we're talking about like
work or school issues or family history
or medical history an hour isn't really
very long no it isn't that and in fact
it really isn't any different for for a
psychiatrist and a psychotherapist we're
looking for the same things
the additional thing is the psychiatrist
might be a little bit more interested in
the presence of medical illnesses and
have a better perhaps a better
understanding of the medications a
person's taking for those illnesses and
and the interact
between them and what you might choose
to use medically yeah for me only about
half of my patients are on medications
oh and I think that's important to note
because a lot of my viewers fear that
they're gonna go in and just be like
prescribed a bunch of things that's
right
take this and presto fix Oh an
intelligent and thoughtful decision is
not to automatically use medications I
saw somebody yesterday a new guy whose
daughter made him come in to see me and
she thought he needed meds and I took a
history from him at some lengthen he
doesn't need that yeah a lot of it can
be behavioral or behavioral changes that
they make or just sometimes talking it
out can make us feel a lot better like I
just told a client yesterday put get
outside have you been stuck inside
because you're feeling down I want you
to spend 30 minutes in the Sun and then
I want you shower and that can make us
feel a lot better than okay let's try
the 72 psychiatrist take medication
there was a study actually done
comparing mild to moderate depression
with the treatment with Anton's and and
exercise and and better sleep and
they're equally good problem is that you
often can't get people to do the
exercise and they are slow to like that
so you so you sometimes you can
kick-start them with the medication and
then take them off the medication as
they start to do things better he'll
often say I don't know if I'm feeling
better because of the medication or
because I'm doing these other things I
would love it I don't know and I don't
care yeah I just care that you do those
better things exactly and I just told
them I had a video and I if I find it
I'll link it here but I had a video
where I talked about how it was
important to know that medication isn't
seen as a crutch sometimes it's that
like kick in the pants you need yeah to
get going because right now you feel
like so much it came and get out of
the house um as soon as we need that
little extra that's right to get us
going and conversely it has to be said
to there are people with deeper or more
long-lasting psychological issues
especially if their history goes back to
childhood or teenage years I am and it's
persistence so you might indeed have to
warn somebody if this works for you we
might do it for at least a year or more
and maybe indeed if the end if it works
for you then we'll make a second
decision I mean I there's always a
three-part thing that I'll do
about the medications one can you tell
it if we're going to use the medication
can you tolerate the side effect - does
it work for you then I love the third
question how long do we do it yeah
exactly that's based on already existing
success yeah and what we're talking
behaviorally is usually like a mild to
moderate type of issue and something
that isn't so entrenched in your life
that's right um so for those of you who
are curious if you're going to make an
appointment they're gonna hopefully
spend about an hour is that customary
for most psychiatrist even we talked
about like med management not spending
as much time I think they still usually
spend at least I think that oh yeah I'm
sorry for hesitating but yeah I think I
think most people at least at an initial
session will spend more time they have
to take a history it's just the issue of
subsequent stuff whether or not they're
participating in the psychotherapy if
that person is already seeing somebody
like you for active psychotherapy then
then I and certainly other psychiatrists
are most likely to spend a shorter
period of time or do it less frequently
yeah so there's a lot of people I see
once a month I'll still see them for a
45 plus minute session but if they're in
therapy I don't want to interfere with
the therapy that the other things want
to work together in the best way and not
make you keep repeating everything so if
I'm the only one person saying it's
almost always going to be at least once
a week psychotherapy and medication good
ok so it's probably about an hour for
your first appointment after that
something I would ask your psychiatrist
because it changes and it differs some
of them might see you for 15 to 20
minutes others may see you for a longer
period of time so it's good to kind of
know so you have expectations of what
how much time you need - a lot also
filling out paperwork is pretty
customary and it's probably best they go
through insurance I know that that's
like a total another horrible thing to
talk well it's a giant pain in the ass
in that more and more people are
refusing to take insurance I do take
insurance and because it for me it's a
philosophical I had
but I had a conversation with a
psychiatrist who's coming here from the
east a highly trained guy who says that
all the therapists that he is psyche in
the medical therapist that he's seeing
out there are stopping taking Medicaid
insurance because it's a giant pain in
the butt for much less payment and but
to me it's intolerable to think that I
would only see people who can afford
yeah and it's part of what makes you
such a good psychiatrist and what I hope
other people out there who are actual
treating physicians or therapists is
that you get into it to actually help
people and I think along with that comes
working with them and trying to figure
it out and so I have a video that I will
also link about getting help when funds
are low because there are a lot of
things you can ask like do work on a
sliding scale can I get a super bill so
I can build my insurance or a lot of
things and tips and tricks that we may
know that I've made a video about so
that you can get the help you need even
if you can't really afford it yeah so
thank you so much for answering that
question I know that that has been
weighing on a lot of you for a long time
um so click here to subscribe and I am
sitting down with Barry for more
questions than answers so make sure you
don't miss it see you next time