Psychologist says yes, psychiatrist says no

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ottorocketforever
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19 Oct 2009, 10:47 pm

Always trust the psychologist. They know more about this stuff. :) :P



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20 Oct 2009, 12:01 am

Well, in my experience with my psychiatrist.. I mostly talk to him for about five minutes, he asks how my meds are working out and if i have any concerns about negative side-effects, and he writes me out another prescription. He never really gave any input on what "disorders" he thought i had or didn't have, he just basically took the info from whatever therapist or psychologist i was seeing at the time, plus the little bit he heard me say, and decided on a medication to put me on. In fact, back when i was originally only seeing a therapist, and went to him for medication for anxiety and depression, i never got an offical diagnosis from anyone. The first therapist when i was a kid suspected Asperger's, and then after seeing her for a little bit said that she was certain that i had Generalized Anxiety Disorder and Depression and then from there i saw the psychiatrist to get antidepressant meds for that.. And no one brought up aspergers again until years later(at that point, the extreme anxiety was probably overshadowing the aspie traits themselves). In fact, i didn't get a diagnosis for anything until this year with my current psychologist. Even the first psychologist i saw didn't give me any kind of official diagnoses that i'm aware of.. Just went along with what we already knew, that i had anxiety and depression. I think that if my experience with psychiatrists and psychologists is normal, then the psychologist probably knows you better and probably would be able to give you a more reliable diagnosis, and the psychiatrist could probably read that psychologist's report on your diagnoses and symptoms and know what medication to put you on. heh.



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20 Oct 2009, 12:20 am

Wow, looks like I inadvertently stirred up a hornet's nest here.

Anyways, my psychologist has had experience working with autistic children, she mentioned working with a 9yo with Asperger's to me once. I don't know if my psychiatrist has had any experience with people on the spectrum but he didn't sound too knowledgeable because he was saying that people on the spectrum "don't get better" and remain the same from childhood. From what I've read, it's certainly not been suggested that way in the literature.

Some of what I've read here is interesting though, especially the debate about psychologist vs psychiatrist. Maybe my psychiatrist is more analytical than my psychologist, which is why he's skeptical? Or maybe my psychologist does know more than my psychiatrist and I should follow her opinion more?

Still a bit :? I do wish I didn't bring up AS sometimes with my professionals, then I wouldn't be in this situation.

PS: Personally I don't believe in self diagnosis, mainly because it's just not objective enough.


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20 Oct 2009, 2:10 am

This entire debate is on the nature of the psychology/psychiatry split. A lot of psychiatrists here in the U.S. will see you once every two to three months, and even then it's probably not more than a half hour. In counseling, you'll see someone and talk to them once a week, or once every other week for nearly an hour.

Personally, I think for anyone to rule AS in or out they're going to have to talk to the patient and get an idea of what they're having difficulties with. In areas where Psychiatry's role breaches into that of counseling, the psychiatrists may very well be more qualified than psychologists. In areas where Psychiatrists hardly speak to the patient, and do little more than med check, they're not qualified to do anything more than act as a vending machine for pills.



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20 Oct 2009, 2:56 am

• There are no pharmaceuticals for treating AS.
• Psychiatrists typically refuse to recognise AS.
• Psychiatrists are not required to have studied any psychology.


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20 Oct 2009, 7:55 am

I've had this before. I think it's because there's no standard medication (that I'm aware of) for AS, so psychiatrists can't make any money off of you. Therefore, any psychiatrist who's ever seen me has said.

"Oh, you're fine. You're just depressed. Here! Have some paxil!"

And then they write that down with their paxil pen on their paxil prescription pad right before going out to a steak dinner with a pharmaceutical rep.



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20 Oct 2009, 8:07 am

Flismflop wrote:
• There are no pharmaceuticals for treating AS.
• Psychiatrists typically refuse to recognise AS.
• Psychiatrists are not required to have studied any psychology.
The vast majority of psychiatrists HAVE studied psychology, though. Just like the vast majority of lawyers have passed the bar exam (technically, anybody can be a lawyer).

The psychiatrist seeing you for fifteen minutes is quite similar to any doctor, who will also see you for fifteen to thirty minutes, whether you have the flu or terminal cancer. Actually, that's part of the reason people go to alternative medicine practitioners, who will spend an hour with them... People like having personal relationships with their doctors, and will go for the personal relationship over actual competence. Of course, the fact that there are fewer doctors than we need--even here in the US where there are more doctors than in quite a lot of places--means that appointments will tend to be short no matter what you do.

Doctors expect most cases to be fairly uninteresting... in run-of-the-mill cases, they can make diagnostic decisions pretty quickly, and be right as often as if they were spending more time. So, they don't spend the extra time, because the only thing it does is build a personal relationship with the patient--it doesn't make them any more accurate in diagnosing or treating anything. Unfortunately, psychiatrists may work the same way; but it doesn't work as well with a psychiatrist faced with a childhood disorder in an adult who has poor social skills. As far as a psychiatrist is concerned, a missed autism diagnosis in an adult is a real zebra. I only got lucky because my own psychiatrist had an adult autistic son, and so knew what it looked like.

This is probably why psychologists are qualified to diagnose mental conditions, even though they are not medical doctors--they spend the extra time that the psychiatrist can't. Some people think they should even be allowed to prescribe medication, but I disagree--psychiatric medication has an effect on more than just the brain; and before you mess with the physical make-up of the human body, you should know, in detail, exactly how it works.


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21 Oct 2009, 3:59 am

Callista wrote:
Flismflop wrote:
• There are no pharmaceuticals for treating AS.
• Psychiatrists typically refuse to recognise AS.
• Psychiatrists are not required to have studied any psychology.
The vast majority of psychiatrists HAVE studied psychology, though.

I doubt it.

Out of the four psychiatrists I've seen, only the first one acted like a psychologist. And that first one either didn't notice my AS-related behavoir or, still didn't want me to know what it was. The other three were much worse. One had me locked up amongst psychopaths, under the false pretense of paranoid schizophrenia. The next one wouldn't give me a chance to discuss my reasoning that the diagnosis was flawed. The last one educated me about the rift between psychiatry and Scientology but, didn't want to hear how I felt about my treatment from the previous two psychiatrists.

There's also the huge number of other AS people with bad experiences from psychiatrists. Those people vastly outnumber the ones coming to the defense of psychiatry.

Quote:
Just like the vast majority of lawyers have passed the bar exam (technically, anybody can be a lawyer).

No, that doesn't support your claim at all. Not just anyone can be a psychiatrist so, there's no similarity with being a lawyer.

I didn't quote any more of your reply because it went down a winding path, far unrelated to my post.


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hush6
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21 Oct 2009, 4:22 am

So....if psychiatrists have absolutely no psychiatric/psychological training...then what are they studying for those 3 - 6 years after medical school when they study their specialty (psychiatry)??

People who think they have AS have a problem with psychiatrists because they don't just give them what they want or tell them what they want to hear.



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21 Oct 2009, 5:23 am

It's not that they don't have any psychological training.. But their main training is in the medical field, not the psychological field. Generally they have medical degrees, not psychological degrees. But they specialize in medically treating psychological conditions.. Usually also have training in psychotherapy, diagnosing mental illnesses, and stuff. Psychologists have degrees in psychology, not medicine(therefore cannot prescribe meds), so they are more trained in psychology itself... not mainly how to treat it.
So, yeah. THEREFORE... I think a psychologist, in most cases, is more likely to really get into your mind and understand how you think and what might be affecting you. And a psychiatrist is more likely to know what medical treatment to give for whatever "disorder" it is. Afterall, they are technically physicians, not psychologists.



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21 Oct 2009, 5:26 am

But the Psychological/Psychiatric education a Psychiatrist receives AFTER completing medical school is the same lenght, if not longer, that a Psychology degree....so, wouldn't they be at least just as qualified??? When a doctor takes a spiciality after med school it is like doing a whole other degree (it might even be another degree).



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21 Oct 2009, 5:34 am

hush6 wrote:
But the Psychological/Psychiatric education a Psychiatrist receives AFTER completing medical school is the same lenght, if not longer, that a Psychology degree....so, wouldn't they be at least just as qualified??? When a doctor takes a spiciality after med school it is like doing a whole other degree (it might even be another degree).


Well, they are qualified to diagnose mental illnesses.. But it's still not the same as having a degree in psychology. The training they get after med school, as far as i know, is mostly specific to things they will be doing as a psychiatrist: treating and diagnosing mental illness. Not to mention the fact that nowadays a lot of psychiatrists basically just prescribe meds. It's not so much a psychological education they get as it is just a psychiatric education. They don't get the full psychology training that a psychologist does. So i'd expect a psychologist to have a more complete view of how a person is thinking. I'm not being negative about psychiatrists or anything. I'm glad i went to a psychiatrist and got meds or i'd be a wreck. This is just going by the basic requirements for each, and stating the differences. I'm sure there are some people out there who have both a medical degree and psychological degree, or whatever. This is just how it usually is.



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21 Oct 2009, 6:03 am

Yeh nah, it's all good!! :)) I'm just confused by this a little as well cause I think alot of the non-medication based 'talking therapies' and CBTs were developed by psychiatrists, and that's what psychologists learn. It's all very confusing, and I think things might be different in America to here.



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21 Oct 2009, 8:19 am

In the UK, psychiatrists have completed the MRCPsych (Member of the Royal College of Psychiatrists) qualification. My general practitioner also happens to have this.

The syllabus break down provides some idea of the material covered: http://www.rcpsych.ac.uk/exams.aspx

Also, see this much more detailed, but earlier, version of the psychology covered: http://www.aippg.net/forum/viewtopic.php?t=10989



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21 Oct 2009, 12:51 pm

Callista wrote:
I'll take a pill-pushing psychiatrist over an alternative "medicine" quack any day. At least the mainstream meds have half a chance of actually working.
I found acupuncture is effective on anxiety without the multitude of side effects that made it so difficult to function from day to day. if only I could get a Rx!



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21 Oct 2009, 3:57 pm

The only thing that really made a difference for me was medication and I had been in and out of therapy and trying for as long as I could remember. It was like I had been looking through a dirty glass my whole life and then somebody had wiped it clean.


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