When to consider seeking a psychiatric medication consult?
- Find a supportive therapist
Words are very powerful; we all know how words can hurt, but words and self-expression often go a long way towards healing. Finding a supportive therapist that you believe you can be candid and emotionally open with is a good place to start in the process of restoring mental health and wellbeing. A therapist can help you decide if a medication consult is indicated in conjunction with talk therapy.
- Start with a thorough medical exam
It is important to understand there are potential medical causes for symptoms that exhibit as anxiety, changes in energy, decreased ability to concentrate, irritability, or depressed mood. It is a good idea to initially undergo a thorough medical health physical to rule out underlying illness which can present as changes in mental wellbeing. This can include thyroid dysfunction, metabolic issues (such as diabetes), anemia, medical medication side effects, or cardiovascular problems (such as perfusion changes or high blood pressure). This is only a partial list of medical concerns that should be ruled out.
- Talk to your primary care provider
Often your primary care provider can triage and manage mental health symptoms which are not complex, such as depression. If you feel comfortable with your PCP, you can bring up concerns about symptoms at an appointment. The provider will let you know if they feel comfortable managing your treatment, or if they would prefer you see a psychiatric specialist.
- Consider your overall daily functioning
Considering when to seek out medication intervention can often be guided by how you are viewing your overall day to day functioning. It is important to be aware of trends and patterns in how you are interacting with the world around you. This can include, but is not limited to, patterns of withdrawing from loved ones or friends, feeling you have no energy to face the day, changes in job performance, persistent problems sleeping restoratively, intense feeling of guilt or shame about self or events in the past, and certainly thoughts about death or that life is not worth living would be important reasons to seek medical intervention.
What to expect from a first visit with a medication provider?
- Your provider will ask questions about both your physical and mental health history.
- The first visit may last close to one hour, but subsequent visits are typically 20 to 30 minutes.
- Your provider may ask questions about alcohol or drug use history; this is only to properly choose the best medication that may help you. They may also educate about how, when there is active substance abuse, mental health medications may not have the ability to optimally benefit you.
- It is important that you receive sufficient education about the potential risks, side effects, and possible benefits of the various medication alternatives your provider discusses with you. This could be verbal information or, if you prefer, request the information in writing (such as in a handout), just ask if this could be provided to you.
- It is important for a provider to schedule a follow up visit in a timely manner if you are started a new medication or have a change in dosage. Typically, you would want to have a follow up in 4-6 weeks.
- You should always be informed as to how your provider plans to manage any emergencies that arise after office hours. Important questions to ask include: what is the best way to contact your provider between appointments? Do they prefer using e-mail or an answering service?
Strategies for using medication
- Medications can help our brains
Understand medication interventions typically work by helping the brain utilize its own natural chemistry more efficiently. This process can take time so you may not be able to fully judge if the medication is helping for up to 4-6 weeks.
- Don’t give up hope
Improvement in mood or anxiety symptoms usually occur subtly, over time, and not in a ‘dramatic’ or immediate fashion.
- Substance use
When you combine alcohol, marijuana, or other mood-altering substances to your mental health medication regimen, your mental health medication may have diminished benefit, or possibly, no benefit at all.
- All medications have some limitations
Mental health medications are not ‘one size fits all’; it is more like the process of finding the right ‘fit’ with your chemistry. One might think of it like a ‘Cinderella slipper’, sometimes a person will need to give a series of different medications a try before achieving the best possible relief of symptoms.
- Preparing for your appointment
It is also important to know all medications have some degree of limitation in respect to benefit. You may respond well to a mental health medication and have positive relief of symptoms; however realize, we all experience ‘blue’ days or feelings of anxiety at times and this is a normal part of life. Again, it is important to be aware of patterns and trends in how you are feeling and functioning.
- Managing risks and symptoms
All medications come with some degree of risk. If you observe a sudden change in symptoms, and have thoughts of harming yourself or others, contact your provider. In case of an emergency after hours, resources include:
- Calling 988 or text “Hello” to 741-741;
- Valeo’s Crisis Center (ages 18+) 400 SW Oakley, (785)234-3300;
- Family Service & Guidance Center’s Crisis Team (Ages under 18) (785)232-5005;
- Stormont Behavioral Health Center (785)270-4630;
- If you are experiencing a life-threatening emergency, call 911.
Quick tip: Before your appointment, think about what you need your provider to understand most about how you are feeling, thinking, and functioning day to day. Write some talking points to review with your provider at your next appointment. Also consider, what do I want my provider to understand about my current treatment goals?
Written by Gina Robertson, APRN