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Initial Assessment with Psychiatrist

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tsunami

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Hi, I am new to this forum, first post so here we go.

I have been treated for depression for over 2 years and have been on various anti-depressants. Currently on Fluoxetine 40mg (dropped from 60mg because it made me hyper). I have also had two sessions of talking therapy and one session of counselling.

About twelve months ago my GP suggested possible bipolar and I was given an assessment with a psychiatric nurse. I was given two screening tests which were positive and asked to complete a mood diary and come back two months later. The mood diary showed a regular pattern of swings between about 8/10 and 2/10. When I saw the nurse again the assessment was that I was not bipolar but my mood swings were to do with my personality. :scratcheshead:

About two months ago I pushed the issue with the Primary Care Team because I was extremely irritable, not sleeping and on the go all the time. I was given a further triage assessment and told that I would be referred to the CMHT for further assessment, but I then got a phone call saying I was going directly to the psychiatrist because they already had plenty of evidence.

I have my appointment in three weeks time and I am a bit apprehensive. Don't know what to expect. Does the psychiatrist decide there and then or do I get further assessments?
 
Kerome

Kerome

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Usually a psychiatrist will review your notes before the appointment and make a decision, and the appointment is more to inform you and discuss the diagnosis with you. If you have particularly strongly held views on what your condition is or is not you'd be able to air them then.

And :welcome: to the forums...
 
T

tsunami

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Thanks, should I read anything into them saying that they had plenty of evidence?
 
Kerome

Kerome

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It sounds like they feel they have enough evidence to make a solid case for one diagnosis or another, nothing more than that. So it's probably not going to be one of the "vague" diagnoses like "psychosis (not otherwise specified)". Beyond that, it's hard to say.

It's good to remember that what defines you is your story, your symptoms, more than some arbitrary label they stick on you. Diagnoses are just a shorthand for your condition, and are often necessarily a very incomplete portrait. That is why often when you get a new psychiatrist you may also get a new diagnosis... They are not that consistent, and ultimately your story and symptoms are much closer to the real you. ;)
 
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Helena1

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Or they could mean they have plenty of evidence you have an issue severe enough to warrent a psychiatrist's appt. Also if they already were sure of your diagnosis, it wouldn't be an assessment.
 
T

tsunami

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Been told the appointment will be around an hour, is there anything that I should do to prepare for the appointment?
 
SarahD

SarahD

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If the psychiatrist is going to,assess you he/she will read the notes, then observe you during the assessment, go over your history, symptoms and experiences, in order to make a diagnosis.

If I were you, I would read up on the conditions they have suggested, and anything you think is more likely. Sometimes there might be symptoms you experience that you haven't realised are symptoms. Also anything you think is particularly important or relevant you can emphasise to make sure it is not overlooked.

Then just don't be too worried. Diagnoses often change, psychiatrists also get it wrong, you can just hope this one is on the ball and can help you.

Best wishes, Sarah x
 
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Topcat

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My experience was sat down and spoken at by a doctor who didn't listen and kept getting details wrong 10secs after I answered him.
Lots of questions about lots of things, some seemed irrelevant like housing situation, love life etc, but I suppose they have reasons.
Notes written, diagnosis given with no explanation or details. Prescription handed over despite me declining it, again with no explanation given as to what it treated, side effects etc. By that point I had given up with two way conversation and was tempted to just leave without making the next 3mthly appointment at the desk as was told to.
So, although the appointment should be thorough and professional, sometimes its a pile of shit.

Good luck with your appointment, hope it goes well.
X
 
T

tsunami

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Been back onto the primary care mental health team to try and get greater clarity, they just said I would have the appointment and then have a care coordinator appointed and that I would be treated as an out patient. Really confusing, what does the care coordinator do?
 
SarahD

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This probably varies from one area to another. Generally a care coordinator coordinates whatever care or services you need. They monitor you, keep an eye on how you are doing mentally and report back. If there are any worries they can alert the psychiatrist or whoever else needs to know. If they think you need help in any way, eg in the home, they can arrange this. They can help with other problems you find hard to deal with. If you think some other intervention can help with your mental health, they can try to arrange this.

It depends how it is run where you are, also whether you get someone good.
 
Passionflower

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Where I am, a care coordinator is either a CPN or a social worker and Sarah is spot on with what duties they carry out.
 
pepecat

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My first assessment with a psych was about an hour (I went over, so it was longer, but ther letter said it would be an hour).
It was quite detailed - he went into all sorts of stuff; family history (of mental and physical illnesses), what had been going on with me, symptoms, how it affected me, was I feeling suicidal, any plans, what I did job-wise.... it was a whole bunch of stuff.
I took my partner with me which was really helpful, as she could add stuff that I'd forgotten, and she was much better able to tell him how the depression was affecting me.

I'm not sure reading up on conditions before you go is a good idea...... it might lead people to answer questions a certain way because they think that's the 'right' answer for the condition they think they have, rather than just be themselves on the day and let the psych decide.
 
T

tsunami

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What is peoples experience of the outcome of a first session, does the psych usually suggest a diagnosis?
 
Passionflower

Passionflower

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A first assessment diagnosis is not usually the norm. It took years for me to get a diagnosis although it is schizophrenia not bipolar.I would be wary of a diagnosis given after an hour assessment.
 
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tsunami

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Another question (mind racing with what ifs). I had strong suicidal thoughts just after New Year, is it a good idea to discuss this or should I keep it under wraps?
 
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