Tips for a Successful Psychiatry Appointment - Dr. Ashley Weiss
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- Опубликовано: 30 май 2024
- In this video, I have a video chat with Dr. Ashley Weiss, a Psychiatrist based in New Orleans in the United States. We discuss some helpful tips to consider in order to have as successful of a psychiatry appointment as possible.
Thank you so much Ashley for being a part of our new series!
This video is part of a series where we are speaking with different kinds of mental health care professionals to get their perspectives and also to learn more about how they can help those living with schizophrenia or schizoaffective disorder.
Time Stamps
00:00 - Introduction
03:13 - Establishing a partnership
04:14 - Look for a psychiatrist that you feel comfortable with
05:24 - Ask your doctor a lot of questions
09:24 - Go to your appointments even if you're doing well
12:43 - Asking for higher frequency appointments if necessary
14:00 - Bring in your medicine
16:22 - Having a family member or friend attend an appointment with you
21:48 - Collaborate in defining goals
29:44 - Conclusion
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The last 5 minutes is exactly what I needed to hear, as someone who is trying to support someone with this.
They are in danger, but refuse to engage with psychiatric assistance for fear of hospital and medications. Due to previous trauma.
Thank you
Chris Harrild - The problem is that, unfortunately, subsequent engagement with psychiatrists in no way guarantees that they won’t suffer a repeat of the same experiences. Unfortunately, referring a patient to the emergency room for a psychiatric evaluation is a very easy way to protect yourself against liability concerns (however improbable and remote) and also a great way to get rid of a “problematic” patient without, again, running up against concerns of liability or that rare patient suing for abandonment. A mental health professional suffers almost virtually no consequence even for a blatantly inappropriate (defensive medicine) emergency referral, and a patient with reasonably good insurance (or even Medicaid) has a very high probability of “being sent upstairs”, because, usually, most psych emergency room attendings would rather play it safe and refer for inpatient treatment, rather than risk potential liabilities associated with discharging someone. Most mental health professionals aren’t particularly concerned or even cognizant about the trauma that can be inflicted by a stay in an inpatient psychiatry ward, and the inpatient ward is just a super convenient “dumping ground” for anyone a mental health clinician doesn’t feel like dealing with. Clinical training, extremely short appointments were some psychiatrists will literally spend under five minutes writing scripts, and “clinical boundaries” make it extremely easy to treat the “crazies” like the Other, and not give a second’s worth of thought about how an inpatient placement (especially on an involuntary basis) may subsequently impact someone. I have nothing to say other than your loved one’s concerns are quite valid, and there are no guarantees that they won’t be retraumatized - or even that most clinicians would even be particularly concerned about inflicting further trauma.
thank you for making these videos
That was a helpful video. I see my psychiatrist Friday and it's complicated. Thank you...
Great video!! A separate video dealing with fear of hospitalization would be great.
Please talk about your childhood in a video, if you had problems even before the first episode. How it was on school. My first episode was at 18, already at college, but my childhood was pure lonliness and suffering before that.
Yaaay!! Another amazing video! Thanks so much Lauren to both you & Dr. Weiss!! The content & info is awesome...as are YOU!!
Yes thank you for making these videos! You are such a breath of fresh air. ❤️😎👍😘
this was incredible timing I have my first appointment with a real psychiatrist for the first time in like... 3? years on Tuesday and this was really encouraging that it won't necessarily go as poorly as my last psychiatrist was
Such a helpful video for anyone managing life with any sort of mental health issues!!! It was especially helpful to hear the rationales behind the tips. Thank you so much!
Hi Lauren! I live with schizoaffective disorder depressive type and I was wondering if you could do a video about catatonic behaviour in schizoaffective/ schizophrenia. I think it’s one of the least talked about positive symptoms and it’s something I really struggle with myself. Thanks :)
I believe it's a negative symptom because spontaneity and movement are taken away. I would like to see more on this as well. Maybe she doesn't suffer with it and can't comment...idk?
mo arroz it is a positive symptom because the behaviour isn’t removed from normal behaviour, it’s added on, and thus the movement symptoms are taken away as a result of the behaviour being added on
@@fkaharsh569 my book and websites say it's negative but i see how you would think that.
www.seabhs.org/poc/view_doc.php?type=doc&id=8810
I hope they do a video on this for us lol
You are doing an amazing job dear i am sure you will be helpful to many people out there suffering with these problems keep it up ❤❤
Gee, you blow me away with the videos on your channel. You are very open with your illness and show remarkable ability to be alive and wiliness to help others. The video with you interviewing your partner so far is my favorite! Do you ever have online chats with your followers?
Thanks for this video, I have a video visit with my psychiatrist later this afternoon, and these really helped me
I myself have been treated for Bipolar Affective Disorder for near a decade now after having been diagnosed and re-diagnosed the preceding several years. In my experience of having the same long term care provider(s) throughout most of this duration: the concept of not only establishing a partnership with our doctors and care providers, but to really focus on maintaining this partnership resonates with me and is of utmost importance. Throughout my journey I have fallen in and out of being comfortable with my psychiatrist, and it actually reflects on how well I am at a given time in hindsight.
What the psychiatrists really want to see, from my understanding, is that their patients take a very active role in understanding their illness, and that they positively collaborate with them on mitigating the negative effects (much like medical specialists of any other physical ailment). When such a relationship is developed between us and our treatment personnel, it shouldn't come as a surprise when we are told that they notice when we are not doing well. I have experienced this a number of times, and had been defiant and even rebellious, but when push comes to shove: the medical professionals are not there to torment us with adjustments to our treatment, and are truly looking out for our best interests. The sooner that this collaborative effort can be accepted and exemplified, the sooner we can start seeing very positive progress in our situations moving forward.
I really must thank you, Lauren, as even the fraction of the content that you have put out that I have taken in has helped me to turn a page in my ability to apply greater insight to myself and my illness.
Thank you for this can you do a video in how to study with meds AND schizofrenia , It Is very important for us please !!!!!!!!
Good interview, thx. The sound & video quality is improving from earlier ones
Great,thank you.
Wish we could get a Doc that cared this much or spent so much time with people.
Thank you information
Great interview!
I remember there was a black lady that had schizophrenia and told on her video she believed she was hitler, it was amazing to see that early on my journey. I haven't found that video again.
Oh my, what an unusually friendly shrink, especially for a program focused on young people. I happen to be acquainted with some who worked as a research assistant at Columbia Psychiatry/NYSPI psychosis prodrome longitudinal study (COPE). The psychiatrists/co-PIs that initially started the program were very personable and genuinely took interest in their patients/research participants. The program involved clinical assessments and administration of rating scales, structural and functional MRI scans of the brain, and the option to enroll in clinical trials conducted by the PIs or other researchers collaborating with the group. Participants were also provided the option of receiving weekly psychotherapy with trainee psychotherapists doing their clinical training at Columbia Psychiatry. If necessary, the two psychiatrists/PIs leading the program also would provide psychotherapy and prescriptions of psychotropic drugs when needed for a diverse range of issues. The inclusion criteria cast a pretty wide net, offered fairly robust privacy protections, and many young people who enrolled out of concern about nonspecific symptoms benefited from the free psychotherapy provided. Unfortunately, back in 2012, the two co-PIs left the COPE research project and were replaced by a single PI/medical director who assumed a very different approach. This particular researcher had a special interest in violence and mental illness, and given the American concern about the interplay of mental illness in mass shootings, secured a research grant to study violence. This individual was also quite notorious for sticking people into the hospital, to the point that a nurse working in an inpatient unit that sometimes received patients referred from Columbia Psychiatry’s outpatient clinics and research units remarked on how when this individual was a psychiatry resident, he had probably sent more of his patients into the CPEP (the psychiatric emergency room) than all of the residents combined. Any statement on the part of a patient that hinted at the slightest liability concern for this clinician/researcher, no matter how vague and exceedingly improbable, would result in a patient or research subject receiving a security or a police escort to the CPEP. It was remarked that if a patient didn’t feel like spending the night at home, saying the word “suicide” to Ragy was enough to earn an immediate trip to the ER for a psychiatric evaluation. Patients unfortunate enough to find themselves in such circumstances were also promptly discharged from Columbia Psychiatry’s clinical and research wings, and this individual was notable for petitioning for full removal of such patients from Columbia’s psychiatric treatment. Needless to say, from what I have heard, not many people experiencing such a, um, misadventure with inpatient psychiatry pursued subsequent psychiatric treatment, especially if their presenting concerns were something minor like anxiety or depression, and especially when the emergency or inpatient referral was perhaps unwarranted and a pretty obvious overreaction. This clinician-researcher was also famous for giving the diagnosis of Borderline Personality Disorder to practically everyone, and some of his clinical rationales for assigning this diagnosis were entertaining and a stretch of the listed DSM criteria, to say the least. I have no idea if he was ever sued by any patients or their families, although he was named as a defendant in an unrelated lawsuit. But having a talent for securing research grants seemed to have made this individual mostly immune from the risk of being removed or otherwise reprimanded, and he has since been granted tenure. Anyhow, just my late night rant on how the stigma against psychiatry is oftentimes the direct result of the actions and behavior of psychiatrists, and how psychiatrists are often themselves responsible for patients being “noncompliant” with treatment, especially when the clinician can’t be bothered to spend more than two minutes “evaluating” their patients.
Hello! I'm not sure if you'll see this, but I have a question in regards to alternative methods of assisted therapy sessions. Specifically, psychedelic intervention. There's many out there putting these compounds to the test in a therapeutic setting. Have you heard of these types of trials? Are you perhaps interested in the subject? Because the evidence is overwhelming positive and there is still much more research that needs to be conducted on this matter. LSD was once used to try and understand the internal processes that occur in the brain of those who have schizophrenia, and many of the effects of LSD and schizophrenia occur in the same part of the brain, and there is much overlap as shown in previous research. If you see this, than thank you for reading!
Great video, Lauren. How you seen the trailer for a movie called Words On Bathroom Walls? It's about a teenager coping with paranoid schizophrenia in high school. Interested in your take on it.
What about older people and seniors? I am 62 and there are many many things going on within me sometimes. I feel confused with life. All my life I knew that something wasn't right but I kept on with what felt right to me based on my mentality and which personality was in charge. I have asked for help but none have helped. I became scared of the questioning. Lately I have asked my doctor about psych help. My home health nurses all have seen me in the bottom of the well of life. The last psych I visited told me that I would die a lonely man and from being so depressed and confused. Nobody visits me. No close person to recieve a loving hug from. I live in my own little world at home. This covid has really kept me home for days and even a week or so of isolation. I have things to keep me occupied. I would rather do those than things others would expect me to do. I am the child that wants to play and not do the chores. But then a day comes along and I spend the whole tending to needful chores around the house. I've been kicked out and blocked from chat rooms and places like Match.com. I see previews of some really nice looking ladies with interesting information. But a voice inside tells me I am not worth anything to persons like that. So I sit around sad. I'm on Welbutrin now. It does help but it does not fix the problems that haunt me every day. I'm sorry, I didn't mean to take up too much of your time.
Can you do something on the differences between BPD, schizophrenia and your schizoaffective disorder?
she sounds great I wish she was my psychiatrist
Yesterday i talked to my therapist for the first time (i go to IOP pogram)! The thing is she thought i didnt speak english because she didnt understand my accent, it didnt last long and she sent me back to the room with the others :(
I have a question. And I know you're not a psychiatrist but as a fellow person living with schizoaffective disorder, perhaps you could give your take on this. My doctor told me I have schizoaffective disorder. However she refuses to put it on my health records because she believes as long as the medication works that's all that matters. But I don't think that's safe practice. How will any of my other doctors know? What if I go to the hospital? What about therapy? Isn't there a need to know what your diagnosis is in order to accurately give you therapy??
Sara Weaver - your doctor is doing you a tremendous favor, you can trust me on this. Having a schizophrenia spectrum disorder listed in your medical records would significantly compromise the quality of general medical care that you would subsequently receive, ranging from microaggresions, to delays in care, up to and including life-threatening symptoms and diseases being disregarded or otherwise written off as symptoms of your mental illness. A listed psychiatric diagnosis might also imperil your physical safety, as ill-intentioned family members or future romantic partners have been known to use a psychiatric diagnosis as an excuse to perpetuate abuse or utilize police to harass or otherwise harm the individual or inappropriately try to place them under guardianship. Unfortunately, the judicial review process for guardianship can be extremely lacking. If perfectly healthy and otherwise competent people have sometimes found themselves inappropriately placed under guardianship, having a diagnosis of schizoaffective disorder listed in your medical records would make it extremely likely that a judge would approve a guardianship application, no matter how unwarranted. Additionally, police being told that an individual has a schizophrenia spectrum disorder tends to make them more likely to resort to violence, despite training that allegedly attempts to counteract this tendency. Your doctor knows all of this, is being extremely forthright with you regarding what she believes is your diagnosis, while also taking the highly unusual - and unusually heroic - effort to safeguard you against the very real harms that such a diagnosis might bring about. If you have any doubts, a simple Google search about discrimination and mistreatment by medical professionals against individuals diagnosed with mental illness will tell you with everything that you need to know. Your doctor is probably one of the exceedingly rare doctors who is congnizant of everything that you might face, and who is genuinely acting in your best interests. You can ask your doctor - she will most likely tell you exactly what I’m saying.
Sara Weaver - As far as medical treatment is concerned, a diagnosis of schizoaffective disorder will have no bearing on your medical treatment for physical conditions, save from the potential discrimination and delays in care that I had listed earlier. As far as potential drug interactions, your current medications is all that the treating clinicians would need to know. As far as psychotherapy, ironically, there is still the persistent belief that psychotherapy shouldn’t be offered to individuals with psychotic disorders, and that psychotropic drugs should form the mainstay - if not the exclusive element - of treatment for an individual with a psychotic disorder. The only thing that such a diagnosis would do is make a psychotherapist exceedingly less likely to take you on as a client, even if the problems that you’re seeking therapy for are in no way related to psychosis. While I generally advise exercising a degree of skepticism, in this situation, you should trust your doctor without hesitation.
This may be an incredibly stupid question so I apologize in advance: What if you hear voices, but, they are supportive and encouraging.? Would you still be better off taking medication?
Yes because it's all about balance. Also if you are hearing any type of voices it distracts you from many things, and being able to live a productive life. I personally laughed all the time and thought it didn't need to be treated. I feel a lot better being treated and laughing at appropriate things and not as frequently. Balance
Breggin.com
Lauren, I would personally love to meet you when I'm in Edmonton next
❤️
Could you also add neuropsychiatry some people have brain damage.
I recently tried a moderate dose of mescaline from a San Pedro cactus. While I cannot suggest it to everyone it was definitely a compassionate feeling and event that helped me grow and end old biases that I could only discover on the drug. I would suggest trying it for those prone to psychosis well over marijuana. Thank you for the insightful interview as I search for holistic solutions.
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30 mins! Must be nice!
😂☠☠☠ lmao hahah riiight
Pharmaggedon
Jil
She keeps saying "medicines" instead of "medications". I find that to be a little odd. She doesn't seem like a legitimate psychiatrist. But what do I i know?
Rule number 1, don't show up high
Solid advice.
I found this doctor difficult to follow.
She was ridiculous! Lol very off putting.
I think she is nervous
i thought this doctor was brilliant
psychiatrists do not like icognative talk. it frustrates them.
She seems to have her own self-esteem issues being on camera