Your psychiatrist, as a medical doctor, is very interested in understanding the details of how you’re feeling and functioning, especially if you’ve been prescribed psychiatric medications. Signs are objectively observed phenomena (such as the results of blood tests or the existence of hand tremors). Symptoms are what you experience firsthand and typically may not be observable to your psychiatrist during your visit. Symptoms may include oversleeping or trouble falling asleep, tearfulness, experiencing acute anxiety, or feeling scattered and unable to focus.
By explaining symptoms clearly, you help your doctor make the right diagnosis and develop the best treatment plan. It is helpful if you can describe the severity, how often they occur, how long they’ve been happening, and if you notice possible triggers or patterns to the symptoms. Please don’t hesitate to mention symptoms even if they seem embarrassing (such as sexual functioning or changes in bowel habits).
It can be helpful to make yourself a note to bring with you to your appointment in order to avoid forgetting important information during your visit. Include new symptoms you’ve had since your last visit, how things have improved and any questions you have. At times, people may minimize their symptoms and say they feel better than they really do. Unfortunately this might prevent your psychiatrist from making adjustments that could help your treatment be more effective.
Read more about psychiatric appointments from the American Psychiatric Association.
Blog Archives
Signs and Symptoms
Problem Drinking
It’s not always easy to see when your drinking has crossed the line from moderate or social use to problem drinking. But if you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory. Alcoholism and alcohol abuse can sneak up on you, so it’s important to be aware of the warning signs and take steps to cut back if you recognize them. Understanding the problem is the first step to overcoming it…
From Alcoholism and Alcohol Abuse: Signs, Symptoms, and Help for Drinking Problems at HelpGuide, a website providing accurate and reliable information re: mental health, substance abuse and relationship issues. Further information is available about
- Understanding alcoholism and alcohol abuse
- Signs and symptoms of alcohol abuse
- Signs and symptoms of alcoholism (alcohol dependence) including tolerance and withdrawal
- Drinking problems, denial and common myths
- Effects of alcoholism and alcohol abuse, especially on relationships
- Getting help for alcoholism and alcohol abuse
- When a loved one has a drinking problem (including teenagers)
- Additional resources and references
Mental health issues and alcohol use may co-exist and in fact “reinforce” each other. Someone who struggles with feeling stressed and anxious may find that alcohol sometimes helps them to relax. However, increasing alcohol use may interfere with everyday responsibilities or relationships. These difficulties may then contribute to increased anxiety and worry. In an effort to manage these increasingly negative emotions a person may rely more and more on alcohol as a coping mechanism. Untreated anxiety can lead to alcohol abuse. Alcohol abuse can intensify anxiety. And so a “vicious cycle” is established.
Talking with your doctor or a mental health professional can help you determine if your drinking is having a negative effect on your well-being. There are many effective methods and treatments available.
About Psychotherapy
It can sometimes be difficult for clients to start psychotherapy. Unsure what the process will be like and perhaps feeling a little nervous. At other times, people feel excited or relieved to find a therapist whom they can meet and talk with about the help and support they need.
Psychotherapy is confidential and non-judgmental. It provides you with the opportunity to discuss personal concerns with an empathic and trustworthy expert in human behavior. In your first session, your therapist typically will ask a number of questions. This information helps in making an initial assessment of your situation. Important areas to discuss will likely include:
• Why you decided to come to therapy at this point in time.
• Your personal history or “life story”.
• Your current symptoms. These could be emotional problems, behavioral difficulty or how you see yourself.
• Your goals for treatment. What you would like to be different in your life.
Psychotherapy is not “one size fits all” and every therapist will strive to focus your therapy in ways that will be most helpful for you individually. As therapy progresses there are additional topics that may be very helpful to discuss:
• Your level of comfort and trust in your therapist. Although this may seem to be an awkward topic, the quality of the relationship between you is very important. Most therapists welcome these discussions and the opportunity to openly address any concerns.
• Ask questions if you need further information or explanation. Feel free to return to issues that you need to discuss in more depth. Express any doubts or disagreements you may have. Let your therapist know what is particularly helpful for you.
• Provide feedback regarding how you are feeling about therapy, whether or not you believe you are headed in the right direction. There may be additional concerns that you didn’t mention at the start of therapy, but would like to address now. Talk about thoughts you may have about changing the frequency of sessions (more often or less often), if you want to “take a break” or are wondering when you’ll know it’s time to end your therapy.
Medication Management
When taking prescription medication it’s of utmost importance that all of your doctors are aware of all medications and any supplements you may be taking as well as other medical conditions you may have. Smartphone apps can be quite helpful for some people. These apps may involve simply listing your medications, including dosage and frequency (be sure to keep the list updated). This can be helpful when completing medical histories at doctor’s offices, as well as having available if you ever need to go to the emergency room (when it may be difficult to remember these details). Other mobile device apps assist in identifying possible drug interactions, reminding you daily when it’s time to take your medications, or alerting you when it’s time to refill the prescription.
As a medical consumer it’s important to be aware of the following:
- Drug – Food Interactions. Alcohol, caffeine, grapefruit juice, and dairy foods may either intensify or inhibit the effect of prescribed medication. Also, there are medications that specifically should be taken on either a full or an empty stomach.
- Drug – Drug Interactions. There may be prescription or over the counter medications that should be avoided when taking other medications.
- Drug – Supplement/Herbal Interactions. As an example, St. John’s wort can have a negative impact if you’re also taking prescription medication for depression or anxiety.
- Drug – Disease Interactions. For instance, someone with a heart condition needs to be sure that all of his/her doctors are aware of the condition and how it’s being treated. There are certain medications that might be helpful to the general population, but potentially harmful to a person with cardiac disease.
Read more about drug interactions here.
Taking medication exactly as prescribed makes it possible to determine if it’s having the intended effect and whether increasing or decreasing the dose may be indicated. If you haven’t been using the medication as your doctor advised, for whatever reason, it’ll be important to let the doctor know. Your doctor’s goal is to help you feel and function better. If you’re hesitant about medication, sharing your thoughts with your doctor can help you together in achieving this goal.
Finally, simply remembering to take medication is necessary, for which there are numerous tips and tricks.
Read more about adherence to drug treatment here.
A Good Night’s Sleep
Roughly a third of Americans report sleep difficulty, most commonly insomnia. The World Health Organization defines insomnia as a problem of falling or staying asleep, or of not feeling refreshed after sleep at least 3 times a week. In addition this is accompanied by daytime sleepiness, difficulty concentrating or increased irritability. If you’re experiencing problems sleeping it’s important to let your doctor know. There are a number of physical causes that increase insomnia. These include sleep apnea, restless legs syndrome, acid reflux with heartburn, arthritis, back pain, menopause, and certain medications that interfere with sleep.
Other complicating factors include jet lag, shift work, physical discomfort from an injury or surgery. In some of these situations, your doctor may want to focus on treating the underlying condition and possibly order a sleep study to further diagnose your difficulty. Consult with you doctor before using any over the counter sleep aids.
However, it’s important to note that there a number of “natural” things you can do independently that have the potential of providing you a great deal of relief. These actions are oftentimes referred to as “sleep hygiene”. Just as dental hygiene helps keep teeth and gums healthy, sleep hygiene promotes healthy sleep patterns.
Control your sleep environment.
- If your mattress is uncomfortable, it may be time to replace it. Consumer Reports recommends a new mattress every 5-10 years. In the same way, pillows also need to be replaced regularly.
- The room should be dark, cool (between 60-68 degrees is ideal) and quiet. Yes, people believe that the TV helps them to fall asleep, however, if left on throughout the night it interferes with deep sleep, contributing to not feeling refreshed in the morning. In fact, research is showing that the use of electronic screens up to an hour before bed stimulates the brain and makes falling asleep more difficult. Backlit devices and LED screens have the greatest negative effect.
- Consider who’s in bed with you. A partner who snores or moves excessively during the night may be contributing to your sleep difficulty. In the same way, having babies or children in bed can also be disruptive. Finally, sharing your bed with pets can cause you to awaken multiple times during the night, by their moving about, making noise, or increasing the temperature in bed.
Prepare your body for sleep.
- Exercise regularly, but avoid strenuous exercise in the 3 hours before bedtime.
- Eat regular meals. Don’t go to bed hungry. A light snack (nothing heavy, greasy or highly spiced) can help.
- Notice how caffeine affects you. Some people need to reduce their intake, or at least avoid caffeine in the afternoon and evening.
- Avoid alcohol in the late evening. Yes it seems to induce relaxation, but it also disrupts the normal sleep cycle, interfering with restorative sleep.
- Avoid smoking, especially at night. Nicotine is a stimulant.
- Develop a bedtime routine. Make a to-do list for the next day, to help avoid trying to remember things when you should be relaxing in bed. Take a warm bath or shower. Perhaps set out your clothes for the next day. Listen to relaxing music. Enjoy some light pleasure reading for 15-30 minutes. Learn one of the many forms of relaxation that can help you “let go” of the day and clear your mind.
Final rules.
- Go to bed and wake up at the same time every day, 7 days a week. Once you’re no longer experiencing sleep difficulty you can indulge in “sleeping in” for 1 hour on the weekends.
- Use your bed only for sleep and sexual activity. Do not do your bills, catch up on work, have phone conversations, email, text, or eat in bed. You want to condition your body and mind so that being in bed = sleep.
- No clock watching. Turn your clock around or put it on the floor. Watching the minutes tick by tends to increase anxiety and frustration.
- If you continue to experience difficulties, despite efforts to change your behavior, psychotherapy is often very helpful. Anxiety or depression can contribute to insomnia. A therapist can help you find ways to “turn off” the thoughts that keep you awake.
What about naps? See the Harvard Health Letter.
Exercise, Mood and Anxiety
“When you have anxiety or depression, exercise often seems like the last thing you want to do. But once you get motivated, exercise can make a big difference.
Exercise helps prevent and improve a number of health problems, including high blood pressure, diabetes and arthritis. Research on anxiety, depression and exercise shows that the psychological and physical benefits of exercise can also help reduce anxiety and improve mood.
The links between anxiety, depression and exercise aren’t entirely clear — but working out can definitely help you relax and make you feel better. Exercise may also help keep anxiety and depression from coming back once you’re feeling better.” Read more from the Mayo Clinic.
More and more experts are emphasizing the importance of exercise, for both mental and physical health, especially for people who are stressed, anxious or depressed. Despite understanding this, many people feel blocked and unmotivated. They don’t have the interest or energy, or doubt if it really will make a difference for them.
This is one of the biggest challenges for people who aren’t feeling well emotionally… they focus on how they feel and make decisions based upon these feelings. Depressed and anxious feelings can’t necessarily be trusted to support your well-being. Better to rely on your common sense to guide decision making at times like this. Give yourself a chance. Even if you don’t feel like it, spending even a short period of time doing the things you know are likely to be helpful can make a difference. Talk with your doctor or therapist about specific strategies that may help you.