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Comment by peepee1982 | Hacker News Reader

peepee1982

I have had such bad experiences with psychiatrists and psychologists being contrarian and demanding filling in generic tests leading to no working solutions (aka you're depressed here's a prescription for an SSRI. Still depressed? We'll up the dose).

My current psychiatrist figured out my main issues after talking to me for 15 minutes. Sent me off to a psychologist back up his assumptions before prescribing anything. Recommended therapists who specialize in the area I needed support in.

The psychologist I went to was great as well (after seeing one that was a terrible). She did a lot of testing (three sittings lasting around two hours) but said the tests were really just to rule out other things. The important part were the conversations.

My life improved tremendously after that.

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My ex was on antidepressants which had a huge impact on her life. If she missed her meds or (god forbid) was late on her prescription, it was terrifyingly bad.

Orthogonally, she also had sensitivities to light and epileptic symptoms. She told the doctor this, and the doctor doubled her dose of antidepressants. Just one of many, many stories. I've come to consider the higher-level of medicine quite scientific, but the on-the-ground doctors as unscientific. They mostly don't have time or enough feedback to make good decisions in most cases I've seen. That's a profession that shouldn't work on faith.

How does one find a good psychiatrist/psychologist? My experiences have ranged from "very bad" to "OK at best" and I think finding someone a bit more invested into figuring things out might help a lot.

It is definitely not easy. Specially because you cannot "see" their past work or results except from someone telling you about it. I practice psychoanalysis (lacanian if you gotta give it a name) and really liked your wording: "finding someone a bit more invested into figuring things out". Feel free to hit me up (gerhn cupipo com) if interested in starting an analysis (or anyone reading this). We can have up to 4 sessions which you won't have to pay for unless you think we are up to something and decide to continue.

And how do you, as a first-time patient, assess the quality of psych* you are seeing?

One thing you can do to become a tiny(!) bit more informed is take some psych classes yourself. PSYC1030 is a popular (free) one and gives you the first glimpses into social, clinical and developmental psychology. It doesn’t give you any particular qualification but it does at least demystify some of the processes. That makes it easier to recognise the hucksters

If you’re focused in particular on getting a diagnosis for something, I’d also recommend reading relevant parts of “Psychopathology and Mental Distress” which is a tomb of a book that aggregates both DSM and ICD diagnostic criteria, but also provides current meta surveys on relevant research, from multiple perspectives. It’s reasonably easy to read but definitely better after getting the basic thinking tools from a proper course on clinical psych.

This. Studying your own psyche from an (as possible) outside perspective can help enlighten you on the who, why and especially -- when. Uncovering latent trauma isn't fun but it is important.

You enter with an open mind, try their process for a bit, and see if you feel better. You can even have conversations with them about the timeline they expect for improvement or what they think can actually be achieved -- "goals of care" isn't just for terminal patients. You can be aware of red-flags, if something feels wrong or misaligned you can discuss it or try someone else, but at the end of the day, you can't know for sure if a modality or a relationship will work for you if you don't try it, and give it some time.

I mean, it's the same question as "How do I assess whether my plumber or mechanic or electrician knows what they're doing." Sure, sometimes there's an easy, obvious difference, but you can't really know for sure whether or not your electrician is grounding your entire house to your hot-water pipes unless you have enough skill and expertise not to need one. After a point, working with any professional requires a weird blend of faith and of assessment you don't have the expertise to actually do.

I found mine by word of mouth. Other than that, the only way I can think of is trying till you find a good one.

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