Sunday, October 7, 2018

Six questions to ask your doctor about medication for depression, anxiety and other mental health issues

Going to take meds for depression and stress? Here's what to ask. Photo: jnittymaa0.

It's impossible to make an informed decision about your health choices when you're processed in a system that just shuttles you from A to B without explanation. Sadly, many hospitals are faced with too few staff and too many patients and there is just no time to talk.

On paper, it looks efficient to batch process  people but it hides all kinds of problems. For example, there's a letter in The Star today that says some people avoid X-rays and CAT scans because they believe in viral rubbish scare stories and doctors simply don't have to the time to debunk the myths. Read the whole things here.

From what I hear, too many of us are seeing doctors about depression and stress, only to come away with pills but very little else.

I am not a doctor and I can't fix the system to magically give everyone more time. But what I can do for my clients is to help them make the most of their visit. I tend to talk about this in short consultations but I thought it would be useful to write it up here.

First, should you be seeing a medical doctor for stress and depression? I'd say a trip to your family doctor for a general checkup is always a good first step. See why here.

Second, if you are depressed or stressed, should you go and look for pills or talk therapy first? My thoughts on how to make a decision that suits you are here.

So, suppose you decide to see a psychiatrist, a specialist medical doctor about your mental health issue. Here are my top tips for making sure you ask questions that will help you make the most of your time.

First, if you can, take a trusted friend with you. Most of us are nervous when seeing a doctor, and so we forget to ask stuff or forget to listen. Having a friend to listen with you can be a big help.

If you're too shy for company, take a notebook with your questions listed and a pen to make notes of the replies so you don't forget what you're told.

Questions to ask your psychiatrist about medicine:
1. What will this drug do for me? (IE, why am I taking it?)
2. How do I take this drug? (IE every day at the same time? Only when XYZ happens?)
3. How long before we know if the drug is working? (Because some drugs like antidepressants can take weeks to kick in)
4. Drugs can have bad effects, too. When do I know something is very wrong and I should come right back to you?
5. Is this drug addictive?
6. If I take this drug, and I change my mind later on, can I just stop taking it? (Because with some drugs, it can be very dangerous to just stop taking them; you need to be weaned off them slowly, with the help of a doctor.)

If your doctor is too rushed, unapproachable or you don't understand her, my best advice is to have a chat with the hospital pharmacist. Pharmacists are good at answering them and they often enjoy being consulted, so be prepared for loooooong educational lectures.


Also, go back and see your family doctor.

Should you ask a psychologist, therapist or counsellor about your medicine? No, we cannot give advice about drugs. You need a medical doctor for that.

But there is another question to ask: if you see a psychiatrist and take meds, should you also seek talk therapy? I'd say you should think it over because:

1. Pills can't fix your life. If you are on medication, and your stress and depression are not from a purely physical issue, it can be a good idea to add in talk therapy.

2. Also, pills for depression can take weeks to kick in, so a bit of talk therapy at the start can help you manage symptoms while you wait.

3. If you are stopping medication, and you need support for managing the psychological effects of withdrawal, talk therapy is also useful.

Now, psychiatrists can offer talk therapy too but in some countries there are so few of them that they don't run that kind of practice. If you also want to combine meds and talk therapy, ask when you visit. If they say no, you can always 'add on' someone like me. 


As for getting more info about drugs, should you Google? Honestly, I am on the fence with this. There is so much utter trash out there, that part of me says it's best to just stay away. But there's also some good stuff and if you're lucky enough to find it, then it may be useful. I like WebMD as it's written by doctors and Quackwatch which specialises in debunking popular health myths.

However, I know I don't have the basic knowledge to make really good informed decisions (do you? check this for my take on how to find out) and so when I rick my back, have a fever or some other issue, I go to the pharmacist. If they say I need to move up a stage, I see my family doctor. If she says it's beyond her, I see a specialist.

Basically, I see people I trust and I do what they say. It's a system that suits me.


I hope you found this interesting and that it helps you in some way. The main thing is this: don't be shy, reach out and get the support you need.


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