Your First Psychiatrist Appointment or Therapy Session - What to Expect in 2023
The Level 1 Gamer shows up without any preparation to his first psychiatrist appointment. He then gets surprised its long and the questions are hard. He doesn't know any of his medical or psychiatric history. He hides some things or lies because he’s too embarrassed to admit them. As a result he doesn’t end up making the progress he should.
The Level 100 Gamer shows up ready for his first psychiatrist appointment. He knows there's difficult questions but he trusts he will get through it. He's gotten all his past history mentally ready (and his paperwork) because he knows it'll help the doc treat him better. He's nervous but he opens up fully because he knows that's the only way the process is going to work.
I've never seen a psychiatrist as a patient. But I have seen a therapist, so I know how scary the first session can feel like. She asked me some questions I didn't feel comfortable admitting the answer. I felt shameful admitting some of my darkest secrets out loud. But I was there for a reason, and I knew I had to open up if I wanted it to work. If I couldn't do that, how could I expect my patients to do so?
In this post I'll break down exactly what happens in the first psychiatrist appointment. A standard evaluation usually lasts 45 min - 1 hour. Let’s read this thoroughly before our appointment so we know exactly what the psychiatrist will ask us.
History of Present Illness (HPI)
This is a fancy way of saying “what symptoms do we have?” The psychiatrist is trying to figure out which diagnoses best fit us. That way they know the best treatment for us. Let’s go through this list carefully so we’re not surprised. They might ask us about our (in no particular order):
Mood, Guilt, Flashbacks, Anxiety, Hallucinations, Sleep, Stress, Appetite, Energy, Concentration, Focus, Hyperactivity, Anxiety, Trauma, Panic Attacks, Social Anxiety, Suicidal Thoughts, Self-Harm, Appetite, Irritability, Fatigue, Impulsivity, Risky Behavior, Physical Slowing/Speeding, Racing Thoughts, Avoidance Behavior, Paranoia, Delusions, Public Fear, Dissociation, Phobias etc
Past Psychiatric History
This tells the psychiatrist what we’ve tried, what we haven’t tried, what didn’t work for us in the past, how severe our condition is etc. This is very important because it influences our treatment. They will ask us our past:
Psychiatric Diagnoses, Treatments, Medications, Therapists, Psychiatrists, Hospitalizations, Suicide Attempts etc.
Past Medical History
The brain is an organ, a part of our body. So things that affect us medically can also affect us mentally. For example hypothyroidism can look like depression. Or certain medications can interfere with psychiatric meds; For example chronic Tylenol use for headaches can increase our lithium levels). The psychiatrist will ask us about our past:
Medical Diagnoses, Medications, Surgeries etc.
Family History
This is important because most mental illness has a genetic component. For example if our mother has bipolar disorder and we show up with depressive symptoms, its likely we might actually be on the bipolar spectrum and will do better with a mood stabilizer than an antidepressant. Or if one medication worked really well for a parent or sibling, it’ll likely work well for us too. They’ll ask us about our family’s psychiatric:
Diagnoses, Treatments, Medications, Suicide Attempts etc.
Social History
Our psychiatrists understand we’re not just a bunch of symptoms. We’re complex human beings, with feelings, emotions, lives, goals, dreams and fears. This helps them understand us on a personal level. Which actually makes a difference in treatment. For example, if my patient had an extremely chaotic childhood, I might attribute their chronic irritability to trauma rather than depression. Or if my single mom night-shift working patient can only sleep between dropping and picking up her kids from school, I’d focus less on getting proper sleep because I know she can’t change her schedule. The psychiatrist will ask us about our:
Childhood, Siblings, Parents, Education Level, Job History, Hobbies, Religion, Legal History, Financial Situation, CPS Involvement, Current Situation etc.
After the evaluation is complete, the psychiatrist will share their thoughts with us. This includes their diagnosis and recommended treatment. They’ll ask we think, then make a shared decision with us. We’ll schedule a follow-up appointment with them. They'll also provide a way to contact them in-between visits in-case we have any side effects or other medication questions.
And then congrats! We'll have completed the psychiatric evaluation. :)
I’m a psychiatrist who specializes in treating Young Men and Gamers with Depression, Anxiety, ADHD, and Video game addiction.
If you’re interested in working together, click BELOW book your free consult call.
