Depression and Weight Issues - Going to the psychiatrist, sort of?

04-10-2013, 01:14 PM
So I'm sort of going to the psychiatrist today. The sort of being that I am seeing a nurse practitioner and she's going to evaluate my medications? I'm not entirely sure what this means. Well, beyond that she is going to make sure I'm on the right amount of the right stuff. But how does she figure that out? Is she going to talk to me like a psychiatrist?

I'm more than annoyed that the physician's assistant I had been seeing referred me to a psychiatrist. He told me he will not refill my Zoloft until I go. I'm not sure if he can't prescribe me a higher dose of Zoloft or if he just didn't want to without having someone check me out or if he thinks I also need to be on anxiety meds? No idea.

I'm nervous about it. I'm not sure what to expect. Can you guys help me out with what to expect?

04-10-2013, 01:30 PM
I thought Zoloft was both an anti-depressant *and* an anti-anxiety med. That's what my doctor told me 20 years ago when he put me on it briefly.

I'd expect her to ask how you feel, are you depressed, how do you sleep, do you cry a lot, does your anxiety or depression keep you from doing things that you enjoy, stuff like that just to gauge if you really are depressed or suffering from anxiety. I wouldn't expect that she would give you any life advice or delve into any psychoanalysis. I could be wrong, but I'd guess she's going to stick to treating the symptoms and leave the causality treatment to the psychiatrist.

I'm a little surprised because I'm hearing more and more people say they are being stonewalled on getting their AD's which I find baffling. A friend of mine said her last doc said he wouldn't give her any more until she lost weight. Apparently he believes her depression is linked to her weight, even though her depression preceded her weight gain. In any case, she switched doctors.

04-10-2013, 02:01 PM
What a jerk that doctor is! Your poor friend! My friends are angry for me that I have to do this to get my antidepressants. They all just go to their normal doctor and have no issues, not me! lol. They are telling me to switch doctors but I like the doctor a lot when I actually get to see him and not the PA.

It is an antidepressant *and* anti-anxiety but I still get very anxious and panicky. It does not help my general anxiety as much as it helps my depression. My general anxiety has been helped but in specific situations I still get super anxious and have a panic attack or shut down.

Thank you for your answer. I guess it makes sense that is what she would do and say, I'm just in a tizzy about having to go and for the life of me I couldn't figure out what would happen once I'm there lol. New places and new experiences make me anxious if I'm going alone (Which I am).

04-10-2013, 02:33 PM
If the Zoloft isn't working for your GAD, you might ask if there is something else they can give you. When I had GAD, I had Buspar to manage my symptoms long term and Xanax for acute episodes. Nowadays I have Valium to manage acute episodes, and my only real trigger anymore is flying, so I just get a script before I have to fly anywhere.

04-10-2013, 09:20 PM
I suspects yours has knowledge of pharmacology. I have seen Mental Health Nurse Practitioners in the past, and they are able to prescribe medications. I think it's pretty much the same process as when I was talking to the psychiatrists I have had. Western medicine has a huge focus on actual symptoms, so I think he/she will pay close attention when you are describing them. At this point, since mine knows me better, she will ask me how those aspects of my life are. You just have to stay focused on getting better, and let the professional know exactly which parts of your condition you want to improve or get rid of in order to feel better and be healthier :)

I had a similar situation. Actually, the very first Antidepressant I was on was Sertraline/Zoloft. I was first going to get help from my university at the time and so went to the health center there. After not being enrolled in classes (it was only 1 semester of redoing them), I was not able to go to the health center since I wasn't a student. So when I ran out and needed a refill, I had to find someone else. I found a family physician and so set up and appointment, especially since I needed to switch to a more effective med. He would not even refill it for me, saying he was not a psychiatrist. So I ended up with a medical bill (bleh) and a referral, at least. I know people who get antidepressants prescribed from their doctors, and not be referred to a psychiatrist. I think it depends on how comfortable they are prescribing them. It might even be to prevent malpractice issues.

Anyways, you might also be asked questions about your medical history as well, this seems to be very important even after you fill out a form.

04-11-2013, 11:13 AM
Thanks guys! She was really very pleasant, I liked her a lot. She thinks I'm on the correct medicine and that it works well for me but that I'm on the wrong dose. Which might be why my anxiety is still a problem. She bumped me up and I go back in 5 weeks to check in. She said if the new dose works out for me that I won't have to come back often and I'll be able to get a 90 day supply. Yay!