I have just got off the phone with a family member who is being treated by a colleague. This colleague is an experienced clinician whom I respect, and I found myself advising the person on how to explain themselves to their doctor. I frequently find in conversations with friends, family and colleagues that some people struggle to communicate with their psychiatrist effectively. Better communication will lead to better outcomes.

Some important details to understand about us ‘Psychiatrists’:

• It is important to realise that there are different types of psychiatry appointments, some are medication check-ins (15 min), some are follow ups which may include therapy and a medication check-in (30-45 min), and others maybe are solely therapeutic (45-60min).
• The length and structure of your psychiatry appointments is determined by the way in which your psychiatrist has decided to work. Some psychiatrists have a greater interest in medication management only, while others may have a more therapeutic approach.
• You need to understand what type of appointment you are going in for that day so that you can adjust your expectations. If you go for a 15 min appointment expecting to discuss in detail, emotional issues that are troubling you, you will likely be very disappointed after the encounter.
• It’s also important to try and understand how your psychiatrist works since we all work in different ways. It might be useful to ask the psychiatrist in the first appointment how often and how long she typically sees follow up patients for, and what she would predict happening to you.
• Ask if your doctor does longer appointments and schedule one of those if you would like to discuss anything in more detail. Ask if your doctor offers therapy and if you could see him/her more regularly. If not request a referral to a therapist.

For a regular review appointment, it may be useful to write a few notes the day before, in order to remind you in the appointment of what you would like to discuss.

These are some of the questions the psychiatrist is likely to ask you.

• How are you since the last appointment?
• How is your sleep, energy levels, appetite?
• How are you functioning at the moment at work and at home?
• If your medication stayed the same – are you still happy with it?
• If it changed – did you notice any side effects or benefits?
• Any side effects – weight gain, sedation, slowed thinking, nausea, shaking, stiff muscles.

Even what I have written above is a great deal to go through in 15 mins if you are having any complications – and may require a longer appointment. However if you are absolutely well, this may be sufficient time for yourself. Different people get on differently with different psychiatrists; it is an individual experience. It helps if you trust and respect the way your doctor works. Psychiatrists are all different, male or female, different ages and races, differing psychiatric interests, different levels of experience, various ways of interacting and even different ways of setting up our chairs in our office! You are the patient, and you need to be comfortable with your treating doctor.

You need to try and trust and assert yourself in your appointment. You are the person who is taking the medication or undergoing the treatment, you need to be content and satisfied with your medications day-to-day. If you are having disruptive side effects, tell your doctor and bring it up in the appointment and discuss treatment options. Sometimes understanding the side effects and looking at the risk of stopping a certain medication will help you cope with the side effect better. Alternatively, you may decide to switch or stop the medication once you have received medical advice.

Useful questions for your psychiatrist

1. What side effects can I expect ?
2. What are my treatment options and how is my condition normally treated?
3. How will I know that the treatment is working?
4. How long do I need to be on this medication ?
5. Can I fall pregnant on this medication?
6. What other interventions can  I do besides taking medication/ or instead of taking medication ?
7. Are there any support groups or therapies I can attend? Any books I can read ?

Different people get on differently with different psychiatrists; it is an individual experience. It helps if you trust and respect the way your doctor works. Psychiatrists are all different, male or female, different ages and races, differing psychiatric interests, different levels of experience, various ways of interacting and even different ways of setting up our chairs in our office! You are the patient, and you need to be comfortable with your treating doctor. If you have no choice about who your doctor is (most commonly in the government services) it is even more important to talk up and assert yourself as needed.