this post was submitted on 22 Mar 2025
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Hi all. I know I'm pretty dumb for not knowing this, but see the above question.

I've tried various different types of therapists on and off for the past several years and never really found one that worked. They either didn't listen to what I was saying, didn't provide anything of substance (just acted like someone to listen to without any ideas of what I should do), or I could not adequately explain my frustrations with them. I keep getting advice like "well you just have to try 10000 more therapists until you find one who isn't shit and will click with you". Well that's been ludicrously expensive and mentally draining so I don't know that I want to continue on that path. The costs of therapy are absolutely insane in the US.

But as these were all therapists and not physicians, the conversation of medications never came up (beyond initial intake when they asked if I was taking any meds). I understand that a therapist can't prescribe me medication so it makes sense that they wouldn't bring it up.

But then who do I talk to to see if medication might benefit me? When I Google it, most answers I see are "talk to your primary care physician", but I do not have one. I also do not really feel comfortable with a general practitioner permanently documenting in my medical file that I have mental health issues. That can be a huge downside to have permanently in your medical chart like that.

Should I try to seek out therapy practices with specifically a psychiatrist and inquire there? Is that the best way to go about this?

Thanks all.

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[โ€“] southsamurai 1 points 6 days ago

Well, there's a few routes to go. You've no primary doctor, and are aware of it, so there's not much point in going into it in detail. However, GPs sometimes will prescribe and monitor the initial steps instead of just referring you to a psychiatrist.

Which is where you'll end up, eventually. Either directly, or via a PA or other mid level provider under one's supervision.

Depending on how you're paying for it, you may not need a referral anyway. Just a reference, as in someone, anyone, who knows the local options and can point you to psychiatrists nearby. A therapist should be able to do that just as easily as a GP.

You can try community clinics as well, particularly the ones that provide a range of mental health services. They always know what doctors are out there, and sometimes have one.

[โ€“] ArbitraryValue 1 points 6 days ago

Note that finding a psychiatrist who (1) accepts insurance and (2) accepts new patients might be difficult. Mine doesn't accept insurance and charges about $600 per hour. (I have a 20 minute appointment every three months.) Going to a general practitioner would be much cheaper if I had one that would prescribe the same medication.

[โ€“] Onomatopoeia@lemmy.cafe 6 points 1 week ago* (last edited 1 week ago) (1 children)

Psychologist works with you to understand your challenges, and how to approach them from a practical standpoint. They cannot prescribe meds.

A psychiatrist is an MD who can prescribe medications for psychological issues.

Look for a psychiatrist. A good psychologist would say you may benefit from medication, and recommend you see a psychiatrist.

[โ€“] Zorsith@lemmy.blahaj.zone 2 points 6 days ago

I am in the position of having gone to a psychiatrist first; they needed a psychologist to provide a diagnosis before they could prescribe anything (in my case, ADHD), even though they said themselves that they thought i would benefit from medication. Wait time for a psychologist seems to be pretty long (2+ months in my case, sometime next month is my appointment).

[โ€“] blackhole_banana@lemmy.vg 3 points 1 week ago

My PCP was unhelpful and therapy wasnโ€™t helpful for my issues either. I just went directly to a psychiatrist. Just do some research of what is available locally (your insurance website will typically have a doctor search by type) and look for doctor ratings on the web too. They will often say specialties on those rating pages so you can search for ones that focus on the issues you think you might have. Helps to have some general timelines and notes of your issues overtime at work or school to help give them a better picture about how your life is impacted.