# college psychiatrist or psychologist



## Kathy11 (Jul 20, 2008)

I'm going to get counseling at my college for the first time. There is 1 psychiatrist and a bunch of psychologists. I haven't been diagnosed yet, but I'm certain that I have SA. I need a SA medication for presentations that I have in November (I'm already panicing about them). I have medical problems which might make them reluctant to perscribe any type of medication until they speak with my medical doctor but I don't want my doctor to know! And if my doctor were to find out, then my parents would too. Should I go to the psychiatrist or a psychologist? Do you have any advice about going to counseling? Do they usually ask you a bunch of questions or just let you talk?Those of you who have been to college psychologists/psychiatrists and regular adult ones, is there much of a difference? Thanks. :thanks


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## Lisa (Jul 8, 2006)

I dunno about the States but isn't there also something like patient confidentiality? I am not sure your doctor would be allowed to tell your parents very much.


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## Kathy11 (Jul 20, 2008)

My parents drive me to all my Dr appointments and if I said they couldn't come to the appointment, then they would get mad and suspect something. Also I'd be embarrassed if my doctor found out (i know that's extremely silly of me but that's how i feel). Thanks for the response Lisa.


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## CopadoMexicano (Aug 21, 2004)

I think finding a speciailist would be the best direction and if you do see the psychiatrist or psychologist ask him or her how much of their practice is geared towards social anxiety.


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## DT2126 (Aug 10, 2008)

I am actually in a very similar situation as you, i have been putting it off for years but now im forced to take a public speaking class to graduate and needless to say ive been worrying about it for a loooong time. So much so i got a hold of a large quantity of xanax to take in small doses just for that class. I also set up an appointment for a college counselor. Well, 4 weeks in and ive gone to 1 meeting with my counselor and ive stopped taking xanax.
First il say going to see a college counselor is a good idea, but it all depends on the counselor. I went once a year ago and the counselor just didnt meld with me good and it was a bad experience so i never went back. 2 weeks ago i went to see a different counselor and it was completely different, the session went a lot smoother and i felt like he understood a lot better than the first person i saw. From my little experience i would say try to see someone of the same sex and if possible someone with experience with SA. If you go once and if just feels like they dont understand, like they are asking questions that you think dont really have anything to do with SA then nicely ask to see someone else. And most importantly be truthful and thorough, dont hide things if you can because if they cant get into your head they wont be able to understand.
About medication, i would talk to whoever you see about possibly getting a small prescription of benzo's (xanax) for situational purposes only, not for daily use. Im going back for my second visit and my first visit with a psychologist i think so that they can possibly prescribe medication because the counselors cant. The bad news is pretty much all medications for SA are anti-depressants which dont really take full effect for a few weeks and can have side effects.
I recently had an impromptu speech (they give you a topic and you have a couple minutes to prepare and then give a 5 minute speech) and i know i never would have been able to do it without xanax. But ive come to realize while xanax might mask my SA some its only temporary and it can have side effects too. Just tell the person you are seeing how you feel and your worries about the class and see what they have to say.


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## User (Mar 20, 2004)

Kathy11 said:


> My parents drive me to all my Dr appointments and if I said they couldn't come to the appointment, then they would get mad and suspect something. Also I'd be embarrassed if my doctor found out (i know that's extremely silly of me but that's how i feel). Thanks for the response Lisa.


You're a grown woman. You don't have to give them any medical information, and if they get upset then it's their problem. If the psychiatrist simply calls your doctor and asks him a few questions, then there's no way your parents will find out (unless your doctor decides to break the law).



> Should I go to the psychiatrist or a psychologist? Do you have any advice about going to counseling? Do they usually ask you a bunch of questions or just let you talk?


Psychiatrists can prescribe medications, psychologists can't. If you really feel like you need medication (and possibly advice on therapy), then you need to see a psychiatrist. My psychiatrist has also advised me on therapy and given me very general advice (not therapy). Psychologists (or social workers) have a variety of different styles and techniques. How many questions they ask depends on their personal style. When I see a psychologist or social worker, I just give my "life story" and we go from there. I look for a psychologist that listens and doesn't give quick and easy explanations or trite insights.

I hope things work out and you find a good therapist. Good luck!


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## BlackDog (Nov 11, 2005)

*my experience*

When I was in graduate school and in one particularly bad slide of depression/anxiety, I had a number of sessions with one of the therapists-in-training at student counselling services. He was very professional and informed, and he assured me that his notes about our sessions were always reviewed by his supervisors. What I discovered was that it wasn't so much what he said that helped me get over the hump, but just the act of speaking in confidence with somebody who had a remove from my personal life. It was that distance that made me feel comfortable. That is, I thought, "He's telling me I'm doing well and showing me how" not because he's my mom or my best friend, but because he has an outsider's perspective.

For me, that was one of the grandest benefits.


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## mysteryguy85 (Aug 24, 2008)

I only have psychologists at my school. I saw one who made me feel worse about myself! She told me that basically my sensitivity and my anxiety made me unfit for like any career. Come on...


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## Dr. PsyD (Oct 6, 2008)

Kathy11 said:


> I'm going to get counseling at my college for the first time. There is 1 psychiatrist and a bunch of psychologists. I haven't been diagnosed yet, but I'm certain that I have SA. I need a SA medication for presentations that I have in November (I'm already panicing about them). I have medical problems which might make them reluctant to perscribe any type of medication until they speak with my medical doctor but I don't want my doctor to know! And if my doctor were to find out, then my parents would too. Should I go to the psychiatrist or a psychologist? Do you have any advice about going to counseling? Do they usually ask you a bunch of questions or just let you talk?Those of you who have been to college psychologists/psychiatrists and regular adult ones, is there much of a difference? Thanks. :thanks


So it sounds like the primary reason you want to get some help at school is because it is convenient, and because you need some medication to manage presentations? I'd say go to the psychiatrist. Psychiatrists are trained in general medicine as well (yep, they go to med school), so they will be fully capable of prescribing despite any other health issues you have. If they need to do some medical tests, they will probably have alternatives to your primary care doctor-- you should just say you'd rather maintain your confidentiality since it is your family doctor.

The difference between student clinicians and psychologists is that student clinicians are learning the therapeutic and diagnostic skills required to earn their degree. Student clinicians are learning how to conduct themselves with clients.

Psychologists are licensed to practice and require no direct supervision for each of their cases. They are generally much more experienced than student clinicians. The majority of psychologists in the US and Canada cannot prescribe medications.

But, if you just want some medication to help you, then go to the psychiatrist first. You can always get a referral to the therapy center once you have the meds. When you go to the therapy center, request that you are matched with a clinician who has an interest in dealing with a client who has social anxiety. You can also request whether you'd like a male or female student clinician. Generally there is a pool of student clinicians and cases are assigned to one of them based on their own interests.


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## Dr. PsyD (Oct 6, 2008)

mysteryguy85 said:


> I only have psychologists at my school. I saw one who made me feel worse about myself! She told me that basically my sensitivity and my anxiety made me unfit for like any career. Come on...


That's just wrong. I'm sorry that she wasn't willing to do any work to help you.


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## gertrude (Nov 2, 2008)

When I went to see the college counselor it was a HORRIBLE experience. But this was in the early 90s when social anxiety wasn't a widespread diagnosis. Anyway she'd never heard of it and basically told me to just get over it. You know, "don't have such low self esteem." My s.a. became worse and worse and I became more and more desperate and depressed. But since it wasn't "endogenous" depression (I was oversleeping, rather than had insomnia) - it was also something to "get over." She'd never heard of atypical depression. After I graduated I saw an hospital-based psychiatrist who immediately diagnosed social anxiety and atypical depression, and got me decent treatment. Ironically my best therapist since then worked part time in a college counseling office, so not all college counselors suck. And a college counselor will probably be better at dealing with age-specific problems (identity issues, etc.). But I'm definitely wary. I don't think they're necessarily as up-to-date or sharp as those in other settings. But therapists and counselors vary HUGELY in their skills in qualifications no matter where you go. So it's always a crap shoot.


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