Once upon a time psychiatrists actually took the time to sit with their patients (ie. for an hour) and listen, observe and analyze .. then make a real determination of the condition of their patient before pulling out their prescription pad and writing some life-saving antidepressant. However, modern psychiatry has changed dramatically. It is rare that a shrink will spend more than 10 minutes with his patient during an office visit.
How they can possibly make an evaluation of the current condition of their patients in minutes and be able to prescribe what can be some very dangerous medicines is therefore highly suspect.
In fact they are doing a very poor job, not only for their patients but also for themselves. Research shows that doctors in general are at greater risk of depression, mood disorders, and suicide than other professionals. “Psychiatrists commit suicide at rates about twice” the rate of other physicians, according to a study by the American Psychiatric Association, which found that “the occurrence of suicide by psychiatrists is quite constant year-to-year, indicating a relatively stable oversupply of depressed psychiatrists.”
The psychiatrist that had been attending my partner for 17 years disappeared one day, abandoning her practice without informing anyone or referring her patients to other doctors … because she got depressed and decided to run away herself. This was extremely unfortunate, because she was one of the good ones. She spent the time with her patients and did an excellent job of talking and evaluating.
If you are lucky enough to have one of those old-fashioned psychiatrists that has a couch and the time to listen to you, then you may be on the way to getting a proper evaluation. Unfortunately, most of these “old-fashioned” shrinks are reaching the age of retirement and are quickly disappearing from the field. The reason the profession has dramatically changed was explained in a N.Y. Times article “Talk Doesn’t Pay“. 20 years ago, psychiatrists could treat between 50-60 patients in 45 minute sessions per week. Now the same shrinks treat 250-300 per week if they schedule themselves tightly. Before the shrink knew your name and your history and tried to solve your problem, and keep you happy and fulfilled. Now their goal is just to keep you functional and grind through as many patients per day as the clock allows.
The ideal would really be to provide talk-therapy first and then administer drugs as necessary. Most doctors entered this field to be well–meaning and help people. So it is not always their greed that is limiting the patient’s care. Insurance companies are also to blame, limiting the pay to doctors that exceed a few minutes of talk-therapy. Either way, this type of therapy is no longer economically viable for the middle class. The wealthy can still afford the $600-1,000 50 minute sessions.
Even if you could get the time, it is likely that the meds you are being prescribed would either just numb the brain and the pain or give you a temporary feeling of euphoria, neither of which is actually solving the problem of depression. You are just being made to be stable and functional, not happy or leading a fulfilling life.
Since this is the third in a series on depression and things are still not improving, we will take a dive and inspect the hundreds of micro-colonies that survive on a live piece of coral.