Choosing a Psychiatrist

There’s a line I love to quote from the movie Good Morning, Vietnam in which the main character, a radio DJ named Adrian Cronauer (played by the late, great Robin Williams), does a humorous impersonation of a field intelligence operative in the Vietnam War: “We’re having a very difficult time finding the enemy,” states the make-believe soldier. In his normal radio announcer’s voice, Cronauer asks, “How are you going about it?” and in the voice of the operative, who sounds a little like Gomer Pyle, he answers, “Well, we go up to people and we ask, ‘Are you the enemy?’ And if they say yes, we shoot them.”

That’s what going through the early stages of mental illness is like; there’s some massive, invisible enemy looming behind you, and you know it’s there because you can see its shadow and feel its breath on the back of your neck, but you can’t seem to pin it down. So you have to ask every aspect of your life “Are you the enemy?” and wait for something to say yes. Seeing your family doctor first will help you rule out most possible enemies; if you’re lucky, it will be something like diabetes or not getting enough sleep, and you can shoot it down with relative ease. If it turns out to be a mental illness, however, you’re going to have to pull out the big guns.

As the ancient and great tactician Sun Tzu teaches in his military handbook, The Art of War, the best way to defeat an enemy is to get to know him intimately, to study his weaknesses and learn his plan of attack – that way, when he strikes at you, you’ll either be so well-fortified that you can absorb the damage or, better yet, be ready with an even craftier counterattack. But first, of course, you have to identify who or what the enemy is. That’s what psychiatrists are for, and that’s why you should absolutely see one. Not all mental illnesses respond to the same treatment, so if you go running in with an “all-purpose” flamethrower you bought from a motivational speaker on eBay, you’ll be shit out of luck if your particular mental illness happens to be flame retardant.

So you need to see a psychiatrist. Got it. Which one? That’s the tricky part. This is, of course, assuming that your GP didn’t already recommend a psychiatrist to you after your last appointment (you did see your GP first, right?). I recommend starting your search at HealthGrades.com. This site provides a complete listing of psychiatrists within a given geographical region and shows how each psychiatrist was rated by his or her actual patients, according to a range of criteria like how easy or difficult it is to schedule an urgent appointment and how clearly the psychiatrist explained his or her findings to the patient. You can also view each psychiatrist’s credentials from the site (you definitely want a psychiatrist who’s board-certified) and see whether or not he or she has ever been accused of malpractice. If you happen to live in a town near a teaching hospital or a university with a medical college, you could also start by contacting their psychiatry department and asking if you can get a consultation there. You might think that seeing a student psychiatrist would be risky because they have less experience, but a blog I visited recently rightly points out that students are more likely to possess the most up-to-date psychiatric knowledge.

(A quick interjection: Obviously you should try to find a psychiatrist who accepts your insurance, but unfortunately, most of them don’t accept insurance, period. In this particular post, I’m not going to discuss the financial aspects involved. Instead, I’m just going to try and impress this fact upon you: of all the things it’s okay to spend a lot of money on, your own well-being is the single most important investment you can make. Don’t put yourself on the backburner because you don’t feel justified in forking over the funds for treatment. You’re worth it, trust me.)

If you’re feeling overwhelmed by the decision, remember that the first psychiatrist you see doesn’t have to be your psychiatrist for life. My suggestion is that you first take the time to consider whether you would feel more comfortable divulging your personal information to a male psychiatrist or a female psychiatrist, and then take it from there. (But really think about it, because it can be stressful to have to discuss distinctly female problems with a male psychiatrist – and, I’m assuming, vice-versa.) What matters at this point is finding someone who is highly qualified and highly rated, so you can be confident in their initial diagnosis. That diagnosis is your number one quest objective because it represents the name of your enemy, and once you know who’s been attacking you, you can track him down and fight back.

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