# To SuperCrazy & GypsyCat re therapy



## california123 (Jun 8, 2003)

Since I have seen both a therapist and a psychiatrist about my chronic D, I thought I'd share my experience. First, there is a difference (at least here in the US) between a therapist and a psychaitrist. A therapist is someone you go and talk to about your problems--whether they manifest themselves physically or mentally. Ususally therapists cost less, but they are not medical doctors so they cannot prescribe medication. For that, they will need to refer you to a psyciatrist, who is a medical doctor. If you have medical insurance, here is where things can get complicated. Most insurance plans will only cover psychiatric visits for medication supervision. That means you go there once, they determine what meds you should try, and then you comeback on a regular basis for short "checkups"--usually just 20 minutes. For long term talking therapy, most insurance will cover a certain number of visits. For me, since my insurance covers medication but not psychiatric or therapy visits, I pay out of my own pocket. My psychiatrist charges me $125 a session, rather than his standard $150, because he knows I'm paying for it myself. As to what it is like to see a psychiatrist, he or she will generally start by asking you why you are there. This is the time to tell them absolutely everything that is going on--including physical problems like your IBS. Once I told my psychiatrist about my chronic D and all the other stressful things going on in my life, he diagnosed my D as anxiety-induced and prescribed anti-anxiety meds that controlled the anxiety and stopped the D. After a month, he added an anti-anxiety/anti-depression med called Effexor XR which helped to deal with the depression I was feeling. (It also can have a constipating effect--other such meds can cause D--so that was like a bonus.) Your first visit may seem like all talk, which it will be, and no real resolution. But they will definitely be listening to what you tell them and will be trying to come up with a treatment plan, and possibly medication, to help you. I personally found the psychiatrist so much more helpful than the GI, who just said IBS-D and gave me meds that did no good at all. I strongly recommend therapy to everyone, because it has helped me through difficult periods in my life and given me tools to deal with problems. So don't be afraid to tell them everything, that's what they are there for. It may seem uncomfortable at first, but if you are at all like me you will eventually look forward to those visits. Take care.


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## Danielle Garrett (Oct 1, 2003)

thank you california for the post. i will definitely give it more thought. i was thinking i might make an appointment to go to the doctor and see if i could try levsin. i heard it works good on other posts. glad things worked out better for you. scg


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