ISPP 2015

Career Opportunities in Pharmacy
Talking With a Psychiatrist About Therapy & Medication / Kati Morton

Hey everybody! Today I have a wonderful and special guest, Dr. Barry Lieberman, is here to talk with us about medication, psychiatry, and the works. So stay tuned. (Intro Music) So like I said, I have a wonderful and special guest. My friend Barry is here to talk with us about psychiatry and medication and answer all of our questions. I’ve heard from a lot of you that you either are told you need to see a psychiatrist and you have some concerns. So I guess Barry my first question is What is a psychiatrist and why would someone need to see them? Barry: Well a psychiatrist is a medical doctor, whose trained in both psychological problems and general medicine, and specifically the overlap between medical issues pertaining to anxiety and depression and the psychological components of that. So psychiatrists usually can do both psychotherapy and oriented psychotherapy or supportive psychotherapy. But also do medications. But interestingly enough even today, I saw somebody who has a medical condition, but the emotional reaction to that medical condition allows me to treat both that condition and treat him with anti- anxiety medication. Kati: Oh interesting. And I have a lot of viewers who have chronic illness or other things that contribute to mental health issues. Barry: Right Kati: So you said that some psychiatrists do do psychotherapy as well. Barry: Yeah, fewer and fewer. I get complaints from people a lot. That now when they see a psychiatrist, they see them for ten minutes just for a psychopharmacologic, i.e. anti depressant or anti psychotic or anti anxiety medication. But more, but, and that’s happening more and more to my chagrin. Kati: Mmhmm Barry: I actually was not only trained in, but valued do psychotherapy and medications at the same time. Kati: Yeah and I, for those of you who are curious kind of what the format is. It used to be, just like when you see a therapist like me, you see them for about an hour. Barry: Right Kati: And so it gave the psychiatrist more information. I honestly think, so they can better diagnose and treat. Barry: That’s right. Kati: But now, they call it kind of med management is when you see somebody for maybe 15 to 20 minutes. Barry: Right Kati: And they, a lot of my clients have even told me, ‘Hey you’ve sent me to this person. I walked in, and they’re like how are you side effects, duh duh duh.’ It’s just strictly about their medicine and then they want them to leave. So knowing that it’s transitioning to that, do you think that there will be many psychiatrists left who do psychotherapy? Barry: Well I hope so. I mean just babysat for a wedding of a 36 year old psychiatrist in San Francisco who does do psychotherapy in addition to medications. Kati: Oh that’s good to know. Barry: So I’m glad to see people doing it, because it really bothers me. I am one of those people who definitely believes in treating the whole patient. And a patient is not just a bundle of chemicals. Kati: Yeah, agreed. And I think it’s good for those of you out there to know that you have options and different psychiatrists available to you to fit your needs. So just like when you find a therapist, I tell you make sure you kind of like them enough that you could talk with them. Make sure that when you’re looking into a psychiatrist, if you have insurance and there’s a big list they send you, try out a couple until you feel a connection. Or maybe find someone who does therapy if that’s what you’re wanting as well. So that maybe you get that it’s a one stop shop. You don’t have to see, you know a Barry and myself. You just go see your psychiatrist and they do therapy as well. Just make sure you’re always comfortable and doing what’s right for you. Thank you so much for answering our questions. Barry: Sure. By the way I compare that to dating. Kati: It’s true! Barry: As to the compatibility, mutual compatibility. Kati: Yeah, yeah. I always tell them you at least have to feel like ‘I like you enough to maybe see you again.’ Barry: Yeah, yeah. Kati: That’s how to tell. Barry: Say the same thing. By the way even the use of medication, I’ll use the metaphor of dating, or the analogy to dating. Kati: Yeah. Barry: Because medication that might work wonderfully for the exact same condition for one person might not be effective or may be even intolerable for somebody else. Kati: That’s a really good analogy. Barry: So, yeah, so the whole process. And when we’re dating we often say I don’t feel chemistry for that person, so when we’re doing chemistry with these medications. I say uh, dating. Kati: That’s true. What works for one person doesn’t work for all of us. So thank you so much. And we will have Barry on to answer more of your questions, so make sure you click here to subscribe and check out my other videos. Until next time. Barry: I’ve been in this world a long time. Kati: I know. You’re more seasoned than I am when it comes to filming I’m sure. Barry: I have also done interviews too before. Kati: Yeah, that’s true. Sean (camera man): And 3, 2 … Kati: Hey everybody! Today I have a wonderful special guest, my friend Barry here is going blah… I didn’t like that. Let’s start over. I need to say Dr. Barry Lieb, even though I know you don’t. But you know, I’d never call you Doctor, but you’re always like just call me Barry. Barry: Sir. Kati: Sir Barry. (Laughter) Kati: Okay, one more time. We can do that version too. Sean (camera man): Okay. It’s starting to … Kati: Oh, it’s starting to Barry: I can’t repeat that shit all over again. Kati: I don’t like it Sean. Ehhh. Get it right. (Laughter) Sean: All right, I just wanted to Barry: If I need to pick my nose or Kati’s nose Kati: Just pick it. (Indiscernible talking) Kati: Just go for it. (Laughter) Subtitles by the community

63 thoughts on “Talking With a Psychiatrist About Therapy & Medication / Kati Morton

  1. This helped so much (unexpectedly)! I am seeing a psychiatrist later this week and although I knew (or thought I knew) a bit about them, this did clear up some things and also reassured me that this is the right step for me. I'm currently struggling with panic disorder and a few other issues, and I was wondering if you could maybe do a video on what to do when you are in a slump, or a setback in your recovery journey? I personally struggle quite a lot with the ups and especially the downs of recovery. Thank you so much! (p.s. LOVE your videos, I am so glad to have come across them 🙂 ) xx

  2. haha wow, the whole video it seemed to me like Barry wasn't one of those professionals I'd have good chemistry with (not that it matters), and the outtakes completely changed my perception of him. That's interesting to me, and it also shows how 10 minutes with a psychiatrist might not be enough to judge whether you can connect or not.

  3. I've talked to a psychiatrist on the phone (when looking for one a long time ago) who told me that psychiatrists specifically DON'T do psychotherapy and just manage medicine and that I would need to find a psychologist for therapy. My psychiatrist now mostly does medication management but for a while he was letting me come for psychotherapy until I found a therapist for talk therapy. His colleague is a psychiatrist who does do psychotherapy but unfortunately she wasn't taking new patients but then fortunately I did end up finding a great psychologist who I have been seeing for about 2 years.

  4. Hey Kati I have a question, I am in therapy in the UK for anxiety/panic disorder/depression etc and I am Tier 2, there are 5 tiers depending on how severe the issues are. My problem is that I waited ages to get a therapist and she is amazing but I am worried to fully open up to her about me feeling suicidal (she knows a little bit about that) and also going into detail about my self harm… I am worried she will have to move me to tier 3/4/5 and I will have to get used to another therapist and wait ages on another waiting list… Would they do that and how severe does it have to be to move me up a tier in counseling? I love you and your videos Kati! xx

  5. Loved the laid back feel to this video. Someone who can remember that their patient is a human being , and not a number is an awesome person to find.

  6. #katimortonFAQ Hi Kati I find myself frequently in tears at times when it is not appropriate to cry like at work.Do you have any ideas how to control this I have just started with a new Therapist and I haven't had much time with her to talk about these things I am getting triggered a lot.I can't seem to get it under control

  7. My visits to a psychiatrists varied in length. First visit, about a year ago was about an hour. Then there were a few shorter ones to check how the medication is working – at the time I had a few visits with psychologist for diagnosis (polish public health care – existing but taking long time and complicated 🙂 ). Then I was in a three months outpatient group thing and had to go to a psychiatrist managing that (half hour visits while she new things from psychologists managing group). I first one was definitely a better fit for me, but I didn't have a choice. I go to her for check-ups (even was on one today) and always feel like I have to be on defence the whole visit. I don't want to find new one because right now I had lowered medication dose and am stopping taking it all together and planning on individual (sadly paid) therapy and I'm hoping to not see a psychiatrist that often in near future. My today visit was about 10 minutes and almost only about meds. I can say I had a few long visits but it was never long or frequent enough to call therapy.

  8. I have treatment resistance major depression disorder regarding meds.What do I do? I have been struggling with different meds for over 2 years now.Im almost ready to give up.I don't think anything will help me with my family being so dysfunctional and I'm right in the middle of their messes.With my chronic pain,I ask myself,why Am I even here?I can't do much because of my chronic pain and I feel useless. I used to be in the medical field,and that was taken away from me due to my pain.No meds seem to work.Depression meds I mean.Im losing hope fast.

  9. Loved the video and the end was a great treat! Maybe you can include some more unedited moments from now on at the end of your videos….

  10. One of the problems with psychotherapy is that the patient's expectations are often unrealistically high, and people don't want to work to attain what is realistically possible. One problem I have with it is that I'm scared of how I might transfer negative emotions I had growing up onto my psychiatrist. That is scary for me. I'm really a pretty angry person, and I can be pretty nasty in dealing out vituperation.

  11. This is amazing, I want to become a psychotherapist/physiatrists and this was extremely helpful. Thank you, thank you, thank you lol💕

  12. Thank you so much, Kati, for this information. I have a quick question about this topic. Other than the number of years of medical school, what is the difference between a psychiatric nurse practitioner and a psychiatrist?

  13. Really good video! I wish there were GOOD psychiatrist near me or I'd see one. Currently my Family Doc (treated me since I was a child) handles the meds and I've seen a therapist since I was younger and they work together. My therapist doesn't take my insurance now so if I want to see her I must pay out of pocket each visit….I haven't seen her in a really long time due to that. I discussed one time with my Doc who he thinks might be a good fit for me "Go as far west as you can from here!" since my case is so complex. I really wished he was joking but I know he's right (we live in a small rinky dink area where any healthcare seems like a joke). Are there any recommendations you can give? Besides journaling of course. I think maybe some of your viewers can relate maybe feeling they live in the middle of nowhere and Mental Health care doesn't seem up to par. #AskKati

    and so this isn't a total whomp whomp bummer have a festive Thanksgiving! <3

  14. Hi Kati, do you have any tips on how to deal with bad body image? I'm "technical underweight" so the logical side of my brain knows I can't really be fat, but I feel like a heffalump and it's really holding me back!!
    Thanks for all the time you spend on us 💜

  15. My counsellor has told me that she thinks maybe I would benefit more from seeing an actual therapist and doing dbt even though I don't have a personality disorder. She hasn't referred me out though because it took me so long to open up to her and she knows it would take even longer with someone else and I don't know if she is going to refer me out. So how do I cope with this?

  16. Hey Katie this was a great video , my GP has recommended that I see a psychologist , and has prescribed a low dose of meds but I have not followed through on either yet I even cancelled my follow up with her and rescheduled thinking I needed more time. Has not helped. that was a month ago. I am not sure if I am ready to she is concerned with my weight loss and eating habits I am restricting and have lost half my weight. But still feel before I do anything else I need to loose a little more.i am finding I have many side affects from my dieting that I hear you talk about, but it just doesn't seem to matter.thanks for all the videos I watch them daily when I need a boost or some words of wisdom . I hope one day when I decide I have had enough to find someone like you I wish you were on the east coast.

  17. NICE TO see a psychiatrist admitting that he gets complaints for purely medical visits of 10 minutes. The is a shift away from medical psychiatry to psychotherapy due to the serious limitations of medications. As a herbalist there are many herbs I can use to treat depression and anxiety.

  18. Hi Kati- so this is less a factual question and more opinion but…. I wrote some very personal experiences and disclosures in my journal for my therapist to read. It's too hard for me to say those things out loud, I told her she could read them and then hoped that I would somehow feel relieved by her knowing. She said she wouldn't, because reading it would only make her informed and informing her isn't helping me. She wants me to read it out loud to her. I can't 🙁 what should I do? It was hard for me to write those things and to express that I did to her. I'm so confused!

  19. I am going to see a physiatrist for the first time next week. I am really scared. I'm not going for medication I am going for therapy and to get notes for school. I'm afraid that I won't click with this one and I've already went through that with a few therapists and I don't want to go through that again.

  20. I'd love to have him as my psychiatrist 🙂 The one I saw as a teenager was not good for me. I kept telling her that I wanted off my meds and then just ended up with a prescrition for yet another antidepressant in addition to the one I was already taking, which was supposed to stop the side effects of the first antidepressant she prescribed to me…I didn't feel very understood…

  21. Love when you include outtakes! This was a great video. "Sir" Barry seems like a wonderful psychiatrist and hurray for wishing more did psychotherapy! I wish I lived in his area so I could see him. My psychologist is amazing, but the bills are adding up, and my psychiatrist while great at the med part, does not do psychotherapy so it's a quick in and out.

  22. Hi Kati #katiFAQ I have a psychiatrist but I see a registrar mainly when I go for appointments and get a new person every six months which I find hard – I tend to withdraw and not say much when I go. I no I will be getting a new registrar soon, how can I make this an easier process?
    Great video, ending was funny 😀 x

  23. #katiFAQ hey kati what is a good replacement to seeing a therapist? Because I wanna start getting better now and I can't start seeing someone before Feb (insurance company crap)

  24. #katifaq I have a question. I most likely have an eating disorder (never diagnosed) and I am afraid of getting help. I am an ethical vegan and I want to be a good representation of veganism for the animals. My dad is also very closed minded about eating disorders. He thinks I purge (I don't) and one my mom said she smelled something weird (it ended up being perfume) and my dad yelled form the other room "is it vomit". I felt so embarrassed. I also feel that if I get help, that I am a burden. Do you have any advice.

  25. I have real beef with pharmaceutical drug companies. Even if we are just a bag full of chemicals, using the pills we have now will only blanket the issue. What is med-management and why is it okay for psychiatrists to give meds without psychotherapy? We are massively overprescribing drugs, don't you think?

  26. Thank you for this video, Kati. It's the here in the UK whereby a psychiatrist just deals with the meds as opposed to meds and therapy. Being a bit older, I always thought that a psychiatrist dealt with both. It' only through the experience of the mental health care system that I realise this is no longer the case and it' kind of sad because GPs are happy to dole out prescriptions like candy, but the actual psychological element is not truly dealt with.

  27. hi kati
    a year ago i went to therapy for the very first time but i was too scared to really be honest so the therapist ended everything in five sessions. at the time i thought everything was fine but looking back sort of lying to him was the worst thing i could do to myself. im sort of stuck. i know i need help but at the same time im so confused and scared.

  28. how to do you really be honest with your therapist ? its been difficult for me because im always unsire of my feelings and second guessing them. its gotten inn the wau of treatment for me

  29. Interestingly I spent 2yrs in therapy and made no real progress, however when I quit therapy due to the fact that it was going nowhere and I had supportive friends and teachers I no longer felt like I needed therapy. After that I got so much better! I fought through it because I always knew that I didn't want to live my life like this. I have friends who are the most loving, caring and supporting souls and understanding teachers. If I feel overwhelmed or need to take a day off my friends force me to do it and my teachers tell me "well if you're not feeling good, then you're not feeling good right?". That's just my situation. I know that a lot of teachers aren't understanding towards something that isn't cancer or a broken leg, but still has the same repercussions.

  30. I have chronic anxiety as well as vertigo . the symptoms are very similar . your videos are very inspiring keep up the great work :))))

  31. Hmm, I think if I ever got him as a therapist, I'd be scared of him. (But I'm scared of most older men. I'm not comfortable going over the reason on a public comment though, so there's that.)

    Although, I admit, he seems knowledgeable and confident. Which is good.

    Also wanted to say I love your videos. I watch them but don't normally comment. (I hardly ever comment on vids though.)

    I also have a question; I exercise a lot. I don't let my self sleep until I burn all the calories I ate. Usually I want and do do more. I tend to fidget or do crunches whenever I can.

    I also felt guilty when I got seconds today. It was my favorite food. Right after eating, I exercised trying to work it off.

    I also noticed, I been unintentionally ignoring drinks, I normally would drink. As in maybe 2 or 3 a day to zero without noticing it. Same for certain foods.

    But, I don't want to lose weight. I want to become more muscular. I want my body to be complete muscle.

    Is this a problem?

  32. Let me see here. I commented on Twitter, but 150 characters is quite a strict limit. In order, I've seen: my pediatrician (I actually stayed with him until I was twenty one), a counselor he recommended (I was eighteen but I went to a child psychologist and she was the best I ever saw), again my pediatrician after we finished our work together and I needed antidepressants again (for "Reactive Depression"), some very nice paraprofessionals, social workers, and psychologists in a hospital, a nurse practitioner who has been in the industry for twenty plus years and seemed to find me spoiled, ridiculous, and a little too prone to asking probing questions (she was neither the first nor the last), an older psychologist who seemed to think anything on the planet could be solved with CBT and walking, a different psychologist (this one young) who actually listened to me when I talked but seemed to know less about my previous and current diagnoses than I did [Reactive Depression, Major Depressive Disorder, Generalized Anxiety Disorder with Depression, and Bipolar 2 (one that I had gotten after I read about it and talked to a Social Worker family friend who felt that if I didn't take Lithium or Latuda immediately the world was going to explode even though I had been diagnosed with it five minutes ago)].

    I don't know which one of these is right. All I know is that medication either does A. nothing (which I tend to lie about because I feel like no one is going to believe I am actually in compliance) or B. makes me feel like myself at my very worst 100% of the time as opposed to 30 to 40%. It's bad out there, and it's worse if you are a young woman who they think is acting, speaking, and thinking outside of her designated station.

  33. Those outtakes at the end were such a great way to finish the video! 😂
    "Treating the whole patient" – that's what we need to be doing.
    I hate only seeing my Dr. For a brief medication check in & then go to someone totally different to talk.. Always feels like you're just another statistic, which is no good for anyone. 😕

  34. As a newly practicing psychiatrist, I decided to throw a party where I invited all of my patients so they could meet each other and have a good time. It brought all of us closer together.

  35. The old creep keeps sneak-peeking her tits and crotch during the first half of this video. Watch his eyes everytime she faces the camera.

  36. What is the point of going through medical school and all the intense training in psychotherapy if all a psychiatrist is going to do is peddle drugs? Any kid on a street corner could do that without spending a ton of money and the hardship of medical school. The entire point of Freud (the father of psychiatry) was to treat the person's core issue with therapy, not just medicate it away temporarily. Why would anyone go through all this work in school just to peddle drugs? Frankly, this just seems obscene and does nothing to truly help the person understand their problems and find ways to deal with them or solve them. It is like going to a doctor about cancer and all he does is give you pain relievers.

  37. I’m a freshman in college and I’m working towards become a psychiatrist and it made my heart sooooo happy when he said that he believes in treating the patient holistically, and that more psychiatrists should also do psychotherapy (which is what I want to do)

  38. I like your videos. Only from talking about, and listening to mental health issues and the whole person, can we even attempt to break stigma surrounding mental health issues and become more knowable, in order to aid someone with mental health management. Thank you!

  39. The only different between a psychiatrist and a drug dealer is the drug dealer doesn’t have a prescription pad!

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