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by didgeoridoo 3127 days ago
You probably should not get psychiatric drugs from a GP or NP without first being assessed by a psychologist. While GPs have meds training, they aren’t trained in how medication fits into a larger psychological treatment plan to actually address the underlying issue. This is equivalent to demanding OxyContin from your GP for a recurring knee problem, rather than seeing an orthopedist to find out what’s actually wrong.
1 comments

> You probably should not get psychiatric drugs from a GP or NP without first being assessed by a psychologist. While GPs have meds training, they aren’t trained in how medication fits into a larger psychological treatment plan to actually address the underlying issue.

I'm not telling anyone to do anything, but the idea of going to a psychologist for prescription drugs is beyond ridiculous.

> This is equivalent to demanding OxyContin from your GP for a recurring knee problem

It's worse - it's like demanding Oxycontin from your personal trainer at the gym. At least your GP went to medical school and did residency training.

I think you missed my point. I’m not saying psychologists should prescribe meds. I’m saying that medicating psychological problems should not be done in the absence of an appropriate diagnosis of those problems. This can be done only by a psychiatrist or psychologist (edit: and most psychiatrists aren’t trained in testing either, and will generally refer you to a testing psychologist if they think your problems are complex in nature). GPs and NPs do not have appropriate training in diagnosis.
My wife is a psychiatrist. She doesn't prescribe drugs to people with psychological problems. She prescribes drugs to people with psychiatric problems. She's been trained to know the difference. The PA that works under her has been similarly trained. But he doesn't understand the non-psychiatric medicine part that patients often times have.
What is the difference between a psychological and psychiatric problem? I've never seen these terms used in the same context you used them anywhere in medicine.
Hallucinations are generally a pyschiatric problem. Being manic/depressive is a pyschiatric problem. Being a jerk isn't. Having a hard time saying saying no isn't. There are gray areas. As a rough approximation, where drugs can help it's psychiatric, where they can't it's psychological.
If they develop a drug that keeps you from being a jerk does it become a psychiatric problem?
Think "bottom-up/biological" (psychiatric) vs. "top-down/behavioral" (psychological). Many behavioral disorders have components of both, which means that you either need a psychiatrist doing both med management and behavioral work (e.g. therapy) OR a psychiatrist + psychologist working together to address the problem. The second option can be quite a bit cheaper, since the behavioral treatment is usually far more time-intensive, and psychologists' time is generally less expensive.
>"What is the difference between a psychological and psychiatric problem? I've never seen these terms used in the same context you used them anywhere in medicine"

You really ought to stop pushing your uneducated opinions and do more research.

One this is a completely unhelpful comment. Similar to name calling. A much more helpful one would be showing that medical researches clearly divide problems into psychological and psychiatric.

And no one I know in research, or the psychiatrists I know would say there are many problems that fall into one category or the other. The vast majority of problems you'd see a psychiatrist for fall into both camps.

Mood disorders, and anxiety. The two most common categories of disorders are at least partially treatable by both therapy, and medication.

That’s a good way of putting it — “psychiatric” vs. “psychological”, being able to know the difference, and treat appropriately.