Got the courage...scheduled Apt for Mental Health issues...what to Expect

Lots of good answers below, so I'll just add one last thing: Mental health therapists will often have specific training from specific approaches so feel free to ask the therapist him or herself what to expect in terms of their approach.

I see a psychiatric person who can prescribe both meds and supplements that aid in mental health for people who want to avoid meds--let me know if you are interested in her name.

Please don't bring the kids with you.
Leave them with a trusted friend or family member.

Or . . . . bring a trusted friend or family member with you
so that the children can play safely in the waiting room
while you are in the exam room and the doctor's office.

You really don't want the children around
while you are being examined and talking about options.

TELL the examining person(s) that you are breastfeeding
and therefore have concerns about any possible medications.
That breastfeeding is very important
and that you don't want to give that up.

About the mental health appointment . . . .
you probably will be given some questionaires to fill out.
It's best to put down your first reaction to each question.
If you stop to think about the questions,
the results may not be as helpful as going with your initial reaction.

The person who interviews you will probably ask why you're there.
See if you can give an overview
of the total situation you're concerned about.
Save getting to specifics until after you have talked about the larger picture.

About the "one other major issue" . . . . . good.
Don't tell us about it.
But DO tell the screening person about it.
It is probably important to your overall prognosis and therapy options.

Please remember to B-R-E-A-T-H-E.
While you are there and before you get there.
Very important.

You might try practicing B-R-E-A-T-H-I-N-G
while you read these answers.
S-L-O-W-L-Y and D-E-E-P-L-Y . . . .
every so often, for at least a few breaths.

Good luck.

I haven't read the other answers, but I work in mental health (although with teens) and have experienced my own times of depression so I think I might have some thoughts for you. Sorry if they are already said.

The first thing I can tell you is that I highly recommend you find a sitter or someone else who can watch the kids for both appointments. If you can only find someone for one, then at least get one for the therapist appointment. They will be asking you a lot of questions that will make you emotional probably and it will be hard to really be engaged in caring for yourself at that moment (which is what you need to do to really heal) if you are distracted by your kids. Therapy especially is time to really focus on yourself and should be considered your own personal time and space each time you go.

As far as what to expect . . . . for the appointment with the doctor, I hate to say it but its not therapeutic so it's good that you scheduled a therapist too. The doctor will ask a lot of questions about symptoms (how much sleep are you getting, what is your eating like, what are your emotions like, do you have crying spells, etc. etc.). They do this because they have to meet a criteria in order to prescribe medications. As far as the medications go, make sure you tell them that you are breastfeeding and approximately how long you plan to continue it. Most anti-depressants have not been found to be harmful, but they are still doing some research and such on the affects. But, most of the research has not shown any problems from breastfeeding mothers taking them. The doctor will have a good idea though of what to do given this information. Also, know that prescribing anti-depressants is more like an "art" then say prescribing an anti-biotic for an infection. Some people need higher dosages and some people need only small amounts. They don't always get it right the first time and it's important to talk to your doctor if in a couple of weeks your not having any changes and/or things get worse so that they can adjust your medication. Most doctors will schedule follow-up appointments for this exact reason.

As far as the therapy goes, they will ask many of the same questions at the initial session as the doctor will. However, the goal of a therapist is different from the doctor. The doctor diagnoses and prescribes. The therapist is trying to determine the events that cause the most depressive episodes for you, what your current coping skills are, what support systems you have in place already, etc. etc. so that they can help you start to develop skills to cope more effectively and a place to help express your emotions in a healthy way. Therapists are there to build a trusting relationship with you and to do that they have to really understand your situation as much as possible. That is why I say this may be more difficult especially with the kids around. It is not super "clinical, diagnosis" like the doctor is. They are helping you establish a safe environment where you can talk about EVERYTHING that is happening in your life that is causing you sadness, stress, frustration, grief, etc. It is important that you let yourself open up and begin to build the relationship that will lead to healing. I will tell you therapy is very tough. I have gone through my own therapy sessions and then simply being a therapist, it is difficult for many clients, but it is completely worth it in the long run.

The most successful way to treat depression is through a combination of medications and therapy. The medications help balance you so that you can begin to handle therapy. As the therapy does it's job, the medications become less and less needed. It may be good to allow your therapist and doctor to communicate with each other (this is done through signed medical releases) so that they have an idea of where your at with things. Don't worry though, a good therapist will not divulge everything you talked about to the doctor. They will simply let the doctor know how they think your progressing (i.e. she really opened up today about some difficult issues. I think that she is starting to make progress). Also, any good therapist will tell you everything that they talk to your doctor about and tell you what the doctor has informed them of.

Sorry this is long, but it is my life work! and I have definitely been there before. Good luck with everything and let me know if you have any other questions. I'm more then willing to let you know from my own experiences.

i just want to say , i'm sure you would find a sitter if you could so i'm assuming that isn't an option. That doesn't mean you can't still get a lot out of therapy. Make sure you have snacks and things with you to keep the kids occupied and i think you should "warn" the therapist in advance that you have no other option and your children will be there, but if at all possible give any kids old enough to listen and hear you headphones for a handheld or mini dvd player or Mp3 or antyhing, If they are little just pack a bag with lots and lots to do.
and do your best to focus on the therapist and get through as much as you can.
I wouldn't expect the first few visits to really get too heavy, unless you are just really to explode it all out. which is just fine too.
I picture more of an overview of what your issues are, and you could even write those out ahead of time. to keep you focused if the kids distract you. Have two copies one for the dr and one for you. I would think the first few visits would be about establishing what your goals are. Do you need to learn how to handle the grief, how to make friends in this new community, how to communicate your needs to hubby.
They might give you little assignments that you need to work on like, making a list of 3 things that make you happy and chosing one to actually do.

I'm also thinking to keep the tearyness down a big the second meeting might need to focus on just one thing like the move, or the car accident.
I know they all interrelate but maybe if you can go in depth with one thing each time that would keep your focus.

I would think they can tell you about ok meds for nursing moms. I do think there are some out there. and they should be able to give you some suggestions of things to do to get by until you can safely have the meds.
If they push you to stop nursing, i'm guessing they won't be a good fit for you.
I have no experience as i'm to chicken to do what you are so I don't know how on the mark this advice is.

BIg HUGs and best of luck and I think you are so brave for doing this, because this is ultimatly going to give your kids a happier mommy. What a great gift to them.

It would be nice if you could go without your kids to see the therapist so you can speak completely unfiltered.

It can be cathartic to have someone who is paid to listen to you. If it isn't, you may need a different therapist. Good luck.

after what you have been through it is understandable that you are having depression issues and they pile on and it feels like a mountain on your chest. I lost my dad, two of my uncles, a good friend and a grandmother in a year. The doctor will give you some medication it is not a miracle cure it will take a little while to feel a little bit better but after a while the fog clears you are able to get out of bed without feeling like just lying down on the floor. Then my doctor recommended exercise nothing crazy I walk my dogs every night by myself and take a break from everything and everyone. I applaud you for taking this step it is not easy but one foot in front of the other and you will feel more like yourself soon. good luck

There is no reason to assume they will demand you start taking drugs the moment you enter the doors. They can start with the counseling sessions and wait a bit and see how they go.

Depression can be a biological illness that medication can be used to treat that lasts a lifetime.

Environmental depression usually comes after many life changing experiences and the mind and body just can't take it anymore and starts to shut down. Medication in this instance is usually short term just to keep the person from committing suicide or help get them to a level where they are able to function and start digging their way out of the huge hole they are in.

After a period of time the person is able to wean off the meds and may never have to go on them again. During the counselling sessions they have learned coping skills, they are better equipped to meet the new day and all life's challenges with a stronger understanding of how to deal with loss, change, sadness, frustration, and anger.

It is a good thing you are doing. I commend you for taking this step.

If you can get a sitter for the kids that would be better for you so you can concentrate on your issues. If they are old enough to sit still in the waiting room unsupervised for 50 minutes then take them. I would not include them in your session. You obviously have a ton on your plate and need help and support. Generally your first session will be an overview for you and you'll give basic health information and about yourself. When I've gone you get to vent and release a lot of your "drama" Here and there the therapist will ask questions and take notes. You should know after your first session if the therapist has the empathy/sympathy/campassion you are looking for. I am so sorry for your troubles. Best wishes and God Bless. If you are ok with it, I'll pray for you too!! :) Happy New Year

First of all CONGRATULATIONS for seeking help.
You say you are breastfeeding so on top of everything else you recently had a baby. Your body is adjusting and your hormones are changing. This could be a bit of the baby blues. You have a lot going on and change is scary. You can refuse to take any medication. Sometimes talking it out with a therapist and finding your way out of this anxiety/depression is all you need.
This will not be a quick fix, therapy can take a long time so be patient. I understand you don't want to tell everything in your post but while talking to your therapist don't hold anything back. Your therapist is there to listen and help you sort out what is going on, not judge you. Think of your therapist as the light at the end of the tunnel. Don't be concerned if you start to progress and then backslide this is normal, keep working at it
You just moved and you don't have your support system anymore. Normally we can go to a friend or family members' house to talk things out but you don't have that. It's time to re-establish a support system. You need to find new friends. Remember how healing it was to be able to go shopping with your girlfriends before you moved? You could laugh and talk and relax with each other. There must be a place where you can find friends, story hour at the library, volunteer for an organization you support, church, neighbors etc the list is endless. Get out there and just start saying hello.

Really try to find a sitter. You will be distracted with kids there and forget important things that will help the doctor treat you. Also, if there are no insurance requirements with starting with a PCP, don't waste your time. Go straight to a psychiatrist who can take into account your breastfeeding and other issues and get you on an accurate dose. PCPs tend to undermedicate and patients think that meds don't work when actually they just aren't getting enough. Lastly, give the meds time to work. Some may take 30 days to really reach a maximum level.

You will have to answer questions. If you go to a PCP they may do blood work to rule out medical issues causing depression such as thyroid. However, with all your health problems, I bet his has been done. Don't be scared, people do it every day and you will be so glad that you did so you can get back to yourself.

M., Honey I think anyone who has been through what you've been through would be showing signs of depression; I think if you weren't there would be something wrong with you. Sometimes feeling and being depressed is a natural reaction to an experience or situation, you just have to work through it. I know when my mother died I was very depressed and sad for years, I just had to work through it. Remember the Lord will give you stregnth and wisdom all you need to do is ask. God bless you and just keep one foot in front of the other.

you just go with the flow. you WILL be a teary wreck, thats the POINT. :) let it go. relax. these people have seen this before, and worse, so dont feel embarrassed. the greatest news of all is that you are getting help. most people dont make it that far. so you are doing quite well. step number one is ALWAYS admitting a problem to yourself, and getting help. so congratulations! :) :)

antidepressants arent always required, and in my moms experience, they just numbed her and made her feel worse - lost ALL inspiration to paint sing or do anything else she once enjoyed. so no matter what, you do not have to go on antidepressants.

knowing that, there IS a book "medications and mothers milk" that you should make sure to get your hands on. contact a local la leche league, they might have it, otherwise, i got mine off of amazon.com - and i got it used. its great. it talks about medicines of all kinds and how much is documented to go into the milk, what the risks are and etc. it doesnt tell you specifically one way or the other what to do per say, but it at least gives you honest information so that you can make the choice on your own.

good luck. i hope that you can get your hands on this book. if the la leche league doesnt work (www.llli.org) try libraries. :)

I just wanted to add something from my personal experience. Take your time with the therapist at first. Ask them questions about their style, their training, their interest in the field. Don't just assume because you have made the appointment that you should put everything on the table at first. Give it 2-3 sessions, and trust your gut if this feels like a kind and caring person, who has wisdom and who you can trust. There are many different types of therapy, and different skill levels of therapists. Start with a smaller issue first to see how it goes before you open up more deeply. Be honest, but make sure it is someone you like and trust before getting too deep.

As someone who has been in and out of therapy and on and off medication several times over the past ten years, I just want to reinforce some things other folks have said.

1. Get a sitter. You say you're in St. Paul, as am I - honestly, I would volunteer to babysit myself if you have no other options - seriously. More important for the therapist than for your GP, but for both if you can possibly manage it. If you are part of a faith community, ask someone there for help - I'm certain there's a retired but spry grandma who would be more than happy to stay with your kids for two hours every week for free. Or ask a neighbor. You are so brave to seek help, give yourself the best possible chance for that help to be effective.

2. While a prescription is not at all the only choice for you, with all that you have on your plate, it can be a great way to give yourself the chance to let talk therapy work, to get yourself functioning at a level that will allow you to do the real work of therapy, not to mention the real work of living your life and raising your children. I was on Wellbutrin while breastfeeding - and breastfed for two years without any issues. There are several medications that have been anecdotally studied during pregnancy and breastfeeding over the past 30 or 40 years. You have options.

You are brave and strong and so smart to seek help. I know it seems impossible sometimes to find child care (both finding someone good and someone affordable.) Again, if you are in the St. Paul area and just need a sitter recommendation, send me a message, I'm happy to pass on some options for people to call. Or try KidsPark - licensed drop-in day care, hourly from 9 am to 3 pm, $6/hour per kid. It's in Merriam Park. http://www.kidsparkdropin.org/
But don't try to do therapy with your kids there with you - it's not fair to you or your kids. You can't do the work you need to do if a) with them listening and b) while you're also trying to manage them. If you truly do not have any safe child care options, talk with your doctor and/or your therapist and ask for their help in finding a safe option that you can afford. Their may be county or state resources available to help you.

Again, I applaud your bravery - you are doing the best possible thing for your whole family by taking care of yourself. I wish you all the best - and seriously, message me if you need help finding child care. Best to you and your family -

You've gotten some great responses already, but I just wanted to chime in to say that many antidepressants are compatible with breastfeeding. More and more doctors are aware of which ones are and aren't, but if your doctor needs more information he or she can check into Dr. Thomas Hale's work (he devotes a lot of time to the issue of medications and breastfeeding). He has a book called Medications and Mothers' Milk, and doctors can also look at his website, www.infantrisk.org. Good luck to you and kudos on taking the first steps toward getting some help.

HI M.,
Hugs to you during this difficult time. Feel good about the fact that you're taking this really important step to help yourself and your kids. And remember that however anxious you are about attending these appointments, your Dr and therapist are there to help you work through your problems.
In terms of your therapist... It's probably fair to assume that the first few visits will involve you talking and him/her listening. It will take some time to lay the groundwork and start any sort of process, so don't get discouraged if you don't feel better right away or if they aren't giving you the answers you're looking for. Therapy takes years. But there should be some things, suggestions from the therapist or perhaps medication depending on your needs to help you through the initial and toughest times.

Take one step at a time... one breath at a time. Things will get better :)
Blessings to you on your journey to wellness.

Just remember that those people are there to help you. It sounds like you've been through a tremendous amount of unpleasant events this year. No one can blame you for how you are feeling. The dr will probably prescribe some antidepressants. When I went to a therapist, at first, it was really awkward getting the convo started. Then once I did it all came rushing out and it felt so good to get it off my chest to someone that understood. That person then taught me great ways to deal with what I was going through. I've been to 1 awful therapist that didn't help at all, and 2 wonderful ones. Make sure that you get a great therapist that you click with. They can do wonders to help you out.

Is there any way you could get someone to watch your kids? You need to focus on YOU right now, sinds like you have been through a lot.

I've been dealing with depression for 14 years, so kudos to you for taking the opportunity to actually deal with it and not pretend like it's normal. The hardest and best thing for me to realize and accept, was that it was not my fault- it was nothing I said or did or didn't do, it is a chemical in my brain that was causing me to feel that way. No shame or blame in getting help!! Good for you.

My personal experience with physician appointments when it comes to mental health issues is that they will tend to throw pharmaceuticals at you with no real diagnosis. Don't get me wrong, the drugs are a huge help, but it is largely a trial and error process. I think you will find more answers with a mental health professional, so I think you are going about it in exactly the right way, from both sides.

Good luck to you, I wish you all the best.