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What's the difference between a psychologist and a psychiatrist?
Many things are therapeutic, not only individual psychotherapy. Have you tried any of these:
- Schedule an appointment with your primary care physician to rule out stress related illnesses, anything medical that could explain trouble sleeping, and be sure your vitamin levels and hormones are balanced or in the normal range. Sometimes weight gain, weight loss, motivation and exhaustion can be medical, not psychological.
- If you have seen your physician, increase your cardio by 30 minutes, 3x per week. If you are already lifting weights or doing yoga, add cardio. Take the dog for an extra 15-minute walk twice a day without your phone. Cardio is a force multiplier.
- Contact the peer support team or a chaplain if your department has one. Yes it is hard to trust people – that is the problem, not the explanation. Avoidance and denial are symptoms, not solutions.
- Tell a friend or family member about your symptoms (not sleeping, weight change, a change in routine). Ask the friend or family member if they think alcohol use could be making things worse for you. Have they noticed you have been more irritable or withdrawn lately?
If you think your problems are not medical – they could be psychological. Physicians sometimes send their patients to me. If you think a neutral third party can be more objective than a friend or family member then psychotherapy may be a good option.
Is psychotherapy really confidential?
I discuss confidentiality within the first 20 minutes of therapy with a new patient. Some important things to consider:
- If I broke confidentiality 15 years ago, do you think I would still be in business today with first responders?
- If I break confidentiality, I face steep fines and could lose my license.
There are exceptions, outlined in the consent form. I am a mandatory reporter of child abuse and elder abuse. If a child today is being abused, that is an exception. If my adult patient was abused when s/he was a child, that is confidential.
What about suicidal thoughts?
I bring up the topic of suicide and confidentiality on the first visit, so patients will know that I am comfortable with the topic. I have found that a first responder can think of about 5 (maximum) different things to do if they encounter a suicidal civilian during the course of their duties. I can think of 50 (minimum) things to do with someone who has suicidal thoughts. We have different roles, and different jobs.