Questions about which kind of doctor to go to

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Veteran Member

Date Joined Dec 2006
Total Posts : 707
   Posted 9/2/2007 12:05 PM (GMT -6)   
I have been dealing with physical symptoms (heart pounding and shaking being the two most prominent) for weeks now.  Have been to my Primary Doc and no physical reason for the heart pounding and shaking found.  She put me on 0.25 mg of Xanax 3 times a day which I have been taking and it does not seem to be helping with the heart pounding and shaking.  I work for a hospital (home transcriptionist) and called the Employee Assistance Program beginning of last week to maybe meet with someone to talk to about how to deal with this but noone has called me back to talk.  I am in the midst of looking at my provider list of doctors for my insurance plan to find someone to talk to about the anxiety and get at the root of its cause and for coping skills.  What is the difference between a psychiatrist/psychologist?  How do you know which one is best at treating anxiety?  Do I have to call everyone in the book and ask if they are trained in treating anxiety?  How does one go about finding the right person to talk to?  What is a therapist?  Are they different from psychiatrist and psychologist?  All the initials after their names in the book are a foreign language to me.  I want to get help.  I want to live a normal life.  I want to participate in life again and not just "exist".  Any advice would be appreciated.
My primary doctor just keeps wanting to try different antidepressants although I have told her they cause serious side effects.  I have tried amitriptyline, lexapro, zoloft, klonopin, seroquel, cymbalta, paxil, etc.  All with the same final end - a trip to the ER for tachycarda and meds IV to slow down a heart rate that has gone as high as 150 after trying some of the meds. 

Forum Moderator

Date Joined Apr 2007
Total Posts : 32602
   Posted 9/2/2007 2:30 PM (GMT -6)   

Hi, this is Kitt

If you are having tachycardia that requires ER visits and IV meds you may want to look at visitng a cardiologist to make sure it is not a heart problem versus meds.  What were you symptoms with the fast heart rate?

As far as sorting out what you need for a physician, a psychiatrist is a medical doctor and prescribes medications specializing in  mental health. IMHO that is where you should start and then work from there as to what type of therapy  might be the most appropriate for you.

Please keep posting and know we are here to support you.



Moderator Anxiety ~ Panic Disorders
*~* Not a mental health professional at all *~*
Dx: Anxiety/Panic, Depression 
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.” 
~Rosalyn Carter


Veteran Member

Date Joined Nov 2006
Total Posts : 1745
   Posted 9/2/2007 3:18 PM (GMT -6)   
Right. A trip to a cardiologist to rule out heart issues should be your first stop. Your second stop probably be a psychiatrist, as Kitt said. They're medical doctors. With psychologists it's a whole different story. None are medical doctors and none can prescribe medication. There are lots of ways to be certified as a psychologist, and that's where the alphabet soup comes in. Do your research if you elect to see a psychologist later. Often you'll find that many hold a PhD, but if you check their curriculum vitae you'll find that that doctorate is in English or something. Now that doesn't mean they're a bad therapist, necessarily. It just means they likely couldn't find a job with an English PhD (only thing you can do is teach, pretty much) and they found something else to do in order to make a living.

My old insurance had a website that you could browse the in-network psychologists, and the page for each one would indeed say what they specialized in. Well, usually. I wouldn't call one that didn't. Most will have several areas they claim to specialize in. Anyway, then you could get their number and ask to talk to them on the phone before you made an appointment. You can tell a lot in a short conversation.

Ideally you'd find a psychiatrist that also did talk-therapy, like Dr. Melfi on the Sopranos. I understand they're pretty rare these days, but that's the direction I'd go in if I could.
My Brain: My friend, My enemy: A blog to chronicle my attempt to recover from anxiety/panic disorder

Elite Member

Date Joined Jan 2005
Total Posts : 24909
   Posted 9/3/2007 9:46 AM (GMT -6)   
I agree your first stop would be a Cardio ....go from there a Psych would prolly be your next best option
Just my opinion
Thats a very high heart rate I am sure you already know

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New Member

Date Joined Jul 2007
Total Posts : 14
   Posted 9/4/2007 1:38 PM (GMT -6)   

I ended up with a Psychiatrist, that does therapy. My suggestion would be go to a session, find out their approach, & determine if you think they can help.

I found this helpfull when looking, Here's my health companies defenitions:

Masters Level Clinician (Therapist)
Have a Master's degree in one of the following Mental Health disciplines: Social Work, Nursing, Professional Counseling, Marriage and Family Therapy or a Master's in Education. These individuals are independently licensed in the state in which they practice. They provide various services including assessments and psychotherapeutic interventions.
Master’s-Level clinicians provide therapy for many basic needs; UBH’s master’s clinicians work with patients to address concerns and root causes. They can see you alone, as part of a couple, or with your entire family. In some cases, they may recommend that you consult with a psychiatrist or nurse practitioner to evaluate whether medication could contribute to achieving the best outcome. (Most therapists can suggest trusted psychiatrists or nurse practitioners to you for this purpose.)

Generally have doctoral degrees in the area of educational, child, clinical or counseling psychology. Psychologists provide a variety of services including assessments, psychological testing, and most offer psychotherapeutic interventions. Some psychologists have specialties in the area of treating children and adolescents.
Psychologists offer testing that can help answer questions about what may be causing certain symptoms; often, a Masters clinician or Psychiatrist will refer to a psychologist for such testing if they believe it is right for a particular patient. Psychologists can also perform therapy.

Psychiatrists are MD’s that specialize in psychiatry. They provide psychiatric evaluations, prescribe psychotropic medications and may offer psychotherapeutic interventions. They are licensed by the state in which they practice and most are Board-Certified in their specialty. Some psychiatrists have sub- specialties in the area of child psychiatry, adolescent psychiatry, addictions or geriatrics. If you are interested in a psychiatrist who evaluates and treats children be sure to inquire as to whether or not they have been trained in child psychiatry.
Psychiatrists are medical doctors with a specialty in psychiatry. Most often they conduct a thorough evaluation and prescribe medications, then monitor the effects of medications. Some psychiatrists also conduct therapy.

Dx: Panic Disorder
Also have: GAD & social anxiety
Rx:75mg EffexorXr 2x a day, 8am & 3pm.
     .5mg Klonopin @ night if anxious (very infrequent right now)
My advice: Find and a good pdoc! One with alot of experience in treating p/a and uses CBT. There's no shame in going to an expert, most MD's are good, but are just to busy to heal this disease!

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