How effective is antidepressant medication and psychotherapy?

[clareeezy]

Hey guys,

First time poster! So, in September of last year I was diagnosed with depression by my local GP. He put me on an antidepressant and referred me to a psychologist. Being skeptical, I neglected to go and see a psychologist because I simply thought it would be a waste of time, and I was relying on the meds prescribed to me. Not only did I feel like it didn't work but it made me even more tired. I went through one cycle and never renewed my prescription, hoping that time would heal me...

It is now January, a new year and I really want to get on top of my depression (and now anxiety) before it consumes the rest of my year/life. So I'm just wondering how effective is antidepressant medication (perhaps I'm on the wrong ones?) and if seeing a psychologist is actually worth it? and if so, what happens during a typical session? Is it dependent on the therapist? Is it expensive/covered by Medicare?

Thanks,
Clarence

[Paul]

Hi Clarence,

Welcome to Beyond Blue forums. I love your question as it's often asked but the answer can still be a mystery. Depression and anxiety can be pretty frightening and isolating. Please know you're not alone and that most of us here on the forums understand the difficulties and emotional upset. We're there or have been there too.

How effective a particular medication is changes person to person. What is known however, is that getting well and building resilience to depression and anxiety often requires multiple approaches. In my own case medication has stabilised me biologically so that I'm less sensitive to depression and anxiety. Seeing my psychiatrist and having therapy explores possible causes but more importantly gives me tools to be able to understand my depression coming on, recognising triggers and understanding whether there is something that I can do to slow or stop the onset. Sometimes it's a matter of working through things to be able to come out of the depression earlier that I would have in the past.

I can't recommend highly enough that you visit your GP again and chat about how you felt with the medication initially. I know that when I started mine, I felt tired, but the side effects lessened a lot.

It seems that what is going on for you is sticking around and bringing on anxiety as well. Psychologists are fantastic when it comes to helping understand what's going on with our moods.

Your GP can provide you a mental health care plan. This allows 10 sessions with a psychologist and it is covered by Medicare.

A usual session with your psychologist will be just like a chat with a friend. They will ask what's been happening and how you're feeling. This will then lead to conversations the psychologist can use to understand what might be going on. The important thing is that they are there as a guide. To get the best from any kind of therapy it's important that we are given the tools and then we discover the results with the tools and some guidance. The first session with a psychologist will be much like starting medication. It might be tiring as you are digging in to describe what's going on so that the psychologist can assess what might be happening and the best way to help you through the journey to feeling better.

I hope this helps Clarence.Please feel free to ask more questions and stay in touch. We'd love to know how things progress for you in reaching your goal of getting things sorted.

Paul

[Scotchfinger]

How much is the average session with a psychologist, lats? (after getting a GP referral I mean)

[Durras]

Hi Paul,

Thanks for that wonderful insight and understanding of it all. I started my medication before Christmas and found it was making me very tired, my thoughts were getting more stronger and disturbing and I was also getting badly constipated so I stopped taking them, but my doctor didn't put me onto a care plan.

Over the Xmas period I was feeling ok but this past week I started having horrible mind thoughts and feelings were coming back to surface such as guilty, worthless, hopeless, useless and feeling like what's the point. I did have one good day this week but overall mostly difficult.

I just got back from the doctors, my usual doctor was away so glad for that else I wouldn't have seen the one I did see today. He asked me if I was on a care plan and when I said no he seemed a bit confused with why I wasn't. He got me to answer a questionnaire sheet regarding my moods, depression, feelings etc and said I scored quite high and immediately put me onto a care plan.

On this website I looked under professionals and found a psychologist close to home and he has organised for me to go to her. With this he did say most are bulked billed but some may still charge a gap fee which could be around $20-40

Regarding my medication he has given me a new one to go on for a trial which should calm me down more thou he also said to keep hold of my other ones as he hopes I may still go back onto those in the future.

Hope this helps too

Thank you again for your insight, I look forward but still nervous to see my psychologist but now I have read your post it does also give some reassurance too.

May I ask what kind of questions could be good to have for the appointment or should I need to be prepared with questions. I will be starting my appointments after 23rd Jan when I come back from a weeks holiday in NZ

Hugs to you Paul

Durras

[Paul]

Hi Scotchfinger,

The fee varies between psychologists and depends on the type of service being provided. My brother is a psychologist so I'll ask him what he charges for a general consultation. Stand by.

Paul

[Paul]

Hey Durras - Hugs,

I've found the best thing to go in to an appointment with my psych with is the willingness to be as candid as possible. It's pretty frightening sometimes, especially when something is painful to talk about, but the more information I can provide the better the consultation is because the picture I am painting in explaining my emotions is made clearer. Psychologists and psychiatrists can't read our minds, so the more we are open the better the quality of the session.

I think the next biggest thing is that psychologists don't **MAKE** us feel better, they HELP us feel better. So in a consultation, there's a lot of talking and reflection on how you feel and what leads us to feel a particular way - sometimes it can't be explained, most of the time it can. The exciting bit is learning how our mind works and what leads us to feel a particular way. This can be difficult or exciting or a huge relief.

This information is what I've learnt from visiting my psych. Everyone's experience might be different.

Once again though, try not to be afraid of being candid and open.

Like any relationship that involves in depth talking, two people may not "work" together. In some cases you may not feel like the psychologist you just met is for you. That's completely OK. If you aren't comfortable there is no obligation to stay with one psychologist. You need to feel comfortable. Having said that, most psychologists are great and you feel comfy straight away.

Hope this helps xx

Paul

[Scotchfinger]

I used to pay a gap of 50 bucks per session, after a GP referral to a clinical psychologist. That was a few years ago though. Had to pay an upfront fee of about 180 bucks though.

[Guest_5218]

I see a Clinical Psychologist and she charges $160 per visit up front.  Under my mental health plan I get $124.50 back through medicare for 10 visits per year.

Sherie x

[Scotchfinger]

net 36 bucks per session, not a bad deal sherie

[Guest_5218]

Yeah the $35.50 gap payment would be a bargain, if it werent for the fact that I hate going............  

Some of those sessions have been 3-4 hours in duration too, and she hasnt been charging me any extra for that. She's been really great actually.

I know its been worthwhile, so I will push myself to keep going, at least in the short- medium term.

So Clarence, I would suggest that seeing a psychologist would be a worthwhile thing for you to try.  And I hope you are lucky enough to find the right one for you, because that is a very important part of the equation.

Sherie