On your first trip to the psychiatrist

Hi Coquette. I’ve written to you many times and never pressed send, but you’ve been a very helpful presence in my life. I’m writing to you now because I’m going to a psychiatrist for the first time in two days. I’m 21 and I’ve been depressed since my early teens but my parents always told me that it’s just my character and never took me to get help. Now I don’t even know if I actually have depression or if it’s just my personality, I don’t feel like I have an actual personality or a sense of self. I’m scared that the doctor is just gonna brush me off and not give me meds which are my only hope. I feel like my brain is frozen up, I just want to know that there’s a chance I’ll feel something, that there’s something other than this robotic life for me, but then I don’t know if I can handle anything else. I don’t really know what my question is, I cried for the first time in two years while writing this, should I tell all this to the doctor? Everything I’ve read online about preparing for the first visit has only made me more nervous, like she won’t understand what I mean or believe me, because I’m functional and have done well in college and have friends so maybe she’ll think I don’t need medication but I do. But then I’ve felt this way since I was 12, maybe it is just me and there’s nothing to be done. It’s ok if you don’t answer before the visit or at all, I just wanted to tell someone who’d understand because my otherwise loving parents are being gigantic assholes and treating me like they’re doing me a favour by booking the appointment. Anyway, thanks for reading, love you.


The doctor is not going to brush you off. She will listen. She will listen to you like you’ve never been listened to before. Tell her everything. Tell her that you’ve been depressed since your early teens. Tell her about your parents. Tell her that you feel your brain is frozen up. Tell her that you cried for the first time in two years, and if she asks, tell her what happened to you when you were twelve. If it will make things easier, bring her the letter you wrote to me. Use it as a starting point for your conversation with her.

As she is a psychiatrist, the likelihood of her recommending medication is much higher than with other mental health professionals, especially if that’s the reason you showed up to her office. Whether she prescribes medication or not, you should know that meds are not your only hope. They can help, but don’t expect anti-depressants to be a miracle cure and be open minded about other therapeutic options that she might recommend.

Take a deep breath, kiddo. It’s perfectly normal to be nervous, but you’re going to be fine. You’re doing the right thing by taking care of yourself, and if your parents won’t say it then someone should: It’s okay to ask for help, and I’m proud of you for taking this step.


17 thoughts on “On your first trip to the psychiatrist

  1. So, yeah. I know right where you are. 40+ years of thinking/being told that I was “moody” or “emotional”, and believing that “that’s the way I am, so I’ll just have to deal.” It looks different when every time you walk by the swimming pool you have a discussion with yourself about whether it would be better for everyone if you were at the bottom, instead of the top. At some point, I got scared enough to make the appointment that friends and family had been encouraging me to make for more than 2 years. My dear Dr. listened carefully and made suggestions and 6+ months later, I am in a much better place. And I was a poster child for everything looking good, managing well in the face of massive personal issues (dying children & parents, family issues galore), keeping my shit together. Very few people knew how fucking hard it was to get up in the morning.

    Listen to The Coquette. She has it right: you will be heard, and you can say what you need to. And if for some reason you don’t feel heard, get your parents to make another appointment with a different Dr. Sometimes it takes a couple of tries to get things right.
    All the best wishes for you.

    • tall basket says:

      That’s an interesting point, but I feel like it might not apply in this scenario. Thanks for linking to the article though. That’s an interesting read.

      Here’s my reasoning. “I’m functional and have done well in college and have friends” pretty much sums up what I always told myself in the face of mind-numbing despair, and only further reinforced the disconnect between the “successful” image people in my life always credited me with having and what I actually felt. Over time, that disconnect became more and more surreal, almost as if each normal interaction were the metaphorical equivalent of running my tongue over a lost tooth, not quite certain if things had always been that way or if I had just fallen out of the head of my own reality.

      Dissociative behaviors are a common symptom of depression. That doesn’t preclude what the article was talking about but it’s something to think about.

    • RocketGrunt says:

      I feel like the lack of a sense of self might stem from the fact that the writer’s parents treated the depression as the writer’s identity. Besides that, your teen years are supposed to be the time you start figuring yourself out and developing an identity, so being depressed/numb through those years might have prevented the writer from really doing that.

    • Strangely Rational says:

      As someone who also began experiencing depression around that age, I would suggest that lots of things can happen at age 12, just as part of growing up. It’s right in the middle of junior high with puberty in progress – lots of things can go wrong with peers, and hormonal changes can do it too.

  2. Petite Forthwright says:

    I went to a counselor for the first time last year. I was also incredibly nervous and wrote to Coke. When the time came, I went to my appointment as a ball of nerves, but that first session set off a chain reaction in my life and SO much is different since then.

    Keep your head up, be brave and take care of yourself. That’s all you can do.

  3. Echo says:

    You don’t know that something happened to this person at 12, just that they’re depressed. I started having depression at age 9 for no reason other than my shitty brain chemistry. The idea that something traumatic has to happen to you before you become depressed is just plain not true and I’m surprised that you don’t know that.

    • Nina says:

      But we also don’t know that nothing happened. This is a topic that the LW can speak to the doctor about and it may prove helpful.

    • The Coquette says:

      I didn’t say anything about trauma. She specifically mentioned age 12. That kind of specificity is significant, and any halfway decent therapist is gonna hear it and prompt her for more information.

    • Hope says:

      I think that even if nothing “happened’ there could be a benefit to telling the doctor the story of experiencing depression for the first time – what was happening in her life and in her head, how she understood it at the time. Could give some insight to where she is now.

  4. Mags says:

    Hi everyone, I’m the asker, I wanted to thank the Coquette and all of you for your kind and thoughtful responses, you have really encouraged and calmed me down. Seeing you relate to my experience and believe and understand what I’m saying made me realize that the doctor will too, and I feel so much better about the visit now, I’m ready to get better. Thank you all so much, you’ve helped more than you know.

    • Strangely Rational says:

      So glad you’re feeling more positive! This is a huge step, and I’ll tell you that while it can be a difficult path to getting better, it’s so worth it. Just try not to get discouraged if you get a med and it doesn’t work right away – you’ll be on a starting dose just to get used to it. It can take a couple of weeks to start working, and you’ll probably need gradual dose increases until you’re at the right place. But any relief is good!

      Lots of people give up when it takes awhile to get something to work well, but please don’t! Stick with it. I have bipolar, adult ADHD, and anxiety, and my doctors have been adding/subtracting meds and adjusting dosages for the last 9 years. That sounds discouraging, but it really hasn’t been bad. I got a lot of relief within the first month of starting an antidepressant and mood stabilizer. The rest of the time has been spent refining it. Most of it was dose increases due to developing tolerance.

      Good luck at your appointment, and I hope it helps you get to a better place!

  5. dk says:

    It’s common for depression to begin around the time of puberty when the body and brain undergo enormous hormonal changes. Mine manifested around the same time but there wasn’t any particular trauma.

    A psychiatrist can get you meds, which can then help you be present for therapy, but do NOT think the meds will “fix” you! I have been on Zoloft (now generic sertraline) since I was 25 and should have been on it much earlier. I also didn’t start getting therapy till my 20’s.

    The psychiatrist may give you meds but actually not be the right therapist. Don’t give up. A therapist should listen, but also given some feedback. This does NOT mean the therapist will fix you either. Or that they will tell you what to do. They help guide you to make healthy decisions for yourself. I found an LCSW in my late 30’s and she has been instrumental in me making better choices. My family made me feel AWFUL about myself growing up and throughout my adult life. Now that my mom has died and I have had to interact with them all more for us to distribute her stuff, get her house ready for sale, etc, I just can’t believe that as the baby of the family, these were people I used to look up to! It is so clear that I am the most functional one and the only one to have extended therapy.

    I am now 48 and have to work at being well ALL THE TIME. However, everybody has shit to deal with. This is my shit. At least I no longer feel like I am without any mooring or resources to help me. I am also demonstrating to my children that you can have issues but it’s the choices you make about those issues that determine where you are (they are currently questioning why their depressed and heavy drinking father can’t do the same).

    It will take time. However, one thing I have learned is you are never done. There is no time when you are suddenly grown up and finished with making yourself. You will always be making. Good luck!

  6. My folks sent me to a shrink when I was a senior in high school, and then again when I was a freshman at college. I never knew that I could have refused–that’s how lacking I was in terms of a self. But the stinking sin both shrinks committed was that they broke the provider-client privilege and told my folks about our sessions without asking me whether they could. That was a disgusting violation. It’s illegal, too. I can’t even begin to tell you the damage that did, especially since my father was a king-hell narcissist looking for any edge on me.

    So I’d make sure that the shrink never, ever talks to your folks, unless you OK it. It doesn’t matter if they buy–they still don’t get to pry into your psyche in such an invasive way.

    Now, I’m all about getting help. Therapy has been great–I’ve gone on my own consistently, after the college shrink, all my life. Wonderful programs like the Hoffman Process are out there. I highly recommend self-exploration–you’ve got a self to explore whether you feel like you have one or not, and so by all means, go. It’s a wonderful adventure. And all that Dear Coquette says is true–someone will listen to you in a way you’ve never been listened to before, and that’s a treasure.

    You may have stuff about the fact that it’s your folks booking it, and they may be paying for it, but it’s still your life.

    It’s very easy to understand why you’re nervous–facing oneself is THE most courageous thing one can do. I hope it goes well.

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