What Questions Does a Psychiatrist Ask You on the First Visit?

What Questions Do Psychiatrists Ask You on the First Visit?

Mental health professionals are working toward your overall well-being. Each one has a specific role to play, however, broadly, a psychologist is someone who engages in talk therapy, while on the other hand, a Psychiatrist is a doctor (MBBS) with an MD in Psychiatry.

A Psychiatrist is the only mental health professional eligible to prescribe medication. Knowing when should you see a psychiatrist can be crucial for addressing your mental health needs.

For the first time can be a daunting process. You may find yourself feeling jittery, having doubts, and thinking, “My problems aren't that big of a deal, maybe I should just cancel.” Before you do, here’s a thought - maybe you’re, as can anyone, facing uncertainty about how they will react, what are they going to say, what will a psychiatrist ask on a first visit?!

So, let’s demystify this for you. Here are the top 25 questions Psychiatrists ask on the first visit that can help you know what to expect related to your specific needs.

The first 15 questions are a bit generic but can be asked by anyone visiting. The rest of the 10 are for specific concerns you may feeling from symptoms of depression, anxiety, or if you think you may have ADHD.

Top 25 Questions Psychiatrists Ask on the First Visit

A psychiatric interview can last from anywhere between 10 minutes to 40 minutes. While these questions are the most common ones, the clinical judgment of a Psychiatrist guides the number of questions based on how much information is required at least during the first visit. 

1. What brings you here today? 

As someone visiting a psychiatrist for the first time, there is likely going to be a trigger, i.e., any thought, feeling, or situation that made you open the door to a Psychiatrist’s office. The idea of asking this question is to know what was important enough for you to understand the profoundness of your situation.

2. When did you start feeling this way?

You may have been in this boat before. Maybe, more than once. When Psychiatrists generally ask this question they are trying to learn of the severity of the situation from you.

For example, let’s say when you were in the 10th grade, you scored low in your exams but were able to cope. In the 12th grade, a low score felt like an additional pressure as you are also going through a big adjustment of graduating from school and becoming an adult.

Maybe in the first situation, there was a sense of safety of getting another chance to perform better in the next grade. In the second situation, it might be possible that there was pressure from yourself or loved ones to do better and support felt limited.

This difference can provide important clues for the Psychiatrist to understand situational factors beyond your control. It helps to have a first-level understanding of what is controllable and not controllable for you about the concern.

3. How have you approached this concern until now?

Though the conversation around mental health is opening up in India, there is little knowledge about mental health and related services. The fear of being perceived negatively can often impact us to try all other ways possible before we take a step towards a trusted mental health professional.

When Psychiatrists ask this question, they are ideally trying to identify your strengths and existing coping mechanisms such as going for a walk post having difficult thoughts or calling a friend who can play a role in supporting you moving forward with any kind of medication or therapy. 

4. What is different now than before?

It usually gives clues to your Psychiatrist about what has worked before but is not working now.

For example, if it was easier to cope with exam anxiety before than now, posing this question helps identify what may be an additional roadblock or contribute to anxiety. Maybe before, it was a class test, but now there’s a competitive test that brings on different kinds of pressure that seem difficult to handle. 

5. What does your average day look like lately?

The understanding of your day may help the psychiatrist understand if there are any shifts in your daily functions as a result of the problem you are experiencing. As an example, has your sleep increased or decreased?

An average day of your life may feel mundane or even routine to you. However, it might have some information for both you and your Psychiatrist to understand you better.

For example, let’s say you’ve recently finished your board exams and are completely free. Without realising, you’re spending a large part of your day researching colleges which causes intense anxiety about the future.

6. What bothers you the most about this situation?

It helps both you and the Psychiatrist understand what is your priority in this situation. For one person dealing with exam anxiety, the priority could be “not wanting to feel so tense.” For another, it could be to prioritise a good self-care routine to be healthy and study without getting tired. 

7. How is your relationship with your family members, friends or any other person you trust?

Knowing about your relationships lets the Psychiatrist know who is a person you trust and would feel comfortable in case support is required.

8. Have you sought support from someone who might understand the situation? 

Since mental health services are scarce in India and there is still a perceived stigma around availing of services, asking about support lets the psychiatrist know your level of comfort.

You may confide in friends or you may be part of a free support group with similar-minded people. Alternatively, you may find it difficult to open up to anyone in the environment. It is helpful to know that this familiar space exists for support.

7. Has anyone in your family ever faced a similar concern?

Growing up, we learn how to model our behaviours by looking at our surroundings. If you saw your parent feel anxious before big presentations and had to tip-toe around them from time to time during the preparation time, it is likely you may experience similar feelings in your workplace.

It is not always necessary or expected that you will know of these patterns. A mental health professional providing you care is responsible to find out about these patterns and see links with your current coping. 

9. Have you or anyone in your family ever been hospitalized or received psychiatric medication?

Psychiatrists ask for an extensive medical history, including your family tree, to understand if any genetic factors at play require medication or a specific kind of help.

A large part of experiencing mental health concerns is genetic, just like if one’s father has a history of heart disease, their children may be more vulnerable to developing something similar. It is important to understand if there is a family history of dealing with Mental health conditions such as Depression, Anxiety etc. 

10. Do you have any other medical history?

Physical health can affect mental health and vice versa. Hence, any other health condition both mental and physical can affect symptom severity and even cause emotions and feelings in some cases.

For example,  women who experience Polycystic Ovarian Syndrome (PCOS) report experiencing psychological stress, extremely low moods and lethargy. However, professionals seldom check for mental health conditions like Major Depressive Disorder, which are reported to co-occur more in women with PCOS.

The link is PCOS causes many different bodily changes including hair growth, and difficulty in how the body processes glucose (insulin resistance) often leading to weight gain and energy crashes  - all of which when misunderstood by self and loved ones lead to lower moods.

11. Have you ever received any medical treatment or prescription for any other concerns?

Medications can react with each other and cause different side effects that may be unintended. Psychiatric medication, too, can have side effects when taken with other medications including over-the-counter medications that can be bought without prescription. Hence, knowledge about this helps the Psychiatrist make an informed choice in case any medication is prescribed to someone.

12. How often do you engage in social drinking or use of substances such as tobacco or alcohol?

Different substances can impact your moods and mental health by interacting with different chemicals in your brain. You may have noticed feeling lighter or more vocal after drinking socially. The way one uses recreational drugs or participates in social drinking can have an impact on your current concerns. Hence, being open to the psychiatrist about your use of substances is important.

13. Have you met with any other mental health professional before coming to me?

Posing this question allows the psychiatrist to gauge whether there needs to be a different approach right now if there was a consultation with someone before, especially if it wasn't fruitful.

For example, you went to another psychiatrist and they prescribed you medication within 10 minutes of the consult. Maybe it left you feeling unheard. This information allows the current mental health professional to remedy the same by ensuring they make you feel heard.

14. Do you have any questions for me?

After bombarding you with so many questions, you will likely have many questions for your psychiatrist! This is a space offered to you to ask anything and everything about the course of action and plausible thoughts of the psychiatrist. 

15. How to prepare for a psychiatrist appointment

These questions may seem like a lot but they help a psychiatrist to gather a holistic picture of your mental and physical health.

Many times such questions can be personal, and you may feel awkward or anxious to answer. Here are a few points to remember:

• Think about these questions and write down your medical history and any prescriptions that may be relevant.
• Permit yourself to answer what you feel comfortable to answer when it comes to something deeply personal. It is likely that over time, as you feel safer and comfortable you will be able to share what you’d like with your psychiatrist. 
• Write down questions you have for your psychiatrist beforehand. Sometimes answering so many questions can tire you out and you may forget something important that you wanted to ask. Having this list handy will be helpful. 

What 5 questions do psychiatrists ask to screen for Depression?

Depression is a mood disorder characterised by the following symptoms for more than two weeks:

• Persistently low moods and energy
• Significant changes in appetite 
• Sleep disturbances (both sleeping too little or oversleeping) 
• Loss of interest in activities you once loved

Hence, in addition to the 15 questions above, these are the top 5 questions a psychiatrist may ask to screen for Depression:

1. How has your mood been in the past two weeks? Is it stable over time?
2. How has your sleep been in the past two weeks?
3. What has your appetite been like in the last two weeks?
4. How have your energy levels been in the past two weeks? 
5. Are you able to participate in activities you like?

What 5 questions do psychiatrists ask to screen for Anxiety?

Anxiety and stress are a normal part of our lives and affect everyone equally. However, they can exist on a continuum, and symptoms of worrying and anxiety that won't go away may be a cause for concern for people.

Anxiety that becomes all-consuming to the point that one can't stop worrying about something can impair one’s relationships, work, and mental health.

Your doctor will ask you the following 5 questions to figure out the duration, impact, and severity of the anxiety you’re facing to make an appropriate diagnosis, referral, or prescription:

1. Have you been experiencing any physical symptoms of anxiety - heart beating faster, palpitations, uncontrollable thoughts or sweating?
2. How long have you been experiencing these symptoms? When did they start?
3. Have there been any significant life changes recently? Or any ongoing stressor?
4. How do these symptoms impact your daily life? Think of work and relationships
5. How frequently do you consume caffeine, tobacco, marijuana or alcohol?

Do Psychiatrists Prescribe Medication on the First Visit?

The answer lies in the clinical judgment of the psychiatrist. Based on a thorough understanding of your symptoms by evaluating how deeply (severity) and how often (frequency) you’re experiencing a concern, a psychiatrist may prescribe you a medication.

This may or may not be in the first visit itself. Make sure to ask your Psychiatrist about the possible diagnosis they are working with to help you out, how they concluded and how the medicine might help.

Know what should you tell or not tell to your therapist and 25 Important Questions To Ask Your Psychiatrist or Therapist

Conclusion

A psychiatrist is the only mental health professional who can prescribe medication in India. Usually, they will ask you in-depth questions about yourself and your life to understand you and your concerns holistically. Different kinds of questions allow the psychiatrist to formulate the best plan to support you in your mental health journey. 

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