Dr. Jan Fawcett

A psychiatrist has been trained as a medical physician and should be able to diagnose medical problems causing psychological problems such as hypothyroidism causing low drive or a brain tumor causing symptoms. A psychologist has been trained to do various types of psychotherapy or "talking therapy." A psychiatrist has been trained to do both.

It has to show its efficacy. Negative thinking itself is not a disease, but it can lead to a disease, most commonly depression. Cognitive Therapy (CT) was conceived of with this dynamic in mind. Namely, the idea that CT challenged the negative of an individual with depression. Whether negative thinking leads an individual to depression depends on many factors. I like to think of depression as a result of many causes, equifinality meaning many different mechanisms leading to the same end. Negative thinking is not healthy, and people who have it should seek out CT. It is not always an illness, but may lead to depression, which is a disease. Depression is characterized by depressed mood, anhedonia, low energy, decreased appetite, decreased ability to sleep, suicidal ideas, and increased risk of suicide.

Dr. Fawcett

You should see your family doctor as soon as possible - he can rule out anything serious with a few tests and check for muscular causes. If all this is normal, the cause is probably anxiety. There are both medical and psychological treatments for anxiety. A consultation with a psychiatrist or psychologist might well help.

This is quite common. It probably stems from anxiety. Many people use short acting sedatives like zolpidem to go to sleep. Others are opposed to using "drugs" or are concerned about side effects or worry about drug dependence. One thing to try (if you haven't already done so) is to go through the alphabet thinking of animals whose names start with its letters. Some find they have fallen asleep before they finish the alphabet.

Based on the treatment history you provide, I would suggest that you consult a psychiatrist who is an expert psycho- pharmacologist. How do you find one? Your call medical schools psychiatry departments, ask for the chairmans secretary and ask her who with this background the chair would refer you to. What if you were looking to give a million dollars for research to someone who helped you. Who would they suggest you see - could they make this clinician available - you don't have to say that you are actually going to give a million dollar grant.

There are probably warning about this in the in the zoloft literature. In actual practice I think that a reasonable amount of alcohol (up to 2- 3 drinks) is permissible with Zoloft. Other medications may interact differently.

A good psychiatrist should be interested in both prescribing medication and psychotherapy. There has been a trend in psychiatry supported by insurance companies to limit the number of visits to a psychiatrist, that can make doing psychotherapy difficult. You can ask the psychiatrist if they can do psychotherapy in your situation. Many people do psychotherapy, you should ask about their training and after 5 or so sessions ask yourself what am I learning? You should be learning something about yourself that you can apply towards getting better- getting rid of symptoms that bring down your life experience. If you are not learning you should talk with your therapist - and perhaps find another therapist. A rent a friend is soothing but may not teach you anything useful.

Go to your PCP. He might find that you have one of many medical conditions, such as cardiac illness, hypothyroidism, an infection etc. If you have also noted that you no longer enjoy life, you may have a depression, which can respond to
an antidepressant or cognitive therapy or another psychotherapy depending on your situation. If you have trouble sleeping or your partner notes that you stop breathing for brief periods at night , you could have sleep apnea- a highly treatable condition. The first step is a full history and medical work up, then perhaps a referral.

A psychiatrist has a confidential relationship with their patient. They may not be able to tell you much about the patient. If you can arrange a joint appointment with the patient's agreement, you might learn more. Doctors who are willing to listen can be given any observations or opinions that you wish to impart - this can be very helpful to the doctor. The doctor should be interested in hearing from anyone who is concerned about the patient.