DSGamer Down Under (Australia) and back

The "being very manly" comment would be a huge red flag for me. Even if it is Australian culture (which it probably isn't any more than any other western country), it's not a healthy way of thinking.

The problem is that he's the first doctor I've met who's willing to prescribe the medication to allow me to continue my taper without putting me on something else. Finding a good doctor in a new country is really hard.

DSGamer wrote:

Found a helpful doctor today, but he said two things that confused me.

#1 - People in Australia don't really go to psychiatrists. There's a stigma still.

He essentially said that GPs or psychologists will deal with the chemical or counseling side of things. Otherwise you're viewed as having something seriously wrong. Is this true?

#2 - He finished today's meeting by saying what I'm doing (getting off a psychiatric medication) is "being very manly".

Is that an Australian-ism that means something else or did he mean exactly what he said?

#1 Yes. You can 'sort of get away' with mentioning having counselling. If you trust the people you are talking with, say inner circle, you can mention therapy, but coming straight out and saying a psychiatrist, perception is "instant nut-job". It's slowly changing, but this is a real "blokey-bloke" kind of culture still, and it's going to take a few more generations to change that perception (unfortunately). Plus, our Psychologists work in consultation with our doctors, so they have a fairly good range of pharmacological options they can recommend based off current prescriptive practices. Psychiatrists are used more recently for when they need to call in the chemical big guns for a real specialist issue (and also the big $$$). Australia still has a lot of people who think mental health issues can be solved by "drinking wet cement and hardening the f*ck up".

#2 I would chalk that up as a very awkward attempt at validating your decision to taper. Given the above "blokey-bloke" reference, and also not knowing how an American might read other cultural references, it seems to me, at face value, an awkward misstep. Importantly, it's one I'd consider giving a Mulligan to, if this is the first GP who's actually listened to you, and is responding to your consult in a way that you found encouraging. If you're unsure, ask him at your next consultation, and explain it felt a little awkward.

Thanks, Monkeyboy.

He basically said exactly what you said on #1. He basically said that people would assume I was crazy if I went to a psychiatrist. That wasn't his opinion, mind you. I think he was trying to tell me that psychiatrists were different here than in the US. It's common in the US for psychiatrists to only or mostly do talk therapy. So they have prescribing in their back pocket as a tool, but they prefer CBT, etc. So it's not uncommon in the US to just start with a psychiatrist, but to find one with a preference for talk therapy and go from there.

That one didn't bother me. I just wanted to find out if it was true so I could sort out who I should go see if I decided I needed to talk to someone. Either way who I need right now is someone sympathetic to wanting to do things more naturally who doesn't assume I need medication necessarily. Or who approaches that choice with care.

On #2, setting aside "being manly" as a virtue and setting aside the sexism in a statement like that, I would mostly take it as a compliment. I just wasn't sure, because it felt a bit dated. Calling it something other than "manly", I think there is something "tough" about surviving a severe medicine reaction and persevering. Not only persevering, but jumping on a 15 hour flight, moving halfway around the world to a new culture, taking a job and getting on with life. In my more anxious past there are a ton of things along the way where I would have said "no" and given up or done things differently. So I'll take the compliment. I just wasn't sure, since it felt dated, if he was being genuine.

I still find #1 to be weird. Actually, I'm pretty sure that someone in Aus who hasn't needed their services would struggle to tell you the difference between what a psychologist and a psychiatrist offers.

Mr GT Chris wrote:

I still find #1 to be weird. Actually, I'm pretty sure that someone in Aus who hasn't needed their services would struggle to tell you the difference between what a psychologist and a psychiatrist offers.

Well, either way it still means I haven't had any luck finding a doctor here to help manage my situation 100%. I've managed it myself in consultatuon with my doctor back home. She's part of a boutique clinic where you pay a flat fee monthly for email / phone access to your doctor. For someone like me with a specific medicine I need to manage this is really useful. Doubly useful when you're in a foreign country and need to run a symptom by someone who understands your situation.

Basically yesterday I found someone who can continue prescribing my medication. That's a good first step. It would be ideal to find a doctor here whom, if I got myself into trouble with my medication taper, could help me. I still don't know how to find a doctor here, though.

And, yes, #1 doesn't clear up whether or not a psychiatrist is an option or not. It seemed, though, to point in the direction of avoiding psychiatrists, though. I don't know.

From my own experience, a psychiatrist is the one to prescribe more complicated medicines (GPs just offering paxyl absolutely matches my own experiences). However, it seems like others might have other experiences. Confusing I know!

My understanding (coming from personal experience up here in Brisbane) is there's a path of escalating referrals that normally goes GP > Psychologist > Psychiatrist, with the last only getting involved when serious medication is required. I don't think psychologists can prescribe drugs, which is why the line gets drawn there.

I'm not surprised to read about your experiences... When I went to my GP with serious mental health concerns I had the following exchange:

Me: 'I'd like a referral to this particular psychologist please, since I'm experiencing X, Y & Z and she specialises in diagnosis and treatment in these areas.'
GP: 'Do you have a job?'
Me: 'Uhhh... Yes?'
GP: 'Are they happy with you there?'
Me: 'Uhhhhh...... Yes?'
GP: 'Well it's highly unlikely you've got any mental issues. Take a couple of days off if you think you need to and you'll be fine.'

And this was a guy I had been going to for about a decade beforehand >< Needless to say I switched him out, but I ended up going to my psych of choice unreferred and footing the $300/hr bill for the next six months...

Huh. That tracks with what this doctor said yesterday. That you only really find yourself in a psychiatrist's office when things are really bad and you need heavy medication. I guess I basically need to stick with this doctor for now since he'll prescribe the medication I need to continue my gradual taper and then work on finding a good GP. Thanks. I'll take other impressions from others who have dealt with doctors outside the US, specifically in Australia, of course.

DC Malleus, I'm not from Queensland but NSW has a workers compensation system if you have a diagnosed mental condition caused by work; I'd imagine most states would typically have a employer-funded system but it should get you paid-for treatment and lost income. Some private health insurance policies should cover treatment as well.

DSG, you could try Dr Warwick Stening, a GP who practices in a medical centre in the Sydney CBD, on York Street (it's next to the Scots Church I think, in walking distance from Wynyard train station). He's a bit crass, misogynistic (he once told me, without any basis whatsoever, to stop my wife from sticking her tongue in my ear if I wanted to avoid ear infections), but so far his diagnoses and prescriptions were spot on, at least when it comes to physical illnesses. Not sure how well he's equipped to deal with mental health though.

There's an even better GP by the name of Dr Jim Kafiris. I came across him in one of my workplace bullying cases, he has an interest in psychology. From what I read in my client's file, he seems compassionate and competent. But he may be hard to get a consultation as I'm not sure whether he has a fixed office and may only do private onsite consultations.

I actually took a Paxil prescription from a GP and was then referred on to a psychiatrist who monitored my progress and renewed my prescription as required (it worked out so no different meds were required). When I was referred to a psychologist, it was specifically due to a desire for treatment through counseling. Anyway, it seems like my experience was pretty different from others, so it's a bit confusing for me.

Oh no Bf, wasn't work related at all which made it one hell of a non-sequiter from where I was sitting :p

Re: manly, my immediate thought was that DS's guy is taking this guy too seriously

https://www.google.com.au/search?q=d...

https://www.mantherapy.org.au/

I am a manly man!

I'm not sure what it means that I literally laughed out loud at the car parking.

I start my new job at the company where I'll actually get to code on Monday.

IMAGE(http://cdn.meme.am/instances/50627523.jpg)

DSGamer wrote:

I start my new job at the company where I'll actually get to code on Monday.

IMAGE(http://cdn.meme.am/instances/50627523.jpg)

Huzzah!

First day of the new job was great. Everyone was super nice. Unlike the last place I was pulled out to lunch on my first day, which is pretty important as I'm a bit of a loner, left to my own devices. The work seems like a good fit and I was already coding today. A co-worker used the word "ta" (which is slang for "thank you") out loud today and that tickled me.

Someone at work shared this to me. Not sure if this is old, but I thought it was really funny.

Was it 'ta love'? Those 2 words usually go together.

DSGamer wrote:

First day of the new job was great.

Glad to hear it!

m0nk3yboy wrote:

#2 I would chalk that up as a very awkward attempt at validating your decision to taper. Given the above "blokey-bloke" reference, and also not knowing how an American might read other cultural references, it seems to me, at face value, an awkward misstep. Importantly, it's one I'd consider giving a Mulligan to, if this is the first GP who's actually listened to you, and is responding to your consult in a way that you found encouraging.

+1. Australian culture is unhealthily stoic, we even have a day to remind people to ask each other how they're doing. Having that kind of conversation is extremely brave by Australian standards. He was probably hyperaware of the communication differences between the two cultures and just misjudged what to say.

That video was hilarious! "I'm mid-stream!"

Congrats on the new job, DSG!

That's good news!

By the way, there's music playing over a speaker at my new job. I think the Aussies on this message board were lying about this not being part of their work culture. The music is better here and the job is great so far, though, so I can live with it. Just saying...

Sonicator wrote:

+1. Australian culture is unhealthily stoic, we even have a day to remind people to ask each other how they're doing. Having that kind of conversation is extremely brave by Australian standards. He was probably hyperaware of the communication differences between the two cultures and just misjudged what to say.

Ah. I think that's something I've certainly learned that I underestimated. I knew it would be different, but I think I naively assumed since we all spoke English that it wouldn't be *that* different. I'm learning now, obviously. Thanks for the help.

I can remember the last workplace that allowed me to have a radio on. It was in 1998 at a government department. Nothing since then has had it.

However, my wife is an accountant and they *always* have the radio on.

25 years in a design studio environment, and we always had a radio on, usually stuck on tripleJ for the majority of the time.

My (home) office has Pandora running all the time.

I can't do work that requires mental focus with the radio on (as I end up focusing on the songs instead of the work), so I'm glad my workplaces were quiet in that respect, and people who wanted radios could use headphones. I suppose some sort of meditation music might be okay though.

I stick by my statement! The last job where music got blasted outside headphone space was as an inventory controller at Borders 15 years ago. Since then I've done time in the public service & private enterprise across the research, brokerage, mining, travel & charity sectors and can't recall a time when it was acceptable. Lots of devs, designers and miscellaneous creative types with earbuds in but no speakers... Sounds like I might just have been super lucky though

DSGamer wrote:

Ah. I think that's something I've certainly learned that I underestimated. I knew it would be different, but I think I naively assumed since we all spoke English that it wouldn't be *that* different. I'm learning now, obviously. Thanks for the help. :)

No worries - I made exactly the same misjudgement when I went to work in the US