What kind of clinic is a psychosomatic medicine department? From the differences with psychiatry to the flow of consultation | Answering your questions
Hello. I'm Hiro.
Are you thinking, "Maybe I should go to a psychosomatic clinic," but finding it hard to take that first step?
I was the same way.
It's not like it's been confirmed that my mind is sick, and...
I don't know what they'll do to me.
Won't they just load me up on medication if I go?
I think those kinds of anxieties are completely natural.
In this article, I, who actually attend a psychosomatic clinic, will write honestly about everything from how to choose one and when to visit, to what the consultation is actually like.
What is the difference between psychiatry and psychosomatic medicine?
Let's start by clarifying this.
Even though they are both clinics that deal with the mind, there are actually differences.
The question, "Should I go to a psychosomatic clinic or a psychiatric clinic?" is something quite a lot of people have.
Psychosomatic Medicine
Specializes in conditions where physical symptoms appear due to psychological stress.They handle:
Adjustment disorder
Depression (mild to moderate)
Autonomic imbalance
Panic disorder
Insomnia
"My body won't move when I try to go to work," "I can't sleep," "I have no appetite."
These symptoms fall within the scope of psychosomatic medicine.
Treatment is provided by combining internal medicine approaches with psychological approaches.
Psychiatry
Handles all mental illnesses. It covers:
Schizophrenia
Bipolar disorder (manic-depressive illness)
Severe depression
Addiction
If symptoms are severe, or if you experience 'extreme mood swings' or 'a lack of sense of reality,' psychiatry may be more suitable.
If you have mental distress that manifests as physical symptoms, go to psychosomatic medicine;
if you have mood disturbances, go to psychiatry.
However,
in reality, they are almost the same.
To be honest, many clinics in Japan advertise both 'psychosomatic medicine and psychiatry'.
When you are unsure which one to visit,it is safe to use 'psychosomatic medicine' as your entry point.
Once you have your consultation, the doctor will refer you to the appropriate department or hospital if necessary.
Psychosomatic medicine is not a scary place.
I often hear these concerns as reasons for hesitating to seek a consultation.
'If I go once, won't I have to keep going forever?'
'Won't I be forced to keep taking medication?'
'I don't want people to think I went to a psychiatrist.'
These are all misunderstandings.
A psychosomatic clinic is a place you can use with the same feeling as going to an internal medicine clinic when you catch a cold.
If your symptoms are mild, it may end in a short period. Sometimes it is handled only with counseling without using medication.
Just because you go, it does not mean anything is decided.
Just like going to a hospital when you catch a cold,
I think it is fine to have the feeling of visiting if you think you might be feeling a little unwell.
What to do at the first visit: Flow of consultation
I will write about the flow when visiting for the first time.
The flow I experienced and the general flow were almost the same.
1. Filling out the medical questionnaire
After reception, first you fill out a medical questionnaire.
Current symptoms (when they started, what kind of symptoms)
Sleep status
Appetite status
Work and life situation
Medical history and medication history
Please write honestly. There is no need to worry that "if I write something like this, I will be thought of as strange."
2. Interview with a doctor (first visit is longer)
The first visit often takes about 30 minutes to an hour.
Based on the medical questionnaire, the doctor will listen to you directly.
"When did it start?" "What happened at your workplace?" "What is the most difficult thing for you right now?"
In my case, when I talked about my interactions with Z, the doctor listened quietly while taking notes.
It is okay to be emotional. It is okay to cry.
Go ahead and let out everything you are holding inside—what you felt, what you are feeling, and why things ended up this way.
This is a place for that.
3. Explanation of diagnosis and treatment plan
After listening to your story, the doctor will explain the diagnosis and the future treatment plan.
In my case, this is what I was told.
"I understand. Please take a leave of absence immediately. I don't think you realize it, but you have reached your limit. It is dangerous to go any further."
When I heard these words, I cried for the first time.
Hearing the word "limit" from someone else's mouth made me feel like I had finally been given permission to rest.
This is just my case, but there are also times when you continue to work while visiting the clinic to see how things go.
Also, basically, they will respect your wishes.
The doctor is only providing their judgment, and if you want to continue working, they will respect that as much as possible.
Therefore, you will not be forced into anything.
4. Prescription of medication (if necessary)
Depending on your symptoms, medication may be prescribed.
Commonly prescribed medications:
| Type | Purpose |
|---|---|
| Sleeping pills/hypnotics | For symptoms of insomnia |
| Anti-anxiety drugs | To alleviate anxiety and tension |
| Antidepressants | To improve depressive symptoms |
| Mood stabilizers | To stabilize mood swings |
If you are afraid of medication, you can tell the doctor, "If possible, I would like to see how things go without medication."
In my case, I was a little resistant to taking medication.
In the initial stage, I was prescribed and took an antidepressant called mirtazapine, but the feeling of being too dizzy didn't suit me, so I told them I wanted to see how things went without medication from then on.
As you can see, it is a place where you can express your wishes, so you don't need to hold back.
What do you do during clinic visits?
Clinic visits after the initial consultation are shorter than you might think.
Each visit usually takes about 5 to 15 minutes.
"How have you been lately?", "How is the medication working?", "Are you sleeping well?"
These kinds of check-ins and medication adjustments are the main content.
If you wish to have counseling (interviews with a psychologist), many clinics require a separate appointment and often charge an additional fee.
How to choose a psychosomatic medicine clinic
Even when you decide you want to go, I think you might not know where to go.
I will write down the points I prioritized.
1. Close to your home or workplace
I feel this is the most important thing.
It is not realistic to keep going to a distant hospital when you are not feeling well.
Please look for one within a range that you feel you can manage to travel to.
2. Check if you can book an initial consultation
Psychosomatic medicine clinics are often difficult to book appointments at.
The first clinic I called also told me, "The initial consultation has a two-month wait."
Calling multiple clinics at the same time and booking the one that can see you the soonest is the realistic approach.
Some places allow you to register for a waiting list. If you tell them, "Please contact me immediately if there is a cancellation," you may be able to have your consultation sooner than expected.
③ Check reviews to see if they will listen to you
Please try checking Google Maps reviews or hospital review websites.
Choosing a place with many reviews saying, "They really listened to me" or "They explained things carefully," will lower the hurdle for your first visit.
Conversely, if reviews that say "They just gave me medicine and ended the session immediately" or "They didn't listen to me at all" stand out, you might want to consider somewhere else.
④ It is okay to change if it doesn't feel right
If you go once and feel like it's not a good fit, it is perfectly fine to switch to a different clinic.
The compatibility with your doctor greatly affects your recovery.
Just as there is the term "second opinion,"
there is no need to think that going to another hospital or transferring is a bad thing.
Finding a doctor who suits you is also part of the treatment.
To those who are hesitant about visiting
Finally, let me say one thing.
I went to a psychosomatic clinic the day after I felt like I couldn't go on anymore and ended up crouching in my entryway.
Until that morning, I kept thinking, "Should I really go to a psychosomatic clinic?" or "Maybe I'm just overreacting."
But it was only when the doctor told me, "It's dangerous to go any further," that I realized I had reached my limit.
The moment you think, "Maybe I'm still okay," is the best time to go.
Once you break down, it takes time to recover.
In fact, I was told that it is perfectly fine to go when you think, "Maybe something feels a bit different than usual," rather than waiting until you feel like you can't go on anymore.
If you have even the slightest thought of "maybe I should go," just searching for a nearby clinic on Google today is enough.
Let's have someone listen to you.
I think it's perfectly fine to feel that way.
That first step is the beginning of your recovery.
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Hiro