psychiatrists, neurologists, & other specialists

[jago45]

Aren't neurologists also psychiatrists? I'd mentioned before that I have depression, chronic headache, reflux, hypertension, and now chronic fatigue. My primary care physician suggested cutting back on some of the medications. Everything else is pretty well controlled now except for the fatigue, but the headaches still flare up occasionally.

The first neurologist I went to was of no help. There's one (of only two in the state) who specializes in headaches. Would such a specialist be able to deal with the psychiatric as well as the other problems I have?

Jim

[malign]

My understanding, Jim, is that neurologists and psychiatrists, while both being medical doctors, are different specialties. I don't think that most of them choose to certify in both disciplines. I believe that the former treat mostly physical ailments of the brain (like tumors), while the second deal mostly with medications for mental illness. So, they might overlap somewhat, and it might be useful to have a neurologist rule out physical issues in the brain, if those are suspected. But I would imagine that, of the two, the psychiatrist is more likely to be able to help you.

But that doesn't discuss non-medical mental health professionals, who at least for me, have been the most help. Therapists, who might be social workers or psychologists (different degrees, same basic training), have been more helpful to me, except when I was on medication.

[Luna-]

They're not the same thing. Neuros deal with physical nerves (cells) and the brain, organically, whereas psychs deal with mental symptoms, which may or may not be of organic origin. There is of course some overlap, eg epilepsy and headaches, and medications for these organic conditions are used by both. But a neuro does not do psychiatric things like depression, anxiety, schizophrenia, bipolar, chronic fatigue and psychs don't do any illnesses of the nervous system or most organic brain conditions except in as far as those conditions cause psychiatric symptoms. Headaches are really out of their speciality except that they know that some of the meds they commonly use, help headaches so if they're treating you psychiatrically, they will sometimes do headaches. (Some mood stabilisers/anti-epileptics can help some kinds of headaches.)

Reflux and hypertension are outside both specialities and only relevant (for them!) as far as avoiding medication interactions and any medication that may worsen these conditions. For eg I have hypertension which is treated by my GP and the psych avoids meds which increase blood pressure. I saw a neuro for headaches once, at the headache clinic but that was only to rule out any neuro (physical) origins of the headaches.

[jago45]

Thanks for everyone's thoughtful replies. The problem as I see it is that I have four major medical problems, and I don't want to have to keep going to four specialists. It was my primary care physician who initially treated the depression and pain. Some antidepressants are used in the treatment of chronic headache. All the neurologists I looked up also listed psychiatry as a specialty, but I found one who specializes in headaches. That was why I thought she might be be more comfortable adjusting the antidepressants if necessary.

My psychiatrist had also recommended a neurologist, but the first one I went to wasn't helpful. The pain doctors are usually not psychiatrists and don't seem to deal much with headaches.