Can College Counseling Centers Prescribe Antidepressants

<p>Okay, so I'll make this very brief because I know no one wants to hear me throw a pity party for myself.</p>

<p>I'm 18, and a freshman in college. I've been depressed since I was about 11 or 12 years old, and I think it's gotten worse just about every year. Right now my depression has become so bad that I have no ability to concentrate on anything. I miss class often and I can't even bring myself to read or study. The reason I do so poorly in school is that all I can think about is myself and how unhappy I am. Furthermore, I find that, because of my depression, I cannot really connect with anyone. I've made friends here, and yet I still feel lonely all the time. Like I go out with people and I feel just as alone as I would if I stayed in--if not more alone. I'm sick of this, and I really don't want to live this way anymore.</p>

<p>I've been through therapy twice before because my parents made me go, but I just really, really hated it. It did nothing for me. I'd like to maybe go on some antidepressants now. I was once prescribed Zoloft, but it didn't work, so I want to try another one. If I went to the counseling center at my school, would they be able to prescribe me medication? And would I be forced, then, to also undergo counseling? I really don't want any counseling. Talking about my problems, for some reason, seems to make me feel worse.</p>

<p>I first want to pipe up in support of counseling. Maybe you need a different sort of therapist than the one you had before. If there’s a chemical imbalance medication will help, but there’s a good chance of some underlying issues that a therapist can help you work through. For me at least, the best way to get back on track was a combo of medication and therapy.</p>

<p>As far as what your college can do this is going to depend on how they’re staffed. They either need to have a psychiatrist on staff or work with the school’s doctor (if there is one), because a psychologist cannot write you a script for anything. My college’s counseling center is staffed by trainees. If yours is the same, they’re hands are tied when it comes to medication. </p>

<p>If you have a regular doctor outside of school, you can discuss these issues, too. They may or may not feel comfortable writing a script, but I did get mine through my GP.</p>

<p>I just really don’t want to go to counseling. But how do I find out if they do prescribe medication? Do I have to go there and ask?</p>

<p>As someone who went through this last year, I would highly recommend counseling. Going to counseling for just a couple sessions helped more than 6 months on various doses of welbutrin and prozac. For the record, i and my psychiatrist agreed that there was no single underlying cause, and it was probably a chemical thing, but talking about things that made it worse really helped.</p>

<p>As for your counseling center, they probably can, or at least refer to a person who can. A counselor couldnt do it, but they are certain to have a psychiatrist on staff.</p>

<p>I had a terrible experience with a psychiatrist - sometimes you just get a bad one. There are different counselors with different insights, and you need to find one to fit what you are going through.</p>

<p>As for anti-depressants. Keep in mind that they /will not/ make you happy. They are mood neutralizers. They may keep you from being depressed, so as to achieve a normal or neutral mood, but they will not make you happy. That is where counseling may help - to find areas of your life to improve on to increase your own happiness.</p>

<p>Like someone said before, whether they prescribe depends on whether they have a psychiatrist on board. Or they might refer you to the college health center where a doctor/nurse practitioner or someone along those lines may be able to prescribe it. Or you can go to your regular family physician and see if they’ll prescribe you something.</p>

<p>Also, counseling doesn’t just have to be about talking about your problems. You could just go to someone and ask for advice on increasing your positive experiences at school. They may help you develop a plan for getting more involved in clubs and things that interest you, and chat about the outcomes. It doesn’t have to be all gloom and sob stories. I have a hard time talking about my problems too, but if I talk about where I can improve, rather than just the negative feelings or past experiences, then it can help.</p>

<p>Most counseling centers do not have psychiatrists on staff. (Well mine doesn’t). What they can do is refer you to a local psychiatrist who will evaluate you and make recommendations for treatment. (Health Services will do the same, most likely… They usually won’t prescribe anti-depressants period, especially if there isn’t a psychiatrist on staff- the liability can be too great). Unless you are in imminent danger of harming yourself, a referral is the first step to getting treatment (And if you feel suicidal, you need to seek emergency help- don’t hesitate). So make an appointment at the counseling center. </p>

<p>Also, a lot of insurance companies require referrals for psychiatrists, so check your policy.</p>

<p>It’s important for you to touch base with a professional in the mental health field as soon as possible, so that they can see what is going on and guide you in what to do next.</p>

<p>Speak to your parents about this and get their financial support and guidance (assuming your relationship with them is at least minimally positive). You want to do this right, and not cut corners. </p>

<p>You want a medical doctor, a psychiatrist, to evaluate your situation properly and carefully and then closely monitor your health while you are under his or her care. Psychiatric medications are not to be taken lightly, particularly for someone in your age group. </p>

<p>While you are waiting for the appointment with a psychiatrist, a psychologist is someone you should be able to access very quickly (either through your counseling center or privately nearby). </p>

<p>Spend some time on a search engine looking at the credentials of psychiatrists who are both close to your school (or at your school) and covered by your insurance. You could start with your health insurance company for this. Maybe your parents could also help in the selection, or maybe they could take care of this part for you.</p>

<p>I am sure I do not need to tell you this, but I will say it anyway. Go immediately to the counseling office if you feel that your situation is any way unsafe. If they are closed, talk to your RA or another trusted person if waiting is unwise.</p>

<p>Be very weary of people who prescribe medications without doing thorough testing first (unless it is deemed that waiting could be harmful to you, because in that case something may need to be done right away). You and your parents will be filling out questionnaires about the present and the past, so that a trained set of eyes can closely investigate what might be going on (and have a reasonable chance of nailing a diagnosis and medication match). So basically, this could take a little time before you get everything you need. </p>

<p>Usually after finding a good psychiatrist, you have to get an appointment. That can take a while (a month or two, or more). You may want to inquire of his office if there is someone else who you can call to do the testing. Some licensed psychologists do neuro/psych evaluations, and that can speed up the process. Of course, getting an appointment with those folks can take time as well.</p>

<p>BTW…Psychiatrists are usually doing medication management. Psychologists and licensed counselors are the ones you typically go to for counseling and testing (cognitive behavior therapy and that sort of thing).</p>

<p>Do not doubt that counseling can be very effective. You just have not found the right person or process to match your particular challenges. Don’t give up. There are problems that can be helped by medication that counseling could not improve, and there are also situations where medication is useless and counseling is a proven help. In a lot of diagnoses, both are needed for optimal outcomes. Go see some good professionals and hear what they have to say.</p>

<p>One more thing…While you are taking care of yourself by getting professional help, you can probably elevate your mood and energy through daily exercise (with a doctor’s approval), healthy food choices, vitamin supplements, and meditation. Don’t dismiss any of that. It works, and even if you end up on medication, it is something you always want to be doing as a part of managing your health for the long term.</p>

<p>You can just go to your usual family practice doc. Prescribing antidepressants is a pretty common thing for family docs. If they aren’t comfortable with it or think you’d benefit from a psychiatrist, they’ll tell you.
As far as getting a script at your college counseling center - they would need to have an MD, DO, PA, or NP on staff.</p>

<p>It is true that family docs can be seen for this, but the OP has described being unhappy with a previous prescription. IMHO, a closer investigation by a more highly trained professional seems warranted, someone whose background and more investigative methods would increase the chance of a better match. This is actually a good conversation to have with a primary care doctor, who could provide a reference to a psychiatrist if necessary.</p>