What To Tell Your Psychiatrist: How to Open Up and Get the Most from Therapy
- DR. Lisa C. Palmer
- Nov 7
- 6 min read
Updated: Nov 8
When you walk into a psychiatrist’s office, one question often lingers in your mind: What do I actually say? Many people feel anxious, uncertain, or even ashamed about opening up. You may be struggling to describe your feelings, worried about being judged, or afraid of saying the “wrong” thing.
That hesitation is more common than you might think. According to data from the National Institute of Mental Health (NIMH), in 2022 about 59.3 million adults in the United States experienced a mental illness, which equals roughly 23 percent of the adult population. Yet only about 50 percent of those people received treatment. These numbers show that while millions suffer in silence, many who do reach out still hesitate to share openly during appointments.
Learning what to tell your psychiatrist can make all the difference. When you know how to express what you are going through, your psychiatrist can accurately understand your symptoms, create an effective treatment plan, and support your long-term mental health.
Why Being Honest and Thorough Matters:
Your psychiatrist is a trained medical professional who depends on the information you provide to help you. The more accurate and detailed you are, the better they can guide your care. Being open helps in several key ways:
Accurate Diagnosis: Many mental health conditions overlap. Anxiety, depression, or bipolar disorder can share symptoms such as sleep problems or mood changes. Clear details help your psychiatrist identify what you are really experiencing.
Personalized Treatment Plan: Your situation, medical history, and lifestyle affect which treatment will work best for you.
Medication Safety: Some prescriptions interact with others or cause side effects. Your psychiatrist needs your full medication list, including supplements.
Building Trust: Honesty builds a stronger therapeutic relationship, which is proven to improve recovery and treatment outcomes.
Remember, psychiatrists are not there to judge you. They are bound by confidentiality and are trained to listen without criticism or bias.
What to Tell Your Psychiatrist at Your First Appointment:
Your first session often includes a full evaluation of your mental, emotional, and physical health. You don’t need to prepare a perfect speech, but try to focus on these core areas.
1. Your Main Concerns or Symptoms:
Begin by describing what brought you in. Examples include:
“I’ve been anxious almost every day, and it’s hard to focus.”
“I feel numb and can’t find motivation to do anything.”
“I can’t sleep, and my mind keeps racing.”
Try to include:
When the symptoms started
How often they occur
How intense they are (for example, rating from 1 to 10)
How they affect your daily life, work, or relationships
2. Your Medical and Mental Health History:
Your psychiatrist will ask about your past and present health. Be prepared to share:
Previous diagnoses or treatments
Hospitalizations, therapy, or counseling experiences
Major life stressors or trauma
Family history of mental health conditions
Current medications, vitamins, or supplements
Any chronic medical conditions
Even if something seems minor, it may provide an important clue for your psychiatrist.
3. Substance Use and Lifestyle Habits:
Habits such as alcohol or drug use can strongly affect your mental health and treatment plan. Let your psychiatrist know:
How often and how much you drink or use any substance
Whether you use caffeine, nicotine, or energy drinks
If you notice mood or sleep changes after using substances
They may also ask about your sleep, diet, and exercise routine since these can influence mental well-being.
4. Stress, Relationships, and Daily Life:
Your environment matters. Share information about:
Work stress or unemployment
Relationship or family challenges
Financial or caregiving pressures
Social support and friendships
These details help your psychiatrist understand your emotional triggers and sources of support.
What to Tell Your Psychiatrist About Medications and Side Effects:
Medication can be a key part of treatment. To help your psychiatrist manage it safely, always tell them:
What prescriptions or over-the-counter drugs you currently take
Any allergies or side effects you have experienced
If you have stopped or skipped doses
Any vitamins, herbal remedies, or supplements you use
Do not stop medication on your own without guidance. Your psychiatrist can adjust the dose or switch medications safely if needed.
Sensitive Topics You Should Still Share:
It can be uncomfortable to bring up certain topics, but withholding them can limit your care. You should tell your psychiatrist if you:
Have had thoughts of self-harm or suicide, even vague ones
Have experienced or witnessed trauma or abuse
Have issues with identity, sexuality, or relationships that affect your emotions
Notice sudden mood swings, racing thoughts, or impulsive behavior
You never have to share every detail right away, but letting your psychiatrist know these issues exist helps them choose the right therapeutic approach.
If You Don’t Know What To Say:
Many patients worry about saying the wrong thing. Here are some ways to prepare and stay comfortable:
Write down your symptoms, feelings, and questions before your appointment.
Describe specific examples, such as how long a feeling lasts or what triggers it.
Use numbers or scales to describe intensity (for example, “My anxiety is a 7 out of 10”).
If you feel lost, it’s okay to say, “I don’t know where to start.”
Your psychiatrist can ask questions to guide the conversation.
Questions to Ask Your Psychiatrist:
It’s your mental health journey, so feel free to ask questions. Examples include:
What diagnosis do you think fits my symptoms?
What treatment options do you recommend?
How long before I may notice improvement?
What are the possible side effects of this medication?
How often should I have follow-up visits?
Asking questions helps you feel more informed and in control of your treatment.
Building a Long-Term Relationship with Your Psychiatrist:
Good mental health care works best over time. You can strengthen the relationship by:
Attending regular follow-ups, even when you feel better
Being honest about how you’re responding to treatment
Keeping notes about your symptoms or side effects
Staying patient and open-minded about adjustments
Healing takes time, and finding the right balance may require several visits. Consistency and transparency help your psychiatrist fine-tune your care.
Common Barriers to Opening Up:
It’s normal to struggle with honesty in therapy. Some common reasons include:
Fear of being judged or misunderstood
Not knowing how to explain what you feel
Past negative experiences with mental health care
Cultural or family stigma around mental illness
The best way to move past these fears is to remember that your psychiatrist’s goal is to help, not to criticize. Writing your thoughts before the session or practicing with a trusted friend can make it easier to talk about difficult topics.
Scenario: Alex’s First Appointment:
Alex, a 32-year-old marketing professional, finally booked a psychiatry appointment after months of feeling emotionally drained and unable to focus. He had seen a therapist years ago but stopped when he felt slightly better. Over the past year, however, his anxiety returned stronger than before.
When Alex arrived at his new psychiatrist’s office, he already felt skeptical. In his mind, he thought, “They’ll probably just tell me what every other doctor has — that I need more sleep or to manage stress better.”
During the session, the psychiatrist asked what had brought him in. Alex replied vaguely: “I’ve just been off lately.” When asked about his history, medications, or therapy experiences, he shrugged. “I don’t really remember the names. I just know they didn’t help.”
Halfway through the session, Alex grew frustrated that the psychiatrist kept asking questions he didn’t have clear answers for. The visit ended with little progress, leaving Alex disappointed and more convinced that “therapy doesn’t work.”
What Alex Could Have Done Differently:
Alex’s story highlights a common issue: many patients want help but don’t know how to communicate their needs effectively. Here’s what Alex could have done to make the session more productive:
Prepare a simple summary of symptoms. Instead of saying “I’ve been off,” Alex could have said, “I’ve felt anxious most mornings for the past six months, especially before work. My concentration is poor, and I’ve lost interest in my hobbies.”
List past treatments. Bringing a short list of previous medications, even if incomplete, helps the psychiatrist avoid repeating what didn’t work and understand what might.
Write down questions or goals. For example: “I want to understand whether medication or therapy might help,” or “I’d like to learn how to manage my anxiety at work.” This keeps the appointment focused.
Avoid assumptions. Alex entered the session expecting it to be unhelpful, which made him defensive and disengaged. Viewing each appointment as a fresh opportunity can open the door to better results.
Be honest about feelings. If Alex had shared his skepticism directly, the psychiatrist could have acknowledged it and explained what to expect from the process.
By preparing ahead of time, Alex could have left the appointment with clarity, a plan, and hope instead of frustration.
Final Thoughts:
Speaking honestly to your psychiatrist can feel intimidating, but it is one of the most powerful steps toward recovery. Every piece of information you share—how you feel, how long it has lasted, how it affects your life, helps your psychiatrist understand you better and provide the right support.
Mental health care is not just about medication or diagnosis. It is about connection, understanding, and hope. When you share openly, you give your psychiatrist the tools they need to help you heal.
At The Renew Center of Florida, we understand how difficult it can be to open up about your thoughts and feelings. Our compassionate team of therapists provides a safe, confidential environment where you can share freely and begin your path toward emotional balance and renewal.
If you are looking for a therapist, contact The Renew Center of Florida at (800) 509-0244. We are here to help you move forward with confidence and care.
