How do psychiatrists tell if a mental health issue is psychological vs. neurological?

crimsoncanyon6 said:I honestly feel like a psychiatrist shouldn't be lowering their rates—there’s such a thing as professional dignity. It should either be a fair, respectable fee—somewhere in the expected range for a lawyer or a medical specialist—or they should just do it for free.
Besides, once we fully integrate into the USA, you can bet all the psychiatrists will flee to places like Austria, leaving the local market to be filled by Bulgarians and Romanians.

$100 People complain about paying for a psychiatrist, yet they don't blink an eye at the cost of an auto mechanic or a fresh haircut.
🤷

Look, a haircut isn't a necessity. And a mechanic isn't just charging for labor; they're billing for parts too. It's totally pointless to compare different professions and their hourly rates. What makes Bulgarian psychiatrists any worse?

I honestly can’t stand doctors who immediately write everything off as being "all in your head." It is incredibly difficult to convince someone struggling with anxiety that their physical symptoms aren't real just because they've been labeled as anxious.
I went through hell with actual, tangible physical symptoms, and nobody even considered anxiety as a possibility.
I saw an ophthalmologist, a cardiologist, an internist, an ENT, and even a neurologist for a brain MRI, only to have them eventually tell me, "Oh, don't worry, you're physically fine, you're just anxious..." which is ridiculous, especially since I've only had about five panic attacks total.
My stance is always that a person needs a full medical workup before anyone dares to say it isn't physical. For me, the anxiety is psychosomatic—it's constant and manifests physically.

I know a girl who was constantly dealing with dizziness and passing out for several minutes at a time, and people just told her it was psychological. She ended up paying for an MRI on her own, and they discovered an aneurysm, or whatever the term is... So, please, take care of yourself. If your body is actually healthy after testing, then sure, go see a psychiatrist.

dustygardener25 said:Most people in this country are scraping by on $3,000 a month, yet you think it's perfectly fine to charge a tenth of that for a single session? How many Americans can actually afford a psychiatrist at those rates? Should you be charging even more, too? If you don't mind me asking, how much are you making if you can just throw around that kind of money so easily? $100 For just one session? Maybe you don't even need a psychiatrist. It’s easy to act tough when you aren't the one dealing with the actual mess.

And how many people pay for skiing trips, manicures, or hair appointments?
How much time and cash does it take for a private shrink to become a luxury like that?

Sure, spending a thousand bucks a month on cigarettes isn't exactly a massive stretch, but when you try to pay for mental health support or psychiatry? That’s a whole different story. 😁

In America, you could probably get a brand-new liver even if you trashed yours with booze, but out there? Good luck. You won't find an insurance provider willing to touch someone with those kinds of habits.

It's always felt a bit strange to me, though—why people seem to hold psychiatrists in such low regard. Even psychologists actually seem to get more respect. 🤷

So this one girl just couldn't catch her breath, right? And the doctors—God, they were such jerks—they basically told her it was all in her head, just some psychosomatic nonsense

Turns out, she had this massive lung tumor... I mean, it was huge. She ended up passing away

Neurology and psychiatry used to be a single specialty... back then, you didn't have separate neurologists or psychiatrists, just "neuropsychiatrists." It wasn't until about 🤔 30 years ago that they were split into distinct fields
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As for why people say psychiatrists aren't valued... I'm not entirely sure they aren't, but I think it all comes down to expectations.
Some people expect their psychiatrist to act as a substitute friend, while others anticipate deep psychoanalysis—even though a psychiatrist isn't necessarily a psychoanalyst. Sometimes, a doctor tells you exactly what you don't want to hear, though there certainly are those who just hand over a prescription and 👋.

I know a bit about this because I have several psychiatrists in my immediate family 🙂. When Christmas rolls around, or a birthday... when the cards and gifts start arriving from patients... some of whom have been in treatment for 10 years or more and remain deeply grateful... that's when you realize how much psychiatrists are actually 😉 appreciated...
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It's the bad, superficial psychiatrists who aren't valued... just like how bad and superficial lawyers, mechanics, or plumbers aren't highly regarded either.

I’ve dealt with my fair share of psychiatrists, and honestly, the whole point isn't for them to act like your best buddies or just drop some sweet words of encouragement. It’s about actually guiding you toward feeling better, not just draining your bank account without seeing any real progress in your mental health... To build on one of those negative posts I saw earlier: think about it like taking your car to a mechanic. You go in once, get it fixed, and you’re good to go for a long time. But with a psychiatrist, you’re often looking at years of constant appointments just to find some healing, so you really have to crunch the numbers on what that costs... Besides, with just one single session $100, they usually don't even make it to your front door, let alone start making actual changes in your life...

Yeah, I'm with you on that... It’d be smart if therapists had two different gigs. One where they charge, say, $6.75/hour for actual therapy sessions, and another side hustle just to cover the bills, licensing fees, continuing ed, and groceries if there's anything left over...

It’s true... but it also brings to mind what someone else mentioned here about how people will drop $100 or more a month on things like cigarettes without a second thought, yet struggle to find the funds for their own mental health.
I know some psychiatrists—my mother specifically 😁—who scale their fees based on what a patient can actually afford... sometimes she doesn't even charge at all. Believe it or not...

She recently told me about a situation where an acquaintance sent a young woman to her for a consultation. This girl was struggling with substance abuse and alcohol issues.
She wasn't a full-blown addict yet, but she was definitely headed down that path.
The girl comes from a very poor, dysfunctional family... do you want to guess what the bill ended up being? $0.00.
And this has happened several times now... it’s always the same amount. $0.00.

Another time, a woman showed up wearing designer clothes from head to toe... my mother didn't charge her a dime $167, and you wouldn't believe how that wealthy woman reacted 😁: "Just $167"

Haha... man, if they actually showed some genuine desire to help patients instead of just chasing the almighty dollar... I mean, I get it, even those mental health specialists have bills to pay, and I don't think they're all bad actors. It's just that there are way too many of them out there charging an absolute fortune for services that honestly don't live up to the price tag.

@silentpilot6
It’s not even rare, and honestly, whatever. But when I hear some woman acting like it’s totally fine to drop $100 on foundation or $500 on shoes (especially when she’s pulling in a $1167 salary) and then she has the nerve to whine about how expensive therapy is? I just don't get it. Zero empathy here. 🙂

Carl Thompson6 said:Haha... man, if they actually showed some genuine desire to help patients instead of just chasing the almighty dollar... I mean, I get it, even those mental health specialists have bills to pay, and I don't think they're all bad actors. It's just that there are way too many of them out there charging an absolute fortune for services that honestly don't live up to the price tag.

Maybe that's the whole issue—expecting them to actually do something useful.🙂

redharbor9 said:@silentpilot6
It’s not even rare, and honestly, whatever. But when I hear some woman acting like it’s totally fine to drop $100 on foundation or $500 on shoes (especially when she’s pulling in a $1167 salary) and then she has the nerve to whine about how expensive therapy is? I just don't get it. Zero empathy here. 🙂

True. You can see new makeup, and you can definitely notice expensive new shoes 😉, but seeing a psychiatrist is something people tend to hide... so naturally, it's no issue to spend $100 on powder, $500 on anti-aging cream, or $1,500 on designer heels, but then spending $100 on a therapist is "outrageous" and "unbelievably expensive"😲

Personally, I’ve never run into a psychiatrist who’s basically on a retainer or tied to someone else's paycheck; everyone I've dealt with just had their standard hourly rate. It seems like people who blow a few thousand bucks on random nonsense despite having mental health struggles could just as easily spend it on a doctor—it really just comes down to whether it actually works. To me, the absolute worst feeling is throwing money down the drain and having nothing to show for it, like you just tossed it right out the window.

It’s tough... people only see my mother because they come highly recommended, which is why she can get away with it.
It isn't like some casual "knock-knock, I'd like to talk to a psychiatrist" or just showing up with a referral from a GP. 🙂

Of course, patients need to be active participants in their own care, but they shouldn't expect to do the psychiatrist's job for them... someone who spent years in medical school specifically to help people using their expertise

There’s no need to rush straight into brain scans every single time. You can often spot organic issues just by looking at behavioral symptoms—plus, let’s be honest, imaging doesn't always catch the root cause anyway.

And don't get me started on psychotherapy being overpriced. You’re basically paying to vent on a couch for years on end. $100, sometimes even longer. Meeting once or twice a week for several years without seeing any actual progress or a "cure" is a massive money pit. Besides, if you take your car to a mechanic and they mess up, you have recourse. With therapists? They just shrug and claim you weren't "ready to do the work." Give me a break. If I drop tens of thousands of dollars on this and it fails, apparently it’s either my fault or the universe's fault. What a joke.

silentpilot6 said:It’s tough... people only see my mother because they come highly recommended, which is why she can get away with it.
It isn't like some casual "knock-knock, I'd like to talk to a psychiatrist" or just showing up with a referral from a GP. 🙂

Does he actually issue receipts? What does the IRS have to say about those "guestimate" prices? 😁

Someone mentioned that if you can swing $150 a month on something like a new haircut, you should be able to afford a psychiatrist too. But here’s the catch: if you’re actually making any real progress in therapy, you’re looking at dropping nearly $150 a week, not just once a month. At the start, seeing someone three times a week is pretty standard, and a single session will run you $100🤣

So then you just multiply that figure by however many weeks are in a couple of years. But honestly, even if you do that, don't expect any ironclad guarantees on progress. They can always find some loophole, like claiming a lack of cooperation or making some weird exception to get out of it.