thanks, I just encounter so many MSers in my journey who have easily treated problems not getting treatment, because they don't get to visit the specialist most well versed for what their problem is, and the other doctors often don't think to refer them, precisely *because* they often don't have psychiatric (mental illness) issues. Psychiatrists (especially neuropsychiatrists) treat more than mental illness, they also treat developmental problems (think autism, ADHD etc etc) and prescribe medications for a multitude of other things that involve visible changes to the structure of the brain including injury, stroke or degenerative issues, IF they are neuro-specialized.
Nerve pain, fatigue, and other CNS dysfunction meds in MS, these are not considered psychiatric medications. I'm referring to neuropsychiatry as it relates to CNS-acting medication for structural brain changes completely unrelated to psychiatric meds. E.g., Gabapentin is a epilepsy medication, used off-label for nerve pain in many conditions such as trigeminal neuralgia, diabetic neuropathy, MS etc; modafinil is a narcolepsy med, used to reduce fatigue and sleepiness in MS; some SSRIs/SNRIs are used for nerve pain in multitudes of conditions also, and often completely unrelated to depression.
Thinking of neuro-specialized psychiatrists as prescribers of only psychiatric meds, can be a very real barrier to MSers getting effective symptom-management treatment. So I like to advocate and clarify what was explained to me, and is explained to many MSers at our MS clinic. We have a wonderful neuropsychiatrist, he also does all the evals for cognitive impairment too. Funny enough, it's the nurses and neuros that screen for depression at our MS clinic, not the neuropsychiatrist.