Pcp Doubts My Psychiatric Diagnosis

[Chava]

Sorry, that sounds awful. Yuck. I like my doctor, though she is clueless in some ways. I don't tell my doctor too much but I get the feeling she somehow "gets" it or has had enough education on trauma stuff (she knows some of my psych stuff, hard not to because her main focus is treating patients with eating disorders). She doesn't make it into her specialty or meddle with my psych stuff...she even respects my leaving the therapist she referred me to so I could try a somatic approach outside of the clinic. She doesn't know much about that approach but asks how it's going. Anyway, I think she's abnormally patient and open-minded. It's important I feel okay with my doctor. Some appointments are hellish even when I feel totally okay with the doctor (I am done with the separate Ob/Gyn floor of the clinic...arrrrgh).

I still don't talk to my doctor about trauma stuff because I don't trust anyone to respond well or help me if I feel overwhelmed. Honestly, I have a bad habit of telling my therapist too much via e-mail (indirectly, from the safety of my isolation)...and I feel like I trust her, or at least relative to others. I'm speaking here from inside a shell that I like very much!! I think it's good if you are seeking ways to interconnect your care...it's important to clue your doctor in to psych things (and clue therapists in the medical stuff). If your doctor responded by shaming you, please get a new doctor. I don't know exactly how it went down, but the silence initially doesn't sound right either.

 

[greenleaf]

@change -- I agree with other folks that changing your doctor is a good idea.

I would go even further... I think it's a crucial thing to do for your health!

Aside from the bad impact on your PTSD issues of having someone invalidate you, your PCP needs to be capable of coordinating your physical health care. This person is just plain not competent to treat you.

It might not make a huge difference right this second, but you might have a physical issue in the future where your PTSD would change the care you should be getting. So it's important to have a doctor who accepts all your diagnoses like a rational sane being instead of letting whatever issues they have interfere with your care.

Oddly enough, a condition that causes dysregulation in large parts of our brains and endocrine systems, actually affects our health in serious ways sometimes, irrespective of other things that the trauma may have done to us! I bet you're all like totally shocked about that. There is, like, all sorts of official research and stuff, like.

 

[catjudo]

My primary doctor knows my diagnoses, what medications I'm taking and who my psychiatrist is. She needs this information. Knowing my diagnoses helps her know how to best approach certain things with me. She's able to see when I'm more anxious than usual and can adjust how she interacts with me that day without a lot of probing questions that would just make me even more anxious. She knows I have a trauma history...this effects her approach, what she says and how she interacts with me leading up to and during a pelvic exam. She does not know the details of my history, that isn't necessary. Knowing what medications I'm taking allows her to make sure that she doesn't prescribe anything that would have an adverse reaction with my existing medications. Also, knowing what psych medications I take she checks in with me periodically to make sure that my psychiatrist is doing all of the blood tests that she would like done and as often as she thinks necessary. Even though my psychiatrist is really good about blood tests, occasionally she'll decide she wants to run a couple of extra tests just to be on the safe side based purely on what psych meds I'm taking.

A recent example of why I think it is important to have a primary doctor who is understanding and accepting of my mental health issues-- I've been struggling with a pretty severe depression for awhile now. Along with that was a period of significantly increased anxiety and some panic attacks. I had a couple of physical symptoms that I knew had to be related to my anxiety but there was no real way to prove it to myself. Just telling myself that the symptoms were probably nothing just wasn't working. The anxiety was causing physical symptoms but not being able to prove to myself the symptoms were caused by anxiety was making my anxiety worse...it was a vicious cycle.

I finally made an appointment with my primary doctor. I lied to the office staff about what the appointment was for...it's enough that my doctor knows how crazy I am, I didn't want to share that with the receptionist, med assistant, etc. When my doctor finally came into the room I immediately apologized for lying to her staff and told her I didn't want everyone to know how crazy I was. I apologized to her because I felt like I was wasting her time. And then I explained my symptoms and told her I was sure they were probably anxiety related but I needed her to check things out and tell me everything was okay. I kept apologizing over and over again.

And do you know what my doctor did? She kept reassuring me that I wasn't wasting her time. She understood why I had told the receptionist a lie about what the appointment was for...she didn't care. She checked the things I needed her to check. She made sure she did a thorough exam so as not to miss anything even though we were both reasonably sure there was nothing to find. I felt like she took time to do a thorough exam and so when she told me everything was okay I had every reason to believe her. It wasn't like she just rushed through to humor me and get me back out the door (which was what I had been afraid would happen). She was absolutely sincere when she told me that the things I was experiencing were real. Just because I was dealing with anxiety and mental health issues did not change anything. If I was feeling them then they were real and I shouldn't hesitate or apologize for coming to see her.

These would be my reasons and examples of why it is important to find a primary doctor who who is open-minded and understanding. Seeing a doctor who tries to pretend my mental health diagnoses don't exist just wouldn't work for me. I need a doctor who sees me as an individual and provides care that is appropriate for my needs. That can't really be done if they refuse to acknowledge your PTSD.

 

[Lucycat]

She understood why I had told the receptionist a lie about what the appointment was for...she didn't care.

is it common practice to have to tell a receptionist why you need an appointment? I have never come across that before.

 

[Notsowild]

My doctors receptionist always asks what the appointment is for. I assume it is to know who much time you'll need for scheduling other appointments. Kind of nosy if you ask me. I'm sure you can say its personal though.

 

[JEKBreatheandBelieve]

@Lucycat - I always have to state the reason for my visit as well when making an appointment.

 

[Chava]

I know without an appointment scheduled ahead of time I can't just get in...but I can get in sometimes short notice if I have a lot of pain. Many docs have a tiny bit of wiggle room, or space where an appointment was canceled. The assistant/scheduler is usually the one making that judgment though. Also they probably do more of the insurance paperwork than the doctor does. But I have had lots of pain stuff lately and have been willing to get in with almost anyone. When a nurse or scheduler hears what I'm going through, she can find a way to get me in within a couple hours (hope that part is better now though). An assistant of some sort is probably less about being nosey and more doing her/his job in some way. But they have privacy rules.

Anyway, agree it's helpful for doctor to be aware of mental health stuff. Both of my doctors are pretty sensitive, gentle, patient with lots of questions or concerns. And they understand my body is hyper-sensitive to some forms of pain and stress, without judging me for it or making me feel weak.

 

[KwanYingirl]

Yes, @Chava docs should be a wellness team. I have learned how much my body has suffered due to my depression and PTSD not to mention medication management. Keeping an eye on my liver and brain. Western medicine needs to embrace the mind-body connection if they want to seriously improve people's functioning. I know people don't want to be told their body problems are all in their head, but YES!!-the body knows the score and it manifests our trauma memories. That causes a cascade of mutisystem dysfunction. Move the body towards the light and the mind will follow.