When Your Mental Health History Affects Your Medical Treatment
I think we need to seriously alter the way we think about the relationship between physical and mental illness. I think we’ve gotten, or are getting, to a point where most doctors acknowledge that there’s often a physiological cause behind a mental illness, or at least that physiological alterations can potentially contribute to mental illnesses. I believe that’s progress. But I think there are still serious issues with stigmas attached to mental illness and the impact that this can have on medical care.
In my experience, doctors have been sort of awful at considering that it’s possible for me to have both physical and mental illnesses. When a doctor can’t figure out what’s wrong with me when I go to them for physiological symptoms, they often give up trying to help me and jump straight to the conclusion that I must be mentally ill. And often when a doctor finds out that I have depression or anxiety, they immediately decide that there’s nothing wrong with me physically because they haven’t been able to find an answer yet — so it must just be all mental. There is still a huge stigma attached to mental illness in the medical community.
When I mention mental illness above, it’s in no way meant to be derogatory. I have both depression and anxiety, as I said, and I am by no means ashamed to talk about it. I also strongly believe that mental illnesses can cause or worsen physical symptoms, and vice versa. But what upsets me and what I feel is dangerous, is when physical symptoms are ignored and written off as mental illness without being investigated.
Let me give some examples of experiences I’ve had with doctors where this has happened:
My first rheumatologist told me all my symptoms were because I was, “just a stressed out teenage girl who can’t control her anxiety.” This was all said prior to her examining me or receiving the test results that made her take back her words. Of course, she didn’t apologize to my face, she just changed her notes to say it appeared that there was something autoimmune going on after all.
A second time was when I went to the emergency room before I found out I have chronic lung disease (COPD). I’ve never smoked and have no idea why I have it. I hadn’t been able to take a deep breath for two weeks, and after telling the nurse practitioner this, I was told I need to “see a psychiatrist and get my anxiety under control.” Again, all she had done was run like two tests, both things I’d already had done that I told her would be negative. You’d think breathing would be important. I went about another year struggling to breathe before anybody believed me and finally figured out I have something seriously wrong like COPD.
In the first example, I had been upset when I went into the appointment. I was 18, just starting college, finding out my life was likely going to change forever, and not in a good way. What 18-year-old wants to be visiting a rheumatologist? What 18-year-old even really knows what a rheumatologist does? Obviously I was upset. But because of my distress, she made an assumption about my mental state that set my journey to a diagnosis of a physical illness back.
In the second case, the nurse practitioner had seen in my chart that I had been on anxiety medication. Again, she made an assumption about me and neglected physical symptoms because of the stigma that having a mental illness still carries.
Being upset because I am in physical pain and scared doesn’t mean I’m mentally ill, and my mental illness doesn’t negate the presence of physical illness or my awareness of what’s going on in my own body. These assumptions can be extremely dangerous!
That being said, I, in no way, intend to minimize how much mental illnesses can affect a person holistically. I believe wholeheartedly that my anxiety and depression cause me added physical pain some of the time. But I’ve become good at recognizing the different kinds of pain I experience and at checking in with myself when I am in extra pain to figure out if I’m extra anxious or depressed for some reason. And for me, my depression and anxiety didn’t begin until after I became physically ill. Just because I have mental illnesses doesn’t mean I’m unaware of myself and my body. If anything, I feel that I’m probably more aware of myself than most people are.
A person’s physical suffering should never be written off and ignored because of their mental health history. I’ve even had medical professionals tell me to keep my mental health history private when possible when visiting a new doctor because it will impact the care I receive. That’s not OK! We should be past these prejudices against mental illnesses by now.
You know your body. Nobody else experiences what you do. You have to trust yourself and become your own advocate. If something doesn’t feel right in your heart, even if a doctor tells you “this is what’s wrong,” consider a second opinion. A doctor’s word isn’t the be all end all. They’re still human and can make mistakes. They also still have biases. So if you feel you’re being treated improperly by a doctor and not being respected because of your mental health, or for any reason, don’t be afraid to stand up for yourself.
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Thinkstock photo via Tharakorn