Overcoming the feel of Stigma in the doctor's office either real or imagined

[Jesse910]

Quite a few years ago, I decided to get rid of my psychiatrist and was able to find an internist willing to assist me with medication needs. It has taken me a long time to trust him, but I have come to view him as a very compassionate person who does not judge me for being bipolar. However, each time that I visit his office, I am reminded that I am bipolar by his staff. The other day, I had a visit and I watched as the nursing assistant called up my chart and read it. I felt violated and I wanted to swat her. It felt like a complete invasion of the most sensitive material within my life. Afterwards, she turned to me and stated that she wanted to go over my medications. I told her no and asked her to leave. Following my visit, I was given a copy of the printout the assistant had reviewed and I just wanted to crawl under a chair. My entire history of all complaints and ailments including the bipolar and depression stuff was listed. Later, I had an appointment with my therapist and I asked her straight up if she viewed me as a "real person" or as someone who is bipolar. She told me that she has always viewed me as a real person for which I was grateful.

I would like some handles on this because it's bugging me that I cannot work myself past this sense of feeling different. Outside of my doctor and therapist, my husband and a very select group of people know of my situation. I am not proud of it. Thank you.

 

[forgetmenot]

I understand Jessie i feel very uncomfortable in doctors office just knowing they all know the secretaries and probably the other doctors and it hurts really

I am glad your therapist sees you as a real person not your label hun wish more professionals were like your T hugs

 

[Jesse910]

Thanks Forgetmenot. I raise this issue not only for myself, but also for others who frequently encounter it. I'm just wandering if someone has found a way to deal with it in a good way that doesn't continually draw attention to us. After I started this thread, it occurred to me that I could have ask the assistant to not open my records and tell her that I would take the heat for her not doing her job.

 

[forgetmenot]

Could we not ask that the only one that sees our health records is the primary doctor could that not be written in an agreement with the doctor we chose I don't know it would be good if that was the case

 

[sunflower]

Hi Jesse,
I have the same situation. I use my regular doctor for psychiatric medication. Each time it is protocol for the nurse to do the intake. To ask about the medications and symptoms etc. Improvement, same, worse. etc. Then the doctor comes in for 10 minutes. It is the hospital and insurance protocol. To save money put the intake on to the nurses etc. Medical factory, in a way.

Once I told the nurse I would talk directly to the doctor. The doctor did not appreciate that. Because I did not comply with the protocol. I very much like my doctor. But the days of any sort of confidentiality between doctor and patient are history where I live, in the US. I do not know what it is like in Canada. It does feel violating. But I accept that this is the nature of medical care in current times. Its sort of a health care factory So I detach from the process. I do have to admit that I dread going there. But I am grateful for my doctor. I just detach from the process while assuming that the people in the office see all sorts of things and people. And the diagnoses are not meaningful to any of them. If the doctor is good then thats the important thing.

I am glad that you like your practitioner. BTW, some very amazing and wonderful people live with bipolar. I am sure you know that. Jane Pauley is one of them. I do understand though the stigma that is way too often associated with mental illness.

 

[Jesse910]

Sunflower, I also live in the U.S. Your comments re insurance is something I had not considered. Yet, I do not allow the nurses to take my vitals because it makes me very uncomfortable. And, after this recent visit and because I'm allowed to contact my doctor via email, in the future, I will continue not to discuss medications with the nurses. I firmly believe that patients should have the freedom and permission to clearly state how they wish to be treated. Bipolar does not and will not define who I am.

 

[sunflower]

Jesse, you write that Bipolar does not define and will not define who you are. I totally agree with you. None of us is a diagnosis. None of us is the conditions that are our challenge. I greatly admire your determination to require the bounderies you consider to be so important. I think it does speak to an inner strength and respect for your own bounderies and requirements.

 

[Jesse910]

Thank-you Sunflower. At times, I feel that I make more of a big deal out of protecting myself than necessary. However, I'm not comfortable campaigning publically against stigmatism.

 

[sunflower]

Jesse, I think that for many people the "big deal" has a core history of societys judgements. And so it can be quite painful. The seeds of society's judgements often take root within us. For very understandable reasons.

Perhaps Just like with abuse, once it has happened, the person becomes on guard for when it will happen again. So there may be a commonality with society's judgements regarding mental illness, and abuse. Once it occurs we become on guard for when the next "blow" will come. Perhaps that does make it a big deal. yes? "Campaigning against stigmatism" is not a comfortable thing for many. Certainly myself included.
:flowers:
Reminds me a bit of a TED talk I heard online. Someone named Kevin Breel. The TED talk titled: confessions of a depressed comic. He talks about stigma and how society views mental illness. Depression in his case. And how it made things worse for him

 

[Jesse910]

Sunflower, thank-you again. Your words help me to feel less vulnerable and more empowered. I want all of us who deal with mental illness to find a healthy way to stand up for ourselves as we live our lives.

 

[cswhitchurch]

Hi Jesse, I just wanted to add my two cents to this discussion, although I recognize that we probably have different comfort levels and completely respect that.

I hope you don't take this question to be attacking or belittling of your concerns-- I don't mean it to be at all, but realized upon typing it that it could be read that way... What keeps you from returning to a psychiatrist (a different one, if you didn't like yours before) for your medication management? I am sure your internist could provide you with a referral. I ask because, as sunflower noted, most primary care practices have a standard protocol that they follow. I'm not suggesting that you are wrong for not feeling comfortable with this protocol-- but it sounds like the staff have treated you like they would any other patient they see in their office... am I wrong? To me, that would be a good thing. Going over the list of medications is standard procedure to ensure their files are accurate prior to the doctor seeing you, no matter what you are being seen for, because it is important to know what you are taking in case of a medical emergency or any need for treatment while you are in the office. To be honest, many nursing and medical assistants who work in primary care offices might not even know what your medications are for-- they are often not very familiar with psych meds (I have had to spell names of medications for them on more than one occasion). Their job is simply to record/verify that the medications they have in your file are accurate. My reason for mentioning these things is not to belittle your feelings of discomfort-- I hope you don't take it that way! But that's why I ask what keeps you from seeing a psychiatrist for your med management-- because it sounds like you are just more comfortable with how things are handled by a psychiatrist's office than by a general medical practice-- and that is completely valid.

 

[Jesse910]

Hi CS:

Glad to hear from you. And, I'm not uncomfortable with your questions. Initially, I had two bad experiences with psychiatrists - one who humiliated me and made me feel as though I would always be "sick" and the other who talked about how crazy her father was during a session. I realized she was venting because she was worried about her mother's safety. However, the fact that she kept harping about the "craziness" of her father, made me wonder how she felt towards me. Also, I got anxious each time I visited due to the hospital setting, the name of the department on the main door, intrusions of the receptionist, and the security guard.

A dear friend turned me onto my internist who is very compassionate person and I feel reasonably safe with him as a doctor. He gets the fact that privacy is a huge part of my life and that I wanted to be treated like everyone else. He was also a witness to what I am like when I'm triggered by a woman. I was molested by a woman when I was a kid. Being in a room alone with a woman is still very scary for me and it takes me a while to recover. Again, my doctor gets that. Now, here comes the oddity, my therapist is an older woman and while she scares me at times, she and I have a long history. She got me through the loss of my mother and in many ways, she's the surrogate "good" mother I never had. And, in spite of my fears, I have found a way to be myself most of the time with her. Because of therapy, I am now able to interact with some women on a limited scale and always in a group, but never alone.

 

[Bumblebean]

Oh Jesse, I don't know how I'd react if something like that happened in my dr's office. The only time his nurse goes into my chart is to add something that's been sent over from the lab or to look up something specfic I've called to ask about. I don't know what the rules are regarding what a dr's staff can legally do or see regarding someone's file, but I think what your internist's staff are doing is so wrong To me it seems like such a violation.

My closest similar experience was a few years ago with a locum who was filling in for my dr and I had to go in for something - probably an ear infection, I don't recall. She ended up sitting with her back to me and pouring over my psych reports for nearly 20 minutes (I could see over her shoulder so I know it wasn't my imagination). Now what that would have to do with a simple infection, I can't guess, but I was so angry and humiliated, especially the way she was downright snotty to me after she finally came up for air, that I cried for days. I didn't mention it to dr or psych, and I wish now I had.

For whatever it may be worth, one of my cousins over in the UK is bipolar. He's a wonderful person and I love him to bits. I'm so proud of him for carrying on in life with that heavy burden, and over the past few years especially he's started feeling a bit of that pride himself, which makes me so happy to see. It's not conceit, just being able to give himself some credit. When I talk with him, I'm talking to my cousin, not his condition, and when I read your posts, I see a person (a real person) behind the words, not a condition.

:flowers:

BB

 

[wheelchairdemon]

Jesse910, you raise an excellent point.... how do doctors and other medical professionals view us....

My question has a twist on the same thing....

Can one be mentally ill and not even know it?

I ask this because, when I moved to a new city and tried to line up supports for a physical disability (I use a wheelchair), I was told I need to see a psychiatrist. I couldn't believe it.

To find out why they said this I finally got copies of my medical files. Sure enough, I was shocked to read that I have a bipolar disorder, several personality disorders, and a somatization disorder.

No one ever told me I was sick, I was never referred to a psychiatrist, and I was never prescribed any medication.

I used to be in the "system" way back in the 1990's and before, but I left it all behind when a Family Doctor provided positive support and successfully tapered me off all my medications. As soon as I got off the medications and was around someone who was positive and motivating, my brain woke up and I never looked back.

I've been living on my own and functioning very well for years. I've even been able to hold jobs, some part-time and one full-time. I live alone and am high-functioning despite the wheelchair, so it was a real shock to see I was deemed to be very sick by the medical and home-care support systems.

The down side of the labels has meant I can't get support for my physical disability. I'm told that the only way I will get it is if I admit That I have these mental illnesses. They said the patient is always the last one to know they are sick; that it's not unusual to find I'm in denial.

My head is spinning. When friends saw the medical files, and saw that one doctor even wrote down that I was a professional patient, they laughed. It was their shock reaction. They said you? You're more sane than anyone I know....

However, I can't eradicate the labels. No lawyer will touch it. They say it's impossible to prove I'm not sick.

I therefore avoid doctors. I'm more healthy that way. On those rare occasions when I must see someone, I feel too dirty and too full of self-doubt to speak reasonably. I've also lost all trust of doctors.

Has anyone else been labeled and then not told they were sick?

 

[PrincessX]

The down side of the labels has meant I can't get support for my physical disability. I'm told that the only way I will get it is if I admit That I have these mental illnesses. They said the patient is always the last one to know they are sick; that it's not unusual to find I'm in denial.

This sounds like some misunderstanding to me. I have seen the Canadian application, there are totally different sections on mental and physical functioning, meaning, one can be physically but not mentally disabled and vice versa. Must be some misunderstanding on your or their part? Also, it is the doctor or another health professional, not the patient filling in the details of disease, so if you are in denial or not should not make a big difference, according to the application.

 

[wheelchairdemon]

This sounds like some misunderstanding to me.

Sadly the problem stems from miscommunication alright. Something negative got added to my files that should never have been added. Then, the policy of the hospitals is to have doctors read old notes written by other doctors before they actually see the patient.

The doctors read the old notes, saw the mistake on my files, didn't know it was a mistake, and without seeing me (in response to a specialist's referral) replied back to the family doctor with a note saying it was their recommendation to send me back to a psychiatrist.

I'm sorry if this post got misunderstood as to its intent. The intent was to point out that it's mighty scary - and damaging - when a mistake gets into a file and then keeps getting carried forward inadvertently.

I finally had to use the Information and Privacy Office's sanctioned Lock Box to stop the error from being carried forward.

Things are cleared up now.

I shared the message so it could act more as a caution.

 

[PrincessX]

Thanks for the clarification. Mistakes happen everywhere.

This whole thread...presents doctors and "nursing assistants" in a pretty bad light. I am not sure if the first post talks about some administrative assistant or a nurse, which are different professions, but it sounds somewhat derogatory.

It is "them" and "us".

We are all human after all.

I understand the concerns about protecting private information. But, not all nurses and doctors are unprofessional.