Thursday, September 6, 2007

Mental Health - A Proactive Approach

I decided to share one of the strategies that helped significantly, while on my diagnosis journey. I only wish that I had used this strategy earlier, because it could have saved me time in the end.

As I have detailed previously, I was told several times, by multiple physicians, that my symptoms were attributed to a mental health condition, such as depression, anxiety, and stress. This scenario occurred repeatedly for nine years.

In November of 2006, I decided that I needed to remove any physician’s ability, to diagnose my symptoms as mental health related. Therefore, I decided to do what these physicians did not. Using my medical insurance, I referred myself for an evaluation with a Psychologist. I intended to have an evaluation, in order for it to be made perfectly clear, that my mental health was not the cause of my physical symptoms. With my HMO plan, I do not have to have a referral from my primary care physician, in order to seek out mental health treatment. Therefore, my primary care physician was only made aware of my plan, once my evaluation with the Psychologist was complete.

When I met with the Psychologist, I outlined to him my reason for being there. I provided my complete medical history, so that he would understand the motivation behind my visit. Although my reason for seeing a Psychologist was to rule out mental health conditions, I entered into the process with an open mind and the understanding that I might not hear what I wanted. I had made the decision that if the Psychologist diagnosed a mental health condition that he felt was causing my physical symptoms, I would accept that diagnosis, and I would address the diagnosis appropriately with the proper treatment. I was not arrogant enough to ignore the slight possibility that my symptoms might be due to mental health issues, although I felt strongly that they were due to an unknown physical medical condition.

The Psychologist and I met weekly for a period of two and half months. During those visits, he asked many questions, in order to have as much information about me as possible. Some of these questions were about my childhood, my family life, work, and any other subject he thought would assist him with the evaluation. Additionally, he had me meet with a Psychiatrist, as an additional diagnostic source.

During this time, I had decided to go off Sinemet, because I was aggressively pursuing a diagnosis. I believe that the timing was beneficial, because the Psychologist was able to observe me when my symptoms were being helped with the Sinemet, and he had the opportunity to observe the difference while off Sinemet. It is my perception, that having the opportunity to see me under both conditions assisted him with his final diagnosis.

In January of 2007, the Psychologist informed me that he did not believe that further visits were necessary. He said that unless I just needed someone to talk to once I was given a diagnosis; there was not any purpose for future visits. He rendered opinions, one of which I was already aware of. He told me I had minor Obsessive-Compulsive Disorder that did not require treatment. Additionally, it was his opinion that I was suffering from minor Depression because of not knowing the cause of my physical symptoms, but not causing my physical symptoms.

Once the evaluation was complete, the first thought that came to my mind was “validation”. When I arrived home and told my husband about the Psychologist’s opinion, I broke down and cried. For so many years, I had been told I was depressed, anxious, or stressed, that I was suddenly overwhelmed by the magnitude of what this evaluation meant. For example, I now realized, without a shadow of doubt, that I had a physical medical condition that would eventually have a name to it. For so many years, I had been prescribed anti-depressants that were not needed. Additionally, for so many years I suffered through physical pain, which could have been avoided, had physicians not insisted that I had a mental health disorder. With this realization and validation, I gained new confidence, which has enabled me to be more firm when dealing with my most recent specialists.

Now when I see a specialist, if the subject of mental health issues is brought up, I let him / her know about the evaluation. I then offer to provide the contact information for the Psychologist who evaluated me. Not one specialist has felt it necessary to contact the Psychologist. I firmly believe that had I not proactively been evaluated, that it would have left the option open for any specialist or physician, to make an initial mental health related diagnosis. By choosing to have a mental health evaluation done, it opened the door to seeking out the physical condition that was causing my symptoms. At this point, all I needed was a patient friendly specialist to take an interest in my medical history, as well as my current symptoms. In July of this year, I found that specialist. Again, I only wish that I had thought to obtain a mental health evaluation sooner than I did. Being proactive in my approach to rule out mental health issues has helped to expedite the diagnosis process.

I have been in contact with other patients, who have also been informed that their symptoms are mental health related. It appears that Depression is the condition that is diagnosed most often. Like me, many of these patients are female. Many have been prescribed a variety of anti-depressants with no resolution for their symptoms. Additionally, many have never been referred to, or instructed to seek out, a mental health evaluation by a licensed Psychologist, Psychiatrist, or Therapist. In my experience, it appears to be common for a primary care physician or a specialist to make the diagnosis and prescribe anti-depressants, prolonging the proper testing and evaluation for a potential physical medical condition.

Nine years ago, had I known at that time what I know now, I would have obtained a mental health evaluation then. Hindsight is always 20/20. Therefore, if you are a patient with undiagnosed physical symptoms, and you are being told that they are due to a mental health condition, I would seek out an evaluation as quickly as possible.

If you do have a mental health condition that is causing the physical symptoms, then you will already be under the care of the appropriate specialist, who will be able to render treatment.

If it is determined that a mental health condition is not the cause of your physical symptoms, then you will have a great tool to use as proof that a physical medical condition does exist. It will give you the ability to insist, with confidence that the specialists concentrate only on medical conditions that exclude mental health. If a specialist or primary care physician still refuses to acknowledge that an undiagnosed medical condition may exist, then it is time to find one that will. Although you now know without a shadow of doubt that a non-mental health related condition is highly probable, you need a specialist who also has that opinion. It is imperative to find a specialist that is willing to work with your primary care physician and you as a team, to determine the true cause and appropriate treatment for your medical condition.

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