so i said i might try to describe how i've been interacting with with medical professionals...
October 2, 2015
so i said i might try to describe how i”ve been interacting with with medical professionals re: my mental health and getting treatment and/or diagnoses.
if you”re anything like me, you”ve probably already spent hours (or more) researching whatever disorder you have before ever thinking to actually approach a medical person for help. if you”re also anything like me, you probably have some amount of anxiety about seeking treatment for mental health. if you”re also like me (in this case autistic) you might have serious issues with lying (unless you”ve scripted the thing, but this isn”t reliable bc… other people are unpredictable).
the ableism and stigma is very, very real.
i”ve been… kind of succesful in how i deal with medical people on these issues? not entirely, because i appear to be very ‘pleasant” for this ppl which i suspect means that they don”t tend to think i”m as socially disabled as i actually am.
the thing with symptoms is that most doctors (even the specialists) will not consider atypical symptoms to be, you know, actual symptoms. fuck, sometimes they won”t even think actual symptoms listed in the DSM (or other such official manual) are real symptoms (if they aren”t the stereotypical ones).
take my post about panic attacks. while many sources that you”ll find (like wikipedia) will give you the ‘classic” DSM V criteria, you can find other resources that mention things like feeling like you need to go to the bathroom.
my first suggestion: look at the classic symptoms and see which you have. if this is enough for you to suspect or dx yourself with the disorder, then continue to do research. once you”ve figured out (more or less) your symptom profile return to the classic symptoms.
now, what i tend to do, is look at these classic symptoms and figure out some what to reword them that approximates the symptoms i”m actually having. this is basically telling half-truths (which will also be easier to keep up because you are giving them your real symptoms, but using their framework so that they actually can understand you).
so a symptom like:
- panicking bc i”m on a train and i need to take an urgent shit
- my stomach starts hurting/cramping/whatever (nausea or abdominal distress is a DSM symptom)
for panic disorder you”re supposed to have ‘four or more” of the listed symptoms. i generally try to hit the minimum threshold with maybe one or two more.
if this also seems difficult for you (finding creative ways to describe your symptoms in their terms), another approach is, well, being passive.
honeslty? my experience with psychs is that they”ll really just ask you a bunch of questions that are intended to see if you have symptoms. in a lot of cases, you often can get away with ‘yes” or ‘no” without further elaboration. if they ask for an explanation, take a cue from the keywords in the question and vaguely describe your symptoms based on that.
being super descriptive and exact when communicating your symptoms can really backfire. basically, you want the psych to fill in whatever you don”t say with their preconceived notions of the disorder. they”ll take your lack of personal ‘insight” as a generally good sign.
i just recently noticed that psychs often describe me as ‘pleasant” which… yeah, is totally a defense mechanism when i”m feeling anxious. if you can… remaining calm but engaged seems to be a good tactic. they like to see that you are invested in your own ‘healing” but with the impression that you are relying on their guidance and help.
these are generally pretty arrogant people. they will be convinced that they know the disorder and you better than you ever will.
on this note, this also means never mentioning that you”ve been researching online or even talking to people with your disorder. they want to feel like a white knight coming to rescue you from the torturous hellscape that is your mind. these are people with a serious savior complex, so let them save you! :S
i was talking with a friend today about how it is difficult to strike the right balance with these people. if you are too assertive or authoritative about your own mind, they tend not to respond well. but you also can”t be too passive. its really hard and i haven”t really figured this out for myself. i think the key here might actually be getting a supportive person to try and be your advocate for you. i”ll be testing this out in the future, lol.
3) getting a diagnosis
after figuring out what symptom communication style works for you (see above suggestions) the clearest and bestest thing you can do for yourself is never, ever EVER mention the diagnosis you want and/or have given yourself.
this is why i try to script (in advance) some ways to describe my symptoms that sound like classic ones. these are what i tell the doctor and then i let them come to whatever conclusion i want them to draw.
now, this doesn”t always work. but it has mostly been successful. a combination of my overall demeanor, how i talk about my symptoms, and really giving the medical person that i”m genuinely seeking their help because i want to get better seems to work a lot for me.
re: symptoms, this also includes just… ommitting any atypical symptoms you might have. because it”ll only muddy the waters. remember, this person does not actually care about you or treating your exact symptom profile for the disorder.
they are not your friend, they do not really and truly care about you or your recovery and/or treatment, so don”t try and… like, unburden all of what you are experiencing in the hopes that they”ll do something.
i find it is also really a good idea to go there with a particular diagnosis in mind and to selectively describe your symptoms to give yourself a fairly ‘classic” symptom profile so that they draw the right conclusion.
Because you aren”t giving them everything and hoping they sort it all out for you, you might find yourself in my current position: doomed by diagnostic overshadowing.
but… something is better than nothing or being dismissed entirely. and there is the hope that some future medical professional will be able to diagnose you with whatever updated information or new insights you have into your brain.
this isn”t a foolproof plan. it certainly hasn”t worked for me in all cases. like. i have a diagnosis of ‘major depression” when i really should have one for atypical depression (bc its more accurate) but… doctors apparently don”t get that atypical depression actually exists. i also think that i have bipolar II, but… the medical professionals i”ve spoken to don”t actually think it exists (ie, that only bipolar I exists). this one was where i had a mistep, since i tried the above strategy… but since the person didn”t even recognize that there are two bipolar types, i fucked myself over by not re-framing my hypomanic eposides as classic mania.
idk. this is getting really long. but i hope it helps some people.
successful diagnoses so far:
- generalized anxiety disorder
- panic disorder
- major depression
- bipolar II
(i”m sure there is something else but i can”t think of it at the moment… maybe i”m more successful at this than i thought)