Thursday, September 8, 2016

What a Depression Diagnosis Means When Your Doctor Is Terrible

A while back I took an extended break from grad school for medical reasons. Many, many medical reasons, but chief among them being that I was constantly in pain, and exhausted from being in pain, and generally miserable all the time. And being in pain, having difficulty being fully load-bearing on one's feet, having limited motion, etc. is a bit difficult to get around in a theatre program. In the words of one of my advisers, the group would only be as good as its weakest link.

So maybe that was a pretty shitty thing to say to me, but I pursued medical treatment expecting...well...better treatment. Medically. From a professional who would take me seriously instead of insinuating that I was making the whole thing up. 

Ha, ha. 

I went to the doctor, who sent me to physical therapy (again). However, she was more adamant that I go to psychotherapy. This was because when asked whether I felt "down" or "depressed," I made the mistake of answering honestly. 

Of course I felt down, I said. I was in pain. Sitting in this chair hurt, but not as much as I knew it would to get back up. I was in pain and it was keeping me from doing the things that I like to do. And that's depressing. Who wouldn't be depressed?

Apparently I must have been speaking backwards, because she told me that no, I was in pain because I was depressed. And did I have any trauma in my past that maybe I wasn't dealing with?

I did agree to try a prescription of anti-depressants and go to a psychotherapist. The pills, surprisingly, alleviated the insomnia, which was awesome. But at the dosage required to be effective, they made me really nauseous. I was constantly sick to my stomach and missing work because of it, so I stopped taking them. While they worked, the trade-off was too much at that time. 

Therapy was similarly unfit for my lifestyle. It was expensive and yielded poor results, if any. I tried a couple of people, but I think I may be one of those people for whom therapy doesn't work very well. I find it intrusive and offensive to sit there and take it while a total stranger describes everything wrong with me based on 30 minutes of my rambling. (Also I hate feelings.) 

I went through this rigmarole to satisfy my GP, who held other treatments and referrals -- like allergy testing, sleep studies, physical therapy, and more -- hostage on the condition that I forced myself to continue a treatment that was, if anything, making things worse. I tried to go around her to find a place that wouldn't require a referral to a specialist, but I live in a rural area dominated by one major health group. To see someone in that group, you need a referral from a doctor already in that group. 

Finally, I was able to get a referral to the physical therapy that I desperately needed by simply lying to my GP and telling her that yes, of course I was still seeing that psychotherapist and taking my antidepressants. 

And guess what? My PT person was nice and listened to me. Physical therapists are the nicest kind of doctor, at least in my experience. Probably because their job requires them to listen to their patients. And have the best "bedside" (poolside?) manner. I was scaled back from land therapy to pool therapy, made some improvement, and was given a regimen to complete on my own at home. 

And because of the improvements resulting from that treatment, I started to feel less in pain and less depressed overall, like I told my doctor I would in the first fucking place. 

She left the practice because her family moved. At first, I felt bad that I'd thought badly of her. We got off to a good start, but our relationship disintegrated over time. I wondered if I'd done something wrong, offended her somehow, and that was why she didn't take me seriously. I figured she was trying to do her best. She did help me with some things, after all. 

But you know what? No. She could have helped me. Instead of insisting that my pain was all in my head or perhaps due to something in my past, she could have wondered, hey, maybe it's being exacerbated by your job as a cashier where you stand for 8+ hours a day. She knew that. She could have done something, like written me a note that said I was allowed a chair at work. Or more frequent breaks. My physical therapist at the time urged me to quit that job. And sure enough, when I switched jobs, that had a huge positive impact on my health. 

She could have done something, instead of throwing up her hands and trying to fob me off to a psychiatrist. 

But, I don't think she ever really believed I was in real pain. Because surely, if she had, she would have done something about it besides ask if it was all in my head. 

I could go on about this doctor and all the things I didn't like about her. Instead I'll just keep doing my exercises.

2 comments:

  1. Many doctors these days tend to, sadly, overlook the possibility of anything that doesn't fit into their first, instant evaluations. But I'm glad you're doing something now with someone who believes you, and that works.

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    Replies
    1. Thanks! I still want to get in for a sleep study, but again, referral (or finding someone outside this area and driving to them). With PT, they do a few weeks of exercises and then send you off on your own. I'e been slacking slightly lately because the pool hasn't been open when I need/want it to be, but I'm getting back on track with it.

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