Being honest with your doctor

[musikk021]

So next week I have my ever so dreaded complete physical exam. Aside from the uncomfortable part where I have to completely undress and the doctor has to examine everything, I'm concerned about the part where they ask about your mental health. Before the doctor comes in, I always have to fill out a form checking off whether I've been exhibiting any symptoms of so and so. I've never officially been diagnosed, but I've been suffering from depression and social anxiety for over 4 years.

Every time I see the doctor, I have to lie on the forms and lie to her face. If I told her about my emotional issues, she'd refer me to a psychologist/psychiatrist and my mom can't know about my issues. I'm under her insurance, of which I don't think even covers psych services. And that would open up a whole can of worms when I have to explain why I've been feeling the way I do...long story. But I just hate pretending like everything's okay when I'm feeling depressed, anxious, irritated, and angry all the time.

What would you guys do? Would you tell your physician? Are they obligated to send you to a counseling service?

Thanks for reading.

[kitsune309]

Tell your physician!

One, it could be either impacting your physical health in a negative way that would make your body more vulnerable to disease. Two, it could be being caused by physical issues such as your thyroid, and it could be an important warning sign she doesn't know about, or a depression that could easily be cured by a physical treatment.

Two, you're 19. You can be on her insurance and still not have any of the details of the whole doctor visit disclosed to her. You're not a five year old, you're an adult. If you tell the doctor not to tell her, the doctor cannot tell her, by law. Here's the link with proof in legalese. It's there to encourage full disclosure of all symptoms to your doctor. You're not even a minor, your mother has no rights at all to your medical information.

Three, no she doesn't have to refer you to a psychologist. You're not a danger to yourself or others, you're just depressed. Family doctors can and very often do prescribe antidepressants, and those are often very inexpensive. Also, be honest with your doctor. To a fault. Tell her about why you don't want a psychiatric referral, and she probably won't give you one. Tell her why you didn't say before and she'll tell you all about the cut and dried pieces of Doctor Patient Confidentiality. She's there to help you, not to hurt you. Also, she's a doctor, not a police officer. If she tells you to go to a psychologist, but instead you run off and don't, nothing happens. Seriously.

[Bobbgooduk]

Agree 100% with Kitsune - hiding the truth from your doctor is almost as bad as hiding the truth from yourself. You're going to stay stuck in this rut of depression unless you are prepared to get help.

[pitabread514]

What are you afraid of exactly? I can only guess. Anxiety is caused by fear of the unknown. Coming from someone who has suffered anxiety for much of his youth, I can tell you it is better to confront your fears then to continue to go on as you are without dealing with them. Once you find out what is bothering you, you will feel totally liberated, whatever type of fear that may be.

[Chrissouth53]

Be totally honest with your doctor, including what your concerns are about your parents and insurance.

First, your doctor should know EVERYTHING about you in order to give you the best care possible.

Second, your doctor may know of resources that you can use that will help get the psychological care you think you may need.

[musikk021]

I understand that my physician cannot disclose any information to my mom, but all the medical bills still go through her. So if I did tell my doctor that I have depression and social anxiety, and say she doesn't refer me to a psychologist, how can my doctor herself prescribe me antidepressants? Doesn't there have to be an evaluation by a psychiatrist for that? And even if my own doctor was able to give me medication, it's not like I can slip her cash under the table for some pills. It'd have to be a prescription that I have to go to the pharmacy to get and pay with my parents' insurance card.

My mom used to work for big corporations, and our medical bills were always covered by the company's insurance. Now my mom is not working, and my dad is self-employed with his own business, so we have to buy our own insurance. It's super expensive and only covers like 2 or 3 visits to the doctor per year. One time, my mom went in for a complete physical and she told her doctor she had some back pain. Just for telling the doctor that, they billed her an extra sum of money because it was considered an additional consultation for her physician to address her back issue! Tell your doctor one little thing and they're going to bill you without warning...

The American healthcare system is a disaster.

[Bobbgooduk]

If you were seeing a psychologist, they would not be able to prescribe drugs, whereas a psychiatrist IS a medical doctor and could presecribe.

However, your family doctor can also prescribe drugs, so you can get them without being referred to a psychiatrist.

You'd have to be pretty messed up to be referred to a psychiatrist straight away so I don't think you need to worry about that just yet.

Also, you can explain to the doctor that you wish to keep it confidential - I'm sure it could be described as "vitamin supplements" or something for the sake of the billing - doctors are usually willing to do all they can to maintain confidentiality, which is a legal obligation on their part.

[TraceElement]

Originally Posted by Bobbgooduk

You'd have to be pretty messed up to be referred to a psychiatrist straight away so I don't think you need to worry about that just yet.

As someone who does see a psychologist ad a psychiatrist, that comment strung a cord. I don't think you meant it to be an insult, but please be careful next time. People who have mental health issues know we have problems, can be sensative to comments like this because it's not a "visable" problem that people see.

I would also suggest telling your doctor. It could be that something is off in your body, like your thyroid that is causing the problems, or it could be general depression.

[Bobbgooduk]

You're right - as someone who has had mental health issues myself, it was not intended as an insult at all.

I was simply making the point that the first port of call would not be a psychiatrist unless there was imminent danger of serious self-harm or suicide.

A doctor is far more likely to pursue more every-day avenues first.

I wish you a speedy recovery.

[TraceElement]

Originally Posted by Bobbgooduk

You're right - as someone who has had mental health issues myself, it was not intended as an insult at all.

I was simply making the point that the first port of call would not be a psychiatrist unless there was imminent danger of serious self-harm or suicide.

A doctor is far more likely to pursue more every-day avenues first.

I wish you a speedy recovery.

Thank you for explaining I am in agreement.

[kitsune309]

Even if it's billed to insurance, it would show up as just medicine, not a specific type of medicine. And if you pay the pharmacy with cash and they don't bill your insurance (yes, you can do that. It's not a big deal) it won't show up on insurance at all. Prozac is only 10$ a month, without insurance. Generic Prozac is 4 dollars. It's easy to afford.

[suninthesky]

Are you going to college soon? You might be able to talk to someone there.

[musikk021]

Originally Posted by suninthesky

Are you going to college soon? You might be able to talk to someone there.

I'm a third year college student. I haven't talked to any counselors or anything. And I don't like/ have a hard time making friends so my isolation makes it even worse.

[seeksanctuary]

Please talk to someone. Your mother doesn't have to know, and even if she asks "why"... you don't have to tell her why.

[KaraBulut]

Your family doctor can prescribe anti-depressants for you. You can also mention that cost is an issue for you. Several of the commonly used medications are available in generic and are cheap enough that you can pay them out-of-pocket instead of submitting them on your insurance.

However, sometimes part of the problem with depression and social anxiety is the avoidance- avoiding talking about it and avoiding getting help for it. In concealing this from your physician and your family, you're just continuing the avoidance that is part of the disorder itself.

[Foxywolf]

I just have a quick question, sorry to hijack the thread. Does it not matter if the doctor is still your pediatrician? (yes I'm 19 and still go to a pediatrician) It still stays confidential?

[Bobbgooduk]

Absolutely. Patient confidentiality, whatever the kind of doctor - applies to counsellors and therapists too, but it's a big issue with doctors.

[Chrissouth53]

Originally Posted by Foxywolf

I just have a quick question, sorry to hijack the thread. Does it not matter if the doctor is still your pediatrician? (yes I'm 19 and still go to a pediatrician) It still stays confidential?

Yes, all the more reason to be open and honest with your doctor.

Again, the doctor may know of programs to help without your being exposed to discovery by your parents.

[KaraBulut]

Originally Posted by Foxywolf

I just have a quick question, sorry to hijack the thread. Does it not matter if the doctor is still your pediatrician? (yes I'm 19 and still go to a pediatrician) It still stays confidential?

It depends.

In countries where there is socialized medicine, your medical information is between you and your physician.

In the US, as a 19 year old you are an adult (even if you see a pediatrician) and your medical information is considered private under US law. However... if you are insured through your parent's insurance policy, there are circumstances where your parents can gain access to information if they are the persons financially responsible (the "guarantor") for your bill.

For those under age 18, your parents have the right to access information about your healthcare, including your medical records unless forbidden by state law.

[musikk021]

Originally Posted by KaraBulut

Your family doctor can prescribe anti-depressants for you. You can also mention that cost is an issue for you. Several of the commonly used medications are available in generic and are cheap enough that you can pay them out-of-pocket instead of submitting them on your insurance.

However, sometimes part of the problem with depression and social anxiety is the avoidance- avoiding talking about it and avoiding getting help for it. In concealing this from your physician and your family, you're just continuing the avoidance that is part of the disorder itself.

It's true that I'm very avoidant when it comes to sharing how I feel or asking for help - I never do either of those things. Things like depression and social anxiety just work in a nasty cycle that prevents me - and others, I'm sure - from progress. The depression makes me more isolated; the isolation, in turn, makes me more depressed; the more depressed I get, the more isolated I want to be; the more isolated I am, the more depressed I get...and it just continues on in this cycle. Same with social anxiety. I've never talked to anybody about my issues, which is why I don't know where or how to begin.