Honesty and Trust in Primary Care: Addressing Complex Mental Illness

When it comes to sharing my complex mental illness with a new primary care physician, honesty can be difficult. Over the years, I've learned that the approach to discussing mental health varies widely, and often, the way doctors handle these discussions can affect patient trust.

Previous Experiences

For the first decade after my diagnosis with Major Depressive Disorder and Anxiety, I always disclosed my mental health history to any new physician and specialists. I even shared the medications I was taking, knowing it was crucial when prescribing treatments for other conditions. Unfortunately, my experiences soon revealed a problem. Doctors' focus on mental illness became excessive, with irrelevant questions that seemed disconnected from the physical consultation.

I realized that doctors were just as guilty of labeling me as those who lacked proper understanding. They needed to verify that my symptoms were genuine and not psychosomatic. While I could understand the need for this verification, I was deeply upset by the way they handled me. I felt humiliated and accused of hypochondria, even when I was very ill. Hypochondria is a real condition, and there are individuals who only seek attention by fabricating symptoms.

Finding Balance

Paradoxically, the overwhelming focus on my mental health led to a lack of trust from me. I no longer felt inclined to share my diagnosis with every new doctor. Recently, after my psychiatric diagnosis was changed to include Bipolar Disorder and ADHD, I decided to keep my history to myself, except for emergencies.

During a recent knee surgery, for instance, I only mentioned my medications to the anesthetist a few minutes before the operation. The surgery went well, but the rheumatologist later prescribed medication that clashed with my bipolar treatment, leading to hallucinations. This experience reinforced the importance of discretion in sharing my medical history.

Advice to Patients

While my experiences may influence the way I handle my mental health with doctors, it is essential to stress that keeping quiet about your mental health does not necessarily mean a lack of transparency. Patients should seek balance: be honest but selective in sharing their mental health history. If you feel the need to disclose your mental illness, it may be beneficial to have a conversation with your healthcare provider first to discuss the best approach.

Final Thoughts

Disclosing complex mental health conditions can be challenging, but it is vital for receiving appropriate care. While doctors play a crucial role, patients must also take responsibility for their healthcare decisions. Balancing honesty and discretion is key to maintaining trust and effective communication with your healthcare providers.