Note: This is a sneak peek Bipolar rules! — that means it’s a draft. This is not the final version.
When you have bipolar disorder, supporting your health is critical and yet more difficult than it would be for the average person. Doctors are often blamed for this difficulty. Not all doctors are the same, of course, but many treat people with serious mental illness in ways that are different from other patients. This is unfair and puts additional barriers in front of people who can handle them less.
Some doctors don’t believe in patients of any stripe advocating for their health. I’m not sure why this happens, but it’s very common for a person to see a doctor about a complaint and the doctor tells them it’s “all in their head”. This happens to women and minorities more often than others, and for people with bipolar disorder, it gets much worse.
People with bipolar disorder are often thought to lie or make things up. They are often assumed to be drug seekers. They can also be seen as attention seeking or hypochondriacal. In other words, the second you sit in front of a doctor as a person with bipolar disorder, they may be inclined not to believe a word that comes out of your mouth. The doctor may treat you like you’re “crazy,” whether he knows he’s doing it or not. Standing up for yourself can be perceived as a nuisance.
But let’s say you overcome this problem and your doctor believes you when you talk about your health concerns. That’s great, right? Well, it might be. But then again, you may run into the second big problem: Doctors who blame every worry on bipolar disorder.
One of the problems with bipolar disorder is that it can have many psychological and physiological effects. I suspect we can’t even detect every effect with our knowledge right now. In this case, doctors are prone to attribute all illnesses to bipolar disorder or the side effects of bipolar medications. And while sometimes this makes sense, other times people actually have other problems that need attention as well – and unfortunately, doctors are often blind to this.
In addition, people with bipolar disorder are battling a potentially fatal illness. This often makes us very, very tired. Bipolar disorder can also hinder us cognitively. We don’t have the same inner resources to deal with the built-in challenges of the doctor-patient relationship, let alone deal with the added difficulties of being thought of as “crazy” or “difficult” because of a brain disorder we don’t want and didn’t ask for. In short, we are less able to deal with these multifaceted situations because of everything we face and yet more compelled to deal with them because of the complexity inherent in having a serious mental illness.
How to defend your health
But you shouldn’t give up. None of this means you’re actually “crazy.” None of this means that a health complaint is “all in front of you.” None of this means that your health concern should be ignored. This means that there are systemic issues in medicine that can cause you difficulty.
Whether you’re seeing a doctor because of a lump under your arm, a scratch on your neck, or a side effect from medication, you need to know how to advocate for yourself successfully.
Remember these things:
- You’re not crazy. While it’s possible there’s a health concern in your head (it can happen), consider the facts. What other conditions might be responsible for your concern? Have they been blocked?
- You are the expert on you, not the doctor. If something doesn’t feel right inside, it probably isn’t.
- You deserve to be treated with the same respect, dignity and trust as any other patient. It’s not okay to write off your concern because of a mental illness diagnosis.
- You deserve to be taken as seriously as anyone else and you deserve to spend the same energy worrying about it as anyone else. This may mean additional tests, referrals, etc., to get to the bottom of your concern.
- You deserve an explanation for your concern that fits the facts of your case.
When you’re sitting in front of a health-supporting doctor, try the following:
- Do your research beforehand. This does not mean diagnosing yourself. This means finding out what might be worrying you so you can talk about it.
- Make a plan before seeing a doctor. Write down all your concerns, symptoms, questions, etc. Write down what you need to know. Write down your goals for the date and what you don’t want to go without.
- Keep calm and refer to your notes. You’ll look organized and, indeed, not “crazy.”
- Give as much detail as you can with as many examples as you can. For example, saying “I feel pain in my arm all the time”, is not very helpful. Saying, “My elbow hurts 90 percent of the time, and it’s especially painful after I shower,” is much better.
- If a doctor doesn’t take you seriously, be open about what you feel is going on and what you need. For example, “I may not be speaking very clearly. The pain is intense and keeps me awake at night, so I need a way to sleep.” (You may have been too clear, but falling on your sword a little might help the conversation move along.)
- Ask lots of questions and try to understand what your doctor is thinking. They may have good reasons for behaving a certain way, but they don’t communicate them effectively to you.
- Ask for or even demand a treatment plan. This plan may include tests, a referral to someone else, or another appointment. Anything is fine. Nothing is okay.
- Bring one person with you to your appointment. Someone strong who supports your concerns and does not have bipolar disorder may be someone the doctor will listen to. (Yes, that’s unfair.)
- Make the doctor document everything. For example, if they deny you a test you think you need, have them write it on your chart. If a doctor is forced to document something, they often suddenly become more rational. (They probably don’t want to be responsible if they make a mistake.)
- If none of these work and the doctor still isn’t giving you what you need, ask for a referral to someone else. This is a last resort because it can be difficult to find another doctor in some cases.
In short, try to work within the system as best you can, even if it means compensating for a doctor’s bias. I know this isn’t fair, but addressing a doctor’s bias is likely to make your relationship worse and unlikely to get you what you need. If you don’t need to continue the relationship with the doctor and want to say something about inadequate treatment, then fine, but otherwise, I’d keep bias charges to yourself – for your sake. And finally, remember that supporting your health is good – it’s what you make it must to do. Some awful doctors make it harder, but it’s still one of the most important things you’ll ever do. After all, if you don’t have your health, you have nothing.
