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Date of last update: 8/24/2017.

Forum Name: Psychiatric Topics

Question: Do I have to self-disclose my psychiatric conditions to drs?

 re_becca - Thu Sep 04, 2008 8:32 pm

Do I have to tell every doctor who treats me (from emergency room doctors to optomotrists to dentists) that I have a psychiatric problem? It seems to me when I tell people that I have OCD and bipolar that ER doctors automatically assume that that I am making things up and it's apart of my OCD, but there is nothing really wrong with me.

Last week I went to the dentist and even though on her lenghthy form I wrong "Does not pertain to you" when asked about medical conditions she forcefully got it out of me. All I wanted was a check up. Did she really need to know that I had OCD? Does my anxiety around throwing things out or around intrustive thoughts really have anything to do with needing my teeth cleaned?

My optomotrist was very forceful and made it clear that she would not treat me if I did not tell her what my medical conditions were. I said "fine then I'll find another optomotrist", and got up to leave. It was then that she put her hand out and said "Ok let's start over", but why did it have to come to that?

My OCD can be embarrasing? I didn't tell anybody for years and years, because I was so afraid that even having these thoughts would be grounds for me to be locked up in the mental ward or put in prison. It wasn't until I had dropped out of university (after having getting into a colledge with a minimun of a 90% average to get in - gives you an idea what my marks were), found I could not work, lost all intrest in live, and spent all day on my parents couch or in bed just praying for God to kill my body after killing my life. It was only then that I asked for help.

So why do I have to go through that stigma and shame every time I just want to get my eyes checked, my teeth checked, or for some other minor thing?

Do I realy need to tell them that I have OCD and bipolar? Will it really influence my treatment in anyway that would be benificial to me? Or are they just being snoopy?
 Dr. E. Seigle - Fri Oct 03, 2008 8:00 pm

Hi re_becca,

My sympathies go out to you, because you are dealing with a very real dilemma of opening yourself to be vulnerable to the stigma of having a mental condition, and of having other medical providers often being prone to dismiss your physical probelms or to automatically attiribute them to your psychiatric disorder.

The other horn of this dilemma is that your other medical and dental providers really do need to know about your mental disorder, since boththe disorder and any medications you take can very possibly have some relationship to whatever you are being seen for.

It has long been a problem in society, including the non-psychiatric medical providers, that they give psychiatric status second class status sometimes, and though we would like to believe that they've all grown and been educated to be more enlightened and sensitive than this, it isn't always so.

I very much like your assertive and self-protctive attitude when seeing other providers; my suggestion is that you use this to be very clear with your providers that while they might be tempted to attribute yourcomplaints to your mental disorder, that the trade-off for your full honesty, which is important, is their fullest consideration of your medical issues. When you experience stigma or you don't feel taken seriously, speak up, as you have done.

You are brave to discuss these issues with your providers, and rely on this strength to protect you while you do continue to provide full, open medical disclosure of your OCD or other mental health issues.

I applaud your courage and thank you for raising an issue that I am sure many of the readers here can relate to!

-Eliot Seigle MD
 re_becca - Wed Oct 08, 2008 7:37 pm

Thank You Dr. EEliot Seigle:

This gives me alot to think about. I delayed expressing my appreciation because I wanted to think about it before answering your kind and considerate email.

Thanks also for your compliments.

As in regards to my current dilemia with the dentist. Unlike my optomostrist, in which I had somewhat of the same argument, my dentist, did not in any way want to start over after starting off on the wrong foot. I am now lined up for several appointments with my dentist, and I've canceled out on the first two of them, just because of anxiety of not wanting to deal with somebody who reacted so negitively to my having a mental illness and not wanting to disclose it. I don't want to deal with it. I'm lined up for a root canal among other things (since it's been around 10 years since I've seen a dentist - due to anxiety and money - mostly anxiety) - and so canceling means several appointments at once need to be canceled?

What do I do? Let my OCD ruin my teeth? I'm already without alot of other things due to OCD and bipolar, I don't want to be without my teeth as well? But with dentists being agressive as they are about the whole mental illness thing, it sort of seems to a choice I will have to make? Neither choice seems like a good one.

Anyways thanks once again.


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