To think these comments left by my gp were rude

[Ispy9]

This isn’t really relevant anymore as I am in a much better place now than I was but I’m still quite annoyed about it. A year ago I was suffering quite badly with anxiety and depression so I went and saw my GP about it.

I recently downloaded the NHS App and I thought I’d have a look through my notes. I saw that on the appointment about my mental health my GP had wrote these notes.

‘Examination: Not sleeping, not looking after herself. Unkempt, looking down, shoulders hunched, not wearing a bra, hair not brushed’

aibu to think these comments on my file are quite rude?

No, it’s just a normal examination.

one of the first signs of depression is you start to neglect yourself. He/she was just recording what they noticed to provide a picture.

This isn't restricted to mental health assessment. I read a comment about a scar on my arm on a letter to the GP from the hospital. Absolutely nothing to do with what I'd gone in for.

It upset me so much that I never ever speak to a medical professional without long sleeves on now and I immediately stopped trying to get treatment for the issue and pretended it was resolved.

It still gives me the creeps now.

It comes across a bit ‘patient too depressed to comply with patriarchal societal expectations.’

A friend was talking about a health visitor recently that said she worries as much about people presenting too perfectly, as a sign of depression / not coping, as much as the opposite.

‘Examination: Not sleeping, not looking after herself. Unkempt, looking down, shoulders hunched, not wearing a bra, hair not brushed’

So, the GP is noting signs of poor basic self-care, often associated with some forms of depression.

My depression was picked up at a pap smear once, as I'd reached the point I couldn't face washing my hair and I guess my face and posture also made it apparent.

I don't think it's rude to make clinical notes to back a diagnosis. What is rude is to disbelieve a patient who is suffering from depression and/or anxiety because they look well put together, which has also happened to me with another GP.

Yep.

I think it’s perfectly reasonable.

The bra thing relates to outward appearance as much as unbrushed hair etc.

Amen.

Same here too! I wear bra at work, or if I really have to. Not wearing a bra is not the social and mental self destruct that some seem to think. I pray for the day when they stop being the norm and women can go round swinging low or high just like blokes do in their boxers and trackies.

Not rude in the least, but uncomfortable reading for you. All of those things, including the bra if he knows you generally wear one, are indicative of depression, and should be noted. He would have been remiss not to.

I am reminded, just a bit, of a patient of ours who just fell apart when he read his chart, and it said, "Patient is SOB." He didn't realize that was "Short Of Breath." So often laymen do not understand contractions, or the importance of physical changes in documenting things like mental/emotional stress.

Yes, this sounds reasonable. A GP can note concerns without making hurtful or biased comments that the patient may one day read. If it's a habitual practice to always be professional in making notes, it must become second nature.

Not wearing a bra? WTF?

I haven't worn a bra for a few months now and my mental health is perfectly fine! In fact I would say it's improved because of the fact my boobs are no longer imprisoned.

thank you everyone for your comments. It was factual at the time yes. I think it was just uncomfortable reading it.

for anybody that wants to access their full records it would be under ‘consultations and events’ under the ‘your health’ section of the app but you need to ask at your GP reception for access to this and also bring ID to prove who you are

www.nhs.uk/using-the-nhs/about-the-nhs/how-to-get-your-medical-records/

I can appreciate they are hard to read. But it seems reasonable.

Dred to think what mine might say: Mrs oblomov charged into the room complaining yet again that she hasn't been seen for 18 months...

Why is it rude?
It is true
And valuable information for the state you were in.
You sounded like you were in a bad state

(Or me on a Saturday morning 🤣)
No but seriously. Dont be offended.
It's great the doc was thorough.

Not wearing a bra is not usually normal in a public setting, so it was just recorded as an observation indicative of a degree of self neglect as part of your mental state examination. You record any visual observations that are not the norm

It is completely normal for some not to wear a bra, some people never wear them.

PeloFondo
You we’re probably thinking more about the tee shirt than your back!!! (Love the sound of it btw!!)

Somebody said above about not judging men that way but there’d be different indicators. When my brother isn’t at his best we notice he hasn’t had a hair cut, shaved and we always breathe a sigh of relief when mum tells us he’s having a long hot shower and is going to the barber’s later (he has as among other things)

I think the way the GP described you is offensive. Yes, I understand that they need to be factual. But not wearing a bra is not something that should be judged, many choose to do so. Some very mentally well women choose to have messy hair too. Some people choose not to shampoo for long etc etc. That would be enough: “Patient experiences difficulties with self care and the lack of motivation prevents her to look after herself properly” or something along the lines. Not this disgusting way of describing a person.

Yes and maybe that is normal for you. But the point of the GP noting these things is to be able to pick up on CHANGES to each client's normal. So if it's normal for someone to be wearing a bra, be well groomed and always dressed up etc and then one day they rock up with unbrushed hair and wearing PJs or track pants, you know you might need to dig a bit deeper or monitor a bit more.

People it's got nothing to do with patriarchy or expectations on women. It's done regularly to gain a sense of what each patient's normal is. Anne is not compared to Susan. Anne is compared to Anne's previous presentations and any deviations from Anne's normal are noted as they might indicate something going on that she needs support with.

Same but I DO brush my hair it just doesn't look like it

Saying 'struggling with self care' is completely different to describing your appearance. The latter is a factual, objective part of the psychiatric clinical assessment. I agree the comment about the bra is a bit strange though.

Ps the exact same is done for men too

It is an observation of physical presentation within a clinical setting.

OP’s appearance at the time is consistent with the presentation & symptoms of depression.

Loads of women don’t particularly like wearing bras, so go without or wear bralettes at home, but climb into one for the day to look ‘dressed’. Particularly so for women with large breasts who I rarely see out & about or in workwear braless.

Not wearing a bra may be an indication in that clinical setting of being indifferent to their appearance or low motivation to change clothes for an appointment. Alongside the observations about being unkempt & unbrushed hair, the bra comment is congruent.

@Ispy9 Good to hear that you are in a better place.