Scared to admit depression to GP/go on anti-depressants (NHS confidentiality) sorry long

[secretsorrow]

Hello. I have namechanged for this.

I have been depressed for ages - years, on and off - and it is gradually getting worse. So far I have been able to keep things under control by being very busy and exercising a lot but things are getting more difficult. I feel like I'm sinking, and losing my grip a bit. I have had about 8 sessions of CBT with a reputable, experienced private therapist. According to the Beck (?) depression questionnaire he had me do at my first session, I have moderate to severe depression. He did say to me that he felt it would be difficult for me to feel better without medication. This is meant to be treated with drugs AND therapy (NICE guideline). I don't feel any better for the CBT sessions I've had and I'm inclined to give up on it.

The problem I have is that I am too afraid to go to the GP and ask for anti-ds. I don't believe that NHS health records are really confidential, or that we can count on them being kept confidential in the future. I have in the past had employers, pension providers, insurance companies etc ask me to fill in health questionnaires that include a question on whether you are or have ever been treated for mental health problems. I don't want to have to say yes because I'm afraid that people will find out and treat me differently/discriminate. I know I could then sue etc but I don't want people I work with to know my medical problems in the first place, especially MH ones. I am also afraid to lie on this sort of form because apparently all these sorts of people are allowed to phone your GP and check your answers? I have dealt with it by avoiding situations where I am required to complete a health questionnaire. Currently the most serious consequence of that is that I am in my mid-30s with no pension.

Do other people worry about this? What should I do? I have wondered about trying to register with a new GP without giving details of my old one (say I have been living abroad or something) but I'm afraid that won't work. I don't think I will ever feel better if things carry on as they are though. I thought therapy would help but it isn't. If anything, I feel worse, because the thing I was pinning my hopes on has failed and some feelings/issues that I usually bury have been brought to the surface.

I did explain to my therapist why I don't feel comfortable seeing my GP about this. He tried to reassure me and say that doctors are not allowed to pass on patients' information but I don't believe him. He is based at a reputable private mental health clinic and has also suggested that he could help me get a private prescription but I haven't pursued that as money is too tight. I can't really afford to continue therapy let alone take on other costs. I don't have private health insurance because of the questionnaire issue and other things.

I know this sounds rambling and paranoid and probably mad. I am really not someone who thinks that the government is spying on them or anything like that. I am just concerned with privacy and presenting a good face to the people I encounter in my working life. But I am also so depressed now and it isn't getting better. I don't know what to do. Ideally I would like to find some way that I can be prescribed a suitable anti-depressant without it ending up on my medical records.

Going to bed now but will check over the weekend for replies. Thanks to anyone who can help. I'm really sorry if this has freaked anyone else out.

Hello OP, I didn't want your post to go unanswered.
I'm sure many people will say otherwise, WRT medical confidentiality, but I have experienced issues with this. A while ago for many reasons I opted to have a termination. I specifically requested for my GP not to be informed, but when I went to my docs months after to sort out going on the depo jab, they knew about the procedure. NOT happy.

If I was required to fill in a medical history form I would think twice before ticking "mental health issues" - which is technically what I had. (I was on Citalopram for reasons unrelated to the termination but decided to come off them after a month.) I wouldn't want to be "classed" in that way just because many bad things collided in my life and I struggled.

I really hope things pick up for you, OP. I wouldn't think of telling anyone else how to "sort themselves out," but for me I realised the only person who could make my life better was me.

xx

I also have struggled for a few years but went to the Drs in the end, it was not as bad as I thought it would be and I knew I would not get any better without some kind of kick start.

One in 4 people will have a mental health problem at some point in their life - that's a lot to discriminate against.

Plus yes NHS data protection guidelines are tight. During a recent discussion my GP would not even confirm that my dh is his patient too (I know he is of course).

On a practical level I've had to contend with PTSD in one job and now anxiety in another job and both employers have been very supportive.

Please get the treatment you need.

I agree with madmouse. I am very new to all this ( see my thread on struggling for 6 years with pnd) but I'd got to the point like you where I NEED help. I can't think what about an employer/future employer might/might not think. My priority right now is me and my family. Do get some help for yourself.

Sorry you are going through this, but I really wouldn't worry too much about the confidentiality thing. Suffering with moderate to severe depression is far worse in my opinion than the other scenarios you are worrying about. If in doubt talk to your gp - as someone else said 1/4 of us have had mental health issues. Most of my friends have been on Ads at some point. You won't be the first to raise with your gp!

Me too agree with Madmouse, CharlieBoo and bluejelly. I have had 2 major episodes (including hospital admission) and when I had the first one, 15 years ago, I was working in a professional capacity and there were no problems whatsoever. I have honestly never given a thought to the things that you are worried about - think I am right in saying that mental health issues are included in the Disability Discrimation Act. There is still a stigma about mental health issues and so long as people try to keep it hidden, this wil only get worse.

You need to get to your GP asap and get the help you have needed for a long time. I am not surprised that CBT has not made you feel better. If you are so low in mood and have other depressive symptoms, it isn't possibe to make good use of therapy. It's only when your mood lifts and some of the other symptoms have subsided that you can benefit from therapy.

OP, I understand how you feel and have similar concerns.

I have been to my GP about mental health issues, as a teenager and again more recently. When I went most recently I said that I did not need a referral to counselling, and that was partly because (as I understand it) health insurers etc. are more interested in actual referrals (as opposed to just discussing the issue with a GP) - but I may be wrong there. I have filled in health questionnaires in the past though, and I always just tick 'no' in response to any questions about mental health issues. Perhaps naively, it would never have occurred to me that my pension company would be interested in mental health issues (and I cannot recall if I ever filled in this type of health questionnaire for them anyway). With the PMI, at my work everyone had to hand the completed form back to HR, which wasn't really private enough. But I guess potentially I could have insisted that I returned my own form direct to the PMI company, but then it would have looked like I had something to hide.

I do agree with the posters who say that people should just be honest and get the help that they need, but I guess that (in my experience) it has not been simple to do that. So I don't have any useful advice really - just saying that I understand where you are coming from OP and I do worry about the same sort of issues. I guess I tend to agree with WhyIsTheGinGone that the only person who can make my situation better is me, whereas if you feel that a prescription is really what you need, then maybe you do need to speak to your GP and get the medication that will help you.

I completely understand where you're coming from. This was (still is to a lesser extent) a huge concern for me. I remember in my late teens my then boyfriend felt I was struggling with depression (his mum had suffered) and tried to get me to talk to my gp. I kept refusing because I was concerned about it being on my health records. He'd said "Fuck your records, they don't mean a thing if you're dead!" Only you (and those around you) know how bad things are. If your quality of life is so poor because of the depression and you think a prescription would help then personally I'd try not to think about your records. It took me 4 years to get to this stage. If I had the option I would go for a private prescription every time even if that meant I had to do without something else. I hope you get some more positive help soon.

Have you thought about going down the herbal route? I suffered badly with PND after my second and was pushed to my doctor by my health visitor. The tablets I was perscribed had so many side effects and made me so ill I went back to the doctors only to be given more tablets to combat side effects! I was seriously worryed about filling my body with so many chemicals and the side effects were making me more depressed than I was before!! Then my mum (who also suffered with depression for many years) introduced me to 5 HTP Serotonin. This is what is made in the body and is your 'Happy' brain chemical. I take the suppliment for this and its wonderfull. It takes a couple of weeks to get the full effects but personaly I have found that it works and has no side effects and you can order online and no one need ever know! The suppliment I take is called 'Happy Days' and is from Healthspan. Hope this helps.

Can any of you who worry so much about this explain what exactly you think will happen? Employers, pension schemes and the like cannot get any info from your GP without your consent. Life insurance and critical illness cover are the only things I can think of that would be difficult.

I'm a lawyer myself so aware of laws and particularly of how laws are broken, but it would not occur to me to endanger my health and my ability to care for my nearest and dearest for a non-existent fear that the whole world will find out and judge me because my GP will tell all.

Horsewhisperer I'm glad it worked for you, but 5HTP is not at all risk free and it is over simplistic to say it is what your body makes too. It can have some dangerous side effects. Plus it is not suitable to treat more severe forms of depression (neither is my good old favourite, St Johnswort)

When I say life insurance will be difficult I mean that the questions would be hard to avoid and they may indeed charge a higher premium.

I'm sorry about your depression secretsorrow - it's not something I have huge amounts of experience with although my ds is suffering considerably at the moment which is why I'm checking out this section of MN.

Anyway - just to say - employers aren't allowed to ask pre-employment health questions anymore. It was part of the Equality Act introduced in Oct10.

Will send you a private message on thisxxx

Madmouse - No I cannot really explain exactly what I imagine would happen. I think it is just a general fear that personal data is being compromised more these days (am thinking the publicity around lost government laptops etc), and also not really understanding what various agencies/companies need to know and why, and what they do with the information. There has also been some negative publicity around the new NHS computer systems and whether info will be accessible to a number of different types of public sector workers rather than just the GP (though this may just be the media scaremongering). Also, although there are obviously laws surrounding how employers can behave, I am certain that the HR dept in my old company was working on behalf of the directors and not the staff with regards to things like an awareness of anyone having a mental health issue. I also think that on some level if I am not officially 'labelled as suffering from X' then it is easier on a personal level to go through periods of convincing myself that I am actually fine (though I know that is not really very helpful).

But rationally I completly agree with you Madmouse, that this is probably not a logical thing to worry about in the context of it being much more important that people ensure that they are happy and healthy enough to function well and care for their children etc.

Secretsorrow - sorry that I do not have any more useful advice for you.

Secretsorrow This has probably already been said but I think you need to get treatment for your depression first and foremost. This is because left untreated, depression can affect your physical health.

I take ADs myself and took out some life insurance fairly recently. The insurers did want to write to my GP but had to have my consent to do so. However in the end the insurance policy was not right for me. I chose to go to a broker who offered a better deal. They did not have to write to my GP so it does depend on the policy.

I think what I'm trying to say is don't sweat the small stuff, there will always be a way around a problem. Your health should come first.

Saggermakers- re health replated questions pre-employment. I recently completed an application form which included a question asking how much sickness days off I'd had in the last 2 years. I think I'd only had a couple but couldn't remember but are employers allowed to do that?

Madmouse, I basically think I'll be discriminated against. While I understand that employers can't get info from my gp without my consent I've always felt (rightly or wrongly) that by refusing it would indicate there was something to hide. About 8 years ago after returning to work after "official" time off for depression my employer referred me to Occ Health who then wanted access to my medical records. When I refused I was told they couldn't do anything to help if I didn't agree. This year I took time off "unofficially" because my organisation was/is in the middle of a restructure and management had already been less than sympathetic about another lass in the office who was signed-off work with stress. I didn't want that to be me being talked about in that way. Yes it's wrong but I have seen it first hand where declaring a mh issue has resultant in less favourable treatment. I agree though that health shouldn't be endangered and I'd definitely encourage any friend who was 'that bad' to see their gp if their life was endanger or if all attempts to improve the situation were failing.

Talk to your GP & they should be able to advise/reassure you on your concerns. If you have moderate/severe depression it is likely you will benefit from a course of Anti-D's - 6m is the shortest recommended course. But you won't be forced to take them!

I've worked as a nurse in NHS for 20 years, have personally taken Anti-Deps 3 times in my life, filled out many many forms as I've changed jobs a few times & never had any issues with this. I had the same worries as you...the only time I've excluded it on a form was for travel insurance as depression wasn't an issue & the cover would have been extortionate!

Doctors in my nursing experience don't write much about their consultations so there may be no record of anything you have said during consultations other than a prescription record or diagnosis. You can choose how much you say to the GP or any person questioning your history, ie " Had a depressive episode 2009, due to such & such, responded really well to a short course of CBT/AD & no problems since". When sitting with your GP you can ask "please don't write that.." and they can find words which you are happy with. I had a sick note for 4w and the GP put "tiredness" down as I didn't want my Boss - a GP - to see "Depression". And I had plenty or reasons for tiredness which he knew about!!

Episodes of depression or anxiety are so so common these days, and are the number one reason people see their GP. Confidentiality within the NHS is incredibly tight & records are blocked in the sense that a GP can see all information, nurses can access most information & receptionists etc can access very little, often just personal details such as name/address etc. Doctors & nurses tend to take a fresh history each time you are seen so it is rare that records are read through ( although summaries are easily available).

It sounds like you are doing really well in trying to deal with this and functioning really highly...please don't suffer with this, have a chat with your GP & explore all your options....often one of the first things the GP will do is a routine blood test to make sure you're not anaemic or have an underactive thyroid gland...both of which give depression symptoms but are corrected with other treatments. HTH x

Thanks everyone. I don't feel very reassured but it's good to know that some people understand why I'm struggling with this! I don't feel suicidal and I don't have any dependants. My therapist says that I am a "high-functioning" depressed person. I am able to work. It's hard to admit that things are getting worse.

madmouse I am afraid that my weaknesses and problems will be revealed to people I work with, through some nosy HR person finding out my answers to, for example, a PMI or pension questionnaire, and spreading gossip around the company. It does happen. I'm afraid of discrimination and of unofficial/social stigma. I'm afraid I'll be in a position of having to make an insurance claim for something mundane like physio on a dodgy knee and the insurance call centre person will see on their computer that I have MH issues and will think I'm a nutter, won't give me good customer service and will laugh at me with their colleagues when the call ends.

I'm afraid that within my lifetime, health records just won't be kept confidential any more. This information is increasingly being moved from paper records and local computers in surgeries to national databases. I was shocked and horrified to find out in my mid-20s that what I tell my GP is not, as I always thought, 100% private. It appals me that a corporation can call my doctor and be told intimate things about me, just for the sake of financial profit. In theory, anyone who knows who my GP is could call them pretending to be from a life insurer and ask for information. It's all very well to say that companies "cannot get any info from your GP without your consent" but in practice, if you don't give your consent, the company won't deal with you and you lose out. I already choose private healthcare for everything other than very boring stuff, but money is tight at the moment and I don't know how to go about getting a private prescription for anti-ds. It's good to know, thought, that insurance companies don't always ask the same questions - thanks for that orangeflutie :)

horsewhisperer78 I am glad that herbal supplements are working for you! 'm reluctant to go down this route - if they don't work, I've wasted my money, and if they do work, I am taking a psychoactive drug without medical supervision. I don't think that's a good idea given that my mental state is already fragile.

saggar thank you for telling me about this new Equality Act. My therapist mentioned something like it but I didn't really take it in. I will look it up.

I know someone going through this and I see exactly where you;re coming from. My view is, the worse your depression gets, the more your options shrink and the more anxious you will get about this. If your usual strategies aren't working, what are you going to do and do you know when you will consider drugs? Because the stress of keeping it all under wraps can just get too much, unmanageable.

I think it takes a huge shift in mindset. To be open with a few close people, to gradually lose the shame and to be prepared to fight for your rights if that time comes. Not at all easy.

secretsorrow I understand your point of view perfectly. There's no simple answer. I would go to your GP and explain the problem and ask if it could be recorded as 'functional depression' ie that it has arisen out of a particular incident eg bully, assault, or something similar - which would be a perfectly natural reaction to any external event like that.

If you are ever asked to disclose treatment for mental health problems i would just say you'd never had any, and hope for the best. If there was any reason why an insurer would ask your GP, he would be told 'functional depression' and that would probably be an end to it.

Some people would disagree wholeheartedly with this approach but the fact is that mental health problems are still stigmatised and people can be seriously disadvantaged because of them. There's no reason why the op should fly the flag for mental health anti discrimination.

However secretsorrow - you MUST get some treatment or things will only get worse and you may well end up in a situation where everyone will know anyway.

Hello all (waves) - just thought I should come back with an update.

Unfortunately, things have got worse - I'm now unemployed :( which obviously is stressful and have also hurt my back so I haven't been able to exercise, which is what has kept me sane for the last few years. I finally saw my GP and have a prescription for Prozac but I haven't started taking the pills yet. I'm having some physical health problems (besides my back problem) and I feel like these aren't being taken seriously because I have admitted to being depressed. I know that things like tiredness and sleeping badly can be depression related but I am also having tummy problems, salt cravings, hair seems to be falling out, bad taste in mouth, weight gain on tummy which is usually the one place where I DON'T put weight on - this happened before I stopped exercising so it's not down to that. I have had some blood tests already but nothing conclusive came back - just mild thyroid problems (apparently not enough for them to do anything about it). I think they should do more tests, e.g. for PCOS.

I know I am depressed but I don't want to start my ADs until my physical problems are diagnosed properly in case I get side effects that confuse the issue. I am afraid that if there is something medically wrong, it will be masked by the ADs. I don't think my GP is listening, I feel like now I have admitted to depression every other health issue I have is being dismissed as part of that or hysteria or something. The GP hasn't asked about how I'm feeling, symptoms etc - just said "OK, blood tests haven't shown up any medical reason for depression, do you want ADs?" I felt like she just wanted to prescribe something and get me out of her room. I am going back tomorrow to talk about this again.

I never went back to my CBT - I would like to start again but can't afford it now that I'm out of work. I have refused an NHS referral as I am too ashamed to let anyone else know I'm depressed and I don't want to make a bigger blot on my heath record than I already have. Also apparently when the GP refers you, all you get initially is a phone call from some randomer to assess how mad you are and I couldn't cope with that. I hate the phone at the best of times.

Ugh, I am doubting myself now. Maybe all my symptoms are in my mind? I know that health paranoia can itself be a feature of clinical depression... but really, I am not imagining these symptoms. I just feel like I don't want to start on the Prozac until I have a better idea of what's wrong physically.

Sorry not to have more positive news. Hope everyone else is doing OK.