MH can mean difficulties with accessing help

[LovelyBath77]

for physical health?

Some times in the past I have been acutely ill (needing surgery in the end, after they sent me home on more than one occasion) but what happens is the doctors see my anxiety more than anything else and assume my symptoms are psychosomatic or as a result of anxiety. Mind you have had some unusual physical problems as well which probably complicates things.

Why can't my doctors or the people who triage at A and E see past this and accept more than one thing can be going on at once? I'm really scared of being sent home again, even though the GP has now set up a care plan for admission to hospital and put this on the 11 system to help me if it happens again.

To clarify, I feel that sometimes they don't do the same extent of tests and examination, and feel it is anxiety - for example one time I was told my heart rate was very fast, but it was due to anxiety, but it wasn't, and no further exam took place.

YADNBU Bath this can absolutly be a real problem from the GP upwards. I can't go into details but we have had many instacnes of this and each time the condtion (in the end) proved ot be non-anxiety related but caused all sorts of delays, dificulty and distress in in the meantime.

We feel anxious (the irony!) about any other issues developing becasue of the prejudice. Like talking ot a brickwll.

An also it is odd that if Drs think the anxiety is so bad that it is causing all these extra symptoms but yet mental health care continues to be under funded both with the NHS and social services.

It seems to be an excuse just to dismiss and give no treatment at all

Soory for speeling/ typing - not well

With ds who is non verbal, we have had challenging behaviour regarded purely as part of his autism rather than because of a reaction to illness or pain.

Yes, well I nearly died, I needed emergency surgery and by the time finally admitted to hospital the surgeons kept saying "Why didn't you go to the GP?'- I had to have surgery in the middle of the night. I told them, I had. But they didn't do anything. Except check my high heart rate and put it down to anxiety, then dismiss my pain. I find it hard to trust docs since then, but then they put that down to MH too! They also kept reassuring me, you seem young and healthy, that kind of thing. Very worrying. I would think now due t the extent of surgery and it being on my record they might take it more seriously in future.

Also, as DH was there and they basically reassured him too, he then thought the symptoms were down to anxiety too, and kept reassuring me I didn't need to see the doctor again, or go back as things got worse.(sad) I ended up calling 999 to get taken into hospital and after a while of them too suggesting I had a tummy bug they eventually did a CT scan and operated at the last minute. But up to then, they gave no pain relief but paracetamol, seemed to think I wanted painkillers. The PCA with the surgery was the first pain relief I got. After being in agony overnight. I don;t want to go through all that again.

Did you not know that if you suffer from depression / have an ASC this means you are immune from all illnesses known to mankind. Well you would have thought so according to our GP.

I think they believe all symptoms are psychosomatic unless proven otherwise.

After my times on hospital, I got a new surgical consultant and told him I think the GP thinks it's due to anxiety, he said I'm not suprised you're anxious, going through all this! Then he wrote to the GP saying I was 'very sensible' about my condition and symptoms, the previous surgeons also wrote that 'we need to ensure we support her with the severity of these episodes' and she 'needs to come into A & E in future and is aware of this' again- as if I'm stupid, or something. They also seem to confuse MH with stupidity, at times.

Are most GPs' like this or only some? Would love to hear a GP's take on this, or other doctor.

the previous surgeons also wrote that 'we need to ensure we support her with the severity of these episodes' and she 'needs to come into A & E in future and is aware of this' again- as if I'm stupid, or something.

This sounds like it may have been the surgeon(s) spelling it out to the doctor, not implying you were stupid. Unfortunately they're not allowed to write "you utter moron, stop being an ignorant know-it-all and take your patient's pain seriously"! I think "very sensible" is doctor code for Not making it up.

I know what you mean about being treated like you're stupid in general though. Especially when they have a sort of "dont worry your little head about that!" attitude, when you are trying to clarify something (that in my case turned out to be having been prescribed the wrong medication...)

doobree also it is odd that if Drs think the anxiety is so bad that it is causing all these extra symptoms but yet mental health care continues to be under funded

Good point!

I have the joy of endometriosis (aka crazy hysterical woman moaning about period pain, collapsing and vomiting, tsk tsk) and mental health issues of the traumatised-but-we-don't-do-therapy-so-write-you-off variety.

One day I'll write about it and call it "Mad? - I'm furious"

Sigh. anyone?

My daughter's current GP is like this. I had to request a printout of her blood test results and diagnose her folate/B12 deficiency (which exactly matched her symptoms) myself! After years of accessing MH help for her, I now assume that I will be doing at least 50% of the work for most of the professionals... as well as the DWP, council etc, although that is more like 80%.

No one who hasn't experienced it can believe how bad it really is or how massively it discriminates against people who can't do these things- ESOL, LDs, literacy issues would all make the things I do as standard impossible.

PS I'm particularly sensitive about it all right now as her new PIP form arrived today. Last time took almost 18 months from initial phone call to inevitable appeal, with a formal complaint needing to be put in about the assessor along the way. On the plus side, I do now know that it doesn't matter how clearly and sensibly you explain the facts to the DWP, only going through the process of MR and appeal will get the correct outcome. Hey ho!

Yes, what they don't seem to understand is that painful conditions lead to or worsen anxiety and depression, they are interlinked, not one or the other. Functional I also have pelvic pain as well due to all the adhesions from the surgeries. Not easy is it.

Silver yes I finally got GP to do bloods for things like Vit D, iron etc which were low and can also make MH worse. and pain. It really helps to have a holistic kind of approach but as with you, had to do / prompt this myself.

About the pleasant description, the thing is at my worst physical health, I was not pleasant as was in pain and upset. It is not always possible to be pleasant. However it is often due to the issue not being tackled.

I mean, I know they get these 'heart sink' type patients, (where the docs heart sinks apparently) who may go on about imaginary stuff but that isn't everyone. I suppose it must be difficult but surely they should screen people or examine them and then dismiss it when tests come back negative.

Silver I understand as also have been through that for PIP. What i found helpful was to not take it personally as their decision makers are not medically trained, but it is very upsetting and the way they word things makes it worse. Appeals are better, though. Hope all goes OK.

You're quite right about not taking it personally. I did last time and wrote far more and longer letters than were needed during the MR and appeal stages, setting out the proof we'd provided and even points of law from their own guidance. It was all quite wasted and if I'd just written 'We want and MR' and 'We want to proceed to appeal' it would have had just the same outcome and been a lot less stressful.

The assessor was something else though- she was a mental health nurse, and part of the reason I made the complaint about her (lots of copy/pasting thoroughout of irrelevant conditions such as dyslexia, saying DD could do tasks easily when actually she needed considerable help and prompting, saying she read the newspapers when what was mentioned was sometimes seeing news articles about celebs on facebook etc) was that I felt she shouldn't be around anyone with an MH condition.

The "pleasant" thing is just more doctor code. There was a thread about it on here a while ago... I think the consensus was that doctors write "this pleasant lady/this charming lady" as standard, but if you're an arsehole they just write "this lady..." It's about how they percive you, taking into account the circumstances - they understand you'll be a bit ratty if in pain. (NB. Many mental health professionals do not do this - one is expected to be calm and coherant at all times. Then they can also say there is nothing wrong with you!)

Functional yes I may have written that post! Perhaps.

Silver yes we did just the same, reams for the MR and then the appeal. Looking back would have done like you said, as well. It seems once the decision maker has made their decision, they only seem to overturn it with more medical evidence, I since found. But we had sent all ours to start with.

Hopefully next time we will know their ways, and also have the appeals confirmation to work from.

The assessor which messed up mine chose to do the reassessment on paper, and missed off my surgical condition, basing it just on MH! So as you can imagine it was a mess. I just did a paper appeal pointing out the error and won that, so it was at least simple then, but spent such a lot of stress on it. And it also felt like past times when condition dismissed, as well

My GP is not like this, she takes all my concerns seriously regardless of my mental health etc.
BUT
Every other doctor, including those in the mental health unit, continuously disregard me. I have suffered my whole life (since I was tiny) with one of two things. The first one is ear infections. I get really poorly really quickly with them. I was told by another doctor that it's 'not possible for an adult to get really sick with an ear infection' (i'm quite literally laid up in bed - same goes for any kind of vomiting bug).

The second one is (it's odd, i'll admit, but again have always had it)
that I can't eat/drink anything containing full fat cows milk. I haven't a clue why, but if I do, I feel sick, need a lie down, vomit and then i'm fine. I've been the same ever since my mum put me on cows milk, so i've always had semi skimmed. I have always been told by doctors/psychiatrists that this is 'anorexia induced anxiety' and apparently 'every baby drinks full fat milk'

To be fair, my MH unit don't take my MH issues seriously, so i'm left untreated as per usual, but that is a whole different thread!

Yanbu.

This is a recognised thing. It's called diagnostic overshadowing.

In my experience, even when a doctor doesn't fall into this pitfall, persuading other doctors (for example specialist colleagues when trying to refer for assessment or treatment), can require quite a lot of assertiveness.

I think you are rightly frustrated with your GP, who is unfortunately, due in part to pressure on resources and time, it seems making a wrong assessment of you.

However, I also think you are being very unfair when you say this:

"Then he wrote to the GP saying I was 'very sensible' about my condition and symptoms, the previous surgeons also wrote that 'we need to ensure we support her with the severity of these episodes' and she 'needs to come into A & E in future and is aware of this' again- as if I'm stupid, or something. They also seem to confuse MH with stupidity, at times."

The consultant, a fully qualified medic, is communicating with great authority to another doctor HIS VIEW of the clinical situation. He is not patronising you, he is just ensuring his own duty is discharged by telling the GP what to do. You cannot do that for him, because you are not a consultant. That is all. He is trying to help and to discharge his own obligations in relation to your care. It is nothing to do with what he thinks of you.

Ok, thanks Kimmy yes I see, and I'm grateful for his support as well. It has been helpful.

In my experience, even when a doctor doesn't fall into this pitfall, persuading other doctors (for example specialist colleagues when trying to refer for assessment or treatment), can require quite a lot of assertiveness

Yes. In fact remember a referral letter from a previous GP who said I 'have a history of low mood and has been under stress however with the weight loss being significant feel this needs investigated further' kind of like they have thought of that already and still feel it needs looked into.

Maybe it also depends on the doctor and how they know you.

Kimmy yes think you are right about the letter but have found at other times, docs can speak very patronisingly to you as if you are a bit stupid, when they realise you have MH problems.

Found this article on diagnostic overshadowing, helpful thank you.

www.psychologytoday.com/blog/two-takes-depression/201510/depression-and-diagnostic-overshadowing

I hope this doesn't happen now (although it sadly wouldn't surprise me if it does) but it happened with my mother in her concerns for my legs and feet as a baby/child.

Because she had mental health problems the GP didn't take her seriously when she brought me to them, after being turned away many times she ran out of energy to keep trying.

I was 30 and had suffered years of pain, immobility and continence issues before I was diagnosed with spina bifida and a tethered spinal cord for which I required surgery.

I had a home birth a few years ago and got given my whole medical notes to keep at home for it and it was all in there in black and white.