GP Report Anxiety & Stress After Rape

[GoosberryGhost]

I am off work for anxiety/ stress/ depression. What work don't know is that this is as a result of PTSD due to historic sexual assault. I don't want work to know this bit. GP agreed to just state anxiety and depression on sick note. If they ask my Doctor for a GP Report (they have done for a previous health issue) would it have to cover the PTSD and rape? Or could it continue to mention what I want it to - the stress and anxiety issues?

I am not sure but I would put it in writing to the practice manager and ask for a note to be put on your records. You have every right to keep this information from your employer.

This is causing me a lot of additional worry at the moment. If I refused a report could that go against me in anyway? They already have the sick notes anyway.

I'm sure it's very distressing for you but I can't see how the GP cannot omit this part. It's not your symptom, it is the cause of your MH problems so there's no need to disclose such personal information. Contact the practice manager and discuss with them

The problem is PTSD is part of my medical diagnosis so I think they might have to divulge that as part of a medical report? The symptoms I am struggling with are anxiety/ insomnia/ depression/ stress which is what is listed on my sick note. My bosses are all men in their 50s and as lovely as they are I don't want this information out there. Not helped that there is no HR department for the company I work with.

Surely PTSD, depression and anxiety are the health issues? The cause of those problems is irrelevant.

The PTSD is relevant as your diagnosis and in terms of the nature of the support or adjustments that may be useful. PTSD could be caused by any number of things, they won't know what your trauma was.

The cause of the PTSD is irrelevant and there would be no reason to include any reference to it.

Whenever I have had medical reports written about me for an employer I have always been sent a copy first so I can confirm there are no mistakes and I can consent to it being sent on.

Is your GP going to let you see a copy first?

@GoosberryGhost

This is causing me a lot of additional worry at the moment. If I refused a report could that go against me in anyway? They already have the sick notes anyway.

Just re-read your op. They haven't actually requested a report yet?

Usually you can refuse but you would be disadvantaging yourself - your employer would then have to make any decisions about reasonable adjustments or dismissal on capability grounds without information that could have enabled you to continue working instead of being dismissed.

Better to work with your GP and your employer.

Although at the moment it sounds like these are all hypothetical worries. Are you feeling out of control and trying to find some certainty?

Yes they would let me see a copy first. I know that at that stage I don't have to consent to my employer seeing it. If I don't consent can there be any repercussions? And if my GP has agreed to leave PTSD out of my sick note do you think there is a chance they would agree to leaving it out of my report?

No but last year I had to take 4 weeks off for a respiratory condition and they requested a report. My colleague had a report requested when signed off with depression. So I expect them too.

Your GP cannot disclose or name you as a victim of sexual assault - it's illegal.

The report should be written by an occupational health professional anyway - GPs don't usually get involved with this, the same applies - they will not disclose sexual assault.

The occupational health person may ask your gp for a report but again no disclosure will be made to your employer about what caused the trauma.

I can't speak for your GP but it's possible. They might take the view that it would be better for the employer to have that information (only the PTSD diagnosis, not the trauma itself) in order to better understand and support you.

Worst case scenario, if you didn't consent to its inclusion and GP felt it should be included then they're not going to send it.

There's no HR department, but I would be surprised if they didn't ever use external HR/legal/occ health consultants. Having more detail might result in them engaging better advice for themselves. But I've not known a GP write more than a very basic one page letter - they're not occupational health specialists. They're basically trying to avoid paying for OH by asking for a GP report.

Medical reports to employers only disclose what is relevant and necessary. They shouldn't even name specific medications just identify any effects the employer needs to be aware of (e.g. can't operate machinery).

They're not going to disclose your trauma.

It feels too personal to have them know I've even been through any amount of trauma even if they don't know the cause. I don't want them to see me as a victim. My GP agreed to leave it off sick note because I was distressed at thought of it being included. (The PTSD). I really want to know if it can be left off a report. Because the reason I am off work is anxiety/ depression/ insomnia. Not the PTSD.

I am off work is anxiety/ depression/ insomnia.

All symptoms of PTSD - you are off work because of PTSD i am afraid.

I don't think any GP will leave that off the report - who diagnosed you with PTSD?

Why would you mind having the PTSD listed though? If they didn’t mention the rape or the cause of the PTSD (I don’t think they would anyway).

Sorry for what you’ve been through

I guess because I work somewhere quite gossipy and it invites speculation to what trauma caused it? Even if it'd just amongst the bosses. When my colleague had time off for depression the whole office knew about it. It's a small business with no HR department. It's a nice place to work but undeniably gossipy. I might just say no if they ask and see what they do with that. I was happy to provide all medical info requested about my other condition. This one feels deeply personal though and I'm almost protective of it. (I know that sounds and is bizarre).

@MonkeyMooning the GP (the one who would write the report and who also agreed to leave it off my sick note) diagnosed me today when I told him about all of the symptoms I've been experiencing. He has referred me to additional support but there is a very long waiting list and has also prescribed anti depressants.

Ok, so if the reason you are off work is anx/dep/ins and they ask for a report about why you are off work it will detail your anx/dep/ins not your entire medical history. Just like they wouldn't mention your previous respiratory condition, and the report about your resp condition only discussed your resp condition.

(Usually the request for a report will be worded along the lines of "employee is off due to anx/dep/ins, please provide details of how this affects them in workplace, any adjustments, etc" , so it's already ringfenced.)

But if this scenario happens, all you have to do is speak to your GP. They sound like a reasonable person who has listened to you and respected your wishes in the past. There is no reason to think they wouldn't do so again.

If it sets your mind at rest, maybe write down somewhere safe what your plan is if they ask for a report. So "I will make an appointment to speak to my GP to discuss it" perhaps. "My consent is central to any report that is issued." "My GP has always respected my consent in the past." Maybe a note that you can call the Acas Helpline if you want employment advice on the process. Things like that.

It might help you feel more in control and able to take a break from actively worrying if you've got a plan written down safely for if you need it? (I do appreciate that this thread is already you doing that too.)

Victim is an objective descriptor. It's not a slur. It doesn't infer anything negative about you. It doesn't redefine you. The judgement you're placing on being seen as a victim is coming from within yourself not other people. Trauma makes us feel ashamed even when nobody else is actually shaming us. (And not all trauma is caused by humans, so people don't always make the assumption it was.)

At least, that's my view as someone else living with trauma and how I try to stop uninvited feelings of shame from crushing my soul.

Ah. Today! So the idea of PTSD is still very new and a bit of a shock then?

Pp does make a fair point that anx/dep/ins would generally be considered secondary to PTSD.

Tbh, maybe just make a phone appointment and ask your GP because this is clearly causing a significant amount of distress and none of us can definitively answer what they will or will not do.

In the meantime, did they offer you any resources to help you with processing, making sense and coping skills for the trauma symptoms?

No nothing like that. Just told me to take a break from work, gave me the prescription and told me the further specialist help could be 6-12 months away. It's all come as a bit of a shock. I was raped almost 9 years ago and I didn't really think it was relevant to my current situation. I do constantly feel on edge/ unsafe at the moment though. My partner has been suffering with depression and I thought my MH issues was a response to having to deal with his and not something in their own right if that makes sense?

That does make sense. It's very normal for trauma not to really hit you until many, many years later. It's normal to feel shocked to hear it as a diagnosis too!

I can't find the link I wanted (it was a couple of pages of trauma-specific self-soothing strategies). Which is a bit frustrating. 6-12 months is a long time for you to be left without even a psycho-education leaflet.

I'm not going to advance search you, but I'd be lying if I said I wasn't a bit concerned by what you might be referring to with your partner. Your current difficulties could be at least aggravated or brought to the surface by whatever is going on there.

Separately, things that are helpful in recovering/managing trauma especially when you're in a bad place:

1. Understanding trauma and how it works - helps you to make sense of what you're feeling, your reactions, what your brain is trying to do (/why you can't "just move on" even though you want to) etc; helps you feel less crazy; helps you be kinder to yourself; helps you care for yourself

1. Grounding - connecting to the present and bringing yourself back to where you are right now rather than in the past with your trauma or in the future with your worries about medical reports. So paying attention to the wind whistling outside and the floor beneath your feet, your breath moving through your lungs. Reminding yourself where you are right now and what is happening right now.

1. Safety - finding ways to feel safe. Whatever that means for you. Maybe there's a particular place in your home, or body position, or mantra you can use to remind yourself "I am safe" (keeping it short and simple and repetitive is best).

1. Soothing - calming your nervous system. Being kind to yourself (it has similar effects to another person being kind to you); holding a soft blanket or cushion, having a warm drink, using the Breathe app to settle your breathing down, watching your favourite film, doing a puzzle, using a colouring app...

1. Compassion - be kind to yourself, don't beat yourself up, be a gentle friend, do nice things for yourself for no reason other than to do something nice for yourself. As mentioned above, it does actually calm your nervous system in the same way as when another person is kind and comforting to us, so it has a purpose!

Grounding / safety / soothing are useful things to deploy in response to a trigger or spike in difficult feelings. Soothing / compassion are things that can be helpful throughout the day.

Give yourself a bit of time to wrap your head around the appointment today. The shock will ease up.

Thank you @user1174147897 that is very helpful. I will save your post so I can read through it as and when I need to.

DH has suffered with depression for many years. After lockdown/ Coronavirus it has gotten significantly worse. I am under a lot of stress/ pressure trying to keep things going and I think that has bought previous unresolved trauma to the forefront.

I hope things start to ease up for you

My colleague suffered PTSD following a traffic accident. It doesn't have to be something as personal as the causes of yours. There is no reason that the root cause and assault should be disclosed.