Please note: this is a preview of Bipolar rules! —That means it’s a draft. This is not the final version.
When you have bipolar disorder, advocating for your health is essential, yet more difficult than it would be for the average person. Doctors are often to blame for this difficulty. Of course, not all doctors are the same, but many treat people with serious mental illnesses differently than other patients. This is unfair and places additional obstacles in front of the people who can least handle them.
Some doctors do not believe in patients of any kind advocating for their health. I’m not sure why this is, but it is quite common for a person to see a doctor with a complaint and the doctor to tell them that “it’s all in your head.” This happens to women and minorities more often than others, and for people with bipolar disorder, it gets much worse.
It is often assumed that people with bipolar disorder lie or make things up. They are often assumed to be looking for drugs. It can also be assumed that they are attention seeking or hypochondriacs. In other words, the moment you sit in front of a doctor as a person with bipolar disorder, you may be inclined to not believe a word that comes out of their mouth. The doctor may treat you as if you are “crazy,” whether he knows he is doing so or not. Your self-defense can be seen as a nuisance.
But let’s say you overcome that problem and the doctor believes you when you talk to him about your health concerns. That’s great, right? Well, it could be. But then again, you may run into the second big problem: Doctors blame all worries on bipolar disorder.
One of the problems with bipolar disorder is that it can have many psychological and physiological effects. I suspect we can’t even identify each effect with our knowledge at this point. This being the case, doctors tend to attribute all ills to bipolar disorder or the side effects of bipolar medications. And while sometimes this makes sense, other times people actually have other problems that also need attention and, unfortunately, doctors often don’t realize this.
Additionally, people with bipolar disorder are fighting a potentially fatal illness. This often tires us very, very much. Bipolar disorder can also hinder us cognitively. We do not have the same internal resources to deal with the inherent challenges that exist within the doctor-patient relationship, much less to deal with the added difficulties of being perceived as “crazy” or “difficult” due to a brain disorder that We neither want nor ask. In short, we are less able to cope with these multifaceted situations because of everything we face, and yet we are more forced to confront them because of the complexities inherent in having a serious mental illness.
How to defend your health
But you shouldn’t give up. None of this means you’re actually “crazy.” None of this means that a health problem is “in the future.” None of this means that your health problem should be ignored. What this means is that there are systemic problems in medicine that can cause you difficulties.
Whether you’re seeing a doctor because of a lump under your arm, an itchy throat, or a side effect of a medication, you need to know how to successfully advocate for yourself.
Remember these things:
- You’re not crazy. While you may have a health problem on your mind (it can happen), consider the evidence. What other conditions may explain your concern? Have they been discarded?
- You are the expert on yourself, not the doctor. If something doesn’t feel right inside you, chances are it isn’t right.
- You deserve to be treated with the same respect, dignity and trust as any other patient. It is not okay to dismiss your concern because of a mental illness diagnosis.
- You deserve to be taken as seriously as anyone else, and you deserve to spend the same energy worrying as anyone else. This may mean additional testing, referrals, etc., to get to the bottom of your concern.
- You deserve an explanation of your concern that fits the facts of your case.
When you’re sitting in front of a doctor advocating for your health, try these things:
- Do your research beforehand. This does not mean diagnosing yourself. This means finding out what might be causing your concern so you can talk about it.
- Make a plan before seeing a doctor. Write down all your concerns, symptoms, questions, etc. Write down what you need to know. Write down your goal(s) for the appointment and what you don’t want to leave without it.
- Stay calm and refer to your notes. You will look organized and, in fact, not “crazy.”
- Please provide as much detail with as many examples as you can. For example, saying, “I feel pain in my arm all the time” is not very helpful. Saying, “My elbow hurts 90 percent of the time and it especially hurts after I shower” is much better.
- If a doctor doesn’t take you seriously, tell them openly what you think is happening and what you need. For example: “I may not be speaking very clearly. The pain is intense and keeps me awake at night, so I need a way to sleep.” (You may have been very clear, but falling on your sword a little can help move the conversation forward.)
- Ask lots of questions and try to understand what your doctor thinks. They may have good reasons for why they act a certain way, but they don’t communicate them to you effectively.
- Request or even demand a treatment plan. That plan could include testing, a referral to another person, or another appointment. Everything’s fine. Nothing is not right.
- Bring one person with you to your appointment. Someone who is assertive and supportive of your concerns and who does not have bipolar disorder may be someone your doctor will listen to. (Yes, this is unfair).
- Force the doctor to document everything. For example, if they deny you a test you think you need, tell them to write it in your file. If a doctor is forced to document something, it often suddenly becomes more reasonable. (They probably don’t want to be responsible in case of error.)
- If none of this works and the doctor still isn’t giving you what you need, get a referral to someone else. This is a last resort because in some cases it may be difficult to find another doctor.
In short, try to work within the system as best you can, even if it means compensating for a doctor’s bias. I know that’s not fair, but facing a doctor’s bias will probably make your relationship worse and you’re unlikely to get what you need. If you don’t have to continue the relationship with the doctor and want to say something about inappropriate treatment, then that’s fine, but if not, I would hold charges of bias against him – for his own good. And finally, remember that defending your health is good: it is what ought be doing. Some horrible doctors make it harder, but it’s still one of the most important things you’ll ever do. After all, if you don’t have health, you have nothing.
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