Allie left her physician’s office feeling frustrated. Last month, her physician informed her that she has a chronic condition. She prescribed a medication with a list of potential side effects. Her doctor also explained to Allie that she may experience further deterioration, even with the medication.
During the weeks that followed this appointment, Allie had a difficult time. First, the side effects were even worse than the doctor had warned her about. The high copay is a financial burden. And she is worried about her future. Allie found herself bursting into tears often. She didn’t sleep well. And beyond going to her job, where she felt she was doing just enough to get by, she isolated herself at home. Allie feels sad and angry, and wonders if she will ever be happy again.
Allie brought this up with her physician at her follow-up appointment. “I don’t think I am doing very well emotionally,” Allie said. “I’m really struggling.”
“You just got diagnosed,” her doctor responded. “It’s always hard at first. But I’m sure you’ll feel better over time. Stay focused on your regimen. That’s what’s important now.”
Allie wasn’t so sure. And when she attempted to describe how she had been feeling, her physician seemed uncomfortable, and said: “Look, Allie. All I can offer is a prescription for antidepressants. Is that what you need?”
Allie doesn’t know what she needs. But she had hoped her doctor might be more willing to listen.
Have you ever felt like Allie? Some physicians are open to talking about emotions. They may be able to offer help, or if not, at least offer suggestions or recommendations. Maybe even a listening ear and some encouragement. Others don’t seem to be so willing to have this discussion. Or don’t feel it is their responsibility to help their patients cope emotionally with their diagnosis and its treatment.
Here are some ideas on talking about emotions with your doctor:
Not sure if your doctor can talk about feelings? Ask. If your doctor hasn’t asked you about your emotions, that doesn’t mean he/she isn’t willing to have this discussion. Don’t beat around the bush. Instead, use the direct approach: “I am having some emotions that I’d like to talk to you about.” You’ll get a pretty good idea by your doctor’s reaction whether your doctor is comfortable with talking about feelings.
Don’t make your doctor out to be the bad guy. Physicians are human. Some are comfortable with emotions, some aren’t. Some have had some training in how to help patients cope emotionally, others haven’t. And some don’t want to get involved. Just because a physician doesn’t feel comfortable with emotions doesn’t mean they aren’t the most qualified to treat your condition. Doctors have limitations. Emotional support may not be their strength.
But don’t let your doctor off the hook too easily. Medications can affect you emotionally, and the feelings you are experiencing may actually be side effects. Even if you get a sense that your physician isn’t a feelings person, don’t hesitate to talk about emotions from a side effects perspective. Be direct: “I’m concerned that this medication may have some emotional side effects. I’ve been feeling ____. Could this be medication related?” It can help to include a timeline, e.g. when you began feeling this way. Physicians are usually attuned to any emotional side effects of the medications they prescribe. If not, request that he/she find out. And do some research on your own.
The available options vary among physicians. Physicians have a specialty. And unless your physician is a psychiatrist, their specialty isn’t mental health. Having said that, some physicians are quite competent at making mental health treatment recommendations, and have a range of medications they prescribe for emotional issues. Along with a list of therapists they refer patients to. Other physicians are limited to a “go to” antidepressant or anti-anxiety medication they may prescribe, which may or may not be optimal for you. If you’re not comfortable with your doctor’s recommendation, consider consulting a mental health professional – including a psychiatrist – before moving forward with any treatment.
Having difficult emotions doesn’t mean that you have a psychiatric diagnosis or that you need medication. Most – though certainly not all – physicians think in terms of diagnoses, and that is how managed care reimburses their services. A new medical diagnosis, or the challenges of living with a chronic condition, can result in distress – but that may be temporary, and therefore not necessarily a diagnosable condition or something that requires medication. So keep in mind that you might also feel better with emotional support from friends and family, as well as by working with a mental health professional. Medication is not your only option.
You can find a mental health professional on your own. If your doctor hasn’t offered ideas to get help with your emotions, that doesn’t mean help isn’t available. You can check on the website – or call the behavioral health number – of your insurance company for a list of providers. You can go through the listings of local mental health providers in your area. You can check into community resources. Advocate for yourself.
Above all: You don’t have to sweep your emotions under a rug. While your physician may not be open to talking about your feelings, this doesn’t mean your feelings aren’t valid, or that you are overreacting. Medical diagnoses – and their treatment – bring up all kinds of emotions. That’s not a weakness. It’s human. And asking for help is showing strength.
Taking care of your emotions is a critical part of your self-care. So here are three important “don’ts” for you to keep in mind: Don’t be afraid of your emotions. Don’t ignore them. And don’t go through this alone. Reach out for help!