You are always the expert on you, and your health – mental, emotional, spiritual, physical, biological, sexual, psychological, social – is always your responsibility.
Mental health problems – stress, depression, anxiety, etc. – can occur for a wide variety of reasons – infection, inflammation, diet/nutrition, parasites, metabolic or endocrine problems, medications and medication changes, chemicals and toxins, injuries, physiological problems, environmental problems, social/relational problems, trauma, lack of exercise, sleep problems, etc. Problems in all these can cause symptoms of mental illness, but symptoms do not necessarily mean you have a mental disorder. Mental health symptoms rarely occur without some other underlying cause. However, underlying causes are often missed. The more information you can provide the more likely you are to receive the care you need.
If you are experiencing an acute, sudden onset see a physician as soon as possible. If your problem(s) have come on gradually you generally have time to collect information. In either case, the more information you can provide, following the guidelines below, the better off you should be.
Psychiatric medication may be needed for initial stability and some people do need or choose this option. However, all medications affect people differently, all psychiatric medications have side effects, and all these medications can and do have withdrawal syndromes. Further, psych medications simply don’t work that well. Ideally, you should use psychiatric medications for as short a time as possible and taper off one medication at a time (if on more than one) slowly and gradually. If you do decide to work with a psychiatrist or use psychiatric medications, there are a several things to keep in mind.
First, do not leave your decisions solely in your doctor’s hands. Your health and what you do about it are always your responsibility. Before agreeing to any psychiatric diagnosis or medication your doctor should do a complete and thorough differential diagnosis looking for or ruling out other causes as stated above. You should receive a medical diagnosis in the majority of cases and not a DSM diagnosis. It may be advisable to see another physician if your current doctor or psychiatrist attempts to give you a DSM diagnosis without a detailed examination, including lab work. Therapists can offer their opinions about your symptoms but should give only a tentative diagnosis, pending a detailed physical examination by a physician.
Ask some questions if a physician recommends one or more psychiatric drugs. Four key questions to always ask are:
1. What are the benefits of this medication or procedure, how will it help me?
2. What are the side effects or negatives that could happen with this medication or procedure, how could it harm me?
3. What are the alternatives?
4. What would happen to me if I did nothing?
Is the drug for a particular disorder or merely to mask symptoms? Have your physician write out the name, his or her recommended dosage, time to take the medication, and how to take it (with/without food, with water, with milk, etc.). Ask for a list of all possible side effects as well as known interactions, and your physician should go over this information with you. You have the right:
1. A deductive differential diagnosis – no matter how much time it takes.
2. To question your doctor, particularly if his or her diagnosis is primarily based on the DSM rather than established medical diagnostic procedures.
3. To obtain a second opinion – and as many subsequent opinions as you want.
4. To be fully informed about your condition and proposed treatment, and to ask as many questions as you want.
5. To disagree with recommended treatment and to inquire about alternative treatments.
6. To be fully informed about the risks and benefits of any medication prescribed to you and any forms of treatment recommended for you.
7. And your family members have the right, if you so choose, to be partners in your treatment.
Do additional research on your own before you take any medication. Your pharmacist is a good source. The Physician’s Desk Reference (on line or written) is a good resource. There are a variety of other resources as well. Ask yourself these additional questions:
1. Have you completed the downloadable questionnaire below, and have you and your primary care physician reviewed it?
2. Have you had a thorough examination by your physician or a specialist looking for or ruling out possible causes listed in the first paragraph above?
3. Have you had a second (or third, or fourth) opinion and are you prepared to be assertive in questioning a psychiatrist’s diagnosis?
4. Are you practicing any poor health habits (drinking, smoking, poor sleep habits, lack of exercise, poor diet, etc.) that could be causing some or all of your symptoms?
5. Are your feelings or behaviors possibly reactions to things going on in your life?
Avoid therapies that focus solely on negative emotions, repressed memories, or reliving past traumas. Trauma therapy, if done correctly, doesn’t necessarily require you to relive your past.
Please provide your email address to download a list of questions about ‘You – The Detective’ to help you and your physician.