Last week, I had a patient tell me that she had been in mental health treatment for 30 years, and no one had ever told her her diagnosis. She is a smart lady, and knew that the medication she was taking was an antidepressant, so she assumed she was being treated for depression. With a little information she had seen on the internet, she concluded that having depression meant that she was unable to live a normal life. She thought that she must be quite impaired because of the dosage of medication she was prescribed, which she knew to be on the high end. Her previous provider never challenged those assumptions, and, in fact, never talked much about the patient’s perspective at all.
I also heard a teen say that when she experienced her first episode of depression after the death of a grandparent, she was told that she had a mental “disability” and would need to take medication for the rest of her life. She had been trying to convince herself to give up on her dreams since hearing that prognosis.
What we tell (or fail to tell) people about their mental health condition alters the course of their condition. People look to healthcare providers for explanations and interpretations of the facts. We often don’t give patients much explanation, or talk about what they think their diagnosis means. Believing one is disabled or seriously impaired is likely to prevent them from trying to live a full life.
Leaving patients to Google their diagnosis for information is no substitute for hearing the opinion of their treating doctor. Who knows what information they may find? And when we do educate, we need to remember to include the bet case scenario, not just the worst. Neither of the patients referenced above were disabled or impaired. Both were responding well to treatment, and could be expected to live normal lives. They might even be expected to thrive. They both will benefit from hearing that in their future care.
And telling teenagers with stressor induced depression to expect a life of disability is just giving out bad information. Complicated grief can cause a single episode of depression, and some people only have one bout of depression.
I know time is limited, but I think we in the health professions can do better. We are burdened by administrative concerns, but we need to take a few moments to connect with our patients and give them accurate information, and reassurance.
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