[sconnie892]

It suddenly struck me that at my doctor's appointment Monday morning I will have to decide how much to share about my therapy. I started therapy after my last appointment and haven't been back since then.

To top it off my doctor left this practice and now I am going to be seeing a nurse practitioner. So I will also have to explain all the things my doctor already knew about me (like that my blood pressure goes through the roof when I walk in the door because I am afraid of needles.)

I have individual health insurance so keep some of my therapy stuff off the medical record could be a good thing. (I pay cash for therapy.) But I know the doctor should probably know this stuff too - especially since I am using supplements to help manage the dysthymia.

I just don't want to get hammered about taking meds (I am working hard to avoid meds) or be grilled about my therapy. I kind of like to keep therapy topics with my therapist.

Anyone else been in this kind of situation? How much does your doctor really need to know?

[elliemay]

If you feel as though you have to say something about therapy I would just say "I am in therapy".

Likely they will simply ask "how's that going?"

I would just say "fine".

Regarding the supplements, I think you should tell your them that you are taking then. You really don't have to say why. I doubt you will get hammered for that at all. A lot of people take supplements for a variety of reasons.

All in all, you are in control of this visit and you don't have to say anything you don't want to.

Are you talking about your GP or a pdoc? That would be the difference to me.

My GP knows what meds I take, but he NEVER asks me about my mental health issues unless I specifically bring it up. All he needs to know is what meds I'm taking (he can figure out why on his own; it's not rocket science) so anything he prescribes doesn't interact wrongly. I've been seeing him for years, and he did initially help me with antidepressants, but I moved on to a pdoc to handle my mental health issues fairly quickly.

Now if you are talking about a pdoc, I'd say he would obviously need to know about your therapy. Completely different scenario.

[skeksi]

I edited my original reply because I didn't read your post closely enough!

I don't see why you need to share anything except the supplements you are taking (doctors should know what's going into your body). And there's a simple answer to that: "I take the supplements to deal with some mild depression (if you want, you could add "that I'm addressing in therapy").

If you feel the doctor is pushing meds--which is probably not likely if you don't ask about them or complain about worsening depression symptoms--I think you could just say, "Thank you, I'll keep that in mind."

As everyone else has said, my mental health is generally the last thing on the GP's mind.

[Anne2.0]

The only doc who has ever asked me about therapy was a pain intervention specialist. I am assuming you are referring to going to a GP and not a PDOC. Since people usually see PDOCs because they want meds, you may be going in the wrong direction if you want to avoid them. But my general doc has never asked me about T or hammered me to take any kind of meds, much less MEDS.

I think the conversation that Ellie proposed is a realistic and easy one. It shouldn't be more than that. Docs aren't trained in mental health issues, there are few reasons for them to want to inquire about it, and a check up isn't likely to be one of them.

[ECHOES]

Taking meds is entirely up to you, and you are free to say that you don't want to take them.

I tell my doctor that I'm in therapy and not much else because he doesn't need to know.

[sconnie892]

Originally Posted by farmergirl

Are you talking about your GP or a pdoc? That would be the difference to me.

My GP knows what meds I take, but he NEVER asks me about my mental health issues unless I specifically bring it up. All he needs to know is what meds I'm taking (he can figure out why on his own; it's not rocket science) so anything he prescribes doesn't interact wrongly. I've been seeing him for years, and he did initially help me with antidepressants, but I moved on to a pdoc to handle my mental health issues fairly quickly.

Now if you are talking about a pdoc, I'd say he would obviously need to know about your therapy. Completely different scenario.

It's a GP. I don't think my insurance will cover a pdoc as it provides no coverage for mental health.

I live in US and I were buying individual health insurance, and paying for therapy out of pocket, I would not tell my MD anything about being in therapy or using the words depression .... because once that is written in your history or records the insurance companies have access to it and it would be used in rating you for insurance..

Of course, my opinion of that would change if depression was not helped by therapy alone and my T suggested I talk to my GP about medication...

[Gently1]

I have been with the same GP for years, and in her practice mental and physical wellness have the same importance.
When I first became ill with depression I had not realized that that was 'part of her job description'. I was surprised as I assumed GP's were only about the body. So on recent appointments she asks for an update, even though I see a Pdoc and a therapist.
My GP was my first therapist and this was my first time I ever had depression, that was until I could get to see a Pdoc. (In Canada it can be a 6 month wait) I am comfortable with sharing general information, and never feel anything but supported. I trust that if suddenly I was way off the path to wellness that she would let me know.

If I had a new doctor I would want them to know about all the medications and would want depression to be taken seriously as my physical health.

I can understand the difficulty in trusting a new health care person. Some health care practitioners are not comfortable with the 'mind' and mental illness, but many are there to treat the whole person and respect individual needs.

You have a choice on what you want to say or do not and deciding what is best for you. Having choice also means having to live with the consequences.
And I understand insurance is a big deal as I am on long term disability and dealing with that has set me back on more than one occasion.

Hope your Monday goes better than expected.
G

[healed84]

The only thing my GP knows is that I need meds and she rx to me and that I am indeed in T. And.. for me, that is enough.

[sconnie892]

Originally Posted by Readytostop

I live in US and I were buying individual health insurance, and paying for therapy out of pocket, I would not tell my MD anything about being in therapy or using the words depression .... because once that is written in your history or records the insurance companies have access to it and it would be used in rating you for insurance..

Of course, my opinion of that would change if depression was not helped by therapy alone and my T suggested I talk to my GP about medication...

Yup. Unfortunately last year when I was looking at new insurance options, I had to tell them about my anxiety. So, t is already in my record. But that was before t diagnosed dysthymia. I wish I had discussed this with t last session

[sunrise]

Originally Posted by sconnie892

How much does your doctor really need to know?

sconnie, I don't think my doctor knows I am in therapy. Maybe I mentioned it once a long time ago. I don't recall she had any comment really, certainly not disapproving. She strikes me as the kind of MD who would think well of patients getting help from therapy. If the reason you are in therapy is related to your MD visit, then you could mention it. Like if you are feeling depressed and go see your doctor for that, you could tell her that you are already in therapy but that you need something more and inquire about medication or natural supplements or whatever kind of info you are hoping to get from the MD. I am sure most docs would be pleased to know a depressed patient was already in therapy. I doubt you would be "grilled about your therapy." Medical providers have limited time to spend with their patients so I don't think they are going to stray too far from your presenting problem that day.

I see a psych NP for meds and my family doctor likes that too as it means she doesn't have to worry about prescribing me psych meds or have office visits with me that are psychiatric in nature. That is not her area of expertise.

As far as having to explain everything to your new NP, you probably don't have to. If it is the same clinic, the NP will have your chart from your previous provider. In my chart, for example, it says very clearly on the "current problems" page that I have "white coat hypertension", which means my blood pressure is very high when I have a doctor visit. It sounds like you have something similar.

[granite1]

my np knows about my T she is the one who pushed me to go.it is nice that she knows about my anxiety for the same reasons like my BP going sky high just because i am there. i dont tell her all my problems or anything like that but she does give me medication for anxiety when i need it and to sleep

[Hope-Full]

I might be in the minority here, but my GP not only knows about my therapy, she communicates with my T a few times a year - they collaborate as much as possible to ensure I'm getting the best all-around support possible. My depression meds are all monitored by my pdoc, who also checks in with the team whenever there is a med adjustment. I don't know, I am glad that they all communicate, it makes my life easier knowing they're all aware of what's going on.

Don't get me wrong, I don't talk with my pdoc or GP about the contents of my therapy, that stays with T and T only. But as my health is impacted by my depression, it's good for me that they all talk.

[skeksi]

FYI for the "white coat hypertension" (which is very common), you can ask that they take your BP at the beginning of the visit and again right before you leave, when your anxiety has quieted some.

my gp knows i am in therapy. gp gave me a six weeks off of work, (fmla) and so he communicated with t for that, gp also prescribes my anti depressants and anxiety. last time i told gp i needed more anti-anxiety, he really didn't want to do it, until i added that i go to therapy weekly, then he was right on it. they do talk once i awhile. i gave them both permission, but i have no idea what is said...

[sconnie892]

Originally Posted by skeksi

FYI for the "white coat hypertension" (which is very common), you can ask that they take your BP at the beginning of the visit and again right before you leave, when your anxiety has quieted some.

This is what my old GP did. It was amazing how much it would drop by the end of the appointment.

My T suggested his fathers NP , so they all know everything...go team LOLA

[critterlady]

My GP was the one who first prescribed antidepressants for me. She would only continue them if I was in therapy. She knows almost nothing about what I'm working on in therapy and the most she's ever asked was whether I liked my therapist or did I want a recommendation for someone else.

I've recently started seeing a pdoc for med management. She knows a little more than my GP, but not much. She doesn't ask for details when I deflect her questions. It's one of the things I like about her.

[elysia]

I told my MD about what happened to me. But I do so with Mds sparingly. In the case of this MD, my ex T went to her herself apparently and thought she was a "safe" person to tell.

I saw her because I needed a new MD. I also needed anti anxiety meds because I was going to have to see and interact with my perp. So I needed her to write a prescription. I briefly mentioned I would be in a stressful situation over the weekend. She asked if I wanted to talk about it.

I took the plunge because of what my ex T had said. I told her I was assaulted and that I had PTSD. She told me she would strongly recommend T (lol not like I haven't tried). So in my case my dr was actually the one to recommend T.

For you, it really depends on the relationship, how trustworthy the MD seems, and how comfortable you are. People go to T for so many different reasons. Traumas, illness, injury, genetic issues, anything you can imagine. So just for your MD to know you go to T doesn't necessarily reveal anything. Don't let them pressure you into giving info though! I saw a nurse practitioner who knew I wasn't comfortable but pushed me anyway. I stood my ground and was glad I did. Go with your gut, and GL to you.

[bamapsych]

I have an appointment with an OBGYN next week. I'm a new patient so they sent me alot of paperwork to fill out. It asked questions about my mental health. I gave minimum information. I hope he doesn't even mention it when I meet him.

[sconnie892]

Thanks everyone for your responses.

I think I am going to go the minimal info route, not because I want to hide my therapy from them, but because I want to minimalize the impact it has on my private insurance rates. I am working with t to avoid meds, so prescriptions are not an issue. I will let them know about my supplements, but I won't go into details about what they are for.

I can't wait until per-existing conditions are no longer an issue for getting private insurance. I think being 100% honest with all health care providers would be good for me. It lets them treat the whole patient, not just the issue at hand. But until that won't affect my insurance, I am just not willing to risk it.

[sconnie892]

Am I glad I didn't mention anything about therapy at my appointment. It was a horrible experience and I doubt I will ever go to see that NP again. I am sending a three page letter of concern to the doctors at the clinic.

[elysia]

I'm so sorry that you experienced that. Yeah there was once a horrible experience I had as well with disclosure and an MD that and it can be very triggering. I am glad you are writing a letter and have the strength to know that it's the practitioner's issue, not yours. I hope you are able to find an MD that is worthy of you (rather than them making you feel the other way around). Is a cyber hug okay?