Friday, November 26, 2010

CGR or “Can't Get Respect”

My biggest problem with medical professionals, and sometimes people in general, is something I call CGR. I'm not formally diagnosed with it but some diagnoses make it more likely that you'll have this problem.

For many years I was being formally treated for depression and anxiety. This treatment included medication and therapy. Wanting to be responsible and honest I disclosed my medications to every doctor I saw. When asked about my diagnoses I would include the mental health stuff. As a result, almost every doctor's appointment ended with a suggestion that I talk to my therapist about whatever problem I'd gone in for.

Eventually I came off of my psychiatric medication and was well enough to stop therapy. My migraine preventative was traditionally used as an antidepressant. Naïvely, I expected to be able to clarify that with doctors and then be able to address symptoms that had previously been ignored. No such luck.

My neurologist finally changed my migraine preventative to an anti-convulsant called Topamax. Sometimes this medication is used to treat PTSD or bipolar disorder but that is much more rare than for Depakote. Once this change was made and I was off any medication that a non-psychiatrist might see as a psych med the quality of my care increased markedly. Problems such as chest pain and chronic nausea began to be investigated.

Some might say that this is related to my status as a cis gendered woman. However, Mr. Wacky, a cis gendered male, was once put on a SSRI by his GP to treat his fibromyalgia. After that the same doctor who had prescribed the SSRI would regularly ask if the symptom an appointment was about could be related to depression.

Having chronic pain or really any chronic health condition can lead to secondary depression and anxiety. The key word there is 'secondary.' Treating the primary conditions should help the secondary ones. Instead, when someone has CGR the primary conditions are blamed on the secondary ones. No wonder nothing changes in a positive way.

Sometimes people have a primary mental health condition as well as some other chronic one. These people deserve to have all of their conditions treated and deserve to be treated with respect. Yes, the mix of symptoms can be difficult to sort out

Also, I want to say that coming off my psych meds was the right thing for me. I found out that I'm not one of the people for whom they work well. So the stigma and side effects weren't worth the lack of benefit I got. If you're someone who benefits from anti-depressants, mood stabilizers, anti-psychotics etc then please by all means continue taking them. Ideally the stigma will be removed from taking these meds and needing them. That's the long term hope.
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