Wednesday, February 9, 2011

Am I a diagnosis?

I know some people who define themselves by their illness(es). I guess you can spin it either way: it's a tolerably miserable parasite to live with, or you've somehow triumphed over evil and now you want to shout it from the rooftops.

I don't think I want to do either.

As for that whole bipolar thing, I did end up talking to my doctor and I did end up talking to not one, but TWO psychologists (I was getting a little frustrated with that whole finding the right person process, so I decided to get a little polygamous and improve my odds). After talking to my GP, she seemed utterly convinced that bipolar disorder was a more accurate diagnosis.

I'm not really sure how I feel about this. I think that as someone who works in healthcare, I enjoy labeling things. I find comfort in grouping symptoms together. It was kind of a relief to have a diagnosis that to me, made my life suddenly make a little more sense. I was equally saddened, though. Old MD Girl mentioned in a comment that she thought I knew I was bipolar, but that I didn't bring it up because of the associated stigma. She's right. Depression isn't much of a big deal anymore, but telling someone I'm bipolar?

"Well, I used to think I was just sort of whimsical. Turns out I'm actually seriously nuts."

I dread the day that I encounter another physician (who is treating me) or am filling out some kind of college health form and have to list my medical history. I almost wonder if the stigma is actually worse in healthcare. In the ICU, it seems like the patients with a noted history of mental health issues are always the ones who are suspected of not being credible, of not being compliant, and that they may be trying to manipulate us. I'm not gathering this from any personal experiences I've had with these patients, I'm gathering it from my coworkers attitudes (my generally really kind, not terribly judgmental coworkers).

What's up with that?

Is it just a social norm? I hate to admit it, but I can't deny that I've been uncomfortable around patients who are admitted with psychiatric diagnoses, or that I've sometimes viewed them as somehow less human, as if they were a departing subspecies.

And now, is it reasonable for me to expect everyone to treat me the same way? I really haven't changed; all I've done is let someone slap a new label on me. I really worry that that label is going to follow me around, though. That even when there comes a day when I can come to terms with it and peel it off, there's still going to be all this residue; that even after I go after it with a razor blade and some goo gone, it's still going to be apparent that something was there.


  1. Aw, Mezzo! Of course you're the same person. Everybody totally OUGHT to treat you the same way, and I think it's fair to expect them to. If you worry too much about how other people are acting, you'll make yourself crazy! Plus, if you have your illness under control, you'll be more likely to present yourself in a way that people will take seriously. The alternative of not having it under control seems way worse to me.

  2. No, no, totally agreed. And I'm not really THAT concerned about how people will treat me (and also, I don't really have to tell most people). I think the bigger thing for me has been my gradually shifting perception of the psych population as a healthcare worker (and now patient). It used to be really easy to just draw a line down the middle. Everything was very black and white.

  3. A lot of people worry about this stigmata when it comes time to check that box on your residency application. I can't remember if there was one for the medical school application. need to ask yourself before you ever check "any" box, "how does this really affect me, and who does it affect?" To be honest it seems as if you're somewhat at ease now that someone agreed with your pre-diagnosis. Maybe it will give you answers to why you do or think certain things. Is there a good side to this? Well maybe now that you've reached the top of the hill and figured out what the heck is going on, you can continue down the other side. Your post doesn't seem as lost as some of your other posts. Now if anything comes the part of actually being able to be "empathetic" with your patients. It might give you a new perspective of medicine that you haven't had before. Take this new perspective out for a ride and see where it takes you.

  4. I have rheumatoid arthritis, but the day I let myself be "labeled" that way or start identifying myself as a victim is the day I hang up my dancing shoes. There are plenty of people I associate with on a daily basis who have no idea I have RA (and I like it that way). RA is real and it may prevent me from doing some things in the future (like surgery as a career), but it's not who I am. Any more than bipolar disorder is who you are. Unless you want it to be what defines you. I really do believe that. You've essentially got a chemistry problem, just like I've got an autoimmune problem (it probably all boils down to chemistry in the end anyway). Tell whomever you need to tell but you don't have to lead with it. Treatment is essential, but it doesn't have to become your identity. And this post does sound way more "level" than some of your other recent ones.

  5. P.S. Pretty much nothing is black and white.

  6. I hope this help you and your doc pick treatments that are right for you.