The Stigma of Mental Illness Will Follow You

Let's just get the diagnosis out of the way now and be done with it. I have been treated for bi-polar type II disorder for a bit over eight years. I have never been hospitalized for said illness and cope quite well. I have a good psychiatrist who listens and will make adjustments to my medication when I need it. We make decisions together when it comes to medication. A good psychiatrist will give you back your power when you come up out of the dark hole of depression. My doctor made it clear from day one that I was in charge of my care unless he felt I was a danger to myself or others. I have been in charge ever since and this allows me to be honest with him and not feel like a nut job.

Unfortunately, even though valiant efforts have been made to de-stigmatize people with organic brain disorders the prejudice persists. Where it persists chronically is in the medical profession itself. Even the term, "organic brain disorder" may seem odd to many people. I don't see why really when after all the brain is an organ and if it functions in a disordered fashion barring any physical injury than it is organic in nature. End of story. My childhood was great, my parents loved me, and I like myself. I just have to deal with a mood disorder that has been somewhat hereditary in nature. In order for me to have avoided this disorder I would have had to pass on being born and frankly I like living. What I do not like about living with the disorder is the reaction I have from doctors in other fields of medicine.

In 2007 I experienced a difficulty swallowing on an increasing basis. I began to choke on food now and then. My heart started to race off an on and I was tired. My GP gave me a cursory once over and sent me for some blood work. The second time I visited her I was told that my blood work seemed fine and that she could not find anything wrong. I had lost some weight by then and she asked when was the last time I checked in with my psychiatrist. The proverbial "light bulb" went off in my disordered mind, I add with sarcasm. "She thinks I am a head case", I thought. Then the next thought was, "don't cry"! I got myself together and told the doctor that I clearly knew the difference between being depressed and being sick. I was not depressed but I was sick and if she did not want to help me I could move on. She did send me for an ultrasound of my neck and a barium swallow. The swallow showed a slow wave abnormality where the esophagus empties into the stomach. The ultrasound showed a nodule in my thyroid. I had a biopsy and then a complete thyroidectomy. I had thyroid cancer.

What is important for doctors to remember is that people with brain disorders can also get sick with other things. Cancer does not spare people with depression, bi-polar disorder or schizophrenia. If anything it is more likely to kill people in this population because we are not taken seriously when we get sick. More recently my rheumatologist who has treated me for years for fibromyalgia and arthritis discovered many auto antibodies that are suggestive of undifferentiated connective tissue disease. The tests correlated with how I had been feeling of late. In that context my doctor sent me to a specialist at the Women and Brigham's Hospital in Boston for a second opinion. I was very ready to start on medication to relieve some of the more debilitating symptoms I have been experiencing. My local rheumatologist was very sure I have undifferentiated connective tissue disease based on laboratory and clinical findings. His question was to perhaps start on Methotrexate or Plaquenil. Immune depressing drugs that are commonly used to control autoimmune diseases.

When I first met with Dr. Todd of Brigham and Women's hospital I was a bit taken off guard. His first line of questioning centered around my psychiatric medication. "What are you on Depakote for"? "What are you on clonazapam for"? I answered honestly because I have what I have and it's no big deal or so I thought. In retrospect he didn't ask me why I was on a high dose of Levoxyl. He did comment on my high heart rate. Apparently he was unaware that a person with no thyroid and a history of thyroid cancer must stay TSH suppressed in order to quell any tiny cancer cells hanging around. Thus causing a higher than normal heart rate. I would rather beat faster and live longer if you know what I mean. No mood problem detected in that thought process. A person that wants to live is pretty much mentally holding her own. As we neared the end of the exam he announced that he did not think I had a connective tissue disease at all. He barely glanced at my test results or lab reports concerning my spine problems. When I motioned to the paperwork and asked if he had checked that over he told me that he didn't trust other lab results. He did send me for some blood work in his hospital and said he would e-mail me the results.

The e-mail was also sent to my local rheumatologist and GP. In essence he stated that I had winced out of proportion to the amount of pressure he was applying to my upper extremities. Later in the report he noted that I, "amplified my symptoms". His lab results did show an elevated antinuclear antibody and a slightly elevated RNP which may indicate an autoimmune problem but he did not think I had anything of that nature. In his opinion my pain was most likely related to my spine abnormalities. So, it would seem that the stigma of having any mental illness will follow me whenever I seek out alternate care for unrelated issues. A mental illness of any proportion cannot alter blood work. It cannot curve my spine and create a large bone spur. It cannot create cervical stenosis or degenerative disc disease. It cannot manifest a condition known as raynauds disease which is a circulatory disorder common to autoimmune problems. It did not cause my thyroid cancer. It may however be the death of me as it seems to get in the way of unbiased medical care in a timely fashion.

Luckily, as I am not a head case I get to fire doctors that do not work with me or for me. I get to write about my experiences with the medical professionals that still, not so secretly harbor prejudices against people that live with mental illness. I would like to caution them however, that there by the grace of God you do not have to go. You should be as unbiased when dealing with me as you are when dealing with a diabetic. An illness is an illness by any other name.