Written By Andre Nye, MD – It is common to see your doctor on an annual basis to discuss your medical problems or any preventative care you may need. During your doctor’s visit, there should always be a discussion about your overall mental health. Many times, we focus on taking care of a patient’s high blood pressure, high cholesterol, or making sure immunizations are up to date. However, 40% of what I do in the office is directly related to mental health. This is about the ratio of mental health to medical problems that exist in the general population. So, how do you speak to your doctor about your emotional or mental health concerns?
Mental Health Concerns: Speaking to Your Doctor
The good news is that if you have an attentive clinician, they will more than likely ask you about it first. Many patients come to the doctor’s office with a history of depression, anxiety, or other mental health issues that need to be monitored. For many people who have never spoken with a medical provider about their mental health, this can be a difficult discussion. In this situation, you can try to bring up the subject on your own. However, you may find this a little awkward. That is why your doctor should approach your emotional health with every annual visit and perhaps at any visit you have with them.
Mental Health Questions From Your Doctor
When I approach the patient and want to know something about their mental health, I will start with relatively soft questions. For example, “How is everything at home, and do you enjoy your job?” Usually, this fosters a relatively simple answer such as, “fine all is well.” I may ask a little later, “How is your sleep?”, “Are you able to get any exercise?”, “How is your spouse and are children doing well?”.
Simple questions such as this will open a patient to describe their home and work life. If they are engaged, they will tell you a lot about what is good and what can be frustrating. However, it is usually what is not said that prompts me to think all is not so well.
When I sense that there is something that is troubling a patient I will stop and focus on this. I will explore how things are going in their lives. If there is trouble, it becomes apparent very quickly and this becomes something we can explore together.
Don’t Be Afraid to Speak About Mental Health Concerns
If a patient is willing to answer specific questions, a little later they will elaborate on a particular problem all on their own. This serves two purposes, the first is to help me understand what is bothering them, the second is for the patient to say out loud what is not working in the life. This helps to validate the concern. Once we have defined what the problem is we can then move towards fixing it. Frequently it is as simple as asking a patient, “what do you think the solution is?” If they do not know, then we need to explore deeper so they can understand the problem better and then a way out of it.
Have you noticed I did not mention antidepressant or anxiety medicine, psychotropic medication, sleep aids, or stimulants? All these items are second-line therapy. The first order of business is to define the problem and then try to fix it without medicine.
There are times though that medicine can be a great help. Take the time to talk to your doctor, or better, find a doctor who will take time to speak with you. You might find the solution to your problem is easier than you think.
Additional Reading: Mental Illness: Warning Signs and Symptoms – National Alliance on Mental Illness
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