Thanks for addressing my comment! It really does make a difference if you have a strong enough relationship with your doctor over time so the advice is appreciated!

Hi MMC,
You're welcome :) I was looking for a topic and you handily provided. I'm always happy to address a topic of interest.
- Natasha

This is a great article - and unfortunately it is one that needed to be written.
My personal experience is I have a regular doctor (called a General Practitioner here) at my medical centre who is particularly trained in psychiatric medicine. In many ways he is very astute and I particularly like his pragmatic approach and realisation that some patients need the spiritual side of what they are experiencing recognised. He has always let me decide which options to take. However, he clearly has some kind of political issue with the psych team at the hospital and was not happy that twice I went to emergency psychology services. I actually needed to go both times and one time it prompted a necessary medication change.
My doctor, I think, likes to work alone and not have others involved in his patients' cases. At least not the hospital psychiatrists. It's slightly dangerous but I am aware of it and manage around it. When I wasn't thinking clearly I was lucky to always have my husband or mother with me as an advocate.
Because I'm somewhere around Bipolar II/Emotional Instability I know that my judgement isn't quite correct at times so I do listen to my doctor as well. To get that diagnosis (instead of just depression/anxiety) he did refer me to a specialist psychiatrist at our community mental health service. Apparently he is happy to work with them.
Sadly in all areas of medicine (in my country anyway) there are people with egos and there are politics. This sort of thing should never impact on patient care but it does so we have to trust the professionals, but definitely not blindly.
Thanks Natasha :)

Great article.
I work as a family practitioner with a strong focus on mental health and mens health.
I have to admit one of the patient presentations I find frustrating is when someone turns up and states they are suffering with "diagnosis x" say for example conjunctivitis.
The problem is that I can never be sure that what I have in my mind as conjunctivitis is the same as my patients.
For this reason I usually respond with something like, Ok, seems like you have done a bit of research into this, just to make sure we are on the same page, can you tell me about the symptoms you have been having?
This enables me to get back to the physical symptoms and enables me to make sure it is what the patient describes plus exclude more dangerous things that are not always so obvious.
I think as family practitioner I do this more frequently so P-docs can sometimes get a bit huffy when they are told of diagnosis x or y.
For me in psychiatry we are treating symptoms, so the diagnosis while it's nice to have, making sure the symptoms are fully addressed is more important.
Regards
Dr George

RedBessRead,
Actually, I think doctors wanting to work alone is one of the problems in the medical field. When they don't want to, it makes me think they are doing something wrong and they don't want anyone to find out, or, heaven forbid, question their judgement. And, if you need emergency services, then obviously you _need_ emergency services and politics shouldn't enter into that.
You're welcome :)
- Natasha

Hi Dr. George,
Nice to hear a doctor's voice in the discussion.
I can definitely see where self-diagnosis is frustrating for a doctor. It's frustrating for me too, and I'm just a writer :) I always tell people they need a professional evaluation and diagnosis and self-diagnosis is never appropriate.
It's good you've learned to handle it well, so we can all benefit.
I would tend to disagree that a diagnosis matters little. True, I care much more about getting rid of my symptoms than I do about a label but without that label, research and treatment becomes much more difficult if not impossible. Far too many people with bipolar disorder are treated improperly with antidepressants for just this reason.
- Natasha

This is a great article. I often have discussions with my doctor and we have agreed upon this: I'm really smart, well informed, and as he has pointed out, I am the expert on ME. He is also really smart (my own opinion), also well informed although about different things, and as he pointed out, he has experience and knowledge that I don't have - how the "general population" responds to different treatment. He takes me at my word when I say "I've had this reaction to x medication in the past" and I understand that he knows more about the world in general than I do and our sessions are usually a good two-sided discussion about my treatment. I think it's borne out of mutual respect and trust. And I have to laugh, because before reading this, I had printed out (and highlighted parts of) and article about the HPA axis to bring to my next appointment.
I wish all doctors were like this one. Some just have total ego and self esteem problems and not only refuse to read what you bring in but also dismiss objectively measurable side effects (an example from my own life - resting pulse averaging above 130 after starting a medication with tachycardia listed as one of the most likely side effects) as "all in your head" without even bothering to see for themselves. I think those guys, if you have the option, are best left to torture other patients while you find yourself a decent doctor.

Danielle,
" I think those guys, if you have the option, are best left to torture other patients while you find yourself a decent doctor."
I couldn't agree more.
- Natasha

Last time I went to my Nurse Practitioner Psychiatrist, I asked for my records so I would have a copy. With that she labeled me as untrusting and paranoid, and changed my diagnosis from clinically depressed to schizophrenia. This made me realize that she may be the paranoid one and I am considering changing doctors as a result.