by Andrea M. Darcy
You have decided it’s time to gather your courage and let your doctor know you are struggling lately. But how to talk to your doctor about anxiety and depression in a way that is productive? Or if you feel scared to?
And what if you worry it’s something more serious, like a disorder?
Will my doctor know about mental health?
Most doctors nowadays have a good general understanding of depression, anxiety, and stress.
Not all doctors, on the other hand, will be very versed in things like personality disorders and learning difficulties. Some even persist in thinking things like adult ADHD or complex trauma, relatively new terms, are not ‘real’.
In summary, yes, mental health is a hot topic of late. But not every doctor is the sort to be current. So it’s understandable to worry about bringing it up.
Things to keep in mind when talking to your doctor about mental health
Remind yourself of the following:
- You are the client, they are the doctor. It’s their job to listen to you.
- They will have had many other people ask about mental health, too.
- Everyone feels sad or worried now and then. Even doctors. Don’t assume they haven’t had mental health challenges of their own.
- Unlike friends and family, they are not invested in your decisions. So you don’t have to feel guilty telling them about what you are going through.
- They are bound by a code of ethics and confidentiality to protect your privacy.
Do I have to tell my doctor I’m not okay?
If you are on a low budget here in the UK, and want to access free mental health support through the NHS? You do need to go through your GP to get a referral. Mental health services are by referral only.
If for one reason or another you simply can’t bring yourself to tell your GP you are struggling mentally and emotionally? There are other ways to find help. Please read our article on how to find free or low cost counselling for ideas.
What if they don’t listen to me?
The last thing anyone needs is to gather up their courage to speak up, only to feel brushed off with patronising advice like ‘you just need to exercise and sleep more’. Or, ‘try to take some time for yourself’.
Or, worse, to just be offered medication after a quick 15-minute chat. Which can hardly be a full overview of you and your life.
The best advice here is to arrive prepared.
How to talk to your doctor about anxiety
Arrive armed with exact information so your doctor cannot brush you off as just ‘stressed’.
Anxiety means that you have increasingly illogic patterns of thought that leave you often feeling fearful. And that this sort of behaviour has been going on for around six weeks or more (read our article on stress vs anxiety for a full overview).
Keep a diary for a week or two, writing down:
- what your anxious thoughts are
- what triggered them or didn’t
- and the actions your anxiety then resulted in.
For example, “so worried that I will say the wrong thing at the work party become sure I will end up being hated then fired so pretend I am sick and skip the party”.
Also keep a list of physical symptoms. Anxiety is actually quite a body-based experience. So keep a record of things like a pounding heart, headaches, sleeplessness, and muscle tension.
How to talk to your doctor about depression
Depression can mean we have ‘brain fog’. Avoid drawing a blank in the doctor’s office by writing out what you want to say in advance. Be ready to explain:
- how long you’ve been feeling this way
- if it’s the first time or it’s been ongoing
- what triggered it, if anything (often depression descends out of nowhere)
- your family’s mental health history
- how it’s affecting your day-to-day life, including hobbies, relationships, family, and work
- any physical symptoms, including fatigue, sleep and eating changes, a heavy feeling body.
What if I don’t know if I have anxiety or depression?
It’s possible to have both. And anxiety can lead to depression. So don’t get obsessed over which one it is if you really aren’t sure. Instead:
- make a record of the thoughts you are having
- and the physical symptoms you are noticing
- then clearly explain the difference between what you were like before all this started, and now.
Your doctor should be able to spot if it’s anxiety, depression, or both. And if they are confused too, what matters is that they can see your daily life is suffering, and can then give you a referral to a mental health professional.
And if I am having suicidal thoughts?
Here in the UK you can be sectioned by a doctor if they think you are in danger of hurting yourself or another. So understandably many of us are terrified to admit to suicidal thinking. We want help to make it stop, but we don’t want up in a hospital against our will.
Emphasise you have self-destructive thoughts but that you are not going to act on them. You might, for example be asked if you have researched how you’d hurt yourself, or made an exact plan. Keep emphasising that no, you do not have a plan.
Of course if you want to go to the hospital, or if you really think you might carry out your suicidal thinking and DO have a plan, be straight with your GP. You can also go straight to the emergency services at a hospital.
What if it all goes wrong?
If your doctor tells you to just get rest, or tries to brush you off with a prescription for a low dose of medication, when you really want to speak to a therapist? Then the ‘broken record technique’ can come in handy. Just calmly but firmly keep repeating that you’d really like to talk to someone.
- thank you, but I’d really like to have a referral to talk to someone
- I understand there is a wait list, I’d still prefer to be referred to a therapist
- I appreciate what you are saying, but I’d still really like to be referred for therapy.
And it’s okay to think tactically. It’s your health and wellbeing at stake, after all! If they insist you take a prescription for meds, and it seems that if you walk out with the prescription they might then give you a referral as well? You do not have to then fill the prescription or take the meds. It’s your body and your choice.
How to get the referral you want
It can help to know where your doctor can refer you, particularly if you feel it’s not just anxiety and depression but something more serious. Go to your local council’s mental health pages to see what is available, or even call them up.
If your doctor is then being evasive about a referral, you can directly mention the service you are interested in. “I would like to be referred to the personality disorder team mentioned here on the local council’s mental health page”.
If your council does not have a certain mental health service, consider arriving with a list of nearby specialists who work within the NHS. “This hospital has an ADHD specialist I would like to be referred to.” The worst your GP can say is no.
If you do feel you have a personality disorder or adult ADHD, again, arrive with a diary of symptoms you are worried about. The more you seem educated on what the issue is, the more your GP will be forced to take you seriously.
Maybe I am beyond help
If they brush you off, don’t listen, or in any way belittle you? You have the right to see another doctor. It can feel really overwhelming if we are already depressed and anxious and having to deal with this. Our first instinct can be to go home, cry, and assume we are beyond help or that we are hopeless.
You are not. Doctors are people and are not perfect. And while some are wonderful, some are not. Like all professions, you get varying levels of competence. If you don’t have the courage to call up and ask to see someone else, see if a friend or partner can call for you. Ask if there is a doctor available who specialises in mental health in case that is an option.
Want to talk to a medical doctor who knows about mental health? See here for our consultant psychiatrists in London. Or why not book private therapy directly? Our online booking platform provides therapists for every budget.
Andrea M. Darcy is a health and wellbeing expert, who has done some training in person-centred counselling and coaching. She often writes about trauma, relationships, and ADHD, and advises people on how to plan their therapy journey. Find her on Instagram @am_darcy