Disclosing Suicidal Ideation to my GP

Posted on July 7, 2017

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It is hard to write about difficult things. I worry about people changing their opinion of me. But this is an important topic, so here I am.

A while ago, I was going through a tough time with my body. My chronic pain was almost unmanageable and I was horribly depressed. Some days, when I went to yoga, I could not even do the forward-fold without breaking into tears. I would wake up in the morning wanting to die, or wishing I was dead.

Of course I didn’t consult anyone. The horrors of the Canadian mental health system are very apparent. You get good care only when in crisis. Being a clinical social worker myself, I knew how to de-escalate my situation. I was never in crisis. So I never got any help. I kept up the pretense of being fine. Went about my life. Showing my cheery face to the world. All the while being in so much pain that I just didn’t want to live.

Then came time for my annual physical. I went to my GP. She must be in her 40s. She’s always smartly dressed. She’s popular, busy. All appointments are scheduled 15 minutes apart. I reached her office 15 minutes before my slot as is requested. They took my weight, BP, etc. I was waiting in an exam room for her to arrive. I hadn’t thought of disclosing my thoughts of dying constantly. But I don’t know what got into me, I did.

The moment I said, I feel like I want to die, I saw the dismay and concern on her face. Or was it impatience. Because what followed next was pretty apathetic on her part. She said I have to ask if you have had any active thoughts of how you might do it. Having done the same as a clinician myself, I know the drill. So I said, I have no plan. I just don’t want to be in pain. She said this is referred to as passive suicidal ideation. I didn’t agree with her. But I was done arguing. I felt like I had to take care of her, more than she took care of me. I switched gears and talked of all the things that help me feel better. So she said, just to be safe, fill out this questionnaire. She gave me a tablet and left the room. I had to answer 15 questions about my thoughts, my general mood — these questions are so dumb, that one can just answer them falsely. I didn’t. Because I really didn’t want to die, but I felt like I had to because the pain was killing me slowly.

When did tablets replace human beings? Don’t answer that question. I think she had a better chance of me being truthful had she taken the time herself and gone through the questions with me — NO TABLET! Are doctors so busy that they cannot spare 5 minutes with a person in pain? Was she taking care of me or herself?

She came back in. Before she could offer any medication, I said I will not take medication because I really don’t put any chemicals in my body. I promised to go to therapy. She didn’t ask if I had a therapist. I didn’t ask for the name of one. I told her I would be checking out a support group. She did provide me the name of a physiotherapist I could see — different from the one I had seen the year before. She asked me to take care. I left. I don’t know if she trusted me to know I would do what it would take make myself better, or this is just how the system works. People like me are beyond help.

I went back after a few months. It wasn’t a mandated follow-up; I went because I had another issue that I wanted to have addressed. She didn’t ask me how I was feeling. But I felt like I had to offer that information. I said that I was doing much better (I was). I was working out, meditating, eating differently, etc. She praised me and said that as long as I was working out regularly she wasn’t worried and that I would be fine. No questions asked.

The gross inadequacy of GPs is mind boggling to me! I hear about it at work daily. GPs do not take clients seriously when they disclose issues like memory loss, issues with language. It often takes people several tries to advocate for themselves and get a referral to see a specialist! And heaven help the person if they are in their 40s or 50s experiencing symptoms of dementia! What if the person is losing insight and refusing to get a check-up?

According to the Centre for Addiction and Mental Health, 1 in 5 Canadians will experience issues with mental health in their life time. That’s 20% of the population. According to the Alzheimer Society of Canada, there are more than 500,000 people living with dementia in the country. That number is said to double in the next 15 years!

GPs are our first line of defense. We need to strengthen that base. We talk constantly how people need to take charge of their own lives — but sometimes we falter. If we cannot rely on doctors, where can we go?! It is not enough that GPs pass their medical exams. I feel it should be mandatory for them to take a few courses at least in social work / counselling and their practical training should include mental health practicums.

I am not blaming my GP. She is extremely competent when it comes to generic physical health issues. It is a systemic issue. When will we realize that mental health is an integral part of one’s health? If we wish to reduce the burden on the health system, we need to be strengthening each rung in the healthcare system.

Thankfully, I am fine-ish. I still live with chronic pain. Actually that’s how I thought of this incident only because my neck was aching badly. The workouts and diet have definitely helped. The pain is less excruciating and I feel like I can manage it with rest and exercise. Amen.

Thank you for reading!

P.S. I am aware of the defensiveness and the lengths I have gone to emphasize that my feelings came from a physical cause. Yes, there is a touch of shame, even though I know that it is silly. But the world we live in is not mental health positive. And I have to take care of my market worth.

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Posted in: psychology