My daughter's bipolar diagnosis was communicated without consideration for the psychological impact

Summary

In this anonymous blog, the author argues that clinicians need to consider the impact of their words when they are communicating medical findings and diagnoses to patients. Drawing on her daughter’s experience of seeking psychiatric support, she explains how a more humane approach might have prevented additional harm. 

Content

My daughter, who has bipolar disorder, received her diagnosis at the very end of a 90-minute psychiatrist consultation. 

After spending the entire session observing her as if she were a rare specimen, the psychiatrist pronounced her ‘bipolar’, as casually as if he were giving her a driving test result.

He then quickly added:

“But more interestingly is the fact that your entire body twitches and jerks constantly; I think you may have Tourette’s or some other underlying neurological issue.”

He told us he would not treat the symptoms of the bipolar disorder (we had arrived at his clinic after a prolonged journey of increasing mood instability and psychosis) until her neurological issues had been thoroughly investigated. At that, he ended the consultation. 

I looked at him aghast and wondered if he had any concept of the impact of his words on the person sitting opposite him, and the potential for harm of not adequately considering what it is like to be the person on the receiving end of the diagnosis.

We left, struggling to process what had just happened.

Not surprisingly, 8 months later, still without access to pharmacological or therapeutic services, the burden became too much and my daughter took a massive overdose. She survived.

Two years on, we are still no closer to an answer about her potential neurological issue and are still fighting to get psychological support to help her make sense of living with bipolar disorder. 

Sometimes clinicians think they are serving your needs by giving a diagnosis, but without advice on how to access appropriate support and guidance to deal with the diagnosis it risks causing additional harm. The impact of poor, unempathetic communication in such fragile circumstances, can be equally damaging. Patients are not lab rats. 

The psychiatrist clearly did not consider the impact of telling someone that they are a) bipolar and b) more worryingly potentially have an undiagnosed neurological condition. That’s a lot to take in, especially when the person on the receiving end of the diagnosis has been referred due to recent psychosis, after many years of struggling alone with a serious mental illness. 

My daughter arrived at the consultation hoping to gain some insight as to how to stabilise her mental health. She left with the bottom blown out of her world.