When it comes to discussing your illness with a healthcare provider, the issue is not whether to share, but how to share effectively. You must share in order to get the most out of working with a healthcare provider. Your goal should be to develop the skills and confidence to share honestly and concisely, from the first time you raise your concerns through every subsequent discussion.
Protecting your Privacy
Sharing personal information is never easy. It’s even more daunting when you are not certain whether the other person will hold your conversation in his/her confidence. But when the discussion takes place with a trained healthcare professional such as a doctor, nurse, psychologist or social worker, you can be assured of confidentiality. Healthcare professionals are obligated by law to take specific steps to protect patients’ privacy, and to not divulge any information shared during an appointment or noted in written medical records.
If you have any doubts about whether your privacy will be protected, you should ask your healthcare provider to review his/her policy on patient confidentiality.
The information contained in your medical records is specifically protected by a federal law called the Health Insurance Portability and Accountability Act (HIPAA). HIPAA regulates the use and release of personal health information (also known as protected health information). Under HIPAA regulations, patients must be informed about how their personal health information will be used, and given the opportunity to object to or restrict the use or release of their information. HIPAA regulations establish a minimum acceptable threshold for the use and release of a patient’s health information. Healthcare professionals may not share your personal health information without your consent.
Your initial conversation: taking the lead
It can be difficult to talk about your feelings, even with a healthcare provider you’ve known for years. You may be comfortable discussing physical symptoms like a sore throat or back pain, but it may feel strange to share concerns about your sadness or anger. Conversely, your healthcare provider may not initially be attuned to mood problems you may be having. That’s why it’s important to take the initiative and provide as much information as possible, including not just the physical symptoms you are experiencing (stomach pains, difficulty sleeping, etc.), but the feelings and behaviors you find troubling (persistent sadness, irritability, anxiety, difficulty facing social situations, etc.).
The bottom line: if you don’t share your concerns about depression, your healthcare provider may not be able to spot them. It’s important to talk with a healthcare provider as soon as possible to get to the root of the problem, and to give him/her a full understanding so that he/she can recommend the right treatment options for you.
Make an appointment soon to discuss your concerns with a professional. Before the appointment, it may be helpful to write down some key items. Start by answering these questions:
- What symptoms have you recently had? (click here to see a list of common symptoms of depression.)
- How long have these symptoms lasted? Do they come and go, or do you experience them consistently?
- Do you, or any family members, have a past history of these symptoms, or other serious illnesses, including mental illness?
- Are you taking any medications, either prescription or over-the-counter? Which ones?
- Have you experienced any major life changes recently, such as the death of a loved one, the loss of a job, the breakup of a relationship, or other events that have increased the level of stress in your life?
- Do you use alcohol or drugs? If so, has the amount you use or the frequency of use changed recently? Has anyone else considered it a problem or encouraged you to cut down?
You might also want to use the brief, self-guided questionnaires about depression, pain, sleep and substance abuse found in Are you depressed?, as well as the First Meeting with Your Healthcare Provider checklist to help you prepare. Bring these to your appointment.
Ongoing conversations: making the most of your healthcare appointments
Assuming that you have had an initial consultation with a healthcare professional, you’ll likely require follow-up visits to design and monitor a treatment plan. It’s just as important to maximize the effectiveness of these appointments by being prepared and thoroughly discussing all of your concerns and questions.
Get answers to your medication questions. If your provider recommends medication to treat your condition, make sure you understand which medications are being prescribed, why they have been selected, and whether there are potential side effects to consider. It’s helpful to write down your questions in advance. Make sure to take notes during the appointment as well, so you can keep track of the answers to your questions and have a record of your conversation to refer to later. Here are some sample questions:
- What is the name of this medicine? Where can I read more about it? Note that medications have both a pharmacological name and a commercial or trade name. It’s important to familiarize yourself with both, since one drug formulation may be available under more than one trade name.
- Is there a generic equivalent? Does it work as effectively?
- How often should it be taken each day, and at what intervals?
- Should it be taken with food?
- Does it interact negatively with any other drugs or with any foods? How about alcohol?
- What side effects have been observed with this medication?
- How long might it take to begin to see a result from taking this medication?
- Is this medication covered by my insurance?
Once a medication has been prescribed for you, it’s important to track how your body responds to it, and to share this information with your provider on subsequent appointments. A weekly medicine record (MTool: Weekly Medication Log) is an easy way to track when you took your medicine, the dose taken, changes in your symptoms, and any side effects you may notice.
Your questions about other treatment options need answers, too. If your provider suggests psychotherapy or a form of neuromodulation as components of your treatment plan, make sure you fully understand the type of treatment and why it is being recommended. Here are some questions you could ask:
- Why are you recommending this treatment approach?
- What can I expect from this treatment?
- What qualifications does the recommended provider have in this treatment area?
- Will this therapist work in partnership with you?
- What steps are involved in this treatment?
- How long might it take to begin to see a result from this treatment?
- Is this treatment covered by my insurance?