Diagnostic Overshadowing: Doctors discriminating against people with mental health issues

Last month I was in the psychiatric hospital for almost 3 weeks. I had fallen in such a deep depression that I dissociated for the first 14 days there and was not responding to any of the meds, so they had to be a little bit more aggressive and start me on a high dose of a second anti-depressant. I started feeling better, and I have been doing better with my mental health since the med kicked in and since I've been home. No suicidal thoughts, feeling better about myself, making better choices, facing things I had been avoiding for months.

Last Wednesday I went to see my outpatient psychiatrist. I had mentioned to her that I've noticed a tremor that started shortly after getting out of the hospital. The tremor sometimes makes it hard to do things such as eat, write, and type. When I told her about the tremor her face turned concerned and she asked me about my eye twitch. She has known me for 4 years and I've never had an eye twitch. I didn't even realize that I was having the eye twitch. She became concerned about serotonin syndrome from being on such high doses of the antidepressants. She asked me to get lab work done, but I told her I couldn't afford it, so she decided to reduce my dose of effexor and told me to come back in a week.

Well the next day I was meeting with my therapist and when I told her about my doctor's concern, she became rather concerend also because her and my group therapist had noticed I had been ore agitated and restless than my normal and they had noticed the twitch as well. My therapists didn't think about it being serotonin syndrome until I mentioned that, so she urged me to get the blood work done that my doctor had requested and warned me about how dangerous serotonin syndrome can be if not caught in time. So I took her warning, got the order from my psychiatrist and started the search for a lab that I could get the blood work done at that I could afford.

I also then looked up the other symptoms of serotonin syndrome and had realized that I had been having several of the symptoms for weeks, but didn't really pay any attention to them because I thought they were something else, I didn't realize that if you put all of the symptoms together that it looked like serotonin syndrome. So Friday I tried to find a lab again, but the soonest anyone affordable could get me in was going to be Wednesday. My symptoms had seemed to be getting worse, I was starting to have chest pain. My heart rate was irregular, so I called a nurse's line and told them the symptoms and they urged me to go to the Emergency Room.

I didn't go right away because I was at my moms. While at my mom's I used my dad's blood pressure cuff to check my blood pressure and it was 153/102 which is abnormally high for me. So then I went home. Texted a friend about it. This friend has done a research paper on serotonin syndrome in the past, so she knew they symptoms and such and she was extremely worried and came over to take me to the Emergency Room.

We sat in the emergency room from 7:30PM-1:30AM they were monitoring my heart rate and blood pressure and did a bunch of lab work. My blood pressure and heart rate kept fluctuating, but mostly hanging out on the high end of both, so they decided to admit me to the heart care unit to monitor my vitals.

The next morning, the attending doctor on the unit came in and said he didn't think it was serotonin syndrome because I didn't have tremors or diarrhea. But I did have tremors. So I feel like he didn't throughly read my chart and look at all of my symptoms. They decided to discontinue the effexor. They told me that the symptoms I was having should go away in a few days, once the med was out of my system. So I stayed a while longer and they gave me more fluids. When they started discussing discharge I mentioned to the nurse that my heart rate was still all over and that I felt like my blood pressure was high, and that I had a headache that wasn't responding to the tylenol or ibuprofen they had given me. So he said he'd talk to the doctor. He came back in and told me that the doctor said my heart rate and blood pressure should regulate when I am back in my normal environmnet and not so stressed out from being in the hospital, and my headache would likely go away as well, and that I was just anxious.

I was not anxious at all. I was actually extremely calm. And I had been having the symptoms for 2 weeks in my normal "less stressful" environment, so how is spending 24 hours at the hospital without recieving anything to treat the symptoms supposed to make them magically disappear? I was livid and I feel like he saw my mental health diagnoses and just dismissed it as anxiety, because you know, us "borderlines" are dramatic and manipulative.

Well, big surprise symptoms didn't go away when I went home. Yesterday I woke up dizzy and lightheaded and I couldn't stay awake for more than a couple of hours at a time, so I slept 15 hours yesterday. My chest was still hurting, my nausea was worse, I was irritablem, I felt physically weak. I just felt absolutely miserable. I called a nurses line and they suggested getting checked out again, but then I didn't feel like going back to the hospital and waste more money to be dismissed again, so I just went to sleep.

I didn't feel much better this morning when I woke up, but I made myself go to IOP so I could talk to people there about it. I watched my heart rate go from 194 to 110 to 77 in less than 3 minutes. I don't think it's supposed to flucuate to that extreme in such a small amount of time. So I stopped by the pharmacy to take my blood pressure, it was 156/105 with a heart rate of 127. So neither of those symptoms improved. I still have the tremors, the twitch, no appetite, headaches, dizzyness, nausea, and no energy. I was discharged Saturday and nothing has improved.

Actually I feel sort of worse, because not only am I dealing with the serotonin syndrome symptoms, I'm also experiencing withdrawal from the effexor. You're not supposed to suddenly stop taking it, and the doctors failed to warn me about the withdrawal symptoms of going of the effexor so quickly. I am so freaking frustrated with how the doctors treated me this weekend, and I still feel like crap and I don't know if I should go get it taken care of and looked at again or just give it some time and see if stuff starts to improve on it's own.

I know I'm not the only one who has had a doctor not take symptoms seriously because of mental health diagnoses and this isn't the first time it's happened to me either.. it just makes me so mad that doctors can be so negligent!