Medical Beandipping

by admin on August 2, 2011

Darren has finally resolved a lifelong question as to why he is so disorganized and has always done poorly in school. After a battery of psychological tests administered by a leading Psychologist in his city, he has been given a diagnosis of Adult Deficit Disorder, or ADD. Excited to finally share with his friends that the medication prescribed to him by the Psychiatrist he was referred to for treatment, several of his friends took it upon themselves to immediately criticize the medication he was taking, tell him his diagnosed disorder was non-existent, that all he needed was “more self-control,” and that the pharmaceutical companies were making billions of dollars from patients like himself.

Ruth has been hospitalized for six weeks at a psychiatric hospital and diagnosed as bipolar. She takes medication that stabilizes her condition, but encounters on a regular basis well-meaning individuals who inform her that her “Western Medicine” approach is incorrect, and that she should try a more natural way to treat her condition, such as fish oil, vitamins, exercise and amino acid therapy. The constant disapproval at times leads Ruth to abandon her Psychiatrist’s advice and attempt to do things in a more natural way, leading to severe relapses and distress.

My question revolves around the well-meaning friends and family who respond to illnesses of the mind/emotions with immediate advice and contradiction or out and out doubt of the validity of a diagnosis. Surely this is improper etiquette, is it not?   0723-11

My first thought is typically to frame the issue in regards to how an individual can best mitigate other people’s faux pas committed against them.   Darren probably should not have shared what medications he was taking as that is information best kept to oneself, one’s doctor and the pharmacy.   It’s really no one else’s business what you pop into your mouth.    It’s the kind of information, that if someone has a similar problem or an inquiry as to how efficacious a drug is, that can be shared if one chooses.  But broadcasting it just seems like a recipe to tempt people into expressing their opinion.

It’s somewhat ironic that we have HIPPAA laws to protect our medical privacy but people think nothing of exposing their private medical issues with an accompanying unrealistic expectation that while they were indiscreet, everyone else should be discreet in keeping their thoughts and opinions to themselves.    Regardless of how small the public arena is, once that information is “published”,  our culture views it as available for commentary.   For example, celebrities who reveal their own medical issues (thinking of Betty Ford’s addictions, painkiller addictions by athletes, etc.) undoubtedly know that public exposure carries an inherent risk of public negativity.   But in doing so, some forge ahead believing that educating people far outweighs the negative repercussions.

People should mind their own business and refrain from commenting on other people’s medical conditions and treatments, despite  how well-intentioned they may be.   But we know that busy bodies exist and if we are to thwart their behavior, the best route is to starve them of anything to be nosy about.    It’s one thing to tell friends and extended family what the medical diagnosis is, but any further detail is really not necessary.   If asked, simply say, “My doctor has it under control but thank you for your concern,” or, “My treatment is progressing very well so far, thank you for asking.”

{ 104 comments… read them below or add one }

Just Laura August 2, 2011 at 9:28 am

I could not agree more with the Admin on this one. Excellent advice.
I don’t know why Darren was excited to share his prescription medication information with his friends, unless he is bragging about getting Adderall, a commonly abused prescription drug by young people, particularly college students.
http://www.adderallabuse.net/

As for Ruth, Admin’s suggested response of “My treatment is progressing very well so far, thank you for asking.” is spot on, and doesn’t allow for a nosy person to get into Big Pharmaceutical discussions or a critique of her doctor.

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Madhatter August 2, 2011 at 9:32 am

I disagree with the admin on this one. I went through my own grueling health debacle, and when it was finally resolved and I had a diagnosis (MS), I immediately told my close friends who had been supporting me all the way through. I didn’t get the impression from the OP that Darren was walking around just telling *anyone*. I told my friends about the new medication I was on, how it would hopefully slow down progression, the crazy side effects, that sort of stuff. Sharing something that has tremendously effected your life with your good friends (who have watched the disruptions it causes to your life) is not wrong and should set you up for trouble.

I had one friend, my oldest and dearest, forward me some alternate MS explanations (the stuff that claims it isn’t an autoimmune condition) some of which I knew to be completely unscientific. She’s into alternative medicine. I’ve always known this about her. I was even prepared for the email. I love her for it. :-)

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Madhatter August 2, 2011 at 9:33 am

Oops. Last sentence of the first paragraph should be “Should *not* set you up for trouble.

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Wink-n-Smile August 2, 2011 at 9:57 am

Please avoid discussing medications you are taking, as that will invariably set off one of the “anti-pharmaceutical” people into one of their tirades about how evil the pharmaceutical companies are, and how they charge so much for a pill that costs pennies to manufacture in China.

Sure, the Chines can make it cheaply, because they don’t DEVELOP it. They get a prescription, reverse engineer it, and then break the patent by manufacturing it, themselves. While the actual ingredients and manufacturing process is cheap, the research and development process takes years and millions upon millions of dollars, for each drug developed. The patent lasts for only seven years, and the companies must recoup their development costs during that time period, before it goes to generic.

The pharmaceutical companies are NOT evil. They are trying to fill a genuine need in the marketplace, and make a reasonable (not exorbitant) profit doing so. They do not create problems, just so they can drug them. They only create drugs for which there is already a demand.

The diagnosis, on a large scale, comes long before the pharmaceutical companies even start researching a cure, and no, there is no conspiracy between them and the doctors, to try to find something wrong with you so they can sell you drugs.

Healthy people fall for this sort of conspiracy theory, and poo-poo real illnesses as being “just in your head.” People who are actually ill, on the other hand, just want to be feel better, not feel victimized, as well as sick.

Good friends may genuinely believe it is all in their head, but keep their mouths shut. When they ask, “How’s that treatment going? Any improvement?” and thier friend responds positively, they can chalk it up to the placebo effect, and just be glad that their friend feels better. Save the political debates for the political arena, please.

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Samantha August 2, 2011 at 10:00 am

It’s tough to say that people shouldn’t share medical information, because it often is necessary to explain to or ask for help from others. For instance, when I was diagnosed (late in my young adulthood) with Attention Deficit Hyperactivity Disorder, I told my friends in order to explain many of the behaviours that had often bothered them. When I was put on medications (I went through three) I would tell my closest friends and enlist their aid in monitoring my behaviour. When I finally gave up on the meds due to serious side-effects and started trying to work on things on my own, I enlisted the aid of a larger group of friends to help me with learning what things I really needed to try to overcome versus those that I could leave alone. Now that I can successfully deal with both social and educational situations despite my disorder, I warn new friends about the few tics that I cannot deal with relatively early.

Every step of the way, there were some people who felt the need to try to impose what they thought about my disorder and my treatment of it on me. Some refused to speak to me after I told them that I was doing what was best for me and some insisted on continually telling me that I was wrong until I had to stop speaking to them. I’d like to think that care for me motivated their actions, but in some cases I still think it was a matter of not wanting to admit that these disorders actually do exist and aren’t just made up to excuse bad kids or bad parenting. Even my own father fought against my diagnosis for a while until I finally spent an entire day with him not doing anything to try and hide what my mind was like. Still, I couldn’t have come this far without the help of friends and so I can’t regret telling them, even if some caused unnecessary stress.

I do some volunteer work with a learning disability support group and I tell many kids who come to ask me about why people are so mean to them the same thing. People care and want to help, people are scared of what they don’t understand and people don’t like to have to deal with people who don’t behave the way they are “supposed to”. Some combination of those explains almost every negative reaction we get. The only person who knows what’s best is the person with the disorder or disease and while he or she should definitely listen to doctors and psychiatrists when it comes to things like medications, they should also discuss with those professionals when something feels wrong. Not all doctors and psychiatrists are open-minded, but many are and many are willing to try to work with a patient on finding the best solution. Mine actually let me go off medication, with frequent visits to monitor how I was doing, because of my reactions to the meds. They accepted that having a perfectly neat room and speech with no pauses didn’t matter to me as much as being able to think, to do my homework and to not feel like bricks were hanging around my neck. People demanding that I go back on meds either don’t understand that or don’t value my desires over the slightly increased ease of talking to me. I think that in most cases, it’s the same: people either don’t get it or don’t want to get it.

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Mjaye August 2, 2011 at 10:02 am

My mother suffered from bi-polar ( back then it was called manic-depression) and she was in and out of mental wards for most of my childhood and young adulthood. What would drive me crazy was her sister and brother telling her that it was all in her head and how the doctors were mis-treating her. So, Mom would stop taking the lithium and end up back in the hospital. It was a never ending cycle which even my father could not stop though he tried.
What finally happened is after my father died, my siblings and myself had to move Mom to a personal care favility and also told our Aunt and Uncle to keep their idiotic opinions to themselves. The ironic part is compared to her siblings, Mom was the sane one.

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Ista August 2, 2011 at 10:04 am

The thing is, if a person has been living in a private hell for a long period of time, unable to come to terms with the question of “what is the matter with me”, it can be such a relief to FINALLY know what’s wrong and FINALLY have treatment that works…the person then goes to family and friends and happily states “I’m sorry I’ve been such a pill, but now I know that I’ve been suffering from depression. I’m on medication now and feel great, I hope that I can finally return the love and respect you have shown me all these years!”

Imagine the downer when the family member/friend looks at the patient and says “Medication? That’s a load of hooey. God doesn’t give us any more trial than what we can deal with, with His help.” At this point the patient feels a crisis of faith, and perhaps spirals back into the dark place she’s been in for a while.

The patient doesn’t even have to elaborate on what she’s taking. I have a family member who suffers from severe bi polar, she informed family because she wanted people showing similar symptoms to get checked out and possibly diverted from the agony she had been through. The simple admittance that she knew her illness, followed by her change in attitude was enough for well meaning family members to give her advice and critique what they presumed her treatment to be. Yes, the advice above about God giving strength was one of the fantastic pieces of advice she was given.
Best response so far? “Thank you but my doctor has a degree in his field.”

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alli_wan August 2, 2011 at 10:08 am

he has been given a diagnosis of Adult Deficit Disorder, or ADD. . . several of his friends took it upon themselves to immediately criticize the medication he was taking, tell him his diagnosed disorder was non-existent, that all he needed was “more self-control.”

Sorry, but I’m going to have to side with the friends if Darren is telling people he has ‘Adult Deficit Disorder’. (I’m sure there is a word missing in there, but it sure cracked me up. They don’t have a pill that makes you grow up.)

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Marie Anne August 2, 2011 at 10:09 am

I disagree with the Admin on this one. I happen work in the healthcare field, and this is something I see on a regular basis. When it comes to medical problems, a lot of my patients will seek support and encouragement from their friends, and I think it’s completely appropriate. I don’t see why someone should have to bear the burden such as any kind of illness alone.
That said, it amazes me how many people think it’s a great idea to start giving random advice to said patients based on “an article I read on the internet” or “what my Dad said.” It makes the whole situation so much harder for the patient, and I honestly think it’s selfish. It’s saying “Well, telling you what I happen to think about this is much more important than your happiness or health.”

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admin August 2, 2011 at 12:58 pm

So, one should “share the burden” of a diagnosis with friends even though one knows that some of them are opinionated and nosy thus increasing the patient’s burden even more?

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8daysaweek August 2, 2011 at 10:11 am

I disagree with admin here. When someone struggles for a long time with an issue, never feeling quite right and not having any confirmation of it, trying desperately to make themselves better and never quite getting there, it can be a huge relief to find out that you were right and there is hope. When you’ve been supported through that by family and friends, it’s natural to want to share the end result with them.

These stories remind me of an episode of (I think) the Golden Girls. One of the women is constantly exhausted and feeling unwell and a doctor tells her it’s all in her head. Finally someone gives her a diagnosis of Chronic Fatigue Syndrome. For all this time, she’s known something wasn’t quite right and finally she has confirmation that she isn’t crazy after being judged and told it was all in her head.

I myself recently had what could best be described as a nervous breakdown. My anxiety because so severe I literally could not function. I didn’t sleep, I was terrified to drive to work, I couldn’t give my daughter a bath or put her to bed because I was convinced she would die if I did. It was such a relief for a doctor to take me seriously and confirm that I wasn’t just crazy or making it all up. I had missed several days of work (paid time off that I had accrued) and my colleagues and even bosses were whispering. It was wonderful to finally be able to say “I wasn’t just making it up. There really is a problem.”

I think that a lot of people feel compelled to share medical information when they are judged or mistreated for the symptoms of their condition. Perhaps the real lesson here is to consider that most people do not want to be sick, physically or mentally, and if they are, something is wrong – they are not just lazy, dramatic or seeking attention.

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Girlysprite August 2, 2011 at 10:24 am

I agree with madhatter. Such conditions have a large impact on your life and sometimes do explain why person have certain tendencies (I phrase this careful – it does not explain *behavior*, but it does explain inclinations and tendencies – see the difference?) When something has had such a huge impact on someone’s life, they feel like sharing with those close around them. Medicine details don’t have to be given, but I can very well understand that someone shares that they have ADHD and that they are under treatment for it now.

Yes, sharing means that people can hold mean opinion, but that counts for EVERYONE. I mean, the same line of reasoning could be used for when I would be pregnant. If I don’t want negative feedback, don’t tell anyone about it! Yeah, that doesn’t fly. People share important things with each other, that is what they do. We expect those around us to support us. Cheer along with the good news, give us a shoulder for the bad news.

It is a grey area of course, when it comes to the details of the treatment. Is it really no go to tell whether the treamtnet includes behavior therapy and/or medicines? I’d say it is best to keep that to those directly around us. After all, these treatments can have profound effects, especially in the start, and that is something people (I mean, the person who is treated) wants to share, so some details are ‘leaked’.

But when people are nasty, the ‘withhold information’ tactic works well. That, coupled with the ‘I do what works for me’ line.

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Angel August 2, 2011 at 10:33 am

It’s hardly fair to say that we should refrain from telling our friends anything about our medical diagnoses. To me this “don’t tell anyone” idea implies that we should be ashamed of any mental health issues. We share these things with our friends because we want their support. For them to turn around and tell us that we do not have a real illness, and offer dangerous advice that flies in the face of medical knowledge, is actually beyond rude. They are being very bad friends at a time when they are most needed.

And someone in Ruth’s situation hardly has the option of telling people about her hospitalization and illness. I guarantee you they already know, and she is receiving completely unsolicited advice.

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Harley Granny August 2, 2011 at 10:35 am

So…one gets a diagnosis that explains something that has bothered the guy all of his life and he shouldn’t share his relief with friends? Really? He can’t even share this with his friends? I fail to see where he was bragging about anything or soliciting strangers advise.
As to the remarks on the medications I do agree that they should both just nod their heads and say:
“My treatment is progressing very well so far, thank you for asking.|”

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Rattus August 2, 2011 at 10:41 am

While I believe in general that people should keep their opinions vis-a-vis friends’ medications to themselves, that is not an across the board belief. I have a very good friend who had a breakdown several years ago after brain surgery who has been undergoing pyschiatric care ever since, including an arsenal of medications. I have no problem letting him know when his current melange isn’t working and he isn’t functioning properly. The problem with being on constant meds is that one isn’t always aware of how one is behaving, and if my nagging interjections get him to rejig things with his doctor, then its a job well done as far as I’m concerned.

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DianeRN August 2, 2011 at 10:41 am

My own story: When I finally was diagnosed with depression I was so excited to know what was causing all my problems I wanted to share the news with everyone I cared about. I had been so “sick” for so many years. Plus I wanted to try to help take some of the stigma out of depression.

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Lilybell August 2, 2011 at 11:02 am

This is actually something that bothers me – that some people consider it bad manners to share private details. Sorry admin, I just can’t agree with you on this one. My dad’s family is your stereo-typical WASP-y type: stiff upper lip, very private and formal. My mom is from a big, loud southern European family and everyone overshares. I really don’t see how one way is better than the other and it annoys me when the stiff-upper lip type looks down on the oversharing type. I know who I’d rather hang out with! But then again, I also don’t care if someone asks me an instrusive question. Yes, it’s rude but I’m not so delicate that I don’t know how to beandip or just smile and nod and then do what I want.

This really seems like different styles to me and I don’t see how it’s not poor etiquette to tell me how much it’s ok with me to share with people I know. I am perfectly capable of deciding for myself.

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Calli Arcale August 2, 2011 at 11:13 am

Oh, thank you so much, Just Laura, for making the assumption that the young man was bragging about his medications, which you assume to be Adderall, for the purpose of abusing them. My first thought was that he was just happy to finally have an answer to his problem and wanted to share his joy. Having been on stimulant medication myself for Attention Deficit Disorder (not Adult Deficit Disorder; that appears to be either a typo or a misunderstanding in the OP), I can attest that for some patients, it can make a huge difference. Making assumptions about whether or not a person is legitimately using it or is planning on using it recreationally does not really help with the stigma and busybodiness that surrounds the condition. I admit the OP has a lot of grammatical issues that make it difficult to parse; for a moment, I also thought it was saying he was wanting to share the medication itself, rather than to share the fact that his problem now had some relief.

I’m with Madhatter. You don’t go around spouting your medical information to all and sundry, unless it’s somehow relevant to the topic under discussion, but it’s entirely appropriate to share it with friends and family. After all, one normally expects friends and family to be supportive, and when you’ve got what you think is good news, you want to share it with someone who will be excited for you. They aren’t always, though, and there is a tremendous amount of misinformation out there about psychological conditions — and even, still, a considerable amount of stigma. Sometimes it can get you into trouble, if you tell about your condition to someone you thought you could trust but, it turns out, you’re wrong about.

I’ve had friends who tried treatments that I don’t think are appropriate. Unless I think their health is in serious jeopardy, I keep my trap shut. It’s not my decision, or even my business. I’m a friend; my job is to be their cheerleader, not their doctor. I may gently make some suggestions if it’s a health issue, but once I’ve done that, it’s up to them what to decide, and as a friend, I need to respect their decision. If I don’t respect their decision, how can I claim to respect them?

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Chocobo August 2, 2011 at 11:13 am

Agreed, this is my first thought as well — the best tactic is not to divulge this kind of information, except perhaps to whom it may directly affect (such as your spouse, or parents, possibly a trusted boss solely for work reasons, etc.) and who might support the afflicted with recovery and/or maintenance.

Obviously the conspicuous consequences, such as hospitalization, are difficult to avoid, but it is still probably best to be as vague as possible about it to those not already privy. People kindly will show concern when they think a friend is ill, and I do believe that the above-described innocuous statements are intended to help. But that doesn’t make it sound advice, especially in a social environment that generally does not recognize mental illness as uncontrollable and are simply an issue of will power (re: “more self-control”). Patients then, on top of trying to battle an already difficult and largely invisible problem, feel shame because they take it into themselves that it is somehow their fault that they cannot force themselves to think a certain way. Especially in America, the “pull yourself up by the bootstraps” mentality exacerbates the issue, since one might feel that they are simply lacking in that almighty American quality: Will-Power.

I have friends who insist that Psychology and Psychiatry are a load of crock, not knowing how much it has helped mutual acquaintances. Sometimes they even make jokes or gripe about certain mental diseases in the presence of people they have no idea suffer from those precise problems. I beg anyone reading here not to make such comments — people who have been wise enough not to make known their medical issues will suffer even more having to listen to unintentional mockery.

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Rug Pilot August 2, 2011 at 11:19 am

I always ask people where they got their medical training. That’s why they have to license doctors. Anyone who tells someone they should not take their properly prescribed medication is practicing medicine without a license. I was visiting a friend who is a medical transcriptionist and asked her about side effects of the new drug I was taking after losing all the strength in my arms. We looked it up in her reference book. She wrote the condition down on a piece of paper which I took to my doctor the next week. We agreed that I would take fish oil instead.

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Lucy August 2, 2011 at 11:24 am

I can kind of understand somebody sharing that kind of information with friends out of sheer excitement at finding out that you’re not insane, after all, and that there is hope. I just wish said friends had been, well, friends to him instead of jerks. Jerks without medical training, no less. I was diagnosed with a learning/social disorderwhen I was in college My mother was afraid I’d feel labeled and get depressed. Are you kidding? Finding out that not only was I not crazy, but that what was wrong with me actually had a name and that I wasn’t alone was one of the biggest reliefs of my life.

Anyone who thinks I just need to be more sociable and friendly, and less geeky, and spend more time studying is more than welcome to take my life history of social anxiety, depression, academic problems (including being bullied by teachers. Yes, teachers), alienation, embarrassment, and desperate loneliness off my hands. Volunteers? I thought not. I can be annoying. I know that. I spend a lot of time trying very, very, hard to keep my quirks in check so I don’t annoy people–monitoring myself so I don’t get stuck on one subject, carry small-talk a little too far, respond literally to a non-literal comment. It’s exhausting. No matter how much I annoy you, I guarantee you it’s worse for me when I realize too late I’ve missed the cues.

I’m not going to say that diagnoses aren’t faked or exaggerated sometimes, but for every one that is, I promise you there are plenty that aren’t. The fact that you think your sister’s “ADHD” kid is really a run-of-the-mill over-stimulated, sugar-fed, undisciplined, brat, doesn’t negate the legitimacy of Darren’s problems.

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Gracie C. August 2, 2011 at 11:31 am

I’m torn on this one. I think the lack of honest and open discussion about medical conditions (particularly those that fall into the category of “mental” illness) is what leads to people holding these (usually) uninformed opinions to begin with. While I agree that people shouldn’t be shouting these things from the rooftops, I see no reason not so share with those closest to you. Though you should be prepared with some prepared statements for when people disagree or offer opinions, because people often will.

And PS – one P in HIPAA. And I’m assuming the OP meant Adult ADD (Attention Deficit Disorder), though I appreciate the coin of the new phrase, as I’m quite certain I know people who suffer from Adult Deficit Disorder. ;-)

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chelee74 August 2, 2011 at 11:37 am

I’m with Madhatter. I recently went through a similar experience and found that I’m bipolar and have ADD. I was THRILLED to have proof (SPECT scans) that my brain is not normal and to learn that it’s treatable. (If the scans had come back normal, I don’t know what I would have done – I mean, how do you fix what isn’t broken?) I told my closest friends and was lucky enough to find them supportive of me. The problem is that people that are not or have never been depressed or suffered thru ADD or had any mental illness have NO IDEA what it’s like and sometimes don’t believe it’s real in others. I say good for them! I have wished I could be one of your numbers! Please, sane friends, please don’t just blow off mental illness as someone actually choosing misery over being a happy and productive person. Please see below…

*10 Things to Say (and 10 Not to Say) to Someone With Depression*
http://www.health.com/health/gallery/0,,20393228,00.html

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Dear! August 2, 2011 at 11:42 am

This is a tricky one and I don’t aggree 100% with the admin. In a perfect world this would be the case, but in many situations, people who have been battling mystery illnesses for so long with no idea as to what has been ailing them often feel a sense of vindication upon finding out what was wrong. The people who often offered support, are the ones that they feel they can share their good news, even if it’s just to say “I’ve finally found an answer.” These are often people who are trusted, but sometimes it is easier for them to have a mess of a friend they can pity of feel that their life is that much better in comparision. Once the tables have turned, these “friends” may not feel as happy because they dont have someone who is worse off than themselves in their lives. And, the sad part it may be family members who do this. The same goes with weight loss in many instances. But, in instances with mental illness, Darren might have told his friends about his medicine to say that they won’t have to wrry about him any more or that he will no longer be “that friend.” Just another way to look at things….

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ellesee August 2, 2011 at 11:43 am

Sharing the information is up to the person. They have to be careful with who they share it with and it is unfortunate that some friends are adamant in their opinions/agenda.

I don’t think a friendly suggestion of a different treatment is rude. As long as it is not demeaning or doubting or misinformed. People should handle it with care and respect–if they are not aware of the sickness then they probably have no business directing treatment.

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AMC August 2, 2011 at 11:51 am

I agree with Madhatter. Sometimes it’s appropriate to share personal medical information with close friends and family. One might do this either to celebrate when they get good news like Darren, to warn them about side effects or changes in lifestyle, or just to eleviate their concerns. Also, some medical conditions are just impossible to hide. Pregnancy comes to mind, though it may not necessarily fall under the category of “medical condition” depending on how you look at it. I can’t tell you how many stories I’ve heard from girlfriends who, when they were visibly pregnant, had complete strangers walk right up to them and offer unsolicated advice. Yes, nosy busy bodies do exist, but I think the burden should be on them to learn when to mind their own business and that advice should not be given unless it’s asked for.

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DGS August 2, 2011 at 11:56 am

Sadly, there are always going to be busybodies, and given how much incorrect information, particularly about mental illness, saturates the media, practically anyone with access to an Internet connection and Wikipedia can dub themselves an expert in anything. Also, in our society, the stigma of mental illness remains considerable, and many people take it upon themselves to either minimize the suffering of someone with a particular diagnosis or to deem that diagnosis illegitimate or in the service of their own comfort, suggest other remedies (often dubbed natural and holistic, which are not controlled terms and are often not well-researched treatments) rather than those treatments that have been found to be effective by rigorous scientific study, to their ailing relatives and friends.

I agree with admin that it is usually best to reveal private information about one’s health minimally and selectively and to do so judiciously, only to those relatives and friends that can be trusted to be appropriately supportive and not intrusive or judgmental. And the response of “my doctor has it under control, thank you for asking” is brilliant. I would also say that with a small group of close relatives (spouse/partner, adult children, parents) and friends who may be directly involved in helping someone with a particular diagnosis live a full life, it might be helpful to schedule a meeting with the patient’s physician or psychologist, so that they can be directed to appropriate sources of information and education about the diagnosis and treatment, prognosis, etc. However, with extended family, social acquiantances, etc., the best approach is to reveal minimal amounts of information.

As a psychologist, I have learned to pick my battles and frequently bite my tongue in social settings when I hear people make ignorant and uneducated statements about certain diagnoses, including debunking ADHD as a legitimate diagnosis (or suggesting that “the kid just needs a swift kick in the rear to get his/her act together”), and autistic spectrum disorders, or suggestions that bipolar disorder or schizophrenia can be effectively treated with amino acids or that St. John’s Wort, Kawa-Kawa, etc. can effectively treat depression, or using the terms “psychosis” and “psychopathy” interchangeably. I will usually try to provide correct information if I get a sense that the person may be open learning such information, but I have learned the hard way that more often than not, the person in question spouting ignorance is not interested in correct information but is more interested in hearing the sound of his or her own voice. In that case, the only reasonable way to handle that situation is to quietly shake my head and walk away.

However, this medical beandipping is not only effective for medical/mental health issues but also for matters related to pregnancy and childbirth. A pregnant woman or a new mother is frequently a walking invitation for people to give unsolicited and oftentimes, incorrect, outdated or ludicrous parenting advice. From random lectures on “natural” vs. “medical” childbirth to dire warnings of infants being spoiled by being carried/not being carried/being swaddled/not being swaddled, to old wives’ tale assertions that “if you’re carrying low/high, you must be having a boy/girl”, busybodies often cannot wait to share their opinions on all matters related to conception, infertility, pregnancy, childbirth and childrearing. As in the medical beandipping, the prenatal beandipping is usually a very good strategy, perhaps accompanied with a beautific smile, if one can manage it.

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Elle August 2, 2011 at 11:58 am

“I don’t know why Darren was excited to share his prescription medication information with his friends unless he is bragging about getting Adderall…”

If something dramatically improves the quality of your life, it’s human nature to want to share the news. Also, many times getting a medical diagnosis can be a relief (I’m not broken or a frak up, I just have XYZ which presents itself with symptoms ABC). Again, it is natural to want to share that relief with others. Finally I can see this really being reinforced with something like ADD, where symptoms like poor time management and being scatterbrained would have a direct impact on the people closest to you as well. (Guys, I figured out why I’ve been such a pain in the butt, don’t worry though because I have something that will fix it.)

But you certainly win the interesting assumption sweepstakes (or at least the interesting implication sweepstakes).

I do agree with the admin on the part of Ruth however. Part of the responsibility of friends includes telling them if you think they are making something worse and how to make it better. (“You’re not getting chemo for your cancer? You’re going to cure it by eating paper? That’s a really bad idea.”) Part of the responsibility of having friends is telling them to back the heck off and the topic is closed for discussion (but you love them anyway.)

And in the case of things like fish oil, changing diet, exercise, vitamins, etc – there’s nothing about them that can’t be done with a traditional western (shove a pill at a disease) approach (barring physical injury is there ever a time when exercise is bad? Or good diet, vitamins and Omega 3?). Unless her friends were hiding her medication then the decision to stop taking it is entirely on Ruth. Given that it is not unusual for bipolar patients (and this is nor unique to being bipolar) to go off their meds thinking they are cured. While her friends are jerks for not getting off her case, it’s equally possible that they could be as supportive as all get out and she would still go off of her meds. The LW should not place the responsibility of this on Ruth’s friends.

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dawbs August 2, 2011 at 12:04 pm

Just Laura,
I would expect that Darren was excited to share that he had a diagnosis and was getting treatment.

When one has been struggling with an invisible handicap for many many years, the light that suddenly appears (as angels sing and heavens open up and the sky lightens) at the moment when one realizes there is both a diagnosis and even more exciting, a possible treatment is astounding. It’s something to shout from the rooftops. (why yes, I had that w/ an ADHD diagnosis myself.)

I understand why such things are private–I don’t tell the world about my ADHD diagnosis. But I also don’t keep it secret. If more ‘everyday’ people (not just the brave Betty Fords of the world) admitted the reality of ‘invisible’ and mental disorders, the awareness would be wonderful and stigmas would become more manageable.

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Pixie August 2, 2011 at 12:45 pm

I agree with Madhatter. Sounds like Darren was just happy to know that the feeling of being a failure wasn’t completely in his control. He is probably thrill he can take control for once.

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Calypso August 2, 2011 at 12:51 pm

What I’m trying to figure out is, when did we (collective “we”) start feeling free to weigh in on issues about which we’ve had no education, have no true understanding, and apparently no respect for the people who’ve dedicated their lives to the extraordinary amount of work needed to learn about medical issues? Why are we prepared to favor a Jenny McCartney or an Oprah Winfrey’s opinion over that of people who understand (and actually use) the scientific method?

I *think* it goes back to the 1960s and my Baby Boomer generation who misguidedly got the notion that, hey, our OPINION, our FEELINGS about something, are just as “relevant” as your stuffy old facts, man. Like, facts are tools of opression. Peace out.

At any rate, the advice in the OP is good for dealing with such. Now I just have to deal with how much the willful ignorance of the “grass juice” crowd infuriates me… ;(

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Riri August 2, 2011 at 12:55 pm

Sharing is a two-way street: if you share, prepare for reactions and if someone shares with you, prepare to react. I think it’s TMI for Darren to share about his ADD with “just anyone”, but it’s also rude for “just anyone” to comment back rudely. However, sharing medical conditions with close friends is an act of trust, in which case friends reciprocate the trust by sharing their concerns toward the medical condition’s treatments (I make absolutely no claims of my abundance of medical knowledge, but ADD is considered by many to be overdiagnosed, and hmmm… thoroughly researched, tested and developed Western medicine vs alternative treatments that show no advantage in controlled tests… hmmm). Fact of the matter is, don’t LIE about any medical conditions or procedures (Dawn Yang, anyone?), but don’t get butthurt if you decide to share too much and the less polite act, well, impolitely. But also don’t pry and insult others’ decisions to not share medical conditions (aka Dawn Yang anti-fans) and act politely if someone is only looking to confide, not seeking advice.

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icekat August 2, 2011 at 1:00 pm

“It’s somewhat ironic that we have HIPPAA laws to protect our medical privacy but people think nothing of exposing their private medical issues with an accompanying unrealistic expectation that while they were indiscreet, everyone else should be discreet in keeping their thoughts and opinions to themselves. ”

I’m not sure this is the right way to look at it. Often, those of us with mental/emotional issues are told that we really need a good support system of friends and family if we’re going to get any better. Telling friends and family about our issues is a necessary step in building that support system. Unfortunately I’ve found, as Darren and Ruth apparently did as well, that actual support is hard to come by, and that we’re just as likely to face criticism and indifference.

What etiquette implications does this have? I’m not sure about that either. On the one hand, I’m 100% in favor of not over-sharing. On the other hand, if the experts are to be believed, we’ve got to share a little or nothing’s going to improve.

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AS August 2, 2011 at 1:12 pm

I am one of those who see any form of medication (modern, traditional or alternative) with skepticism. I have had the traumatizing experience of doctors administering medication for my already very sick mother which made her condition worse. When we reported (she was already hospitalized), the doctor told her to continue taking the medication! My dad did the unimaginable thing of stopping her prescribed medication, and she improved drastically. So, you can see why I cannot bring myself to trust any doctor anymore. At least I know that if I follow the nature’s way for certain things that are not life threatening, nothing worse is going to happen. But now that I am older (and a researcher), I try to look any medications prescribed online or in magazines if I have access to them, ask as many experts as I can, and then take a decision on doing something about it. (BTW, alternative medicines are not unscientific, though I’ll not get into that topic now).

That said, I’d probably not let anyone know my opinion about how they are going to approach their own condition unless it directly concerns me (like my family members for whom I have to take a decision). There is no “right way” of treating most of the conditions. If something works for one person, they may not work for someone else. So, if their doctors tell them something, let them do it. But if I see someone’s conditions declining, I will surely tell them to do something about it (maybe change the doctors) – because I care.

I too don’t understand why Darren had to tell his friends about his medical conditions; but as previous commentators said, maybe he had his “support group” and he wanted to share the diagnosis with people who helped him deal with it. When people say something, I like Admin’s suggestion of saying “My doctor has it under control but thank you for your concern” and leave it at that, with an understanding that the friend/relative meant well. I’ll not cast them into direct etiquettehell, because they mean good. But I understand that it can sometimes get annoying for the patient.

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Just Laura August 2, 2011 at 1:16 pm

I admit the OP has a lot of grammatical issues that make it difficult to parse; for a moment, I also thought it was saying he was wanting to share the medication itself, rather than to share the fact that his problem now had some relief.

This is what I thought the OP said. Better word usage would have made my response different. Had he only shared his diagnosis, I wouldn’t have had a problem. But excitedly (OP’s word, not mine) sharing what medication he’s on?

Elle, notice I didn’t have a problem with sharing diagnosis. I had a problem with sharing prescription medication information “excitedly.”

I work with college students with disabilities, and I know for a fact that ADHD meds are extremely helpful for our students. I’ve seen the dramatic results. I also know that other young people simply get these drugs without the barrage of tests, or buy them off their friends and abuse them.

I still side with the admin as far as medication goes. If you don’t talk about it, then no one can say anything negative about it. Yes, I’ve dealt with cancer. Yes, I told everyone my diagnosis and that I would seek treatment. No, I won’t tell you the unpleasant details of what that treatment entailed.

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Harley Granny August 2, 2011 at 1:20 pm

I don’t think it was a “share the burden” moment…..I think he was relieved and wanted people to know.
Myself? I can deal with what I know….I don’t do the unknown very well. My BIL suffered from ADHD and was a total jerk sometimes…very exhausting to be around.
Once he had the diagnosis, we understood and could handle it.
Other people’s opinions are just that…opinions…..he doesn’t belong in E-hell….those who wish to push their opinions on him do.

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Rattus August 2, 2011 at 1:21 pm

***So, one should “share the burden” of a diagnosis with friends even though one knows that some of them are opinionated and nosy thus increasing the patient’s burden even more?***

Yes. A real friend loves you and wants to help, and you don’t leave a real friend in the dark as to the nature of your problems.

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admin August 2, 2011 at 8:13 pm

Then a real friend is not likely to offer unsolicited opinions and treatment options. There seems to be a disconnect as to who exactly one confides in regarding medical issues. Obviously parents, spouses, very close friends would be on the short list of people who could be told. But co-workers, less close friends, nosy relatives, casual neighbors, etc., really have no need to be informed.

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Madhatter August 2, 2011 at 1:40 pm

Admin, I’m afraid I’m not following the bouncing ball. The question at hand is what to do when someone that it’s reasonable to share this info with gives an unexpected response. In my case I was aware of one person’s proclivities and was prepared for the response. If another good friend who had no history of that type of opinion were to tell me that I’m a pawn of the pharmaceutical companies, I would be hurt and surprised, but I’d say, “Oh well. I’m feeling great now. Wanna go catch the latest Harry Potter flick?”

What you’re saying makes sense if you continuously repeat the info to people who are known to respond a certain way, but I didn’t think that was what we were talking about necessarily.

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Jojo August 2, 2011 at 1:45 pm

I agree with Admin’s suggested phrasing for neatly side stepping any medical queries. However, I would rather know about someone’s medical condition or share my own if it affects behaviour and social situations. I asked after the health of a casual acquaintance at a large public event recently and discovered that, although she looked healthy, she had just been diagnosed with a terminal illness. And, while the situation was less than desirable, I would rather know this and be able to offer help and make allowances for her condition than just presume she’s well and has her usual energy to keep up with the evening’s proceedings.
I too have had a number of health issues and have found that sharing them has often allowed me to find solutions to healing the problem – people who have had the same illnesses often have excellent advice. I believe firmly in a number of alternative health practices that have worked for me and would be happy to share them with others, even if it is unsolicited advice sometimes! As for critiquing someone’s prescribed medication, unless you’re an expert in the field, it doesn’t seem fair to share your opinion with a patient.

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Aje August 2, 2011 at 2:09 pm

Medicine is difficult. Sometimes it takes a few different tries before it’s the right prescription. Sometimes different people need different prescriptions. Just because something is right for your cousin doesn’t mean it’s right for you- even though you’re in the same family.

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jen a. August 2, 2011 at 2:17 pm

After re-reading Admin’s comments, I didn’t get the impression that she was saying that you shouldn’t share your diagnosis with those you love. I certainly can’t speak for her, but I thought she was saying that you shouldn’t necessarily share information about the specific medications you were taking. In fact, I think this quote kind of sums it up:

“It’s one thing to tell friends and extended family what the medical diagnosis is, but any further detail is really not necessary.”

I appreciated Madhatter sharing his/her experience, and I think s/he handled things really well, but there’s a difference between someone forwarding you information to someone becoming belligerent about how you and your doctor are treating the situation.

Personally, I think it’s up to us to deal with our own medical information. If we want to share, we share, but we need to be wary of those well-meaning know-it-alls who want to put their point across without any regard for the feelings of others.

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ElleWoods August 2, 2011 at 2:41 pm

I agree with the admin’s sentiment that people should not share private medical information with people they know to be busybodies or intrusive about these personal matters. However, I disagree with the idea that medical information shouldn’t be shared with any friends or family at all. I think when it comes to any sort of disease or medical hardship, the person suffering should be able to make a decision as to which friends and family they wish to share it with. No one here said they have to share it with each and every friend and family member they have, but I think it’s fine that someone discuss such issues with a few people they are close to.

As someone with Adult ADD, I understand the relief that comes from corrective medication. I was diagnosed in college, and since beginning treatment, my grades increased dramatically, and I am attending law school on merit scholarship. That said, I only discussed the details with very few friends and family members, because I was elated that this invisible handicap was gone from my life. And, as a recent college graduate on a campus where prescription drug abuse was widespread, I do understand the allegations that come with an Adderall prescription. This was another reason that I kept my diagnosis to the confidence of few, not because I was afraid of people telling me that my ADD was all in my head, but because I didn’t want would-be amphetamine abusers attempting to buy or steal my supply.

For what it’s worth, my fears were not unfounded. A sorority sister of mine accidentally opened up a piece of mail from home that contained my prescription, and before she gave it to me so I could get it filled, a bunch of other girls in my house found out about it. One of them, a suspected alcoholic and drug abuser, would hound me consistantly to sell her some or give her some. Repeated attempts to explain to her that I actually needed this prescription were useless, and I even caught her in my room trying to steal pills from me. (She was nearly thrown out of our house for that). So yeah, I understand the assumption that people are excited to get Adderall because they plan to abuse it…it happens. Prescription drug abuse, for this reason and others, is a major point of issue with me because I’m afraid that repeated abuse cases will cause ADD medications to be taken off the market, and I need them to function.

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Ista August 2, 2011 at 2:45 pm

Say someone finds out they have a condition that has affected their ability to have solid relationships. That person has a support group he has leaned on through his life; a sister, brother, good friend, second cousin…whatever. People are sociable creatures, and when someone doesn’t have ANYone in their life, that person is…well… virtually nonexistant. Even folks with incredibly difficult mental diseases who run off and live in the streets will occasionally resurface to visit a friend or family member from the past, or build a relationship with an animal. Humans often label animals with human characteristics in order to relate to the creature.Humans are such emotional, emoting creatures that we build an imaginary link to television characters, seeing traits in said characters that they can relate to themselves.
Now suddenly, a person who has finally found the joy and relief of a treatment for a social problem reaches out to share the relief with someone in their support system, (Let’s say a sister for shorthand sake) to explain the problem and state that he’d like to catch up on the lost time they’ve had while he spiraled. He has only seen the kind and loving, never judging face that she portrayed to him when he needed a shoulder to cry on. He has projected onto her the traits he needed.
Never in his most depressed dreams did he think she would react the way she did. “It’s all in your head.” “I know you can beat this on your own.” “You just need to go out more.” etc.
People aren’t necessarily opinionated or nosy, they often have the Best of Intentions. We were built to form mental and emotional “herds”, where we clump together to support each other and get support.
There is such a thing as sharing too much information, but as some stories on this site have shown (like the pregnant OP in yesterday’s letter) there is such a thing as sharing too little as well.

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coralreef August 2, 2011 at 2:48 pm

I think this is more of a “know you audience” type of situation. Some friends and family are controling busybodies while others are more supportive/helpful. I think that with mental disorders, having someone to watch over you (general you) from a distance can really help: if your behaviour changes drastically (due to side effects or stopping of medication), they can intervene if necessary. And any illness, either physical or psychological, is stressful and it’s nice to have someone to vent/cry/talk with. However, I probably won’t recommend in total disclosure to all and sundry.

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sj August 2, 2011 at 3:38 pm

While it is probably wise to keep medical conditions to yourself in most situations, sharing them certainly doesn’t give anyone the right to tell you how to medicate. Are you a doctor? Are you MY doctor? Then why do I care what you think?

Kind advice may be nice sometimes, but judgments and being told your diagnosis isn’t real is just nonsense.

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Lilybell August 2, 2011 at 4:00 pm

Regarding admin’s latest comment… If you know your friends are opinionated then of course you shouldn’t share the info. But that’s not what people are writing here. Some are, but the vast majority that disagree with you have explained themselves very clearly.

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Leslie Holman-Anderson August 2, 2011 at 4:00 pm

Dear Admin — often one does not know one’s friends are opinionated about cats until the cat has been let out of the bag. And yes, one does share one’s trials, tribulations, and triumphs with friends. It’s called having a support network, something health professionals encourage, as in most cases sharing the burden really does help. If one can’t share personal information with a friend, they’re just an acquaintance.

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Elizabeth August 2, 2011 at 4:03 pm

My sister-in-law was diagnosed with MS in 2004. A year or so later came the diagnosis of depression. When she told her mother (my mother-in-law) that she was being treated for depression with medication she was immediately told that depression doesn’t exist and that the treatment is a waste of time and money. Fortunately, my SIL persevered in her treatment, ignoring her mother’s most heated opinions. Interestingly, much of the family thinks MIL would benefit from depression treatment. Perhaps this was an extension of her denial.

I agree that personal medical information isn’t to be shared with a wide circle however one should feel comfortable sharing this with an immediate circle of very-best-friends and family without fear of negative opinion. When feeling the urge to react, it is best to ask ‘did he/she ask for my opinion?’ Most often the answer is ‘no’ and I keep my opinions to myself.

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MissMash August 2, 2011 at 4:08 pm

Admin – firstly congratulations on the birth of your lovely grandchild.
I totally disagree with you! If it weren’t for family and friends nagging me to change GP (doctor) and being so wonderfully supportive re my episodes of collapsing (which my previous GP said were just panic attacks – so why did I have the police break down my door when I went unconscious in my sleep), I may never have found out that I had a serious heart condition. I would probably just put it down to my severe depression, from which I had been on ‘remission’ from for nearly a year and then relapsed (I was on my way there after he said that and then on the next visit, told me to stop bothering him as there were more important patients in the waiting room). I aso totally agree with Madhatter, Lucy et al – the overcoming of medical stigmas overrules etiquette any day in my view.

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Kippie August 2, 2011 at 4:11 pm

@Ista, the proper response to that is, “That is why I’m thankful that God provided me with a wonderful doctor to treat me!”

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Stace August 2, 2011 at 4:21 pm

This is why people with mental illnesses often have trouble getting work. If they disclose, they risk being ostracized. If they don’t disclose, they risk people misinterpreting their behavior/actions.

Is the only solution really ‘shut up and try to be normal?’

My aunt got a diagnosis and disclosed at her job that she had a mental illness that could occasionally result in an ‘episode’. Within two weeks, complaints were trumped up against her and she lost her job. She went to additional interviews, and as soon as she disclosed, she got the ‘don’t call us, we’ll call you speech’. Finally, she refrained from disclosing. She got that job. Six months into the job, circumstances converged and she had an episode at work. She was immediately fired for failing to disclose.

It’s a no win situation and it sucks. And here we have another case. If we don’t disclose, we risk our odd behavior being labelled as ‘rude’ and are denied any sort of support or understanding for our issues. But if we do disclose, we are labeled as ‘indiscreet’.

The proper solution, etiquette wise, is not to blame the victim (EVER). It is to roundly condemn the perpetrators. Anything else is rude.

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