Having Depression and Controlling your Health Care
I just read a very informative book called, You: The Smart Patient: An Insider's Handbook for Getting the Best Treatment. It's about, as you can imagine, being a smart patient. This means not only reading this book or one like it to learn things you probably didn't know unless you're in the health care profession (did you know that the most germy object in a hospital room is the remote control?) but also it means being more proactive about your health treatment than you probably are.
For someone with depression, being a smart patient is as crucial as it is with any other illness. Here are some ways you can make sure that you're getting the best health care possible:
1. Keep a written medical history.
This is a useful thing to do for several reasons. First, it cuts down on errors. A typewritten copy of your medical history written by you is almost always going to contain fewer errors than something handwritten by a second party. Second, you are not relying on your memory at the time that the doctor/nurse practitioner is asking you the questions or you are filling out the forms in the doctor's office. You can put the medical history together over time and fill in the details as you remember them. This is especially crucial for someone with depression. I don't know about you, but my brain used to get somewhat foggy when my depression was untreated. You really can't rely on your memory. The website by the You: The Smart Patient authors has a form to get you started: Health Journal Form
You can carry your medical history with you on a handheld computer. I use a program called HealthFile Plus on my Treo smartphone.
2. Get a second opinion on a diagnosis.
For some reason most of us are reluctant to get second opinions. Either it seems like more trouble than it's worth, or we don't want to insult the doctor who gave us the first opinion. We usually think of getting a second opinion only for life-threatening illnesses or surgery. But it's a good idea for a mental health diagnosis, especially if you might have bipolar disorder. Treatment for unipolar disorder often utilizes antidepressants that could trigger mania in someone who actually has bipolar disorder. So if your doctor incorrectly diagnoses unipolar disorder when you have bipolar disorder...you can see why a second opinion is often a good idea.
3. Learn the ins and outs of your health insurance.
I used to work at a large HMO (Health Maintenance Organization). From what I saw and heard, I can assure you that you're not being paranoid if you think that they're in the business to deny your claim. They are; that's one way they save money. There are other ways that they save money and actually improve the quality of your health care, but never forget that your health insurance company is in business to make money.
You need to be smart in how you deal with your health insurer. I'm going to cover this topic in greater detail in a future blog, but right now I'll give you one crucial piece of advice. If your claim is denied, or partially denied (the company is asking you to pay more than your co-pay), start moving up the chain of command, politely but firmly. That customer service representative you get on the phone only has a certain amount of power to bend the rules. The further up you go in the company, the more latitude the person you're talking to has in terms of making an exception in your case. The key here is to be polite and reasonable, but firm. Don't vent your frustration on the poor person on the front lines who is only doing their job.
4. Be prepared for every visit to your doctor.
This means not only bringing your medical history, but also a list of questions you have for your doctor. The questions again will help you remember what you want to ask and make the visit more productive. You should also bring the actual bottles for every medication you're taking on a regular basis.
These are some very basic ways in which you can be a smart patient. I realize that being proactive and doing research are difficult when you're depressed, but it's crucial that you take charge of your depression health care. Doing so will increase the chances that you get proper and successful treatment.