Unsolicited advice

It is important to learn when to ignore unsolicited advice. Unfortunately, when it comes to psychiatry it seems everyone fancies themselves an amateur psychiatrist. Those who are most vulnerable, because they are depressed or otherwise lacking in confidence, are most susceptible and least able to ignore the unsolicited advice they receive.

Every day in my practice I have patients returning to tell me about opinions they have received from parents, children, spouses, neighbours, roommates, friends and coworkers. A lot of it is bad advice based on misinformation, half truths, prejudice and just plain ignorance.

This unsolicited advice can be broken down into the following categories.

1. Those who deny the validity of the patient’s ailment altogether.

Under the first category are those who don’t believe in ADD/ADHD. These can be teachers, doctors or just about anyone. As I said everyone is an amateur psychiatrist. I had one family with ADD children who had been given this type of feedback by teachers, doctors and others in their community although not their own teacher or doctor. Their doctor, pediatrician and psychiatrist had all diagnosed ADD. This can happen with any diagnosis although it is more common with some than others.

2. Those who have a better idea about treatment.

Here we can include those who don’t believe in medication or want to propose naturopathic alternatives. Remember in most cases these are not professionals and have not done an assessment of you. They may only know what you have told them in casual conversation.

3. Those who know better about the diagnosis.

Here it is not a question about the validity of a particular condition, it is just that it doesn’t apply to you. In their wisdom they know that a different diagnosis is more appropriate. They might think you are bipolar when you have a drug abuse problem or vice versa. You, of course, have not necessarily confided in them fully.

4. Those who have seen the latest episode of a popular self-help show.

This could pertain to diagnosis, treatment, approach to treatment or almost anything. If it occurs on television it has instant credibility to some. It sometimes leads to requests for investigations or treatments that are only available in research settings, that are very expensive or that are completely unnecessary.

5. Those who provide too much information.

This often has to do with providing additional information about medication. Every medication has a list of hundreds of side-effects. Some are common and well established to be related to the medication and others are equally common on placebos, are rare, or perhaps particular to specific situations. Most doctors provide clinically relevant information to the patient but do not go through the complete list of side-effects. Those lists often have more to do with limiting liability than providing good patient care.

6. Those who have a conspiracy theory.

There are those who believe that the doctor has only prescribed something because he is getting a kick-back or some other financial reward for prescribing a particular medication. The pharmaceutical industry is creating diagnoses to promote their treatments rather than developing treatments for previously existing diseases. Of course, this is not actually the case.

7. Those who want to share their medication.

This worked for me, why don’t you try it. This can lead to serious problems like inducing mania in someone who is bipolar and given their friend’s antidepressant or stimulant.

 

My advice is to consider carefully who you share your health care information with if you don’t want unsolicited advice. If you are given advice that you didn’t ask for, tell your advisor that you have a professional consultant whose advice you will heed, thank you very much—then change the subject.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.