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Concerned with Telling a Doctor

by Kristina Randle, Ph.D., LCSW

I’ve been having problems for a while. I am highly disorganized, I have a fear of social situations but have a strong desire for them at the same time if that makes sense. I’ve tried being in talk therapy for those issues, not that much has come of it, however I’ve always been too scared to tell my therapist about other issues. I sometimes see images in the corner of my eye, a face in a window and then its gone, or a person standing on the side of an empty road and when I look in the mirror, nothing. I’m not sure if I’m seeing things or just thinking I see things, I’m concerned with being diagnosed with schizophrenia or something like that. I’m high functioning, about a 3.2gpa in college and I keep burying the issue in fear that treatment might intrude in my school life.
I also hear music sometimes and have taken to writing it down as compositions, would this be a hallucination as well? I don’t compose the music, I literally hear it as if it were being played in the same room as me, would this be a symptom of something?

My last symptom I’ve never told any therapists is the fact I usually hide away, closed doors, closed blinds, avoid going out quite a bit. My mood will fluctuate to being very happy like this, to longing for social contact but too fearful to even leave my own room and I don’t even know why. I just don’t know what’s going on and fear that if I tell a doctor they’ll put me on some treatment that will interfere with what little is going right in my life or send me to a hospital. I don’t expect a diagnosis really, I just want to know what are the chances of being sent away or some other life intrusive treatment?

I understand your fears but you can’t continue to ignore your symptoms. Even though you seem to be experiencing delusions and hallucinations, they are not characteristic of schizophrenia. They may be more indicative of a possible neurological problem. The only way to know for certain is to be evaluated either by a psychiatrist or neurologist, or both.

Compounding the problem is your withholding very important information from your therapist. He or she cannot effectively help you if you don’t disclose your symptoms. Part of the reason therapy has been ineffective for you may have been your lack of honesty. Only you have the power to change this aspect of your treatment.

In addition, there is little to no chance that you will be “sent away” to a hospital. You do not meet the criteria for psychiatric hospitalization which in most states is very strict and requires that someone be a danger to themselves or to others. Often individuals who desperately need or want to be hospitalized have difficulty being admitted. Once admitted, many individuals are released within a few days. The latest data from the National Hospital Discharge Survey by the Centers for Disease Control and Prevention (CDC) shows that the average psychiatric hospital stay is only 7.1 days.

I’m not certain what you consider to be “life intrusive treatment.” Individuals should work with their treatment providers to decrease the intrusiveness of treatments in their life. It is important that you convey this desire and fear to your therapist.

Fear is holding you back from getting the help that you need. Fear can be crippling but only if you allow it to be. Don’t let fear hold you back. Report your symptoms to your therapist. Be honest. Ask him or her for a referral to a neurologist or a psychiatrist for an evaluation. It is the most effective and efficient way to handle this situation.

I wish you well. Please take care. Please consider writing back to let me know how you’re doing.

Dr. Kristina Randle

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