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Summary
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A family is worried about a mother’s mood, eating, and behavior despite her composed public appearance. They ask whether to alert her doctor before a scheduled physical.
The response favors a respectful family conversation and inviting the mother to discuss concerns herself, with permission to accompany or contact the doctor where possible.
It notes that a doctor may receive information while protecting patient confidentiality and cautions that pressuring her could damage cooperation and dignity.
Question
Reader · Identity withheldMy mother is experiencing a range of concerning symptoms, including anxiety, anger, mood swings, disordered eating that resembles anorexia, and depression.
\nDespite this, she presents a nearly perfect image in public and does not acknowledge that anything is wrong. As a result, she has become very difficult for family members to be around, and we believe she needs professional help.
\nShe has a physical scheduled with her doctor next month. Would it be appropriate for a family member to contact the doctor ahead of the appointment to express our concerns and possibly encourage the doctor to start a conversation with her? If so, what is the most respectful and effective way to approach the doctor?
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Answer
Mark Vigil Dombeck, Ph.D.It could be appropriate for you to contact the doctor so as to give him or her a heads-up with regard to some of the mood symptoms that she is experiencing.
However, your doing so will likely cause problems. You’ll embarrass your mother, for one thing. She may feel deeply ashamed as well, and potentially even turn this shame into anger directed at you for outing her. For these and similar reasons, taking this action should be your option of last resort.
\nA far better first option is for you (and other family members who are on board with you) to sit down as a group with your mother and let her know that you are all aware of her issues and think them significant enough to warrant medical attention. It will be hard for her to dispute your observations if they are delivered by the family as a group.
\nIn this meeting you can present her with a strong recommendation that she discuss these issues with her doctor. Allowing her to choose to talk to the doctor herself helps her preserve some dignity and makes it more likely she will comply with whatever treatment is prescribed.
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If you want to ratchet up the pressure on your mother, you can do so by requesting that you come along with her on the doctor visit so as to insure that she does talk to the doctor about her issues.
\nYou might also ask her permission to speak to the doctor yourself (via telephone?) so that you can give him a heads up with regard to your mother’s condition. Again, asking permission first is a way of getting her buy-in and preserving her dignity.
Your mother’s communication with her doctor is legally protected. Her doctor will not be able to speak with you concerning her condition. This does not mean that he cannot receive information concerning her condition from you, however.
\nThe next level of pressure you might put upon your mother would be to tell her that you are concerned enough about her condition that you are giving her a choice: either she discusses this with her doctor, or you will. While this might work to get her to talk about her issues, it might also backfire and make her feel more ashamed and more entrenched.
\nKeep vividly in mind that if your mother is not a willing participant in her treatment for depression or whatever is troubling her, that treatment is unlikely to be helpful. Medications do not remember to take themselves, and therapy sessions which are not attended or which are ignored cannot be helpful either. Proceed with caution if you decide you must force her hand.
Subject matter expert
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Integrative mental health care
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