The negative impact of shaming on diagnosis

Una Cavanagh

​She was worried. She was in her early fifties and usually very active, being a keen walker and horse rider, but for some time she’d been feeling increasingly tired and had gained weight. It had got to the point where she’d had to plonk herself down on a stile after walking for just a quarter of a mile of a normal three-mile walk. She felt utterly drained - her legs were heavy; walking felt like wading through treacle. This feeling of sheer exhaustion was like nothing she’s experienced before, despite having worked previously as long-haul airline crew for years with the long hours and jet lag.

She explained her symptoms and concerns to a GP who responded with “Well, you are quite overweight, so no wonder you’re tired. Walking at the weight you are will be like carrying a large baby around with you all day”. 

And that was it – the advice was just to lose the weight. The woman was mortified – she felt shamed but also angry at the GP’s dismissive attitude and lack of empathy. Of course, she knew she’d gained some weight (it had increased gradually as she approached the menopause) but she couldn’t believe it was just down to this.

A few weeks later, feeling physically and mentally worse, she saw a different GP for a second opinion. This time the experience could not have been more different - he listened to her concerns with compassion and empathy, recognising that she was the best judge of her own sense of “normal” for her body and he requested blood and urine tests. When the tests came back, they showed that her thyroid was under-active, with the GP explaining she’d need to go on medication. The sheer relief at finally being “heard” was enormous and she was reassured by this wonderful GP that she would likely soon be feeling better. Within two weeks, she’d begun to feel the difference and within months was back to her old self.

Why am I telling you this? Because that woman was me and I am really concerned about the shaming element of my experience of trying to get a diagnosis – I now know (from information from The Thyroid Trust and social media) that my experience isn’t uncommon and as a mental health professional (I’m a counsellor) I’m hugely concerned of the negative impact that shaming may have on others seeking a diagnosis. How many people might have accepted the first doctor’s view and blamed themselves for their weight gain, feeling too awful to insist on a second opinion? For me, I’m a few years down the line now and, with the correct diagnosis and medication, I’m fit and back to walking miles again. 

Even in difficult times like these, seeing your GP should be a positive experience and a collaborative exchange of information to assess what’s going on for you. If you haven’t yet had a diagnosis (or you’re concerned about treatment) here are some tips which you might find helpful:

• Appointment times are usually scheduled for 10 minutes (although you can request a longer appointment) so to get the most from the time, prepare in advance 
• You know your own body and what your base-line normal is - if you’ve noticed changes, note them down in advance, including when they started and how your body and mind is being affected. Try to be as specific as you can.
• You might find it useful to take bullet pointed notes with you on a card or on your phone to refer to whilst at your appointment
• Remember, seeing a doctor is a two-way exchange of information and if you’re unhappy with the outcome, you’re entitled to say so. Ask for further clarification for any decisions made and don’t be afraid to ask questions if you’re not sure of anything
• If you’re not happy with a diagnosis, ask for a second opinion.
• Finally, any changes in your body are nothing to be ashamed of – good doctors are always on your team and on your side!

​©Una Cavanagh