I have appointment fatigue

Chronic illness, therapy and being absolutely sick to death of going to the doctors.

In the last month I’ve had three doctors appointments, three therapy sessions and two occupational therapy assessments - one that lasted over two hours.

I’ve also had two vet appointments, a grooming appointment (for the dog) and a haircut appointment (for myself).

Maybe this doesn’t sound like a lot to you, but it amounts to roughly 3 appointments a week all month long for someone who is already burnt out and extremely low energy and let me tell you I am sick of bloody appointments!!

My dog has always needed a lot of appointments and I’ve always felt guilty for not taking as much care and expense with myself as I do with him. But we can’t both need this many appointments, it is simply too much. And I would never let him go without.

Rufus feeling fresh after his haircut.

Who even has time for a job with this many appointments? I am currently off work - with a temporary incapacitation medical certificate due to burnout, physical fatigue, brain fog and pain.

I am waiting on two hospital referrals - one to rheumatology and one to orthopaedics both with the aim of determining if I do indeed have another chronic illness.

I also have ANOTHER intake appointment next week with a private clinic to start the process of following the private pathway as that might happen a lot faster than the public system… if I can manage to afford it.

I am tired. I genuinely don’t know how people manage this.

I am trying to take my health seriously, get some proper answers and access support. To access support requires finding the right specialists and getting answers and reports from them. A task that feels confusing, expensive and extremely energy taxing for someone who is already struggling.

It’s also extremely frustrating that yet again I seem to have to know already what is wrong with me in order to get the right kind of help to confirm what is wrong with me. Essentially a repeat of my autism diagnosis. I had ten years of trying to get mental health support and seeing various specialists before I learnt about Autism and was able to find the right kind of support to finally give me the answer - that by that point I had already figured out.

The whole “have something wrong - go to the doctor - tell them what’s wrong - they tell you what it is” has never held up in my case.

Instead it has looked something like this:

1. Go to the doctor

2. Tell them what’s wrong

3. They run basic labs that come back fine

4. Diagnosis: anxiety

5. I give up on trying to get help for a year or two

6. And repeat.

My faith in general practice and medical practitioners in general is very low right now.

I am questioning if I ever had Depression or Anxiety.

I think when I first presented to the GP at 15 years old I was struggling with my hormones and my mood but I was experiencing fatigue and pain. I may have communicated sadness. I may have communicated heart racing or even said I feel anxious.

But heart palpitations are not always anxiety.

Fatigue is not always depression.

Sadness makes sense when something is wrong with the body.

Or when your parents are getting divorced. Or when you can’t seem to do everything the other kids can. Or when life is overwhelming and out of your control. Or when you’re consistently expected to comply, self-erase and suppress.

There are so many physical health conditions that can cause fatigue, feelings of dread or heart palpitations. Physical health conditions that mimic Depression and Anxiety.

How many people are on SSRIs thinking they are mentally unwell when they have a physical health condition?
How many WOMEN?
How many CHILDREN?

In some ways for me personally, I am glad I didn’t spend years chasing the wrong specialists at great expense. My autism diagnosis has given me context and helped me realise what commonly co-occurring conditions I might be experiencing that explain my long laundry list of symptoms. It has in that sense put me on the right path towards the right specialists and answers.

But what could have been different if I had been screened for neuro-developmental disorders and the co-occuring physical issues when I first presented as struggling in life, to the GP at 15 years old?

Or even if a GP had asked what the anxiety felt like, whether it was mental or physical, whether I was “tired all the time” because I was unmotivated and had low mood or whether it upset me that I couldn’t do as much as the other kids?

Back then they would have said I didn’t meet criteria for Autism. Not because I don’t. But because they didn’t understand how it looked in women, and they didn’t understand how it could be hidden at great cost to the person in front of them.

Some things are changing.

But I still had a GP tell me this month that she wouldn’t investigate my physical health problems until I was under the care of a psychiatrist so some things haven’t changed much. She believes all my symptoms are psychosomatic or attributable to being autistic.

And this is despite the fact that I am already seeing a psychologist who disagrees and the symptoms I am trying to get help with have nothing to do with my mental health. But hey! I am a crazy person! I was labelled with Depression and Anxiety at 15 so what would I know!

Those labels are lazy and they follow us.

I don’t even remember if it was a psychologist who gave me these diagnoses. I think it may have even been the GPs.

A label of Anxiety on your record is a great way to get every single health concern you ever have written off under the view that you are a hypochondriac.

A label of Depression and Anxiety covers a whole host of complaints you could have about fatigue, pain, dizziness, heart racing, unease, inability to engage in activities or tasks.

I don’t think Depression and Anxiety should be given as labels UNLESS physical cause has been ruled out. Even and especially if a patient presents and communicates something like “I feel tired all the time” or “My heart is racing”.

Why are depression and anxiety the first labels we receive?

Why are they the first labels doctors turn to?

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