Unminted Teeth and Medical Gaslighting

Warning:  This is a long blog post.  I didn't mean it to be long, it just kind of got away from me.

I was bemoaning things dental with a co-worker the other day.  I have a lot of things dental; at last count, eight crowns, five root canals, more fillings than you can shake a stick at, one implant, and a bunch of other stuff I forgot.  Partially a bad round of DNA, I think, and partially a bunch of bad dental work long ago that’s causing problems now.  I can’t go in there for a simple cleaning without them finding something else they need to fix.  I have pricey teeth.  (Hey, on the plus side, if they ever find my dead body someplace without ID, they’ll be able to identify me with lots and lots of dental records.) 

 

Anyway, my coworker has a neurodivergent kiddo who is about 5.  She said it had been like World War III getting him to brush his teeth until she discovered mint-free toothpaste.  Apparently, it wasn’t brushing his teeth, but the mint toothpaste that was bothering him.  And not the taste, but the tingly feeling.  (A lot of neurodivergent kids have issues with textures and mouth sensations, which is why they tend to be picky eaters.)

At this point I reached across the desk, grabbed her arm, and said, “Wait a minute.  There’s MINT-FREE TOOTHPASTE?!”  She assured me that not only did it exist, but that there’s also mint-free fluoride rinse.  And I’m like Oh. My. God.  I’m not neurodivergent (unless I am, of course, but that’s for another blog post) but I have Always. Hated. Mint.  For that same reason.  I don’t even like Girl Scout cookies because it feels like a bunch of ants crawling around in my mouth.  I have disliked brushing my teeth for most of the 54 years I’ve been on this planet and now I find out there’s been mint-free toothpaste ALL THIS TIME?!  Why didn’t anybody TELL me?!

 

Well, somebody did, finally.  You can get the toothpaste here (flavor free) or here (fun flavors for kids).  ACT makes a cinnamon, a grape and a bubble gum fluoride rinse, available from Target, Amazon, Wal-mart and probably most drug stores.  You can also get kid-friendly berry, melon or bubble gum flavors from these guys.  So there you go.  You’re welcome.  

So a bunch of you already know that I have bipolar disorder.  If you didn't know, well, now you do.  I do all the right stuff; I see my doc on the regular, I take copious quantities of meds, I take good care of myself (mostly), and I don't drink alcohol.  And for some years, like at least 5 or 6, I've been in remission, meaning few if any symptoms.  Which was pretty cool.

Then this spring, kind of suddenly, I started having symptoms again.  I mean, I had to stop taking one of my meds for various reasons, and we went on a nice vacation, and I was in a car accident, and it was unusually warm, and probably none of that had anything to do with it.  It's just The Nature of the Beast.  So for the past four or five weeks I've been getting some Medical Treatment.  I think my last day is next Friday.  And it's been okay, for the most part.  Really, the worst part about it has been having to drag myself across town every morning in rush hour traffic.  So I can’t complain (but sometimes I still do).  

Part of the deal is that you’re supposed to go see a psychologist or a counselor, because there are certain side effects that can make you hard to live with.  I've had a lot of vague, free-floating anger.  I've also been really tired, and the two probably feed on each other.  So after my doc nagged me for the better part of a week, I made an appointment with a guy I saw some years back when I needed some help with anger management.  (Stop laughing.  Even Buddhists sometimes need anger management.)  He seemed like a decent sort, a bit intellectual maybe.  Of course, things change.  People change.  Haircuts change.  Everything changes, nothing stays the same. 

 So I’m a woman.  I live in 21^st century America. I’ve had my share of being brushed aside by members of the medical profession because whatever I reported was either not believable or not interesting enough to bother with.  You men may not have any idea what I'm talking about, but I'll bet all the ladies are nodding.  Every pregnant woman feels that way!  That pain is normal!  Endometriosis doesn't exist!  Come back when you're really sick!  That sort of thing.  When I was younger I had sinus infections every four months for ten years  (it's allergies!  Get some shots!  Take some Sudafed and you'll be fine!).  I finally saw a surgeon who sent me for a CT scan.  When he saw the results he told me, “You don’t have ethmoid sinuses.  Common birth defect.  I bet you get sick a lot.  We have a surgery that can fix this.” 

 

Lest you think that this is a one-time thing and not a systemic problem, ponder this:  Women have a 50% higher chance than men of receiving the wrong initial diagnosis following a heart attack and are more than twice as likely to die. Of patients reporting severe pain in emergency departments, women are less likely to be given pain medication than men (60% vs. 67%) and are also less likely to receive opiates, the most effective pain medication (45% vs. 56%). Endometriosis, a disease that affects only women, takes an average of seven years to diagnose.  Women are also diagnosed with cancer 2.5 years later than men and diagnosed with diabetes 4.5 years later than men.  Only 8% of girls with autism are diagnosed before age 6 versus 25% of boys.  The average age for a boy to be diagnosed with ADHD is 7 years; for girls, 30 to 40 years.

 

All the same, I have never had an experience with any kind of medical professional that was anything at all like what happened with this guy.  I started keeping a list of bullet points of the stuff he said to me because it was getting so weird.  The parentheses are the things I researched after the fact, plus a bunch of snarky comments that I threw in because, well, that's what I do.  

 

·       Bipolar disorder, especially childhood bipolar disorder, is incredibly rare, so “you probably don’t have it.” (Some 2.8% of the population has bipolar disorder.  That’s 9,800,000 people in the U.S., which is not exactly “rare.”  About 76% of people with bipolar disorder report that their symptoms started when they were children.  Also, clinicians don’t diagnose people by their odds of having something or not.)

·       The serotonin re-uptake theory of psychiatric illness has been “totally disproven.”  (Well, no. New evidence says that serotonin re-uptake may not be as important as once thought, but all that means is that we don’t really know why the meds work, and we didn’t know that before, either.  You don’t need a theory to prove that a medication works.  You need a theory to get funding so you can do research so you can get evidence that a medication works.)

·       “Most” of his patients stop taking all psychiatric medications and “do just fine”  after learning some “emotional and attention regulation skills.” (Okay, so “most” of your patients probably didn’t need them in the first place.  Congratulations?)

·       It’s completely untrue that the brain scans of people with bipolar disorder are different from the brain scans of neurotypical people.  (Uh, no. fMRIs show significant processing differences in key areas of bipolar brains compared to neurotypical brains.  That doesn’t mean there’s a brain scan that can diagnose bipolar disorder, but then there’s no brain scan for pain, either, and we medicate that.  How do we diagnose pain?  Oh right, it exists when the patient has symptoms and says it does.  Hmm.)

·       “The symptoms you’re reporting are not depression but anhedonia, or a loss of interest in formerly interesting things.  You’re not reporting your symptoms accurately.  If you’re not sad, you’re not depressed.”  (Let’s see, what’s the #1 most reported symptom of depression? I’ll give you three guesses.) 

·       “Well, I wouldn’t want to talk you out of thinking you have bipolar disorder, especially since you wear your pathology like a badge of achievement.”

Dude.  I was forty when I was diagnosed.  I entered the medico-industrial complex when I was five, so that’s thirty-five years of people, including numerous docs, telling me “There’s nothing wrong with you.  You’re just lazy, inattentive, moody, hot-tempered, too sensitive, not a hard worker, stupid, ungrateful, overexcitable, hysterical, self absorbed…”

 

Male or female, I hope this sort of thing has never happened to you.   So you know, though, when you keep reporting what you experience and people keep telling you that’s not possible and/or you must be hysterical and/or even if that is what’s really happening, it’s not important anyway; and then one day you stumble on concrete proof that what you’ve been saying all along is actually happening, and it’s not only important, it’s critical;  well, that’s like – that’s like being the guy who finds a Bigfoot in the woods and gets it to follow him back to the middle of town for a press conference and a Q & A with a panel of primate scientists.  

Yeah, not too many people get told “You have cancer” and break out a bottle of non-alcoholic sparkling apple cider in celebration, but plenty of people with neurological conditions get told “You have bipolar disorder / Asperger’s / ADHD / Tourette’s” and reach for that bottle right away.  Because they’ve known there was something going on for years—years—and they couldn’t convince anyone else, and that whole time they could have been taking medication that would have helped with their symptoms and made their lives much better.  Imagine losing years because you can’t make friends, keep up with your schoolwork, cope, get your shit together, interact in an appropriate manner with other human beings, keep a job, or even get out of bed, and then finding out “Oh, we could have treated this all along.” 

And then some guy who's supposed to be a professional comes along and tells you that you're married to your diagnosis.  Oh, I forgot to mention he said that.  That I'm married to my diagnosis.  

 

I had another appointment scheduled, but I texted him and canceled it.  He texted me back and said something like, “Looking forward to hearing from you to reschedule.”  To which I started to reply, “Sure, next time I feel like being dismissed, gaslighted and told I’m hysterical, my badge of achievement and I will be right back in your office.” Joan wouldn’t let me send it though.  Something about not starting wars when a well-placed Yelp review will do.  

Anyway, that's what happened.  Fun times.  Now I'm going to brush my teeth with mint-free toothpaste and go the hell to bed.