Misunderstood by Doctors: A Patient's Struggle with Cognitive Issues

Misunderstood by the physician?

Hello Dr.
Li, I am your previous patient, named Zong.
Last year, I saw Dr.
Peng for quite a long time, the longest ever, for more than half a year, almost a year.
Eventually, I couldn't take it anymore and gave up because I realized that Dr.
Peng misunderstood me just like you did, and he kept pressuring me to work and such.
I underwent some tests last year, and although the psychological evaluation seemed fine, I often find myself suddenly unable to understand what others mean in situations that require communication.
It might be due to their way of expressing themselves, perhaps speaking too quickly, etc.
As I mentioned to you before, I have difficulty understanding movies now.
However, these symptoms that resemble cognitive dysfunction were not present before the onset of my issues in childhood.
I find it quite strange because my IQ test still scores around 100, yet I sometimes feel like my mind gets stuck in daily life.
Therefore, I once mentioned to you that I suspect this might be related to cognitive dysfunction within the spectrum of schizophrenia, even though I do not have that diagnosis.
My cognitive function does not improve with changes in mood; it feels consistently blocked.
You have always believed this is caused by depression, but I have always disagreed.
Antidepressants like Mirtazapine and Venlafaxine have not helped much.
How should I put it? There have been many misunderstandings, and it’s difficult to discuss them in detail on this platform.
I am sending this because I have been feeling down lately and have been reflecting on the past.
In fact, I have never fully agreed with your views, but I didn’t know how to express that, and I didn’t care much.
After experiencing Dr.
Peng's approach and reflecting on things recently, I thought it might be good to talk about it.
Expressing oneself is important; one shouldn’t keep things bottled up.
I later told Dr.
Peng about the misunderstandings as well.
I feel quite helpless due to the patient-physician dynamic; when I present counterarguments, it seems like I am questioning their expertise.
However, I have slowly come to realize that I have indeed been misunderstood by both of you.
In summary, I am experiencing unexplained cognitive decline, which has led to a series of significant issues affecting my life greatly.
This is not merely a matter of self-esteem; this is truly the biggest misunderstanding between you and Dr.
Peng.
I must express this because I do not want to go to a clinic just to discuss this.
What bothers me the most is that you once said that depression is just about not overthinking and to "just do it." I find it perplexing that you could say something like that.

nian shi, 20~29 year old female. Ask Date: 2022/10/02

Dr. Li Jite reply Psychiatry

Hello! I understand that you may feel misunderstood and often hesitate to discuss your concerns with your physician, which can be quite distressing.
However, as you mentioned, expressing yourself is important and should not be kept inside.
Even in this kind of platform, each expression provides an opportunity for better understanding.
From your description, it seems we can agree that you are experiencing a decline in cognitive function and are worried about the causes and implications of this decline.

In your past medical experiences, both Dr.
Peng and I have tended to encourage you by saying, "The current evidence suggests that your cognitive function is not significantly impaired," and "Emotions can interact with cognitive function." Nevertheless, the feelings of distress you are experiencing are very real and have a heavy impact on your life.

I believe that identifying the root cause of your concerns may not be straightforward, but it is important to maintain hope for change and progress.
If you feel that the medical community has misunderstood you in the past, you can still seek assistance from other trusted individuals (and of course, you can still seek medical help!).

Mental and physical health is indeed a complex topic.
Sometimes, when there is an imbalance, like the cognitive decline you are currently experiencing, it may be difficult to find effective solutions.
However, life must go on.
Therefore, I suggest that while you explore the possibilities of improving your mental and physical health, you should also strive to live your life with intention and effort.
This concept is what I mean by "Just do it." I did not intend to make you feel uncomfortable with my previous imprecise wording, but I hope that your sincere expression this time symbolizes your desire to break through and achieve a sense of peace and progress.
Wishing you safety and well-being!

Reply Date: 2022/10/02

More Info

It sounds like you are experiencing a complex and frustrating situation regarding your cognitive issues and the way they have been interpreted by your doctors. It’s understandable to feel misunderstood, especially when it comes to mental health, where symptoms can be subjective and vary greatly from person to person.
From what you’ve described, it seems that you are struggling with cognitive difficulties that manifest in social situations, such as not understanding conversations or having trouble processing information quickly. This can be incredibly challenging, particularly when you feel that your concerns are not being taken seriously or are being misinterpreted as merely a symptom of depression.
Cognitive issues can arise from various underlying conditions, including anxiety, depression, or even neurological disorders. It’s important to recognize that cognitive function is not solely determined by intelligence as measured by IQ tests. Many individuals with average or above-average intelligence can experience cognitive disruptions due to emotional distress, stress, or other psychological factors.
Your experience of feeling "stuck" or having your mind "freeze" in certain situations is not uncommon among those dealing with mental health issues. This phenomenon can be exacerbated by anxiety or the pressure of social interactions, leading to a cycle where the fear of not understanding further impairs cognitive function.
It’s also worth noting that cognitive impairments can sometimes be a side effect of medications, including antidepressants. If you feel that your current treatment is not addressing your cognitive concerns, it may be beneficial to discuss this with your healthcare provider. They might consider adjusting your medication or exploring other therapeutic options that could better support your cognitive health.

Regarding your feelings of frustration with your doctors, it’s essential to advocate for yourself in these situations. If you feel that your concerns are not being addressed, consider seeking a second opinion or finding a mental health professional who specializes in cognitive disorders. Open communication is crucial; expressing your feelings about being misunderstood can help your doctor better understand your perspective and tailor their approach to your needs.

The phrase "just do it" can indeed feel dismissive, especially when someone is struggling with complex cognitive issues. It’s important for healthcare providers to recognize the nuances of mental health and to validate the experiences of their patients. Encouragement to take action should be balanced with understanding and support for the challenges that individuals face.

In summary, your cognitive difficulties are valid concerns that deserve attention and understanding. It’s crucial to find a healthcare provider who listens to you and works collaboratively with you to address your symptoms. Remember, you are not alone in this struggle, and there are resources and support systems available to help you navigate these challenges. Seeking out a supportive community, whether through therapy, support groups, or trusted friends, can also provide a sense of belonging and understanding as you work through these issues.

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