General News

Sod's Law Syndrome

There is a phenomenon which, although rarely discussed, could well be responsible for the gigantic percentage of doctor's appointments that are reportedly never attended. I call it Sod's Law Syndrome and, the chances are, at one point or another in your life, you've been affected by it.

Sod's Law Syndrome is characterised by a period of illness that is sufficiently severe enough to call for medical attention. However, on the morning of your doctor's appointment, the symptoms of the illness spontaneously disappear.

It is usually followed by you foregoing the appointment altogether, or attending and explaining that you did feel terrible but when you woke up this morning you were fine, so you're probably fussing over nothing, sorry for wasting your time, I'll see myself out, etc. It may also be accompanied by a sheepish expression and a sudden interest in your shoes.

Tragically, the moment you find yourself on the other side of the surgery door, the symptoms start to descend on you once more.

This cycle of events is maddening whatever the ailment, but it can be massively frustrating if you're seeking help for a mental health problem.

Psychiatric appointments are hard to get. Mental health services in the NHS are both overstretched and underfunded. Even though the common perception is that people with mental health issues see a psychiatrist about ten times a day, the reality is that we're mostly seen by GPs, therapists, social workers or psychiatric nurses. We're usually only referred to a psychiatrist for diagnosis or adjustments in treatment. A psychiatric appointment is the equivalent of being sent to the headmaster by an exasperated teacher.

Every time I have a psychiatric appointment, the same thing happens. On the day, I wake up. As I stretch my arms, a raft of happy cartoon animals crowd around my bed to wish me good morning. I feel fine - great, even. I attend my appointment, and there's not a sniff of mental illness about me. You'd have to bury your face in my medical records to find it. Then I endure the half hour of awkward questioning and find that I seem to have forgotten why I'm there in the first place. This isn't helped by the fact that the nature of mental illness is that it's very much lived in the present; if you're not depressed at the moment, you can struggle to recall that you ever were. If you're not currently suffering from psychosis, did you ever?

There are no definitive physical medical tests to diagnose mental health problems. Your blood can't be taken and test positive for depression. The diagnosis relies on the testimony and presentation of the person experiencing it. So even if you've spent the past few months barely able to get out of bed ... if you then turn up at your appointment bright eyed, bushy tailed and humming What a Wonderful World, it can be difficult for the doctor to appreciate the extent of your problems.

This may lead to a delay in diagnosis, and a delay in - or even lack of - treatment. It can also instill you with a feeling of fraudulence that may discourage you from trying again.

Why do we become afflicted by Sod's Law Syndrome? Well, seeing a doctor - any doctor - can be nerve-wracking. Few people relish medical appointments. They're a tiresome chore that can bite into our working or social hours. Medical problems can also be downright embarrassing.

When it comes to mental health, it can be extremely discomfortting to discuss intensely private matters with a total stranger. In the same way we automatically answer "I'm fine" to the question "How are you?", we are socially conditioned into wanting to look as well as can be for people we don't know - even if we feel dreadful. Also, those in the medical profession are authority figures who we might feel inclined to impress.

Seaneen's tips

If you want to visit your doctor to talk about your mental health, there are some things that you can do to avoid falling victim to Sod's Law Syndrome:

First of all, keep your appointment, whether it's with a GP or psychiatrist, even if you feel better.
It may be helpful for you to write down your concerns so that you can refer to them throughout (and it helps sidestep the trap of selective memory, too).
If you've been able to confide in somebody about your problems, or have a friend who's been with you and witnessed them first hand, then it's a good idea to bring them along. The other benefit of doing this is that they might have insight into behaviour you may not have noticed or may not have thought important enough to mention.

So, the next time you have a doctor's appointment and you're not sure that you're genuinely feeling better, shoo those chirpy cartoon animals away, slap on that frown and mess up that hair - otherwise you may be kicking yourself later.

Additional Information

Country: United Kingdom of Great Britain
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Source: http://www.bbc.co.uk/ouch/opinion/sods_law_syndrome.shtml
When: 27/3/2009