What are the possible negative repercussions of seeing a psychiatrist about panic attacks?

April 16, 2012 11:22 AM

I have been having anxiety/panic attacks for the past 2 years. I am considering seeing a psychiatrist. What are the possible negative repercussions, professionally, insurance-wise, and other, of doing this?

My panic/anxiety attacks tend to be anxiety about anxiety--thoughts about how stressful it is to have a panic attack tend to actually cause more panic attacks. These have been happening multiple times per week for the past 2 years or so, with severity of the attacks waxing and waning with time. These started when I was in my mid-20s, so I assumed they were just a phase and that they would go away on their own, much as they appeared. 2 years later, they haven't, and I'm thinking that a visit to a mental health professional is probably in store.

I am a graduate student in science/engineering who will be finishing up my PhD soon. What are the possible negatives that might come out of having a visit to a psychiatrist, and possibly a mental health diagnosis, on my medical record? I'm interested in all possibilities, no matter how far a stretch they may be. Will I have trouble, say, getting a security clearance if I eventually want a job that requires one? What if, and I'm talking about extreme cases here because I honestly want to know the full scope of possibilities, I decide that I want to be, say, an astronaut? Will a visit to a psychiatrist have consequences for any job whatsoever?

What about insurance, especially because my student insurance is going to end when I graduate, and I will presumably transition onto some sort of employer insurance? Especially if the supreme court strikes down the pre-existing conditions clause of the healthcare bill, am I at risk for serious coverage denial or premiums going through the roof? Are there any other negative consequences that I haven't considered?

I know the positives of seeing a doctor: I might end these troublesome panic attacks. However, I would like an honest appraisal of the counterpoint: what are the possible negatives of seeing a doctor about my mental health? I live in the United States. Throwaway email: [e-mail]

posted by anonymous to health & fitness (17 answers total)

In the US, privacy laws will protect your future employers from gaining virtually any information about any treatment or diagnoses. In fact, typically all Company X ever learns about the mental health services that their insurance pays for is how many employees used the service - no identification of whom, how often, or in what context.

I cannot speak to insurance issues.
posted by IAmBroom at 11:26 AM on April 16, 2012 [1 favorite]

Also, it may be possible to get a prescription for anxiety meds from your GP/internist, without ever seeing a therapist. I don't recommend this route, but it's doable: I get my meds from my regular doc, who has never spoken with my therapist, nor received any "official" verification of my diagnosis.

Again, medicine without therapy is like putting tire sealant on an old tire: might get you through the day, but it isn't a long-term solution.

BTW, a therapist needn't be a psychiatrist. And the risks to your career are actually higher from untreated anxiety attacks, than from someone potentially discovering someday that you had them. TONS of normal people all around you seek help in therapy.
posted by IAmBroom at 11:30 AM on April 16, 2012

I've had panic disorder since my teens.
These days, I don't have many panic attacks.

I have seen several types of doctors including psychiatrists and psychologists.
I currently work for the gov., I have had multiple insurance companies over the years.
My history of anxiety has never been an issue with any of these things.
I've never had any negative issues with seeing a doctor.

If I personally kept ignoring my need for help, I would still be afraid to leave the house house and be living with my Mom.

Anxiety is not really rare and I would say more people than you know are treated for it.
posted by KogeLiz at 11:31 AM on April 16, 2012 [6 favorites]

If you apply for security clearance, you will have to disclose your mental health history. I don't how much this will affect your chances of getting such a clearance, but I do know a few people who have been diagnosed with depression/anxiety who have some degree of clearance.

The worst thing you could do in that scenario is lie about it. The investigators are far more concerned about anything you might be trying to cover up.

For non-security clearance jobs, this should be a non-issue for reasons covered by the previous answers.
posted by SugarAndSass at 11:32 AM on April 16, 2012

You may have to report your treatment on any firearms licenses you apply for. (May include buying one, or getting a carry permit, etc)

If you apply for a job that requires a security clearance, you will probably need to disclose your treatment.
posted by k5.user at 11:33 AM on April 16, 2012

When I was just out of college, I was working a temp job. The only insurance I could afford was through a 3rd party thing they worked with.

I had a reaction to medication I was already on at the time and my boyfriend at the time made me go to the ER. I was given some Ativan to help me relax and the ER doctor wrote something about anxiety attack on my medical records.

The insurance company refused to pay for the visit since it was a pre-exisiting condition, despite having never been treated for nor taken medication for anxiety prior to that time.

I had to spend the better part of a YEAR getting the hospital and my regular doctors to fill out various forms the cheap ass insurance company needed to verify that indeed it was not a pre-existing condition, that I had not been treated for anxiety or panic attacks previously.

I don't know if the new laws prevent this sort of thing, but FYI etc.
posted by sio42 at 11:35 AM on April 16, 2012

If you apply for private health insurance (ie, not through your school or employer) or for life insurance, your pre-existing conditions will show up. This is a little-known fact (that I know because I used to work in a temporary capacity for an insurance company) but there is a database that contains a redacted version of any medical care you get that's paid for via insurance. The database is run by the insurance companies. It won't say "John Doe, diagnosed with anxiety disorder triggered by the sight or smell of cats" or something really specific, but it will show a minor mental health diagnosis. If you do a health history for the insurance company and omit this and it shows up on the database, they may drop your application. A minor mental health diagnosis will either modestly raise your premiums or, after some years (assuming you aren't under continuing care) become irrelevant.
posted by Frowner at 11:46 AM on April 16, 2012 [3 favorites]

I was on medication for an anxiety disorder for a couple of years, several years ago. The only part of my life that has impacted negatively has been insurance (this is in the UK, by the way). Several years after stopping the medication (I can pretty much handle my anxiety by myself now), my current employer offered me life and critical illness cover as part of my employment package, and apparently I still cost him a lot more than his other employees. The insurance company has also made it abundantly clear that anything remotely related to anxiety or depression will not be covered.

But given the choice between cheaper insurance and the medication and other help I needed, I'd always pick the latter. Life's too short to let insurance spoil things for you. Go see the psychiatrist (or even your GP) and get your life back under control.
posted by le morte de bea arthur at 12:11 PM on April 16, 2012 [1 favorite]

I can almost promise you that any possible negative consequence of seeking treatment will not affect your opportunities in the future as much as not getting treatment might affect them. It is possible that you might be subject to a "pre-existing condition" clause for a period of time if you get new insurance. I have difficulty imagining that you would be excluded from almost any position/profession due to a diagnosis of "anxiety". This is incredibly common. Seeing a GP rather than psychiatrist would not insulate you from a potential risk because you still have to tell the truth regarding a history of treatment. I am confident that no one here can say whether you could be excluded from being an astronaut--I doubt if even NASA could give you an answer out of context. But I can assure you that panic attacks that are not managed would exclude you from some opportunities. Best to you
posted by rmhsinc at 12:18 PM on April 16, 2012 [1 favorite]

There were some mild negative consequences for my friend when she was applying for a clerical job in a branch of (UK) government that involved access to some important secret documents. (I still don't know exactly what she does, but when I think of her at work, I picture Miss Moneypenny.)

As part of the application, she had to give permission for them to view her medical records. She'd previously received treatment for anxiety and depression. While it didn't prevent her from getting the job, it did put back her start date by a couple of months.

The issue wasn't so much whether her past illness would affect her ability to do the job, but whether she was ashamed of the illness and a future blackmailer could potentially use that knowledge to make her give up state secrets.

So they did a bunch of fact checking and risk assessment and follow up interviews with everybody they could think of (her, her SO, her doctor, her friends, her family...) before ultimately deciding she wasn't a risk and giving her the job. The wait period was super aggravating and had some financial consequences as it delayed her first paycheck.

Weighed against the downsides of never having received the treatment, though? Pfft. Waiting for M to make a decision was a cakewalk.
posted by the latin mouse at 12:27 PM on April 16, 2012

I can't find the link right now, but seeking and successfully completing treatment for psychiatric issues is specifically listed as a mitigating factor for US security clearances.

Since you're a PhD candidate, I would be more worried about academic repercussions. Grad school is known to be stressful and different universities and advisers have their own policies for that. Some places will try to get you through the program, with or without treatment. Some places will advise or require a leave of absence until you figure this out. The important factor is risk of harm to self or others. That's when HR/legal will really step in to dissociate the university from you before you kill somebody. For anxiety issues which have not affected your performance for the last two years, that sort of reaction seems unlikely, but you're best placed to judge your particular situation.
posted by d. z. wang at 12:38 PM on April 16, 2012

Will I have trouble, say, getting a security clearance if I eventually want a job that requires one?

You will have to disclose your health history and the investigators may well ask the mental health care professionals you consulted with if there is anything that would make you untrustworthy.

However, and not to stereotype or anything, but if the government barred their engineers and scientists from getting security clearance if they had treatable mental health issues, then there would be a severe staffing shortage.

You may, I stress may, have a problem getting health insurance on the individual market (eg, if you are self employed and need coverage) depending on what state you live in. To hedge against this possibility, you should see if you can get individual health insurance through your field's professional society after "x" years of membership, so you should join now to accumulate those "x" years as soon as possible.
posted by deanc at 12:41 PM on April 16, 2012 [1 favorite]

You may have to report your treatment on any firearms licenses you apply for. (May include buying one, or getting a carry permit, etc)

This isn't true in general for buying firearms in the US, you only have to report if you've been involuntarily committed to a mental institution. Seeing a mental health professional doesn't count, and neither does being held for observation (like if you show up in an ER they keep you overnight because you've had suicidal thoughts). State laws for any sort of firearms permit may vary, obviously.
posted by TungstenChef at 1:34 PM on April 16, 2012 [1 favorite]

Why don't you try going to a therapist and paying for it out of pocket first? You might be surprised at how well it works, and if not, you'll know you gave it a good shot. I did this when I was in a similar position and the therapist and over-the-counter type stuff were enough to get my anxiety completely under control.

I wouldn't let it into my medical records (even via your GP!) without trying the round-about way, first. It very likely will affect your ability to get insurance at a decent rate, at least for a few years after the diagnosis. It won't matter if you're sticking to employer insurance, but where possible, it's nice to keep your options open to finding a job that doesn't provide insurance (meaning you'll have to get your own) or being self-employed (meaning you'll have to get your own.)
posted by small_ruminant at 2:55 PM on April 16, 2012 [1 favorite]

I have had panic disorder since 1988. Over the years, I have taken different medications. At one point in 1994, it got so bad that I had to go on disability leave for 90 days. I basically slept the first six weeks of that leave. I have been taking one medication since then and only have panic attacks rarely - and people don't know when I am having one.

Early on, I had a choice. I was either going to let panic keep me from living my life the way I wanted to, or I was going get treated and take my medication and live my relatively stressful life. If panic attacks are going to keep you from doing what you want to do, then I would recommend seeking treatment because a breakdown will certainly effect your employability and other factors more than getting yourself taken care of and stable.

I am unusual in that I am not associative - I 've never become afraid of situations in which I have had panic attacks. My sister got to the point where she almost wouldn't leave her house. I am also unusual that I don't have anxiety about anxiety. When I notice that I am starting to panic, I can make note of it and just continue what I am doing, knowing that it is a panic attack and doesn't have a reasonable cause. It is uncomfortable and it passes.

I work as a consultant Business Systems Analyst and travel all over the country. I have never had a problem getting insurance through my employer even before the new laws. It is important to make sure your insurance NEVER lapses.

I don't know anything about security clearances. I have worked with a company that builds and operates nuclear power plants and had no problem due to my health history.
posted by Altomentis at 3:32 PM on April 16, 2012

As Frowner points out, unless the new laws change this, you might have trouble getting private insurance for the self-employed. Two things might happen: The insurance company might reject you because of your diagnosis, or the medical-records bureau might enter an error that makes every company run from you (which could happen to anyone).

I once had a diagnosis of major depression. The only two companies in my state at the time that would insure self-employed people refused to cover me at all due to the diagnosis, which had happened more than 4 years previously.

A few years later, I tried again and was repeatedly rejected. I asked to see my Medical Information Bureau record (I think that's what it's called). I turns out that at some point, someone had incorrectly entered a code that said that I was psychotic and confined to my home. The bureau corrected it and I got insurance.

Because of that lesson, from that point on, I paid out of pocket and refused to give my Social Security number for any future psychological treatment and genetic counseling. (Then I left the country to live where I could get medical insurance and decent medical care.)

However, all this applies only if you're planning to be self-employed or work at a place that doesn't provide any benefits, and only if new legislation fails to fix the problem.
posted by ceiba at 3:47 PM on April 16, 2012 [1 favorite]

In the US, privacy laws will protect your future employers from gaining virtually any information about any treatment or diagnoses.

Hmmm. I took a drug test prior to employment once, and the questionnaire I had to fill out beforehand asked me to list ALL meds I was currently taking or had recently taken. That's kind of a sideways way of finding out what illnesses someone has, but it can be rationalized as "we want to make sure none of these meds create a false positive on the drug test". So was that questionnaire illegal? I always felt it was creepy and invasive.
posted by parrot_person at 1:33 AM on April 17, 2012