To be honest, it almost sounds more like what you are wanting is therapy, as it can help you learn how to feel comfortable opening up and looking inside yourself.
That said, the few things currently coming to my mind are thinking about what you want to get out of the discussion with your doctor and starting from there. If you are wanting to try something different/new, then you might need to actually say that explicitly. You might then work backwards to think of reasons why you want to try something different. You can also just straight up say that you don't think you are communicating what is going on effectively. With regards to how you are feeling, if you are unsure what to say, you could also talk about the impact that things are having in your life, for example you are having trouble sleeping, or having trouble focusing which is making it difficult to do your job, or function at home. Whatever the situation may be.
It might also help to think about how you best communicate. For me that tends to be writing, so I write things out versus trying to speak. If it is hard in the moment to speak honestly, maybe you can try writing out a script in advance, either to read from, or even to just give to them if you have to. It's always better to communicate openly and honestly about how you are doing, even if it might not always be able to be done verbally.
But yea, to be honest, therapy is a really good tool for working on exploring what's going on within yourself and learning how to trust and open up to someone in a safe and controlled environment.
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