aura

Does diagnosis matter to you?

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Posted (edited)

I know that all I should care about treatment-wise are the symptoms, but I can't seem to help it... diagnosis matters to me too. My diagnosis has changed a few times in the past couple of years and each time it was a nerve-wracking process of getting my whole treatment team talking to each other and on board. I'm at another crossroads (bipolar or schizoaffective) and it's really stressing me out. 

Can anyone relate? Does diagnosis matter to you or is it all about the symptoms? Tips on changing this mindset?

Edited by aura

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Posted (edited)

I'd like to say no, but the answer is definitely yes.  Namely, recently my therapist dianosed me with PTSD in addition to the bipolar piece.  she said i clearly met the criteria for them both even though they are also hard to tease apart.  my pdoc doesnt/didn't believe and that really hurt because the ptsd diagnosis gave me a closer to perfect lens to see the world from.  I also have certain diagnoses that I fear.

Edited by dancesintherain

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Posted (edited)

 

8 hours ago, aura said:

Does diagnosis matter to you or is it all about the symptoms? Tips on changing this mindset?

Yes, it does matter to me too.  It helps me to understand things better.  Even though it doesn't change the treatment, knowing it is so helpful ie, when explaining to others, instead of naming all the symptoms that will probably not make a whole lot of sense to them. 

I am sorry that I don't have any tips on changing the mindset.  I have never changed mine, and don't want to ... it will always matter to me what the diagnosis is.  The treatment is the treatment.  But having a diagnosis matters a lot to me.

*(did I understand you correctly about the mindset being either wanting to know your diagnosis or not?)

Edited by melissaw72

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On 2017-03-12 at 10:48 PM, aura said:

I know that all I should care about treatment-wise are the symptoms, but I can't seem to help it... diagnosis matters to me too. My diagnosis has changed a few times in the past couple of years and each time it was a nerve-wracking process of getting my whole treatment team talking to each other and on board. I'm at another crossroads (bipolar or schizoaffective) and it's really stressing me out. 

Can anyone relate? Does diagnosis matter to you or is it all about the symptoms? Tips on changing this mindset?

I find this very relatable. I wish it didn't, but it does bother me sometimes not knowing exactly what all of my dxs are. So far I only know that I've got anxiety. But there are other things going on that seem to fit the bill for depression or ADHD-PI. My doc says the meds I'm on are working, and I believe her, I know I would be much worse without the meds. Still I just hate not knowing. And at the same time I'm afraid to know and that the doc would say something along the lines of "No, you don't have (insert dx here), you just have failed to take proper care of yourself and are the weakest link. Get your sh*t together!" 😫 Nooo!

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Hmm. A bit of both. I've had three psychiatrists in the last two years because they keep pissing off. The last one, number 2 was a psychologist is the disguise of a psychiatrist in that he didn't really want to talk about what condition I have to deal with and so much put names to, which was annoying. This new one is the first to diagnose me with F95.2 Vocal and Multiple Motor Tic Disorder [de la Tourette], he left out the last bit but that's what you get if you Google it. I suppose he wasn't comfortable saying it just yet since he didn't mention that in the appointment, it would be a crap way of telling someone through a summary letter. But I've known I've had it for a while; my first suggested it way back. I did ask for a confirmation that I was indeed suffering tics and he said yes, so that was something. 

He also mentioned my Asperger's diagnosis, it's been a while because the last one ignored that. So that was good. 

 

I'd like to have them all recognised to be honest, both symptoms and diagnoses.

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The most important thing to me is adequate treatment. That is the most important. Beyond that, it's nice to put a label on the mental cooties, but I don't lie in bed wondering if I am really Bipolar II or Major Depressive. I'm more interested in knowing whether I'm schizoid or Asperger's. But again, I don't lie awake in bed thinking about it.

A diagnosis is a label, and it's a label that is often fluid. If I get a new label tomorrow, I'll still be the same person I was today. Nothing changes just the label, and possibly the treatment might get tweaked. 

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Yes and no. Finally getting a firm Bipolar II diagnosis after years of being diagnosed with MDD was important to me, not only because it has helped guide what appears to be a more effective treatment, but also because it made me feel like I was finally being listened to after having pdocs blow off my hypomania as being young, what "normal" feels like after being depressed, or not real because I wasn't doing anything that they considered to be in and off itself sufficiently irresponsible or destructive. 

On the other hand, I've never really cared whether a given doctor diagnoses me with GAD or if we just talk about anxiety as a side issue, or if we say I have social anxiety or say that my anxiety in social situations is just another realm of a broader anxiety disorder. I'm not sure why this isn't as important to me. I think maybe because the various anxiety symptoms I have are less disruptive than the mood stuff, so the mood takes precedence? 

Edited by thunder
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I had two docs put me at BP1 (hospitalization during a manic episode) ...then I Had one give me mood disorder nos. what the fuck? That made me feel like he thought I was faking it....but new doc and back to BP1,. Order is restored (ha) 

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I'd like to say treatment but it depends on the diagnosis. I was misdiagnosed with a personality disorder when I turned 18 on my first appointment with my new psychiatrist. He saw me for 10 minutes and made his decision. He took me off my meds. I became unwell, got a second opinion and ended up in hospital and then they realised there is no way I have a personality disorder. However because I was given a wrong PD diagnosis back then, it took 3 months till they found me a bed because they thought hospital wouldn't do me any good. I was severely depressed and I didn't stand up for myself. 

When I finally ended up in hospital they changed my diagnosis back and they apologised because they said there was no way I had PD. 

It wasn't on though because that doc took me off my meds... and I wasted a year out of my life being manic and then depressed.

Sometimes the diagnosis matters because the diagnosis is what decides your treatment sometimes.

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Well that can hold for different types of bipolar/MDD...that's a risky line to walk

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3 hours ago, The Right Honourable Jimmy said:

Sometimes the diagnosis matters because the diagnosis is what decides your treatment sometimes.

This is true but only to an extent. I am diagnosed with major depressive disorder, but I take 2 mood stabilizers and 1 antipsychotic. Psych meds are rather useful across the board and not just for the condition written on the label. I would be lost without Tegretol and Abilify.

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I care about my dx because it gives things a name that ties everything together, rather than just being a collection of symptoms. Right now, my dx, when I asked, turned out to be BP1, but I do not believe it because I get psychotic symptoms outside of mood episodes (which should rule out BP1), and even my pdoc and tdoc themselves have stated that it is really only for insurance purposes (they were very reluctant to even tell me a dx). So that leaves me at that, well, I have mood symptoms and I have psychotic symptoms, without any real name accurately summarizing them, because I have not been given one that fits. That said, though, I would be treated the same way regardless of whether my dx were BP1 or SZA (my tdoc has offhandedly mentioned SZA as a possibility), and indeed my pdoc seems to be treating my psychotic symptoms as distinct from my mood symptoms. Interestingly enough they weren't this way with regard to my OCD traits, which my tdoc regularly directly refers to as such (she says "traits" because she does not think it is severe enough to count as actual OCD per se).

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2 hours ago, Closure said:

I care about my dx because it gives things a name that ties everything together, rather than just being a collection of symptoms.

Exactly.  I completely agree with this.

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4 hours ago, Closure said:

I care about my dx because it gives things a name that ties everything together, rather than just being a collection of symptoms.

You do realize that all psychiatric diagnoses are based on constellations of symptoms, don't you? There is no test yet developed that can tell you with 100% certainty what your diagnosis should be like there is with cancer or diabetes or other physical diseases. So no matter what label they stick on you, it is still just a constellation of symptoms.

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Actually I see his point....without a dx its hard to know how to approach the symptoms ex you wouldn't give a BP person a first line AD

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Regardless of what happens to some bipolars when you give them some AD;s, it still comes back to symptoms. Symptoms are all we can treat and diagnosis is based on symptoms.

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9 minutes ago, Iceberg said:

Actually I see his point....without a dx its hard to know how to approach the symptoms ex you wouldn't give a BP person a first line AD

Yeah, but what difference does it really make if a diagnosis is Bipolar I or SZA Bipolar type? The meds - antipsychotics and mood stabiiizers - are the same that treat both.

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Yeah but that's the point we could trade examples like that all night. I would say at least get a brief idea of what's going on and then treat the symptom 

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I don't think we could trade examples all night. I don't think there are many examples like the AD and bipolar example. Even then, ADs are not absolutely contraindicated in all people with BP.

The fact is that the same psych meds (with the possible exception of antidepressants) that treat one form of mental  illness also treat most other forms of mental illness. I take 2 mood stabilizers and an antipsychotic as part of my cocktail for treatment resistant depression. If treatment were strictly diagnosis dependent then I would really be in bad shape because antidepressants don't work for me. And doses are dependent, not so much on the diagnosis, but on control of symptoms.

I'm not arguing that a diagnosis is completely useless. I'm just saying that it's not as important as a lot of people think it is.

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Stims in BP stims in anxiety aaps in ADHD but no....I actually agree with you...symptoms are more important than Dx...I agree ...I just  thought he had A point

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dx matters to me WAY too much. my therapist says it a lot. I put a lot of stock in labels. who I am, why I am, etc. it makes me feel like I make sense and am not just this chaotic sludge

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I guess I perfer the DX when seeing  another doctor etc.  I feel embarassed sometime and I'm not as open talking about it with people who just don't know the issues themselves

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It doesn't feel like it would mean anything or change anything. Something to write in a report for the health insurance and other docs so they approximately know what might be wrong with you.

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I'm not particularly fussed about my dx. It switches between sza and BP1 depending on which pdoc I'm seeing at the time. Like others have said, the treatment is the same anyway. I suppose it helps for my disability forms but not much else.

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