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Question for Bryan about discontinuing treatment


Guest Catherine

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Guest Catherine

Hi Bryan -

I was hoping to get any take you might have on this one at all:

Every since I changed pdocs and had a breakdown (the other way around really), I am not happy with the services rendered at all. The doctor refuses to acknowlege my previous pdoc's diagnosis of Bipolar 1 mixed and now they have me as major depression, and with four realloy horrendous personality disorders, the PD's rendered by a therapist who is not even qualified to make those diagnosises on her own and she is the only I have tlaked to.

She has also given me the erroneous possibly caselosing advice of going to Voc. Rehab. She also told me two months ago, I couldn't get into anger management then yesterday I could and could go right in to the group now. I could have used anger management back then really badly as I have bipolar rages though they have BPD type stuff with them and it has to be triggered.

I am getting swtiched medications so fast my head is spinning as they think I am just depressed and it is now aggravating my bipolar disorder. Bad medicine and hack therpaists in the puclic system and I want out without looking "non-compliant" and having that hurt my case as well.

I mean what should SSA and the DDS and the medical review team think of someone who has

dependent, avoideant, and NPD - as PD's. I am lucky I have a few good other medical problems.

I am also try8ing to get in to the see the psych and counseling team up at another hospital which is almost the equivalent of mayo clinic from which I was awarded free health care based on my income. But that is going to take me a whiile and I do need medicaid. But I really hate this therapist. I have never really disliked and a distrusted a therapist as much as I do this one.

I feel ready to tell the doctor off too. I think if a person is Bipolar, these people have no business starting and stopping meds that rapidly on a BP with a pain disorder.

Thanks,

Catherine

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Hi Catherine,

I'm not Bryan and am waiting for a reply from him, too, but i thought I'd put my 2 cents in.  If I didn't trust my therapist like you, I would move heaven and earth to stop seeing them, because how do you know if they don't pick up on your feelings and then write something vindictive in your medical records that SSA is going to see?  (But then, if you haven't already informed SSA about this therapist, you don't necessarily have to if you don't think she's going to be of help).

I have read in SSA literature that a PD can be an impairment, but I would push for the bipolar diagnosis if I were you. I got SSDI way back in 1996 and it seemed like all they had to do was find out I had a psychotic break and was hospitalized, and I was approved in 8 months. My congressman bugged them, though, also. But times have really changed - it's no longer that easy.

I'll be rooting for you! I have family and friends on SSI/SSDI, and have helped two people to get approved based on mental issues. Right now, I'm trying to help my husband get approved based on physical issues, and they make it SO much harder. They practically laugh at you when it's just physical issues.

Best of luck! ;)

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Personality disorders can be a basis for disability, but it is very difficult to qualify under this listings.  The documentation would have to show far more than just the diagnosis, but how the symptoms affect one's ability to work, particularly in the "four areas of functioning."

I would suggest finding a new psychiatrist.  By the way, for mental impairments, evidence provided by a psychiatrist or PhD licensed clinical psychologist is accepted as "medical evidence."  Findings by other therapists would be regarded as "lay evidence."

I would find a new doctor.  If there are conflicting diagnoses, this would confuse matters at the DDS level.

As far as continuing treatment while awaiting approval---I would suggest continuing treatment for your condition.  Because it you get denied and your case is appealed before a judge, the judge might be skeptical about the degree of impairment from your condition if it is not severe enough to require ongoing treatment.

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Hi you guys and gals,

I wasn't suggesting that she should give up "all" treatment and I hope nobody thought that I was. I was speaking from my own experience, since I go to a helluva lot of doctors and therapists as I'm changing them a lot. If I think one of them is not going to be beneficial for my SSDI approval or reviews, then I don't even write them down on any SSA paperwork. That's only because I have more than enough medical evidence otherwise!

One thing I have heard suggested bya NAMI president once, which I agree with and always use, is to tell SSA that you have major problems dealing with authority figures. (This could be part of a PD too). Because if you cannot deal with other co-workers and bosses without rage or it interferring in your work, then that is an impairment.

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Guest Catherine

Thanks for your input, both of you. This is a really hard one. This therapist already knows I am

upset with her. I left her another voicemail telling her to please call off her referral to Voc Rehab, that I can't work part time even and I need to get my pain and my psych issues under control and that my mother almost had me committed this morning (which was true).

I go in to see the nurse tomorrow and I want to at least tell her something about how I feel about this so it goes in my chart.

I don't see my pdoc until the 19th of August and can't get in any sooner. Well maybe I can if I try with the nurse tomorrow.

I will stick with this pdoc for as long as i can get medication I need but as soon as I get into the other place, I am going to drop this outfit. I am feeling really paranoid about the therapist and want to tell them that.

I did leave my DDS worker a voice mail today saying I would be trying to get into the other place - the pain management psych dept - as I am not happy with the treatment and rapid med changes, and the horrendous personality disorders I have been hit wtih and need to see more skilled people. I probably didn't say it quite like that but almost.

When I send him my forms, I want to include some kind of note abouot this so it is in writing. Do you think that is wise at all? At least it would show that I am not even able to deal with psychotherapy and conflicts there and that I have a high level of paranoia about such things.

I don't know if my DDS worker knows that this woman is just a "psychology assistant" as he seems to have put a lot of stock in her psych eval and wants to use the fact that I just saw her recently and she did a "psych eval" (what are those supposed to look like anyway - I don't remember having an official one from her if I would have known it was one)  instead of sending me for testing, though I doubt he has seen her eval. yet. I think she said it was helpful to my case but at this point, I dont' see her as being any further help to me especially since I now do not trust her and really don't want to show up for my next appt.. Is that bad?

In the meantime I am going to look into my options and give NAMI a call. I did today and they hooked me up with some folks to call who have all kinds of groups going on and things and have people to talk to who help deal with the kinds of issues I am dealing with. 

The pdoc I can handle, but I think I need to bring in more proof of my old diagnosis as it is kind of hard to see in my old pdoc's notes but they knew I had that dx when I ended up in the crisis unit (before I did even because they got my old pdoc's notes). I have a bill though with my dx code of Bipolar 1 mixed, last episode unspecified I could bring in as my therapist was looking through the notes of my old pdoc as she was arguing about my dx as depression with these PD's over bipolar. 

I really think I need to write a note in explaining things to my DDS worker, at least about the bipolar diagnosis.

I just hate this crap. Everything feels so risky and I feel so mistrustful now of psych people.

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Hi Catherine,

Are you still in the stage of filling out your intitial application? I'm kind of confused about what you've posted here. On all the SSA paperwork I've ever seen, they do leave an area for "remarks" in which you can tell them your thoughts and feelings about things in your case. They also accept actual letters written to them - by you, friends, and relatives, ex-coworkers, etc. Letters can help them to understand things that may not have been addressed in your medical records, and to give more credence to your claims of impairments. However, a doctor's medical findings are always going to carry the most weight.

Also, I have noticed that the more hospitalizations we have, the much better it is for our claim, or review, or whatever. If I had to do my application process all over again these days, I would go to the doctor so often, that it would make SSA dizzy! Because now I understand the importance of getting tons and tons of good, medical evidence! If I had to go to the ER everyday, I would.

Something I've found that also helps is I have actually written letters to the doctor, or therapist, or anyone else involved.  (In my own case, or in the cases that I've helped others on). A doctor cannot ignore or avoid a neatly written letter to them! It's tempting to have the extra knowledge about their patient. Because sometimes the patient just doesn't express things well enough in person, or thoroughly because they may be intimidated in the office. I'm not kidding, you wouldn't believe all the letters I have written to my doctors. And I KNOW they understand me more because of them.

Please keep posting and letting us know what is happening. I care!

M.Y.

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Guest Catherine

Thanks MY -

I love your dog - or whoever's dog that is. Cute cute cute. I have a very cute dog too.

My mother almost had me committed the day before yesterday. I should have let her. But I am willing to go to the hospital if I need to for all this.

And then this one therapist I found out is not even qualified to diagnose me the way she chose to which is going to influence a lot of things about my treatment. It's just bad counseling practice.

I did go in and rant to the psych nurse about it and she is getting me in to see the pdoc this coming Tuesday so I can talk to him.

I was just thinking this morning that I am going to write out a letter that I am going to ask to be put in my chart, so thanks for reinforcing the idea when I read your post just a half hour after thinking this is what I need to do.

I feel they don't listen and then they don't have time probably to write things doen and I also think my therapist wrote a bit long page about me that I saw the psych nurse reading so I am going to make sure my written input gets into my chart via my pdoc.

I have plenty of things to complain about to someone higher than these people if I they don't let me have another therapist or listen to me. But now I bet they will see this as manipulative BPD or NPD behavior or something. Whatever....

I am far from NPD - that is ridiculous. They have seen me 2.5 times in individual and 2 times in group. They assume a lot.

I know my real probelm is BP and I finally brought in a bill from my old pdoc who I saw for three years with my diagnosis code on it that I had the nurse put in my chart.

I am so angry but I will get it taken care of. I have also made sure I have numbers to an ombudsman and other NAMI type people. I think these places are underfunded and underqualified to be doing what they do to some people and I am going to writ to my congressman about it.

YOu have a good day, MY!

Thanks,

Catherine

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Guest Catherine

Oh, also I am at the initial stages of applying. I just finished filling about my ADL forms and symptoms list. I also have three other physical diagnosises. My MI histroy is extensive and I was in a bad car wreck five years ago so I have been having chronic pain issues for as long.

I already had a failed work attempt this year and otherwise have not worked at all for over a year now.

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