Difficulty in diagnosis

Parent Cafe
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<p>It is difficult enough in the US ( & I imagine elsewhere) , to find physicians who take your insurance and who are taking new patients, let alone to find one who can appropriately diagnose , when perhaps you move, perhaps you don’t know what is important and not enough to mention and when your Dr isn’t Hugh Laurie ( or more accurately Dr House, as I don’t think Bertie Wooster would be much help here)</p>

<p>I have been diagnosed with several diff things, mostly depression/ADD- but still feel-off
Varibility in diagnosis’, as environment as well as other things plays a major role.
( not to mention- I don’t like meds & I am not too thrilled with allopathic medicine either- making my attempts at procuring health care, rather sporadic)</p>

<p>But lately, as a new Dr. from a very short list that my ins will cover has prescribed an anti-psychotic ( which I haven’t taken yet- Im doing research first), I am finding it possible, although hard to accept, that I may be able to benefit from an anti-psychotic medication.</p>

<p>Full blown Schizophrenia for example, doesn’t happen overnight, but when environmental factors, genetic factors all come together, it seems to be much, much more common than we realize, although early diagnosis can greatly improve the individuals ability to stay in society.</p>

<p>But I wonder, how many never get diagnosed?
They are still working on more definitive blood tests and brain scan imaging, but those things are expensive of course, and you would first need someone to prescribe it.</p>

<p>I have usually had medical ins, but even still, most psychiatrists seem to accept previous diagnosies, and are content to continue the same prescription seeing the patient maybe 15 minutes every couple months.
( unless of course you have * really* good ins then you might see them every week)
But what about all the people who dont’ have health care, who have drs who aren’t going to be able to diagnose them if they only see them once or twice?</p>

<p>Im not starting this thread to get sympathy- but to increase awareness and to help educate ourselves so that if we, or someone we know does need more support and help, we can break down the stigma and the ignorance that mental illness is something to be ashamed of, and find ways to improve health care not just for those with heart or blood problems, but those things that are harder to figure out.</p>

<p><a href=“http://www.schizophrenia.com/index.php[/url]”>http://www.schizophrenia.com/index.php&lt;/a&gt;&lt;/p&gt;

<p>( now I am in the mood to watch House- but there are only TWO seasons on DVD! :frowning: )</p>

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<p>emeraldkity4, I know it’s frustrating. Trying to find something that works. I ask this so many times. Have you had your thyroid checked?</p>

<p>PS Love the show, House.</p>

3

<p>I unfortunately do not have any advice, but I can solve your last problem!</p>

<p><a href=“http://www.yourtvlinks.com/house.html[/url]”>http://www.yourtvlinks.com/house.html&lt;/a&gt; --All episodes, but I find many of the sites to be slow
<a href=“http://www3.alluc.org/alluc/tv-shows.html?action=getviewcategory&category_uid=607[/url]”>http://www3.alluc.org/alluc/tv-shows.html?action=getviewcategory&category_uid=607&lt;/a&gt; --Not as organized, but some good links
<a href=“http://www.dailymotion.com/house089[/url]”>http://www.dailymotion.com/house089&lt;/a&gt; --Individual who posts many episodes online. Videos are pretty good quality. If the video is here, this is where I watch.</p>

<p>Good luck finding what works for you.</p>

4

<p>Well, EK, you may not be asking for sympathy, but you’re gonna get some {{{{{major hugs}}}}} anyway…</p>

<p>I’m sorry that you are struggling right now, and I so hope that you soon find the answers (and treatment) that you seek. </p>

<p>Diagnosing mental illness can be exceedingly challenging as there can be so much overlap in terms of presenting symptoms. I, too, think that it takes a doctor with a certain degree of familiarity with a patient (and an open mind) to make good, solid diagnoses based on many criteria. Unfortunately, it is very easy for a patient to get misdiagnosed and thus medicated wrongly.</p>

<p>As one example, many people with bipolar disorder only seek help when they are in the depression cycle. Consequently, the doctor may be missing the big picture and medicate the person as a despressed person rather than a bipolar person. This can lead to all sorts of problems.</p>

<p>I’m with you…the stigma for these things must be eradicated and the system for providing treatment greatly improved so that all who are suffering needlessly can get the help they need.</p>

<p>I wish you all the best…I hope that you can get all the help you need very soon.</p>

<p>love, ~berurah
p.s. I have a houseful of House addicts here! :)</p>

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<p>i have a huge academic/professional interest in psychiatry labeling and stigma of mental illness. </p>

<p>so many people are misdiagnosed or not diagnosed at all, and meds are handed out like candy these days, especially in children.</p>

<p>there are also major issues with gender and psychiatric diagnosis. </p>

<p>i recommend the book "they say you’re crazy: how the worlds most powerful psychiatrists decide who’s normal’ which is a really interesting perspective about all of this.</p>

6

<p>Sorry you are feeling poorly, EK, and I applaud your efforts to find answers and help for debilitating symptoms.</p>

<p>I am very wary of anti-psychotics, although I have seen them used so inappropriately in children. So glad you are doing your research.</p>

<p>Schizophrenia is usually characterized by some symptoms that you describe (depression and executive function/ADD type cognitive issues), but almost universally by some thought disorders, hallucinations, delusions, or other loss of connection with reality. I have read your posts for a year now, and have not seen any of these in your posts. Of course, you and your doctor know better about these things, but it seems unusual to draw a conclusion about schizophrenia without the requisite unusual perceptions.</p>

<p>Good luck, and hope you feel better soon.</p>

7

<p>Sometimes, a doctor’s interest in prescribing a particular medication may reflect experience with that medication rather than a change in diagnosis.</p>

<p>Your doctor’s desire to prescribe that drug may not mean “I think this patient is actually psychotic rather than depressed.” It may simply mean, “I’ve had a bunch of patients with at least vaguely similar problems who have done well on this drug. It might be worth a try.”</p>

<p>This sort of thing is not overly scientific, but doctors do it all the time.</p>

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<p>The antipsychotics are not just prescrbed for schizophrenia/they can be used for bipolar disorder and to treat symptoms of insomnia and anxiety when other medications have not worked.</p>

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<p>Is the doctor that you’re seeing a psychiatrist? If not, make sure that you do see a psychiatrist to get a second opinion. Too many general practitioners and family doctors think they can prescribe drugs for psychiatric problems although they lack the training to do so. Even if s/he is a psychiatrist, it can be worth it to get a second opinion even if you have to pay for it yourself.</p>

<p>I know it is difficult finding the right medications for psychological problems, and I send you every good wish as you go about finding help for your difficulties.</p>

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<p>I’d get a second opinion–even if I had to pay the full fee. Your family needs you in tip-top shape, so put yourself first and take good care of yourself. Go to the most highly recommended psychiatrist you can find in your area. Best of luck, ek.</p>

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<p>I might add that the best person to see about appropriate drugs is actually a psychopharmacologist (a psychiatrist with additional training), as they have the most nuanced understanding of the latest medications.</p>

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<p>b’s mom said what I was about to. There are many many drugs that are uesd ioff label (meaning for things other than what theyr were ioriginally developed for). Neuroleptics (antipsychotics) can me used for agitation, mood instability (especially with anger outbursts) and for sleep. They also help organize scattered thinking, which may be why it is being considered for “ADHD” type issues, though that isnt usually the first line of chice in meds. However, maybe this doc is trying something new and different, rather than what has been tried on you before. Best is to ask the doctor why he/she is recommending this course. Good luck</p>

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<p>ooh thanks corranged!
I have dial up so I will have to go where there is free wireless- but <B</p>

<p>One of the things that put me off taking this medicine is that it is a * pesticide*!
um- so how did they find out that it is supposed to help people?
chemistry was never my best subject-
No wonder that I would rather stick with homeopathic medicine- even if they are all sugar pills</p>

<p>Well thanks Berurah
you give great hugs!</p>

<p>I am not sure what the book is about huskem- but I will look into it, although this isn’t a case of drs trying to medicate me into submissiveness, - as I know can be a problem with some patients.</p>

<p>I have bipolar/psychosis from both parents- my dad died of an accidental? overdose of his prescribed meds when I was 17 & I think a lot of diagnoses would probably fit at some point- but I don’t like taking medication and will do just about anything not to- but something has got to change & my H, though I have been with him for 30 years and love him- is pretty unhelpful in more ways than one</p>

<p>yes he is a psychiatrist- but I have only been seeing him for a few months, and even though I think Drs should want patients to be educated, after I told him I hadn’t started taking the meds yet, and I told him why, he also went into this big spiel about all the side effects they are obligated to list on the insert & how* he was the doctor* not I.</p>

<p>apparently he is not familiar with my internet research prowess!</p>

<p>That *is *a good idea to get a better diagnosis.
I am already prepared to take my D to a doc who isn’t on our ins plan ( and I have the name- just haven’t made the appt), because I want her to get a good reevaluation- but I will also do more research and find someone who can give me a through evaluation ( and check thyroid and other things)</p>

<p>grrr ins.</p>

14

<p>ek-
There is a lot of inaccurate info on the web about a lot of stuff, including medications. I am going to be a bit blunt here,and if it offends you, I apologize in advance. I do not mean to hurt your feelings. However, if you have been seeing this physician for several months, you should be talking to him/her about your concerns about meds, not us. If you aren’t being forthright about your med compliance, he may be making treatment decisions based in inaccurate or incomplete information. You need to be honest with him, or you will not get the proper care, and you will be seen as a non-compliant patient. He has liability issues to consider, and if he is making treatment decisions and adjusting doses because he thinks the current dosage isnt working, only to later find out that you arent taking the dose as prescribed, well you both loose. Bipolar disorders can be very tricky, and when the symptoms reach psychotic proportions, thinking can get distorted. Listen to your doctor. That is what you are going to him/her for. Good luck.</p>

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<p>sorry for all the typos in my earlier post (#12). I hope you can decipher what I said. thre are a lot of off-label uses for different meds, but re considered acceptable to treat different symptoms and conditions. Just wondering… how do you see your husband as unhelpful in this situation?</p>

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<p>I haven’t read this entire thread. But I do know several people who have been prescribed antipsychotic’s for treatment resistant depression.
One risperal and the other abilify. Both of my them were given these drugs at very small dosages to supposedly jumpstart the anti-depressant.</p>

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<p>I did tell the dr that I wasn’t comfortable with the prescription & he knows I am not taking it.
I realize that there are other reasons to use it, but considering my contraindications ( asthma- sun sensitivity, low blood pressure, social alcohol use) it still seems to be not something that should be first wave choice.</p>

<p>I didn’t mean to start the thread to get a diagnosis- but to discuss the barriers to getting mental health care for all, the difficulty of an accurate diagnosis/therapy & the obvious damage to more than the patient when a diagnosis or treatment is inaccurate or inavailable.</p>

<p>Yes there are some people who get medications for anxiety/ADHD, whatever who don’t really need them, just as there are people who get antibiotics for cold viruses, pain medication past initial injury and tests to make patient feel better when the results won’t change treatment.</p>

<p>But re: coverage for instance
Our insurance which regionally is considered very good- only covers about 15 visits to a psychiatrist in one year, and that from a very small list. ( for example- of psychiatrists that will take adolescents- in the entire city of Seattle, I was given 6 names. One was the dr she was already “seeing”, but that had health issues and didn’t return calls, show up for appts or turn in the paperwork so the ins would cover the visit. One I had seen before & she was wacko, one didn’t see adolescents, one wasnt taking any new patients, the next wasn’t an accurate phone number and the ins company didn’t have an alternative, and one is the dr * I am* seeing, but he won’t see two people in same family)</p>

<p>I am not in a crisis situation.
There are some alternatives to some people who are in a crisis situation, but of course mental health care, like any health care, is much more effective( and cheaper) if you don’t wait until a crisis.</p>

<p>( not to tell tales- but the reason why my H is not that helpful IMO is for example- I have had to commit myself to a psych ward twice- to get a break when I was mentally and physically exhausted from caring for both of the kids with little sleep for months, when some help at home, or even a night away at a hotel, would have been just as effective and less disruptive- however H also has his own issues- and worries)</p>

<p><a href=“The NewStandard”>The NewStandard;

<p>Medical care is getting harder to find,and expensive.</p>

<p>Many companies are self insuring and so aren’t held to the same standards as the companies that are covered through the mental health parity act
<a href=“http://www.cms.hhs.gov/HealthInsReformforConsume/04_TheMentalHealthParityAct.asp[/url]”>http://www.cms.hhs.gov/HealthInsReformforConsume/04_TheMentalHealthParityAct.asp&lt;/a&gt;&lt;/p&gt;

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<p>Consider this- sometimes part of the illness, a thought disorder, can make a person unwilling to try the very treatment that can make all the difference. Medicine is part of the biological sciences, which are messy, unlike physics and math which are so precise. Every treatment has a risk/benefit profile, you are paying a professional to do the work so you don’t have to know everything to come up with the ultimate solution. Please do follow your physician’s advice and give the medication a fair trial (some take weeks to show results)- your pharmacist can help you with knowing what to watch out for to avoid side effects/complications. </p>

<p>I trained as a physician before the insurance companies were major players in medical decision making- it is so frustrating to have the medically disinterested third party interfere in the doctor/patient relationship, I could rant for hours. The whole issue of mental health and the need to destigmatize it is another topic- I’m a believer in physical, not moral causes for psychiatric disorders. Good luck with your treatment.</p>

<p>PS- I understand why you are frustrated, and I wish medicine could be a more exact science; we have made great strides in delineating brain functions, the sledgehammer is a fraction of its former size…but still bigger than you want.</p>

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<p>well put, wis.
By the way, EK- Insurance rules say that they have to have a certain number of providers in your catchement area. You should call them, tell them what you said here about why there are none available in your area and see if they will make an exception to cover someone as in network (if a provider will accept their rates) or if they will contract with a provider to see you at the Drs rates. However, I’d give your current Dr. a chance first. Why is it you think his diagnosis is inaccurate? And what antipsychotic is used as a pesticide?? I am not familiar with this.</p>

20

<p>Im being treated for ADD, not depression.</p>

<p>When I mentioned I had been seeing this doc for several months- I should have clarified, that, that meant seeing him for approx 3 times for 15-20 minutes, every 5 weeks or so. not every week for the pyschiatrist * hour* of 50 min.
( which actually is fairly unusual anymore)</p>

<p>Phenothiazine is used in manufacturing a large class of anti psychotics, it is also used as an anti parasitic in large animals.</p>

<p>But I am actually not concerned with pesticides but I am terrified of contracting tardive dyskinesia. ( not to mention gaining weight- and flattening of mood. I also am unsure how having had hepatitis will affect the processing of the medication)
I
<a href=“DailyMed”>DailyMed;