Saturday, February 21, 2009

I received 2 wildly disparate diagnosiss, how can people hear the same thing have such different answers? -

After going to two different Dr s., one said I had bi-polar disorder, AD HD, and brain damage (due to a few too many concussions). The other Dr. said quot;the diagnoses are Borderline Personality with Major Depressive Disorder, Mixed Personality Disorder with Antisocial Behavior, Post Traumatic Stress Disorder, and Alcohol and Drug Dependency Recovering. The prognosis is poor. The GAF (Global Assessment of Functionality) is 20. Is this because of when they went to school they were taught more thoroughly (approx. 45-50 yrs. ago) compared to 10-15 years ago? Personally, I think the younger guys (roughly my age) are just using the flavor of the month (not to mention the easier amp; shorter) answer! Probably the drug reps incentives have something to do with the easy-answer guys decision? The real kick in the *** is that Social Security paid for the visit to the Dr. who gave me the more plausible answer, and he is not a Gateway participating provider. Is there any hope of landing a competent Dr. with Gateway? Am I doomed to keep dealing with crackpots (crackheads)? Or should I just take a month s worth of hypertension pills? I have a 30 yr. history of suicidal thoughts/behavior. Some previous attempts included barricading myself in a room and swallowing 300 aspirin, hanging myself, bridge jumping, defenestration, lying my head on railroad tracks, agitating dangerously unstable people (bikers and cops etc.), various quot;accidentalquot; overdoses, and my favorite... wrapping aluminum foil 20-30 times around my head and climbing an oak tree during an electrical storm. So I ve probably heard all the trite advice like quot;It s a permanent solution to a temporary problemquot;. Temporary my ***! The problems grew exponentially upon entering (chronicalogically) adulthood. Severe problems getting and keeping even crappy low-paying jobs. Repeated evictions due to mismanaging insufficient funds. Inability to maintain friendships. Friend counter currently sitting at zero for last 4-5 years. I.Q. dropped from 129 to 104 over last 30 yrs. Attention span GONE! This is the longest thing I ve written in at least 10 yrs. I try to find the (inapropriate?) humor in everything, but laughter being the ONLY medicine is not enough. (it s sort of like drowning, only instead of air I m gasping for laughs.) I ve been on many psychiatric meds over the years, (I had such high hopes when Prozac was introduced!) none worked. WHAT THE HELL SHOULD I DO?

Quite often it takes more than one visit to make a differential diagnosis. These doctors probably only made a preliminary diagnosis. I hope you will be able to choose one and trust that as the doctor gets to know you, a more accurate diagnosis will be made. Best Wishes to you.

Now, is the competent doctor the one who gave you the long or short answer? I d say that if Dr. Incompetent is the one you can get, while Dr. Competent isn t, you might need a third opinion. I hope this helps! ~C

From the information you have provided, it seems as though the second list of diagnoses is probably more accurate. However, every psychiatrist may have a slightly different feel on what a patient s diagnosis is, depending on how the pt. presents themselves at that time. Clients with BPD often have quot;accidentalquot; suicide attempts. They have no true intent of committing suicide. This is simply an attention-seeking behavior. Example: A client will overdose on a cocktail of pills and then call for help once they have done so. There are some incidents where the person will not get help in time and consequently die. Clients who suffer from BPD often struggle with substance abuse issues. Antisocial and borderline personality disorders are axis II diagnoses. The major depressive DO would be an axis I diagnosis. I am assuming you are referring to bipolar disorder and ADHD as the psychiatric flavors of the month - unfortunately they are sometimes used for insurance billing purposes. The GAF of 20 is exceptionally low, as an ideal GAF is approximately 80 or above.

Just curious if you have tried bi-polar meds? They are far different than say prozac. Bipolar meds are mood stabilizers such as lamotrigine or lithium, infact if a bipolar person takes something like prozac it can actually provoke suicidal tendancies. There are many meds to try, but it sounds very much like you need to talk to a therapist regularly to talk as well to keep you focused. Unfortunately I know nothing about Gateway or how it works, I live in Canada. You are going to have to be your own advocate it sounds like and contact perhaps mental health facilities and ask lots of questions on what your options are there. I really hope you find the answers you are looking for.

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