Posted by ed_uk on February 5, 2005, at 13:06:57
In reply to The Honest Truth, posted by pretty_paints on February 4, 2005, at 13:38:38
Hello Katie :-D
>I'm going up to 15mg Abilify and I'm gradually coming off the Seroquel over like a week or so (maybe bit more).
Wow, a week is fast. Don't reduce the Seroquel too fast! You don't want to be itching and feeling sick! Take it slowly.
>But the truth is, I WANT to have a diagnosis, I want to have something serious like manic depression or schizophrenia.
I used to want a diagnosis too. I felt like people wouldn't take my problems seriously unless I had one. I also wanted to be able to use it as an 'excuse' for some of my behaviour- like the time I threw the toilet seat out of the bathroom window.
>I have found out that my mum is a very different character to me. She is not at all affectionate and quite cold.
I can imagine that you are quite affectionate, is that right? Is your dad affectionate?
>And over the years, I think I worked out that to get attention I had to be good. Good at things.
I have also felt the need to be good at something. Sometimes I have felt that if I wasn't the best then I was nothing. I know this was a stupid way to think but I couldn't help it. I have never felt the need to be good at everything. I've always needed to be 'the best' at ONE thing though. I tend to obsess about that ONE thing at the exclusion of everything else. Sometimes I feel like if I'm not the best at anything then I'm worthless.
>Katie plus 10 A*s..
Wow, you did better than me! I got 7A*s and 3As.
> I feel like people won't want me or accept me if I don't get a diagnosis.
I will :-) Most people feel the opposite about being diagnosed with schizophrenia. They worry that people won't accept them anymore if they're diagnosed with schizophrenia. People on p-babble will accept you whether you're diagnosed with schizophrenia or not ........and so will your family and friends.
> I just desperately want it to be the case that I have something definitive.
Katie, you *do* have a definate problem, but you need to accept that no psychiatric diagnosis is definate. Because psychiatric diagnosis is based on reported symptoms and behaviours, all psychiatric diagnoses are somewhat vague and subjective. Different pdocs will diagnose the same patient with different conditions. Making a psychiatric diagnosis is essentially a judgement call. Your symptoms are real and you have suffered definate mental illness, you do not need a diagnosis to tell you that. In the USA, things are different. People *need* a diagnosis in order for their insurance company to pay for their medical treatment! It's not like that in the UK because we have the NHS, there is less emphasis on categorising people's problems and labelling people. Mental health problems are always unique. Two people with the same diagnosis may have very different problems! Psych diagnoses are not specific medical conditions, they are based on clusters of symptoms which tend to occur together. People who are 'undiagnosable' can have equally serious mental health problems as those who have been diagnosed. You *know* that you have had delusions and so you *know* that you have suffered from a mental health problem. You don't need a diagnosis to tell you that. Schizophrenia is not a highly specific medical condition like cytic fibrosis or myasthenia gravis, it is rather vague diagnosis which is diffiucult to define- as are all mental health problems. There is no definate test for schizophrenia, and different psychiatrists will define it in slightly different ways. Although schizophrenia may be related to genetic factors in many cases, there is no gene for schizophrenia. No one gene will ever correspond exactly to a subjectively defined mental condition, different genes may be involved in different people. In some people, many genes may be involved. In others, their schizophrenia may not be related to genetic factors at all! In contrast, a person who's problems are currently undiagnosable might in future be found to have a specific genetic condition. Try not to worry too much about diagnosis. Diagnosing schizophrenia is a bit like saying 'we know you've got a chronic psychotic illness but we don't know why.' Diagnosis isn't even particularly useful for predicting which treatments will work. In Psychoatry, medication choice is generally based on symptoms, not diagnosis. Delusions are usually treated with antipsychotics whatever the diagnosis is! It doesn't matter whether you pdoc labels you with schizophrenia, schizoaffective disorder, delusional disorder, schizophreniform disorder, brief psychotic disorder, psychotic depression or psychotic disorder NOS. These categories are not specific, they overlap with each other greatly. This does not mean that mental illness is not real, it simply means that it is difficult, if not impossible to classify. People's mental health problems are often very individual, they do not fit easily into discreet categories! At the moment, most psychiatrist base their diagnosis on the DSM or the ICD. These systems are not perfect, but they are the best we've got at the moment! If you look on google you can read the DSM diagnostic criteria for schizophrenia and other psychotic disorders.
I hope I have encouraged you that you do not even need a 'definate' diagnosis. Because of the stigma atteched to schizophrenia, you might be better off sticking with psychotic disorder NOS!!
>even if that means no diagnosis
You already have a diagnosis: psychotic disorder NOS. You don't need another one :-)
>And now when she finds out one is not true, and I know that the second was not a solid firm belief, so does that mean I'm not really ill?
Of course not!! You have had other delusions like the one about your cousin. I expect that your pdoc decided to write about the mindreading delsion because mindreading delsions were traditionally thought to be especially characteristic of schizophrenia. Without this delusion, your pdoc may be less likely to diagnose schizophrenia and more likly to diagnose something else eg. delusional disorder. The mindreading delusion is one of the so-called SCHNEIDERIAN FIRST-RANK SYMPTOMS ie. thought broadcasting.
http://www.driesen.com/glossary_s-t.htm#SCHNEIDERIAN%20FIRST-RANK%20SYMPTOMS%20(FRS)
If a person has 'bizarre' delusions they are likely to be diagnosed with schizophrenia, schizophreniform disorder or schizoaffective disorder.
Schizophrenia http://www.behavenet.com/capsules/disorders/schiz.htm
Paranoid schizophrenia
http://www.behavenet.com/capsules/disorders/paranoidschiz.htmschizophreniform disorder (brief episode of schizophrenia-like illness)
http://www.behavenet.com/capsules/disorders/schizophreniformdis.htmSchizoaffective disorder
http://www.behavenet.com/capsules/disorders/schizoaffectivedis.htmPeople who ONLY have non-bizzare delusions are more likely to be diagnosed with delusional disorder.
http://www.behavenet.com/capsules/disorders/delusionaldis.htm
People who's delusions are closely associated with their depression are likely to be diagnosed with psychotic depression.
Major depressive episode
http://www.behavenet.com/capsules/disorders/mjrdepep.htmWith psychotic features eg.
Mood-Congruent Psychotic Features: Delusions or hallucinations whose content is entirely consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment.
A bizzare delusion is a delusion where something believes something which is completely impossible eg. 'My mother is controlling my thoughts with a remote control'.A non-bizzare delusion is a delusion where something belives something which *could* be true- but certainly isn't eg. 'I was raped by my cousin.'
A depressive delusion is a delusion with a depressive theme eg. 'I am responsible for the Tsunami disaster.'
> I know there were loads of others that she hasn't specifically mentioned, but she obviously thought these two were the most important and now she will be angry with me, and worse still, consider me not ill.
She certainly won't consider you not to be ill! She knows that you have had other delusions. Pdocs get used to being lied to! She won't be angry, I'm sure of it. It's good that you've decided to be honest with her, you will get better treatment if you are honest :-)
> I feel worried too that you lot will be dissapointed with me. That you will feel I've deceived you in some way.
Of course not! I don't feel that you deceived me at all :-) Don't worry xxxxxxxxxxxxxxxxxx
>Before, it read psychotic NOS - is that non-specific psychosis??
Yes, it means 'psychotic disorder not otherwise specified.' It is a DSM diagnosis, rather than an ICD diagnosis.
>What does it mean "psychotic illness with depressive features?". What diagnoses could it include other than the obvious schizophrenia that I want?
It simply means that you are psychotic (because you have had delusions) and that you have suffered from depression at the same time.
Diagnoses could include: Psychotic depression, schizophrenia, delusional disorder, schizoaffective disorder, psychotic disorder NOS, schizophreniform disorder.>I hope you will admire me for being honest?
Yes, I admire you very much :-)
>By the way, do you think my pdoc will be angry when she reads the letter?
No! Not at all. She will not be angry or dissapointed. Lots of people want a diagnosis, you are not alone :-)
Ed xxxxxxxxxxx
poster:ed_uk
thread:452494
URL: http://www.dr-bob.org/babble/20050202/msgs/453617.html