Diagnosis Murder

6 04 2011

If you’re expecing a fan blog about the Dick Van Dyke show of the title above, then prepare to feel sorely disappointed. You should do, that show was kick ass.

This bit is about the need and the lack of need for a diagnosis in these hectic times.

Not much of a build up but such is life.

Hi, my name is Steve (yup, that really is my name) and I have had bipolar 2, cyclothymia, depression, narcissitic personality disorder, bipolar 2 again, ADHD, autism/Asperger, and (if memory serves me correctly) a very honest ‘I don’t know’. These are genuine diagnoses which have been flung towards me in a desperate attempt the justufy me listening to people that irritate me considerably.

Now, I’ve known for a long time what I have (Bipolar 2) and I know a phenomenal amount about it (blow my own horn? Don’t mind if I do). As such I don’t normally take crap from doctors because I’m actually very perceptive about things, backed up by an abstract analytical mind. However I know several people in the so called care of CMHTs etc and it never ceases to amaze me that when these people experience a new ‘professional’, a new diagnosis miraculously appears and the game changes… again.

Let me ask you this. How important is your diagnosis? What use does it do you?

Ok, so the deal is that we are all in this because we have mental health… issues. Aside from guiding doctors away from bad med choices (not that it stops them but hey, that’s for another time), what use is a diagnosis? For the patient it means they have something to focus on, to research, to help them not feel so alone in the world, but for the doctor? It has no real use aside from making them seem as they have a reason to mess about, trying to sound like proper medical doctors for whom they can only desperately look towards for inspiration for justification of their practise.

Ooh, very cynical sounding aren’t I. Yeah, maybe I’m being overly harsh there, but the thing is that despite the wide range of meds, they broadly do the same thing as many of their counterparts, and doctors will generally throw one or two at the patient to see how they get on because they have no clue how things will go or why. A patient receiving treatment for psychosis can take the same meds as the person with bipolar and have the same reaction.

So. If you consider that a mental health problem is not a problem unless it’s a problem in your life (keep up, I know, I almost lost myself there), what’s the problem? Most of us want to be able to cope. A cure is not necessarily the point sought, it’s the ability to cope with what is thrown up at us. This is not achieved by meds. It’s generally thought to be talking therapies which help people to cope with what their condition, and life, come up with. Talking therapies don’t really rely on a diagnosis, it’s about tackling the issues you have in life and how you deal with them.

Isn’t it time we went from saying “I’m Steve and I have Bipolar 2” to “I’m Steve and I have problems I’d like help with”? Might simplify life a touch.

I dunno, maybe I’m just sick and tired of the second guessing that doctors come up with. Hell, we know better than them by dint of being the ones GOING THROUGH IT RATHER THAN READING IT IN A BOOK!

And relax… if I can. Oh well, maybe calmer for the next one.




2 responses

7 04 2011
Rachael Black

Hi Steve! My name is Rachael and I’m a bi-polar 2 with PTSD!

Interesting concept. Let me play devil’s advocate (’cause I like it heh).
1. A diagnosis is important not only to the doctor but to the patient
a) The doctor: they’re given a clue about where to start. You are given a battery of physical tests first: blood work, EEC, thyroid tests, and every other thing I was tested for before it came down to one remaining thing: a psychiatric disorder. A GOOD general practitioner will refer such a patient to a psychiatrist; A doctor who is credentialed, tested EVERY year to keep his certification in this specialty, and has familiarity with the illness.

A SHITTY general practitioner will prescribe anti-depressants and never make the follow-up step of sending the patient to therapy. The drugs were designed to make people stable so that they can benefit from the therapy.
Granted a new doc may come up with a new diagnosis but it will be damned close to your prior one. It’s not as if you go to your GP (general practitioner) and he says you have a cold and the next doc says ‘Oops! It’s Ebola!’
And by the way I take exception to your phrase ‘but for the doctor? It has no real use aside from making them seem as they have a reason to mess about, trying to sound like proper medical doctors for whom they can only desperately look towards for inspiration for justification of their practise.’
My father, as a psychiatrist WAS a ‘proper medicaal doctor’ and helped hundreds of people during his life.

b) the Patient: knowledge is power. Learn about your disease. Have doubts? Get a second opinion! Find out what to do to help yourself pull up from the lows and bring yourself down from the highs. Hey, we patients have broken ‘copers.’ Looking for help is the first step we can take. Without a diagnosis we are relying only on an outside source -one physician- to learn everything. WITH a diagnosis we can find solace from many areas. Hell, most people diagnosed with clinical depression are capable of getting off any psych meds. IF they want to work with a therapist and make changes.
Some of us have a long-term physical mental illness. All we can do is control it, it never goes away.
This explains why Lithium has been used for bi-polar disorder from the 1950’s until now. It does work and does help control the illness in patients who will not totally recover despite all the therapy in the world.

Patients need ‘talking’ therapy as you refer to it. Many need some kid of med to make them stable and able to take advantage of this therapy. A few (bi-polar and schizophrenia) require life-long management and medication. SND therapy. To prop up and learn new coping skills.

Well enough blathering. Good post. Made me think.

9 04 2011

Now, you see, this is where the UK and the US differ the most. As we in the UK are, for the most part, seen by the NHS, there is no profit margin to be realised so there is no battery of tests performed unless deamed necessary to find the problem. Blood tests and an EEG were de rigeur in the acute treatment ward, beyond that it’s been a case of talking about stuff to decide.

GPs do NOT get involved with psych problems beyond the point of referal to a specialist.

The point I was making was that regardless of what your diagnosis is, you have problems that you want help with, you want to be able to function fairly normally. Ok, it was oversimplified but it’s more a reaction to the incesant need to adjust a diagnosis to suit whatever the particular doctor has a penchant for at the time, something that seems to happen to people here in the UK a lot.

Yes, my attack on psychiatry was a harsh but I make no apologies for it. No, I don’t know your father however I’m guessing that he came from the old school where psychoparmacology was not even born and through its fruition it appears he saw the bad side of the accidental creations as well as the good. However, it has become quite common practise for psychiatry to become self agrandising to the point where we seem to have far more respect for these doctors than would appear prudent once you start looking into things. I would lose respect for any doctor where their practise to was to treat the effect and not the cause.

Ok, controversial as this may be, I’m going to pause here as I think I’m going to need to do a blog post as this reply will get very long if I don’t. Stay tuned.

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