Tag Archives: Mood Disorders

DIAGNOSES~ MAKING PUZZLE PIECES FIT

Time has always been fuzzy for me. I’m never really sure when I was first diagnosed as having Bipolar Disorder or the exact date I stopped drinking. I do know my Mom passed away in 2008 and after that I spiraled faster and faster towards self-destruction.

It didn’t take long before I had a DUI, my one best friend feared for my safety, and although I’d done worse this was different.

In less than 6 months my Primary Care Doctor suggested I see a Psychiatrist. She had been prescribing me antidepressants but thought something else was going on.

I was drinking almost the entire time I was taking antidepressants. I gave them a month and when nothing changed I couldn’t handle it. Alcohol was mostly a stimulant for me.

The Psychiatrist looked at my file and asked me a few questions. He diagnosed me as Bipolar I and we started trying different combos.

WHAT SHOULD’VE BEEN DONE

  • I was never given a Mental Status Exam.
  • I was never given a Neurologic Exam.
  • I was never given a CT, MRI, or EEG.
  • A full family history was never taken.

The biggest thing that should’ve been done is a family history.

I would always tell every Doctor I met with that my family has a history of mental illness. None of them wanted details.

Even the psychiatrist I have now has never asked for a detailed family history. He should have. It’s possible he has a few things wrong.

MY FAMILY HISTORY

I love most of my family very much but some of them I could do without. I don’t know my father’s side very well. They’re like him, not sociable or outgoing. They don’t show emotions or give hugs.

My Mom’s side is the opposite. They’re loud, affectionate, emotional, and all have some kind of issue.

There were 8 children total on my Mom’s side, one was given up for adoption before the others were born.

My Grandmother was never diagnosed with anything but I can give examples of behavior that point to something. She did drink occasionally. When she did she was like a sailor, playing cards and knife games. She could be cruel, deliberately pitting one child against another for her affection. She left them for awhile when they were all very young. My Mom quit school very early to help take care of her brothers and sisters.

Like many mothers, her sons were her favorites unless they were damaged. My Uncle Jimmy was in a car accident which left him in a coma for a short time. When he woke up he was different. It didn’t help that some friends slipped LSD into his drink in too large of a quantity. He became a different person and was left for the State to deal with. Drug induced Schizophrenia that became worse over the years with hallucinations. He was homeless and used Heroin to self medicate. He passed away from complications of pneumonia AIDS related.

My Aunt D was diagnosed as Paranoid Schizophrenic at a young age also. She had just had a baby. She left the baby with my Mom and was Institutionalized. She has been in and out of places for as long as I can remember. She was recently in the Hospital for Lithium toxicity. Her daughter disappeared a few years ago. She started hearing things and believing people were following her. She was living in a tent in the woods somewhere in Florida. No one has heard from her in 3 years.

My Uncle B is an alcoholic and as far as I know that’s it. His daughter has recently had problems with her mental health. I haven’t been told what the diagnosis is. I was told some of the situations she had been in and they sounded familiar. His son is an alcoholic.

My Auntie J is an alcoholic in remission for a few years now. I’m sure there are other things going on but I don’t ask. Her daughters have both had issues with alcohol.

My Mom had a virus while pregnant with my sister and I, women infected with the influenza virus during their pregnancy are more likely to give birth to children who will develop Schizophrenia.

My older brother is an alcoholic and addicted to gambling. I’m told he was polite and quiet as a child. I remember him always getting into fights at school and eventually he was expelled. He’s done many things that rational people don’t do. He was stationed in Germany while in the Army and decided one day he hated it and hopped on a plane and came home. He caused a 2 hour car chase in the middle of the night going the wrong way on a highway. He was married with children at this point. He’s impulsive, too smart, can’t hold a job and it’s never his fault. Both of his daughters are drug addicts. One has been diagnosed with Borderline Personality Disorder and PTSD. The other I don’t know about because no one talks to me about her. 

The brains of Schizophrenics also contain larger fluid filled areas than other people. I happen to have this in one area of my brain.

There’s also the problem of reduced brain volume (Gray Matter) which on my last scan 10 years ago it said “significant loss of gray matter for patient’s age”. There was also loss of white matter which is connected also.

SCHIZOAFFECTIVE DISORDER

Schizoaffective Disorder is a hybrid of Schizophrenia and Bipolar Disorder. There is a chemical imbalance in the brain. There are usually different types of the disorder.

Similar to Bipolar Disorder, Schizoaffective Disorder can have a Manic Type and a Depressive Type.

Manic Type: Elevation of mood, not sleeping much, concentration is affected, talking too fast, unrealistic ideas. In later stages speech can be incomprehensible. You become irritable and neglect your health.

Depressive Type: Sad all the time, lose interest in what you once loved, loss of motivation/energy, taking care of your personal appearance or hygiene. Irrational anger or fearful response to loved ones. Increasing withdrawal from society.

There is a third type mentioned where you have both. It’s considered Bipolar Schizoaffective Disorder. This doesn’t make sense to me but what do I know?

For some reason more women than men are affected and with women it’s usually the Depressive Type.

Early onset or having a family member with Schizophrenia usually leads to a poor prognosis.

Now I wonder if Doctors have it wrong once again. Looking at my history and seeing that Schizophrenia shows up often and I had a virus in my brain while my mother was still pregnant with me, it would make more sense. I don’t think I’ve heard voices. I have had a hallucination or two brought on by medications, alcohol and I think nearly dying when my kidneys failed. Do those count?

What I know is that I’m not getting better. I’m going backwards. I was better a few years ago.

Now, I don’t leave the house, no one talks to me, I’m isolated, I do get crazy ideas but it’s ok because I’m too afraid to act on them. I want to get dressed up and go to a concert but I can’t. I want to fly to Vegas, L.A., N.Y., but I can’t. It would mean leaving the house. Expending energy to pack and do my hair and make up. Judas Priest is coming to the Casino and I usually go. I’ve never been as a thin person. I could wear whatever I want. Even that isn’t enough to get me going. The lead singer for Buckcherry is coming to Providence and I love him. He’s a mash up of Denis Leary and Steven Tyler. It’s a small place and the tickets would be free. Guess what? I don’t feel like it.

RIDICULOUS!schizophrenia-5-638

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PSYCHIATRY 101 (Kind Of)

CLARIFICATION OF TERMS/VOCABULARY

I thought I knew what most of the language being used around me or in medical reports meant. Turns out I was wrong and so were a few of my Doctors. It’s obvious who keeps up with new research/education/diagnostic criteria and who doesn’t. All you have to do is look at some of the exams used in 2017 for Psychology/Sociology/Psychiatry/Neurology/Pharmacology to see there has been a change in thinking.

PSYCHOLOGY: The scientific study of behavior that is tested through scientific research.

SOCIOLOGY: The study of human social groups and society.

PSYCHIATRY: The study, diagnosis, prevention, treatment, of mental health disorders.

PSYCHOLOGIST VS PSYCHIATRIST: The each have different approaches and degrees/licensing. Psychologists are nonmedical professionals who train in methods of Psychological Testing, Psychotherapy, Analysis, and Research. The can not prescribe medications or ECT. Psychologists look at behavior and track sleep patterns, eating patterns, and negative thoughts. Psychiatrists do have medical degrees and graduate from medical school. Psychiatrists tend to look at biology and neurochemistry ruling out vitamin deficiencies, thyroid problems or other medical reasons for mental health issues before making a diagnosis.

I’m going to focus on Psychiatry/Psychiatrists for now. It can be overwhelming when you read all of it so I’ll stick to the basics. These are some things I didn’t know and was afraid to ask.

What is the DSM?

The DSM (volume 5 now) is the standard classification manual of mental disorders published by the AMA (American Medical Association). A Psychiatrist basically uses this more for billing than anything else. When it comes to Psychiatric Disorders there is no one size fits all so they come as close as they can.

NOS

NOS means Not otherwise specified, again more of a billing thing and because you might show most of the symptoms of a disorder but not all of them but the Doctor is certain that you probably will in the future.

INVOLUNTARY ADMISSION

If you are admitted to a Psychiatric facility involuntarily you must be released in 72 hours. A probate hearing needs to happen within the 72 hours if they want you to remain an impatient involuntarily.

YOUR RIGHTS

As a patient you have the right to refuse treatment (including medications), the right to privacy, to keep personal items (except in cases of self harm), enter into legal contracts, and informed consent. It’s important to know this. I always felt I didn’t have the right to ask questions because they were the Doctors and more educated than me. But there were many times I should’ve spoke up and didn’t. This only added to my problems.

When you feel you are being held against your will and someone threatens to keep you as long as they want if you’re not a “good girl” it’s demeaning and terrifying to say the least.

To find out what is going on a Mental Status Assessment is done which is a view of Psychological Function in time that changes interview to interview. Doctors also use the following:

GENERAL APPEARANCE: grooming, how a person is dressed, hygiene, eye contact, posture, appearance vs stated age. (If you show up in your pajamas and you haven’t showered in weeks and are shuffling into the office most likely it isn’t going to go well)

ATTITUDE: (toward examiner) cooperative, warm, friendly, suspicious, guarded, hostile, apathetic, distant, combative, aggressive, seductive. (Pretty sure if you act seductive you’re receiving that 72 hour hold. Same with combative. I’ve been distant, guarded, hostile and cooperative I think)

BEHAVIOR AND ACTIVITY: Psychomotor Retardation (medical term), restless, agitated, hyperactive, tremors, tics, unusual movements/gestures, catatonia, gait and coordination. (I’ve had all of these at one time or another. It took a long time to figure out it was mostly due to my brain and trauma)

SPEECH AND LANGUAGE: Clarity, Speed, Volume, Relevancy, Pressured, Hesitant, Coherence and Fluency (So I really don’t do well in this department. If I am manic I will talk fast and go from topic to topic, I will also repeat myself. If in a depressive episode my voice is quieter, I have trouble finding words and if it’s a really bad day I will stutter or hesitated before saying a word. Either way it’s embarrassing when I’m in public I usually have to sit in my car and cry for a little bit before I can drive.)

THIS IS IT FOR NOW BUT THERE WILL BE MORE. I HOPE PEOPLE ARE INTERESTED. I ENJOY LEARNING AND RESEARCHING I ALSO DON’T THINK I’LL BE TRAVELING ANYWHERE SO I NEED A PROJECT. BBA3eDB

 


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