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Psychiatry Appointment

17 Jul

For people who follow me on twitter, you will know how difficult this past week has been for me. For the first time since I joined, I actually had to stop going on as I was worried people would see how close to suicide I was. I don’t know how, but with the help of some really good friends on twitter, I managed to get through it. I think it was the closest I’ve been to non-impulsive suicide plans. However, I am now coming out the other side and want to write a more positive post.

Today I had the long awaited psychiatry appointment where I wanted to discuss the bpd diagnosis that I accidentally found out about on my records. My appointment was only half an hour long and I was conscious that once we had gone through the ‘usual’ questions I wouldn’t have much time. However, I was proven very wrong!

When I brought it up she apologised for how I found out. This really didn’t bother me, it was a total misunderstanding and I get that these things happen. She went through my diagnoses and explained briefly each one:

PTSD – delayed onset
Recurrent major depressive episode
Emotional instability disorder

I asked her to expand her reasoning behind the last one as I wasn’t entirely sure I understood it. She asked what I did know and I explained I looked at the ICD-10 (International Classification of Diseases from the World Health Authority) but it was so wooly that I looked to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association) for a more in depth diagnosis criteria. As a side point, it was also the DSM-IV that I used on my previous post on bpd.

I had taken my iPad a long and we looked at my last post and she said she could understand why I had been so put out as she didn’t believe I fitted in to 5 of the criteria which you need for a diagnosis. She explained how she perceives (using the ICD-10) the diagnosis and that I have things going on that she can’t put under the PTSD or depression heading and therefore used bpd. So essentially here is her reasoning:

– I can be push and pull with help. Sometimes my cc visits and I’m all ready to do whatever is asked of me and another time it can seem like I’m just going through the motions.

– The fact that I feel like I’m unhelpable (if that’s even a word!!) makes me extremely difficult to manage.

– That I visit my abusers to be re-abused because I feel I deserve it and am not worth better. She said that’s really complex and doesn’t fit anywhere.

– That when I was in hospital, I didn’t eat for 5 days because I wouldn’t go up to the dining room and then within a week I was asking for leave so I could go to an important business meeting.

– That I feel so hopeless about it all that I’m constantly battling suicidal thoughts.

I thanked her for explaining and said in my head they were all for different reasons than she is seeing:

– I agree I’m push-pull but I am so scared of letting people in to help as its something I have never done before. I’ve always just got on with things and dealt with them in my own way and that this is a learning curve for me.

– points 2 & 3 are really together. I feel worthless. That’s the basis of my belief system and it drives the things I do. So yeah, I don’t feel I’m worth helping and revisiting them just backs up that belief – gives me another stick to add to my collection for beating myself up with.

– I realised in hospital that the sooner you adhered to their rules, the sooner you would be discharged. So for example asking for leave to do with work showed I was thinking of the future.

I also explained that I felt like because they didn’t fit anywhere else, I was being put in to a box that doesn’t fit purely for labelling purposes. She told me that if both herself and my cc were off and someone needed to know more about me, that there had to be something in the diagnosis area for these other symptoms and that was another reason it was there.

We discussed the points for quite a while and at no time did she cut me off or make me feel like she’s the doctor and therefore how dare I be questioning her. Instead, she listened and took my views on board. She said maybe she should have used traits rather than disorder (so emotional instability traits) and I said I’d be a lot happier with that as a diagnosis.

The outcome was that she promised to revisit my notes and give it a lot more thought. I personally believe this was the system working as it should. My appointment lasted close to an hour and not once did she look at her watch or make me feel hurried for which I was truly grateful.

So i guess my point is, just because it has been given as a diagnosis, if you don’t agree with it or need more explanation then please ask. However, as with anything in life, go in to the conversation knowing that a) there might be things said that make you feel uncomfortable (it wasn’t pleasant hearing some of the things about me) and b) that the best approach is a civilised, adult one. It is not about arguing, it’s about discussing. And remember the psychiatrist is on our side – although I admit at times it’s not felt like that!

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12 Comments

Posted by on July 17, 2012 in Uncategorized

 

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12 responses to “Psychiatry Appointment

  1. Mike

    July 17, 2012 at 10:55 pm

    The irony of your post is that you’ve proved you’re the complete opposite of worthless by the way you challenged and reasoned with the psychiatrist. That takes far more nerve and self-belief than most people have — and it seems like the psychiatrist responded.

    I’ve seen the same principle in operation with physical illness in the health service. Doctors quite often hold back on the full diagnosis because they’re not sure if the patient (or relatives) want to hear the full details — and once it’s been said there’s no going back. But if you ask questions then you often get a more detailed story.

     
    • femaleptsd

      July 17, 2012 at 11:01 pm

      Thanks for pointing that out. That’s something I like about blogging – it gives me a totally different perspective because I’d never think that way!!

       
  2. Debi

    July 17, 2012 at 11:22 pm

    Such a brave and honest post. Mike’s point about the irony is so true too. It sounds like you’re now working together in your best interests – and that’s the way it should be. You know how much I hope it continues and that this is the turning point you’ll look back on in years to come.

     
    • femaleptsd

      July 17, 2012 at 11:40 pm

      Thanks so much Debi. I really hope this is the point too – thanks for everything x

       
  3. Debi

    July 18, 2012 at 12:29 pm

    I think blogging has a really useful function for you. You couldn’t possibly condense this post into 140 characters and writing it out seems to help clarify your thought processes. It can also be useful because you can share the clarity with the professionals by showing them the posts, without having to put your complex feelings into words when you’re face-to-face. It means you’re setting the agenda which you can then all work on together for the best possible strategies for you to adopt.

     
    • femaleptsd

      July 18, 2012 at 12:37 pm

      It really is! I literally just start a new post and whatever comes in to my head, I write. That’s probably why my posts can seem a bit jumpy and not that well written but it’s what works for me!!

      I’ve used my blog a few times with the services as I can sometimes struggle to put in to words my feelings if I’m not in the same place as when I felt them.

      I also hope that it helps other people who might be going through similar. Sometimes it’s hard to put out such personal stuff, but if it can make one person feel like they aren’t alone then it’s worth it!

       
  4. Nurse DustyV

    July 18, 2012 at 3:55 pm

    I’m so impressed by your positive engagement with the psychiatrist, and so pleased to hear that you are in a different place than before you went away to the US. This post just sounds really positive and i’m pleased for you, genuinely.

     
  5. thelionthatroared

    July 19, 2012 at 12:22 pm

    This post was very helpful to me, and quite close to the bone. I saw a psychologist a few times (not good at therapy commitment) and on maybe the third visit she gave me a 6 question survey. I noticed at the bottom of the page it mentioned BP diagnoses indicators. I answered the questions, she clapped her hands, smiled and declares, “I knew it! There had to be a reason for you being so emotional one day and committed to winning in Court on others!”. Huh? The short answer would be because some days I feel stronger than others…hardly outrageous with PTSD and anxiety/depression, is it? To be honest, the thought of something else to tackle made me buckle. How was I supposed to carry that label as well as the others? Then I was upset at how she handled it and seemed so pleased!! I think I caunderstand some of the behaviours that you describe, which may lend themselves to BP in some ways. My honest feeling is that they should be looked at in the bigger picture-which for you, and to a lesser degree, me, is not so simple. I cheered inside when you asked the questions which had your Dr explain the thinking behind the notes made and how it may be beneficial for people to understand and help you should your regular workers not be there…I thought that part was interesting. Thank you so much for sharing. I get a lot fro your words and experiences and I thought this was especially interesting to think about. Keep on keeping on : ) You help me chug along, too.

     
    • femaleptsd

      July 19, 2012 at 12:37 pm

      Thanks so much for your comment. I sometimes do think it’s easier to be boxed off and a label slapped on us! My psychiatrist said that she treats people with PTSD, and also people with severe depression and with both and that I show symptoms that just don’t fit. I think I got my point across that just because I have other symptoms doesn’t mean I have to have another diagnosis.

      Like you say though the fact about it being on notes so others can understand does make sense!! I really appreciate your comment, it makes these difficult to write posts slightly easier!

       
  6. Anonymous

    July 22, 2012 at 1:27 am

    Thank you for your blog. Someone I love had an experience similar to yours when she was eleven. I appreciate your honesty and courage in your posts. This girl is now in her teens and struggles to continue on with what has happened to her. Recently, she has been diagnosed with complex PTSD and a dissociative disorder stemming from the trauma. Please know that I cheer your efforts understand and challenge your condition. It takes so much strength and I greatly admire your efforts.

     
    • femaleptsd

      July 25, 2012 at 1:13 pm

      Thank you so much, I hope the person you speak about finds some peace in the future x

       

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