Argh! Changing diagnoses!

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I don’t even know which place to post in because they keep on changing my diagnosis! I’m rather frustrated about this at the moment and want to know: is this normal?

The psychiatrists I’m forced to get help from the last years never even talked to me about my biography, never talked to my parents about my development as a child/adolescent and never did any tests. Even though I asked to have a detailled talk about my life story for a million times, because I think it’s essential to a good diagnosis, they never did this. I’ve talked to others in different organisations and they are doing diagnostic tests and interviews… I never had such a thing. Other people in the same organisation as me recognize my complaints.

I find it a little shocking they keep putting labels on me without even have a deeper talk to me. Varying psychiatrists have told me all these diagnoses at various times: adjustment disorder with anxiety, PTSD, PTSD with secundary psychotic features, menstrual psychosis, psychotic disorder NOS, schizoaffective disorder, schizophrenia, personality disorder NOS, bipolar disorder, ADD. All they did was give meds.

My current diagnosis is psychotic disorder NOS and a “we don’t know” on personality disorders…you’d think they’d have a clearer picture after 5 years of psychiatry, but on the other hand, if you refuse to talk to your patient and are only interested in putting pills in them…how can you get the picture clear… :/.

I feel like they are giving me random diagnoses only based on how I am behaving at a random time, without looking at the development of and causes for my behaviour. When I was feeling bad when my relationship was over and some other bad things happened, my psychiatrist changed his idea to schizoaffective disorder depressive type. When I used antidepressants and I got really happy, the psychiatrist changed his idea to bipolar. All overly-happy symptoms stopped when I quit the meds and never came back, but my psychiatrist kept talking about bipolar. When I was withdrawing from zyprexa I had severe mood swings (anger!) for some weeks. I immediately got labelled personality disorder NOS - I had no such symptoms ever in all of my childhood and adult life (i had a normal life&personality until some trauma around age 29). All of these symptoms stopped when withdrawal was over, but my psychiatrist kept talking about pd.

Is this a normal way of diagnosing people? Wouldn’t it be normal if a psychiatrist or psychologist just took some time (some hours?!?) to talk through a patients life story with them and their family and look at how they’ve developped in general and only then put labels? Maybe do some tests? And look at what the cause of the problem is and solve that, instead of just shoving random meds through someone’s throat after a short conversation? This isn’t something weird I’m asking, is it?

Sorry for expressing my frustration… I’ve been asking for a good diagnostic interview for years now and we’re not getting anywhere…

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That is frustrating! I’ve read a lot of similar stories about bipolar diagnoses, and I think that’s something of a standard - if you respond to ADs with mania, then there’s underlying bipolar. It seems weird to me, too, but it’s common.

The PD diagnosis seems utterly wrong. My pdoc and I were just talking about this - she says that PDs are lifelong things, they don’t just vanish with a change in circumstance.

It’s normal to meet the criteria for a PD at some point, but to actually have a PD, it needs to be persistent and pervasive - it affects everything and it does not go away.

But I agree that diagnosing you without any sort of diagnostic interview is weird and wrong. It sounds like you don’t get to choose which doctors you see, though, so I’m not sure what steps you can take about it, other than to keep requesting one. Good luck!

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Thanks for your response! It helps a little to be able to express my frustrations and get some understanding response. Didn’t know that about bipolar…didn’t have true mania btw, just somewhat extra happy and hyper. I was a little surprised by the PD diagnosis as well… since I have had a normal adulthood without the PD-type problems in emotional and social functioning. It’s just frustrating to get a different label every time based on no real diagnostic testing (but not get any treatment for the trauma I have).

I’ve now requested a different psychiatrist and was very firm. They thought I was a difficult patient…but it might have helped me in getting to see a different psychiatrist. I really do hope it helped and this one takes the time for a good in-depth diagnostic interview.

Thanks for your support.

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isolation of genes have been around for awhile, for instance, they know my daughter’s genome for CF,
and when I did that research study, they did blood draws,

demand you know what is showing up in DNA. I mean, is it there, or not?

Never given a head scan to determine schizophrenia, always read, everyone’s brain is a little different,
but if you got gaping holes in your brain, something is amiss.

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The trouble with PDs is that often they reflect the pdoc’s subjective antipathy towards the patient or are used to label patients that have not made a timely recovery. It can be easier to transfer blame on the patient for not recovering rather than owning up to inadequacies in treating the individual.
Back in 1982 I was seen as having schizophrenia with a PD and then soon after the PD was dropped and the diagnosis changed to schizoaffective/query bipolar.
23 years later to a backdrop of a poor therapeutic relationship( I was awkward and troublesome for seeking more support) the schizoaffective dx was swept away and the PD label dumped on me. Had I drastically changed in that time? No. Could my problems be explained better than by means of a PD ?-yes .
The combination of being disliked by the psychiatric team and still having problems despite the medication being the catalyst for the PD label. It was not considered whether all the problems I had had been sufficiently recognised , which indeed they continue not to be.
A more holistic and intelligent approach ,rather than fixating on diagnosis and blaming me for any failures in the therapeutic relationship / thinking must be a case of PD because still has problems, would have looked at the bigger picture as to why treatment was only very partially succeeding. .

Quite frankly as far as I am concerned they can scrap the diagnostic systems and describe people as, for example," has prominent anxiety with secondary mood and thought problems with suspect" and treat accordingly taking into account other possible issues like aspergers/autism/learning difficulties etc.

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I know your psychiatric culture is different, and I understand why you have this outlook. But I don’t really think it’s universally true that a PD diagnosis is necessarily a dumping ground.

Instead it’s an acknowledgement of mental injury - a person with a PD (think dependent, histrionic, borderline, paranoid) is often someone who learned these thought processes and behaviors from birth as the only way they could get the things they needed to survive. They’re not “bad” people for the way they learned to survive, and it’s not helpful to characterize them that way.

The fact that the therapeutic community where you are handles PDs poorly isn’t a reflection of the diagnosis or the diagnosed. It’s a reflection of the practitioners.

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I agree it is not universally true but the truth is it sometimes/often is and even when it is not other ways of describing the symptoms may be more valid.
Of all the psychiatric diagnoses it is the most subjective and the least grounded in hard science. It’s very much dependant on saying this behaviour is extreme while that behavioiur is within the realms of normality and yet can we really objectively say for certain where those boundaries lie ?
Where it may have some validity is in the position that mental illness should involve either some level of distress/harm to others or impairment in occupational/social functioning but that is a big step away from creating a clear distinction between abnormal or normal patterns of behaviour.

At the end of the day I can only go on the facts appertaining to my own situation. Namely that the radical switch in diagnosis came at a time when the relationship between myself and the psychiatric team had all but broken down and instead of being honest and accepting some responsibility for that situation it was easier to lay all the blame on me as a patient. The truth is there were faults on both sides . However in such situations psychiatrists and other mental health workers are averse to taking any degree of responsibility for the therapeutic breakdown.
As it is due to that poor treatment, and the reluctance to be subjected to more abuse and blame, I am very guarded in my responses when asked how I am. I would rather hope the mental health team has the intelligence to spot a problem and where help is needed than be proactive in asking for and pursuing help. I occasionally bring things up but if it results in a poor/inadequate response I have learnt not to pursue the matter or at least not to try again unless a long time has passed.
i would rather be subjected to indifference than contemptuous abuse . I turn up for my injections every fortnight . I make no fuss. I am like a Stepford patient. They like me that way.

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