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wundayatta's avatar

Are you diagnosed with multiple mental illnesses?

Asked by wundayatta (58722points) December 5th, 2009

I see so many people around here who have multiple comorbidities with their primary diagnosis. Hell, I don’t even know if there is a primary diagnosis. It just seems like people have a laundry list of disorders.

I know that in my “field” (being bipolar), there are a lot of people with several different diagnoses. There seems to be some confusion as different doctors at different times will give some slightly different diagnosis.

I wonder if this is at all helpful. I know that everything from Anorexia to OCD, and a bunch of things in between (or after O, but I don’t remember for sure), share the same mutation on one of the genes associated with those disorders. It’s too soon to say, but it could be possible, genetically speaking, that all the mental disorders are pretty much variants of the same thing. If that were the case, then perhaps it almost wouldn’t matter what you were diagnosed as.

A lot of the same meds are used for many of these disorders. In bipolar disorder, they know there’s one thing (Lithium) that pretty much always works, but after that, they have no idea which drug to go to. Different drugs work with different people, and so every patient is an experiment. I know people who have gone through over a dozen different meds. Over the time they try these meds, they also get different diagnoses.

To the question:
Do you have multiple diagnoses? If so, what are they? What do you think all these diagnoses mean? Do they make a difference in treatment, or is it just an excuse for a doctor to prescribe a different med? And for you—what story do you tell yourself to explain it all?

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41 Answers

gemiwing's avatar

Yes I do.

I’m not comfortable listing them all out, honestly. They do make a difference in treatment because certain methods work better for some than others. Some can be treated through talk therapy, some through medication and others through lifestyle changes.

Lithium didn’t work for me- it almost killed me. I had to ride the med merry-go-round for about ten years. So, for me, I don’t feel that the doctors were using the illnesses as an excuse to give me tons of scripts. Doctors don’t get paid by how much they prescribe- the drug companies do. I do blame the FDA and drug companies for pushing through drugs that have no large group long-term studies to them.

The doctors though? They were just trying to help the only way they could- they were psychiatrists so that’s what they did. If all you have is a hammer, everything looks like a nail.

Story..story… hmmm I view it as different branches on my tree. Some limbs need to be cut off, others can be mended. Because some lower limbs were cut poorly, other ones grew to take their place. It’s not a perfect tree- but it’s mine.

tyrantxseries's avatar

I do to, but I think it’s bullshit
“they” say I have:
schizophrenia- yes
Schizoid personality disorder- I guess (isn’t this the same as schizophrenia?)
Obsessive-Compulsive Disorder- a little
borderline Sociopath- I don’t believe to be true (I don’t fit the profile)

I only get treatment for schizophrenia, as per it is the only illness really affecting my life.
they tried the different meds thing. yay

“what story do you tell yourself to explain it all?” um..what do you mean?

gemiwing's avatar

Schizophrenia and schizoid are on different axis. (axi? axiums?) So they are not the same thing.

dpworkin's avatar

I think the DSM is largely used to get payments reimbursed by the insurance companies, and clinicians will say just about anything they need to say to further that end. Also the diagnostic criteria in the area you are discussing are so sloppy and full of ambiguities and overlaps as to be nearly useless. Maybe DSM V will be an improvement; I wouldn’t hold my breath.

In the meantime, my advice is to go by the way you feel, not by what you are being told about the way you feel, and insist on better help if you aren’t happy with what you’re getting.

(And, yes schizoaffective, schizoid and schizophrenia are quite different than one another.)

gemiwing's avatar

@pdworkin The problem of going how one feels, is that when you are mentally ill you cannot always trust how you feel. Relying on how you feel when manic, for example could end up with you homeless, divorced or dead.

I do agree that the DSM IV is ambiguous; however, I don’t think that the DSM V is going to be a big improvement in that regard.

I wish there was a healthy middle ground. Modern psychology is still young and we have so much to learn. So I do have hope for the future. I just wish we were closer.

dpworkin's avatar

I meant how you feel about the quality of assistance you are getting, not how healthy you are.

Allie's avatar

I haven’t been diagnosed with anything and I don’t take medication for any type of mental illnesses. I do have some OCD tendencies, but it’s not because these things have to be a certain way, I just like them that way. For example, I like to pull my bedsheets down one at a time and fold them into thirds. Like I’ll pull the comforter down and fold it in thirds at the foot of the bed, followed by the blanket, and so on. This is just so that in the middle of the night if I get cold and want another layer I can just reach down and grab it easily and it’ll come up nicely even if I’m 90% asleep. I also have a mental checklist I go through every time I leave some place. In my head I run through this list to make sure I have my stuff together (wallet, cell phone, keys, iPod, camera). I kind of pause, think, and look around when I do this. The people closest to me know what I’m doing and kind of wait for me. The people who don’t ask what I’m waiting for, then I have to explain it to them and a few have them have chuckled and said “That’s so OCD.” Anyway, I don’t really consider these things OCD, but other people have compared it to that. I just think it makes my life easier.

casheroo's avatar

I’ve had multiple diagnoses. Not all currently affect my life at all.
I don’t mind listing them, as they do not define who I am, and are really just labels doctors gave me while trying to figure it all out.

Depression- diagnosed at age 14 (Oh, and then they add Major Depressive Disorder onto that at some point)
Generalized Anxiety Disorder- 14

Social Anxiety Disorder- 15
Agoraphobia- 15 (first episode happened at 15, second was at 19. Haven’t had a “flare up” since)

Bi-polar disorder II- at 17. This was by a psychiatrist who had just met me, and I was going through a serious depression. I was wary of the diagnosis, but my mother felt it meant I’d be “cured” since they figured it out and medicine (to her) cures everything.

Trichotillomania- started at 10, still have it. No treatment for it. Nothing but sheer will power works. OCD goes along with this, as some believe.

Post traumatic stress disorder- This had been toyed around with since I was younger, around 16. I got officially diagnosed with it at 19 when I really started opening up about my rape experience at 14. This seemed to be the cause of all my problems. I was so traumatized and could not cope with happened, and kept it to myself. Recipe for disaster.

I think, looking back, a lot of my problem was coping issues. I could not cope with what happened, thus making me not be able to cope with anything in life. Even the small things. I would emotionally overreact and fall into a depression. I’m glad I figured it out.
It’s painful to think about. That I could have gotten help for this specific thing soon. I regret that. It doesn’t consume me, but sometimes I sit and cry and wonder how different my adolescence would have been if I would have just said something. I had been on a great track, and then it happened and my whole life changed. I sometimes wonder if I would have had normal relationships with guys, been able to finish high school, not try to sabotage everything good. It’s bad to dwell, but I do admit to thinking about it.

MacBean's avatar

@casheroo: Well, now I’m not listing mine, because I’ll just look like a copycat. ;) Also, OMG, TRICH! How bad do you have it? Do you eat it too, or do you just pull? And what do you pull? I do eyelashes (right now half of the top ones on my right eye are missing), scalp hair (I have one small noticeably bald patch), and leg/arm hair (also patchy, but only if you’re paying attention).

casheroo's avatar

@MacBean Nope, never ate it. I find I get that question a lot, and I blame shows like SVU lol.
I started with just eyelashes (since I started at 10, that’d be 1996ish), which is usually my main pulling area. I’ve gone without eyelashes completely before. In 2005, and I remember the night exactly, I began pulling the hair on my head. Usually the left back side, but at one point I was pretty bald from front to back..I took pictures and don’t mind sharing. I never hid the disease, even though my mother always tried to make me feel awful about it. But, it’s not something I felt I ever had control of.
Unfortunately, I’ve had a relapse recently :( I blame the stress of school. I only ever pull when I’m in school.
so crazy, half the top ones on my right eye are missing too. My poor right eye gets the brunt of the pulling

MacBean's avatar

@casheroo: My scalp pulling is usually on the left side, too, but in the front. I have this little dime-sized bald patch right near my part. It looks terribly silly but I can’t seem to stop, or even to train myself to pull from a different area. I’ve noticed that I pull eyelashes as a stress response, scalp hair when I’m thinking deeply, and arm/leg hair when I’m sitting idly with nothing to do with my hands while just watching TV or letting my mind wander.

galileogirl's avatar

Not actually diagnosed but the voices keep telling me I should stop washing my hands long enough to see a shrink.

loser's avatar

This is interesting. I’ve been diagnosed with disthymic disorder, social anxiety disorder, depression induced agoraphobia, bipolar disorder, and borderline personality disorder. Honestly, I think they don’t really know what’s with me. I’m just nuts.

augustlan's avatar

Depression (from a very young age), generalized anxiety & panic attacks, a sort of OCD I only have obsessive thoughts – no compulsive actions, and PTSD. All but the PTSD were treated best by an anti-depressant (tried many before we found the right one). The PTSD was addressed with talk therapy and time.

Ever since I fully accepted that these are my issues, I’ve always just thought of them as my personal ‘mental stew’, and assume they are all related.

Side note: I also have several different auto-immune disorders/diseases/syndromes/whatevers, and there is some new thinking in this field… some suggest they are really all ONE disorder manifesting in multiple ways. I could easily see that being the case for auto-immune issues and mental illnesses.

lovemypits86's avatar

i am 23 and going to school to become a vet. i was told that i had bipolar disorder and ocd at 14 and at 16 found out i had schizophrina but every woman in my family has been said to have atlest one of these disorders. by i am on a great combo of meds and keeps me halfway normal for the most part. but as a teenager i was out of my mind. wouldn’t sleep for weeks clean the house and paint all night wouldn’t eat and picked up a coke habit for three years. but now i am on my meds holding a 3.9 in school and married to wonderful man in the navy who thinks i’m insane but thinks i’m the greatest woman alive. for the most part i think i have it under control.

dpworkin's avatar

@lovemypits86 That was a nice story. Good outcome.

lovemypits86's avatar

i try i work part time at an spca so it keeps me busy along with my 2 pit and my rat terrier. very important not to go on and off your meds it has a real bad outcome messes with your mind and body. i stab a teacher wuth a fork in the 6th grade.

wundayatta's avatar

I am constantly amazed at the number of crazy people on fluther. I say “crazy” as a term of pride. I like crazy people. At least, I like the high functioning ones; the smart, educated ones. I think there’s something about seeing the world through the filter of a brain that is rewired that makes crazy people more interesting and, for my, more sympatico.

Maybe it’s because we have a clue about what’s going on in each other. Maybe it’s because we’ve had the same battles with the health care system. Maybe it’s because we attack life more intensely, and feel things more intensely. Maybe it’s because I don’t feel so alone when I’m with people who share these experiences.

I think that before I was diagnosed, I kept a much tighter hold of myself. It was a great strain, but I wanted to be liked, so I tried to be more normal. After I was diagnosed, I realized that I no longer wanted to control my personality. Part of that was because I could no longer control it. Something has broken out of it’s cage, and I can’t put it back. The cage won’t work any more, and the something is impossible to catch.

Whatever that something is, it’s what powers my feelings and my imagination and my difficulties conforming to standard social rules. It’s what drives me and it’s what kills me. It is what gives me any power I might have. It’s what tears me apart when I try to constrain myself. Unfortunately, I’m very good at constraining myself. I’m so, so tired of my meds.

I need attention. A lot of it. I am lonely five minutes after I’ve connected with someone. My energy for people goes on and on. My moods, up or down, help me get attention, but I hate that. It feels manipulative. I want people to love me because they love me, not because I’ve tricked them in some way.

I am driven to feel. I seek drama. I am touched by the smallest things. My need for drama brings me trouble. I feel guilty about it, and drive myself into depression. When I’ve punished myself enough, I come back up. Medical people tell me I’m not doing it. It’s the disorder. I don’t know if it really is a disorder. Sometimes I think it’s just the way other people use to control me.

So I resent my psychiatrist. I resent my therapist. I resent my wife who tells me that the pills make me bearable.

I know many people in my support group have taken themselves off their meds from time to time. Everyone tells them not to. We all conform to this notion of what being well means. I read in the books that there are many others who have gone off their meds, too. My best friend in the group says that we desire the extremes—both good and bad.

Both extremes help me produce. But what I produce doesn’t often seem to fit into the conventional scheme of things.

I believe that every human has useful talents. I don’t think we should be trying to “fix” crazy people. I think we should be trying to find situations where their “craziness” is an advantage. That’s where we need to work. We may be extremely troublesome to work with, but I think the results are worth it.

But the labor market doesn’t work this way. People apply for jobs. Jobs don’t apply for people. We are goal oriented, not people oriented. We have no faith in people who don’t fit standard molds. Sometimes, we get lucky, and create positions for ourselves where we can shine. Other times, we end up homeless. Other times we take our meds and learn to fit in.

I don’t know if anyone really understands mental illness. The doctors can’t diagnose it, and they can’t figure out how to treat it. They can act really pompous and tell us what is wrong with us, but I wonder if it really has to be seen as wrong. I wish we had a choice. I wish we lived in a society where there really were choices—where people really are tolerant. Well—if wishes were horses…

dpworkin's avatar

@daloon Are you familiar with the work of Thomas Szasz? If not, I think it may interest you a great deal.

lovemypits86's avatar

that’s a good point. i am not a fan of people that’s why i work with animals. i don’t know how to react to being around people. my life would be boring with out my ’‘issues’’ my dad denies that i’m crazy just thinks i’m still spoiled. lol he should have figured out i was crazy when i set my husband on fire. people make me nervous

Ria777's avatar

Hell, I don’t even know if there is a primary diagnosis. It just seems like people have a laundry list of disorders.

right. one more reason that I consider psychiatry pseudoscience and not science.

casheroo's avatar

@Ria777 I wouldn’t go to the extreme and call it a pseudoscience. There are biological aspects to psychiatry. It is difficult to diagnose a person when yes, a lot of the disorders overlap in symptoms…but with proper care, a psychiatrist can figure out the problem and help heal the person. Whether it be with both medication and therapy or just one.

Ria777's avatar

@casheroo: eating an apple has biological aspects. so do many things.

if you call psychiatry a science then tell me what empirical evidence you would to prove the madness as malady paradigm. tell me how that paradigm rests on empirical evidence. tell me how you could disprove it.

unless you can have empirical proof, then you don’t have a science.

augustlan's avatar

@Ria777 I get what you’re saying, but do you realize how many of us would be dead if we hadn’t received the proper care? Let alone just plain fucking miserable. All the evidence I personally need is to look at my own life. Before proper care and medication: Suicidal After: Pretty damn content. That’s good enough for me.

Ria777's avatar

show me the statistical evidence. if you don’t have that, you just have a personal testimonial. and personal testimonials don’t make psychiatry a science.

a meta-analysis undertaken in 1998* and 2005** showed that SSRI’s work as well as placebos. furthermore, Paxil has an addictive effect and SSRI’s cause suicidal thoughts, leading to their ban for users under 18 throughout Europe and the u.k.in 2003 ***.

apparently they have that effect on users under 25.**** and yet SSRI’s don’t work as well as simple exercise.*****

so, you have a class that, at best works as well as placebos, and at worst causes disruption of the sex drive and, in young people, increased risk of suicide.

*—http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1999-11094-001&CFID=4734216&CFTOKEN=46485812
**—http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045
***—http://www.independent.co.uk/life-style/health-and-families/health-news/threat-of-suicide-leads-to-ban-of-major-antidepressants-for-children-576211.html
****—http://www.reuters.com/article/idUSN11535486

dpworkin's avatar

A relevant quote from your source **:

The difference in improvement between the antidepressant and placebo reached clinical significance, however, in patients with initial HRSD scores of more than 28—that is, in the most severely depressed patients

Ria777's avatar

versus, say, getting some exercise, which has no unhealthy side-effects and won’t cost you a dime.

jerv's avatar

Aspergers Syndrome has a high comorbidity with various anxiety disorders so I tend to be a bit high-strung and/or nervous much of the time.

Luffy's avatar

The only mental illness I’ve had was depression.

LeopardGecko's avatar

Yes. I am diagnosed with Panic Disorder and OCD. Both are kind of related.

stranger_in_a_strange_land's avatar

Aspergers Syndrome, chronic major depression, PTSD, I had been previously misdiagnosed as bipolar and ADHD prior to the correct diagnosis of AS. Aspies are frequently misdiagnosed several times prior to proper diagnosis. Some characteristics of AS are often mistaken for OCD.

jerv's avatar

@stranger_in_a_strange_land – Many ASDs are also confused with mental retardation (though Aspies tend to be of above-average IQ), and it’s also a hassle since AS has a high comorbidity with depression, anxiety, and about half of the other mental illnesses/abnormalities in the book… though it’s hard to really tell comorbidity from symptoms. Hell, even the medical community really can’t do it well enough to make a truly accurate diagnosis half the time!

Then again, AS has only been in the DSM IV for less than 20 years; long after you and I hit adulthood.

Ria777's avatar

@stranger_in_a_strange_land: this tends to prove what I said earlier.

wundayatta's avatar

@jerv I’ve heard a number of stories of people getting diagnosis after diagnosis. Usually by succeeding psychiatrists. Meds change each time.

I wonder if there’s a way of empowering patients, so that they at least know this can be the process, and that they must educate themselves so they can speak more equally with the doctors, and so they can make the decision to move on more quickly. I think people often stay in pain for years (far too long) before they finally get a diagnosis and treatment that works.

jerv's avatar

@daloon But many doctors refuse to treat their patients as equals. For instance, my wife knows quite a bit about her condition and knows from personal experience that certain meds do not work on her and others make it worse. The response? Basically dismissing her and prescribing what didn’t work before.

Add in the fact that we now have many people who read WebMD and think they actually know it all… well, some may be smart but others are basically hypochondriacs with an internet connection, and it sometimes hard to tell them apart.

It gets even more fun when you have something that even the medical community isn’t sure how to deal with because it’s only been an officially recognized diagnosis for a few years and that, if some of the symptoms are treated in a normal manner, will lead to prescribing too high a dose of certain meds and making things worse than they would be without meds at all.

stranger_in_a_strange_land's avatar

@jerv And when meds for things like depression have weird side effects but do nothing for the condition.

Ria777's avatar

@daloon: I think people often stay in pain for years (far too long) before they finally get a diagnosis and treatment that works.

I would modify this to say that people often stay in pain for years before they realize that they do not need a diagnosis and they need to do the hard work themselves and accept it from people who really love them, if they fortunately do have people in their lives that love them. you must do the work to save yourself. you must do the work to save yourself. not as a joyless duty but as a gift to yourself.

Fernspider's avatar

<——I’ve had Trichotillomania since I was 14. Only scalp pulling. For some reason the urge to pull eyebrows and eyelashes never started.

Due to heightened stress levels in my life at the moment, I have a few patches that are somewhat obvious sadly.

Nice to know there are other Flutherites with my plight on here. :)

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