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Re: Different Dr.- Different psychological disorder?

Posted by Noa on December 21, 1999, at 2:29:41

In reply to Different Dr.- Different psychological disorder?, posted by kelly on December 21, 1999, at 1:07:47

Katie, the diagnostic system is just a way to organize how to think about the symptoms that a person presents with. So you presented with a number of troubling symptoms, and each doctor used a different diagnosis that seemed to fit the combination of symptoms. It is likely that your combination of symptoms varied a bit at times. Even so, some of the diagnoses are not that different from each other. And medications these days are used across diagnoses, with the doc really looking at the particular cluster of symptoms and how the person reacts to different meds.
Schizoaffective disorder is a diagnosis that "explains" a combo of mood symptoms and disordered thinking.
Bipolar might have been used because you presented with mood swings or a combo of ups and downs, or extreme irritabiity and depression, etc.
Borderline Personality Disorder is a garbage disposal diagnosis. It is often used if you have labile moods, a lot of anger, dificulty coping, stormy relationships, etc., esp. if you have any kind of trauma in your history, or history of difficult early life, or have an eating disorder, etc.
Adjustment disorder kind of makes me laugh, because it is the most benign diagnosis in the book, and is often used as a way to get insurance coverage for treatment when the person really isn't ill enough to fit other diagnoses. It is probably true that after moving, you did have an adjustmen disorder, but that kind of, um, ignores your history.

Depression is one of your symptoms, it sounds like, as are anxiety and fears, as you say.

It isn't unusual to have a lot of confusion about the overall diagnosis, especially when you have a cluster of different symptoms.

Btw, Dr. Akiskal, who is at UCLA, I think, is one of the top current researchers of mood disorders. He seems to think that Borderline personality disorder is really a form of mood disorder, in the family of depression and bipolar. It makes sense because the primary sypmtom is unstable moods. The early history aspect may be sort of beside the point for diagnosis (although not for therapy). I think early history may be the "trigger" that unleashes a predisposition toward a mood problem. Nature and nurture interact and affect each other continuously.
I understand what you mean about it being hard to believe your doc after hearing so many diagnoses. But regardless of the diagnoses, look at your symptoms. Many people with different diagnoses end up on similar meds. IF you are plagued by depressed moods, anxieties and phobias, don't you deserve some relief?




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