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Re: doctor has confired that i do not have depression iforgotmypassword

Posted by Tomatheus on November 8, 2005, at 19:24:02

In reply to doctor has confired that i do not have depression, posted by iforgotmypassword on November 7, 2005, at 13:40:42

iforgotmypassword,

I agree with most of the comments that have been made on this thread.

How exactly did your pdoc confirm that you do not have depression? Did he conduct a diagnostic evaluation and then tell you that you did not meet the DSM-IV criteria for major depressive disorder or dysthymia? If so, it seems to me that he should have done this on your first visit (judging from some of your previous posts, it appears that you've seen this pdoc before). Although I am not a doctor, it is my impression that it would be out of line with the standards of psychiatric practice to prescribe a patient meds for depression and then proceed to tell the patient at a later appointment that he does not have depression "in any remote way whatsoever."

Although it sounds from your posts that you would likely meet the criteria for either major depressive disorder or dysthymia, the treatment that you receive for your psychiatric illness is (in my opinion) more important than the diagnosis that your doctor uses to identify your illness. If your doctor used a valid questionnaire to reach the conclusion that you did not meet the DSM-IV criteria for major depression or dysthymia, then he was technically correct in "confirming" that you do not have a depressive disorder (at least, based on the standards of the American Psychiatric Association). But in terms of saying that "there is nothing" and that you are "only looking for problems" - both of which imply that there is no biological basis to your psychiatric illness - there is no way that he can confirm this. On the same token, I cannot confirm for certain that there is some sort of biological basis to your illness simply from reading your posts. What I can tell you is that there is strong evidence in the scientific literature that for many (but not necessarily all) psychiatric patients, biochemical abnormalities are at the roots of their illnesses. Molecular genetics studies, for example, have demonstrated that there are structural variations in the genes that encode for the production of enzymes (such as MAO-A, MAO-B, and COMT) and the activity of reuptake pumps and neurotransmitter receptors. Some of these genetic variations have shown statistically significant relationships with one or more psychiatric illness. Can I confirm for you whether you have one these variations? Of course not. And even if I could, there would be no way for me to say with complete certainty the extent to which one (or more) of these variations contributes to the symptoms that you've been experiencing.

My point in bringing all of this up is to demonstrate that there is evidence that psychiatric illnesses have biological bases, but there is really no way (with the technology currently available to psychiatrists) to say for certain whether or not a given patient actually has a biochemically rooted psychiatric illness. But given some of your statements ("I still cannot get myself to do anything what so ever," "any task is impossible," and "I cannot manufacture any sort of will, interest, or ambition"), I think the odds favor the possibility that you do have a psychiaric condition that is caused by something other than just "negative thought patterns." And as I said, I'm no psychiatrist, but I think you might benefit from taking medications other than the ones you've already taken. If your pdoc can't recognize this, then I would recommend going to another doc who might see things differently. Remember, it's your mental health.

Tomatheus

> in any remote way whatsoever. he says that i am only looking for problems, and that there is nothing. i still cannot get myself to do anything what so ever. any task is impossible, and i cannot manufacture any sort of will, interest, or ambition. so what do i do now? i am just like this because i choose to live this way, how do i change this when i doing any single small thing is not only extremely difficult but feels impossible?


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poster:Tomatheus thread:576399
URL: http://www.dr-bob.org/babble/20051106/msgs/576865.html