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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Sebastian on March 13, 2004, at 11:13:31
Finaly got a diagnosis out of my doctor.
Posted by PsychoSage on March 13, 2004, at 17:23:39
In reply to Schizoaffective disorder, posted by Sebastian on March 13, 2004, at 11:13:31
> Finaly got a diagnosis out of my doctor.
Congrats. i had that one too. just focus on your symptoms though and just be aware that you can have any symptom that falls under manic,psychotic or depressive. If you believe that then you can let go of the label and as you become accustomed to trying to deal with the disorder you will create a kind of autopilot program that keeps track of your mood. that is what happens when you learn more about these strange mix of symptoms that seem improbable at times or too subtle to constitute a pure type of disorder.I knew a lot about disorders before my diagnoses and self-awareness, but I didn't understand that i did not have to be a full-blown schizo to have psychotic symptoms.
Posted by SLS on March 13, 2004, at 17:42:59
In reply to Re: Schizoaffective disorder, posted by PsychoSage on March 13, 2004, at 17:23:39
A friend of mine has schizoaffective disorder. For her, the key to her treatment is to prevent mania. Once a manic episode is triggered, it eventually develops into psychosis with visual and auditory hallucinations. Stress and anxiety are her worst enemies during times of remission. They seem to trigger the mania. Benzodiazepines, particularly Ativan and Xanax, serve her well to prevent that from happening. An antpsychotic alone just doesn't seem to do the trick. She also takes Zyprexa and Neurontin, and I think Wellbutrin.
- Scott
Posted by kellyr on March 13, 2004, at 18:47:55
In reply to Schizoaffective disorder, posted by Sebastian on March 13, 2004, at 11:13:31
> Finaly got a diagnosis out of my doctor.
I got diagnosis in 1986 w/ Schizoaffective disorder. I found a web site that might help you understand the diagnosis,
www.geometricvisions.com/madness/schizoaffective-disorderkellyr.
Posted by PsychoSage on March 13, 2004, at 19:22:40
In reply to Re: Schizoaffective disorder, posted by SLS on March 13, 2004, at 17:42:59
> A friend of mine has schizoaffective disorder. For her, the key to her treatment is to prevent mania. Once a manic episode is triggered, it eventually develops into psychosis with visual and auditory hallucinations. Stress and anxiety are her worst enemies during times of remission. They seem to trigger the mania. Benzodiazepines, particularly Ativan and Xanax, serve her well to prevent that from happening. An antpsychotic alone just doesn't seem to do the trick. She also takes Zyprexa and Neurontin, and I think Wellbutrin.
>
>
> - Scott
That's brilliant. I am not usually for benzos, but now I will keep that in mind.
Posted by Sebastian on March 14, 2004, at 21:35:40
In reply to Re: Schizoaffective disorder, posted by SLS on March 13, 2004, at 17:42:59
What is a manic episode?
Posted by SLS on March 15, 2004, at 7:36:38
In reply to Re: Schizoaffective disorder » SLS, posted by Sebastian on March 14, 2004, at 21:35:40
> What is a manic episode?
Here is the official definition:
http://www.mentalhealth.com/dis1/p21-ps05.html
When a manic episode begins, my friend experiences a flight of ideas, pressured speech, reduced need for sleep, and some euphoria.
- Scott
Posted by jack9999 on March 15, 2004, at 21:38:58
In reply to Re: Schizoaffective disorder » Sebastian, posted by SLS on March 15, 2004, at 7:36:38
To all that had replied...
My wife is schizoaffective and it has not been an easy ride. she started out with a horrific manic episode that has lapsed into 7 months of a mild psychosis. She spends hours locked in her room or bathroom standing in front of the mirror talking to her hands (this is where the "people" talk through her).
Surprisingly she is able to work, but the symptoms are not getting any better despite loads of meds and med changes.
Is there any hope? Could the meds be causing it (never heard voices until after she started Geodon)?> > What is a manic episode?
>
> Here is the official definition:
>
> http://www.mentalhealth.com/dis1/p21-ps05.html
>
> When a manic episode begins, my friend experiences a flight of ideas, pressured speech, reduced need for sleep, and some euphoria.
>
>
> - Scott
Posted by judy1 on March 16, 2004, at 11:14:19
In reply to Schizoaffective disorder, posted by Sebastian on March 13, 2004, at 11:13:31
that's a tricky dx, the key is to still have some symptoms that last beyond the standard manic or depressive episode. honestly, I think most people with bp 1 fall into this category, maybe they save it for people who experience more psychotic symptoms. I got stuck in the hospital last week and had a depot injection of haldol- a standard for schizophrenics, and I am most definitely BP 1. what caused your pdoc to change? your diagnosis?
take care, judy
Posted by Sebastian on March 16, 2004, at 19:24:21
In reply to Re: Schizoaffective disorder, posted by jack9999 on March 15, 2004, at 21:38:58
When I took risperdal I holucinated a lot, like on acid 24/7. When I stoped it and started zyprexa it all stoped, mostly. Probably is not the right med for your freind. Also I noticed that as therapy with meds went on over the many years my symptoms slowely eased. I was in bad shape in the beginning. 1 year in hospital off and on for 2 years. In between I worked full time with no problems. Then the next 2 years I would work fine except for the 4 month periods once a year that I went nuts and staying in the house with major anxiety, my thought got the better of me. After all that I was fine with meds and never missed a day of work, now in about 4 years. I'm religous about taking my meds now.
Posted by Sebastian on March 16, 2004, at 19:30:02
In reply to Re: Schizoaffective disorder » Sebastian, posted by judy1 on March 16, 2004, at 11:14:19
I never realy had a diagnosis out of any doctor, to my face, till this one. Most of the diagnosises I would make up on my own and run them past the doctor. I was just guessing: From what I read on the internet. I was told about diagnosises 2nd hand, but never realy knew.
Posted by PsychoSage on March 18, 2004, at 21:37:22
In reply to Re: Schizoaffective disorder » Sebastian, posted by judy1 on March 16, 2004, at 11:14:19
> that's a tricky dx, the key is to still have some symptoms that last beyond the standard manic or depressive episode. honestly, I think most people with bp 1 fall into this category, maybe they save it for people who experience more psychotic symptoms. I got stuck in the hospital last week and had a depot injection of haldol- a standard for schizophrenics, and I am most definitely BP 1. what caused your pdoc to change? your diagnosis?
> take care, judyJudy, I was wondering why they gave you haldol, and I found this, so it makes more sense to me now.
Acute Phase
During the acute phase, treatment is aimed at decreasing symptomatology as well as safety concerns. Several reports and commissions have concluded that coercive treatment should be used only as a last resort, with at least one concluding that restraint and seclusion are not treatments, but instead are traumatic and should be used very rarely.[7-9] The Center for Medicare and Medicaid Services defines chemical restraint as a medication that is not given as part of a patient's usual treatment and is used to control movement.....
n another project, 50 experts were provided with a case scenario that varied in the degree of presenting symptoms.[11] Half of the respondents said they would use coercive treatment at the point where an uncooperative patient had both irritable and intimidating behavior. All agreed that restraints would be appropriate if the patient was directly threatening or assaultive. Most said it was not appropriate to restrain patients who simply refused to cooperate, stared intensely, had motor restlessness, purposeless movements, affective lability, or loud speech. Rather, they agreed that attempts should be made to manage patients verbally and with oral medications. Benzodiazepines, either alone or in combination with a conventional neuroleptic, were considered the treatments of choice for an unknown patient who presents a behavioral emergency. However, if it is known that the patient was treated with antipsychotics in the past, antipsychotics would be more appropriate to use as a first-line agent. If parenteral medication is necessary and there is some confidence that bipolar mania is the diagnosis, then a combination of benzodiazepines and conventional neuroleptics, usually haloperidol, would be used. For mania, the first-line choice would be a combination of haloperidol 5 mg and lorazepam 2 mg. The second choice would be lorazepam alone. If repeated doses are needed, there is little additional benefit from total doses above 7.5 mg of haloperidol.
http://www.medscape.com/viewarticle/460892_2
I've just learned that psychotic symptoms and mania go hand in hand, and there is a dopamine related hypothesis regarding mania. THe dopamine model is the main model for schizophrenia.
I hope you do NOT get hung up on your diagnosis, sebestian. As many learn, bipolar and schizo overlap considerably. I definitely try not to keep social connotations and laypeople's opinions about mental illness in my head when I consider diagnoses. I also try not to sell myself short when I realize I have many symptoms but I am short of a full blown disorder. If one has a full blow disorder or falls short, one has to deal with symptoms regardless.
On the flip side I thought I really needed to have a big AXIS 1 {bipolar, major depressive, or schizophrenic, etc} serious diagnosis in my head, so i could have a framework about what I thought I was, and that turned out to be ineffective. It was a great way to be self-conscious and beat myself up.
I have symptoms that relate to anxiety, depression, inattention, hypomania, mania and psychosis. The diagnoses of schizoaffective or amphetamine-induced psychosis helped me understand to what extent i may have them, but saying I have BP1 as opposed to schizophrenia or just schizoaffective as opposed to schizophrenia doesn't make me less vulerable to anything a full blown schizo experiences. It also doesn't make me a full blown schizo.
This dimensional concept that I guess i am inadequately trying to explain is discussed below.
"The perspective of disease works by categories and asks " what the patient has." .The perspective of dimensions works by the logic of gradation and quantification and asks "what the patient is." The perspective of behavior works by the logic of teleology and goals and asks "what the patient is doing." The perspectives of the life story works by the logic of narrative and asks "what the patient has encountered.""
http://www.hopkinsmedicine.org/press/2001/august/McHugh.htm
The problem with the DSM IV is that it is not strong from a dimensional perspective.
Good luck, all!
Posted by judy1 on March 22, 2004, at 13:03:07
In reply to Re: Schizoaffective disorder-judy, sebestian, posted by PsychoSage on March 18, 2004, at 21:37:22
thanks so much for the cited article- it really helped me understand the actions of the ER staff that day. I have been there before for manic episodes so i am known (and also my husband was present). initially they did use physical restraints and i went berserk, which prompted the use of haldol and lorazapam (which was mentioned in the article).
my feelings about DSM diagnoses are that they are essentially used for insurance purposes. there is so much overlap in the treatment of disorders with psychotic symptoms that it really doesn't make a diagnosis relevant in choice of treatment anymore.
thanks again for posting the article- judy
This is the end of the thread.
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