Psycho-Babble Medication Thread 1095814

Shown: posts 1 to 16 of 16. This is the beginning of the thread.

 

what's in a diagnosis?

Posted by Christ_empowered on November 10, 2017, at 15:56:51

My current diagnosis (from the psychiatrist) is Bipolar I w/some obsessive stuff. The counselor leans towards the manic version of Schizoaffective. My community has labeled me "Schizophrenic." Well, that an "uppity mental patient." fun times, lol.

what goes into these labels? my parents now take care of me, and I get disability. They're...not rich, but "well-to-do" (my former psychiatrist's term, actually, LOL), professionals, etc. Is their social class part of the reason my primary diagnosis is still Bipolar I of some sort?

and then my label of "Schizophrenia," in the community. clearly, that's a straight up invalidation. Can't complain, too much...it is what it is, basically.

what do y'all think?

 

Re: what's in a diagnosis? Christ_empowered

Posted by linkadge on November 10, 2017, at 17:48:27

In reply to what's in a diagnosis?, posted by Christ_empowered on November 10, 2017, at 15:56:51

With bipolar, delusions, hallucinations (if they occur) are generally mood congruent. So, if (when your mood is good) you are free of hallucinations, then this would more likely be bipolar.


It seems like you have insight into your disorder that many people with schizophrenia do not have. However, I have no clue what your symptoms are.

You don't come across as being schizophrenic, but how much can one tell by typing to somebody online?

I don't know if you remember lou. But, that's what I think of, when I think of schizophrenia.

Linkadge

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 10, 2017, at 17:54:06

In reply to Re: what's in a diagnosis? Christ_empowered, posted by linkadge on November 10, 2017, at 17:48:27

thanks. I wouldn't mind "Schizophrenia" as a diagnosis if my problem was primarily psychosis, but...its not. so...when people 'round here talk about my 'schizophrenia,' I see that as an abuse of psychiatric labels, to invalidate me.

I don't know why my mind jumped to making it a social class issue. Feelin' a lil Marxist today, LOL.

My psychosis is -bad- during agitated, manic phases. Thankfully, I've only had a couple of those. I've had episodes of severe, psychotic depression...not fun (at all), but the psychosis then is...different. Not as in your face, pronounced. More...whispers, a vague sense of unease and paranoia, apprehension. Like being haunted.

 

Re: what's in a diagnosis? Christ_empowered

Posted by SLS on November 11, 2017, at 7:13:59

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 10, 2017, at 17:54:06

What happens when you discontinue or reduce the dosage of Abilify?


- Scott

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 11, 2017, at 8:09:21

In reply to Re: what's in a diagnosis? Christ_empowered, posted by SLS on November 11, 2017, at 7:13:59

hi, sls.

im down to 20mgs/abilify per day now. i was on 30 for way too long. im settled in at this dosage. there was a little agitation for a while, but low dose neurontin smoothed it out.

when ive stopped the abilify for too long, i get what I think is a rebound, plus the lack of sedation from daily pill intake. some agitation, brighter than normal mood, etc.

with the diagnosis of either bipolar I w/psychotic features or the manic version of schizoaffective, I'm kind of thinking/assuming that a tranquilizer is going to be part of my treatment for a while, possibly indefinitely.

i didnt do well on depakote. ive never taken lithium. other tranquilizers triggered akathisia, eps, depression (dysphoria?).

im wondering how low i can go with the abilify. the psychiatrist seems willing to go lower, but my counselor is big on taking as much as i can tolerate, which...wow. i guess that's how public/community mental health clinics do things?

 

Re: what's in a diagnosis?

Posted by linkadge on November 11, 2017, at 9:03:18

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 10, 2017, at 17:54:06

>More...whispers, a vague sense of unease and
>paranoia, apprehension. Like being haunted

These sound more like mood congruent symptoms than a primary disturbance in thinking and perception. Also, the fact that you can identify them / question them hints to the fact that as mood symptoms resolve, you recognize that the symptoms are not normal.

Unfortunately, schizophrenia is diagnosed more in individuals in the lower socioeconomic realm, and bipolar (or depression) in individuals of higher socioeconomic status. Schizophrenia is also more likely to be the diagnosis in certain racial groups (presenting with the same symptoms). This may be partly due to diagnostic biases; but it may also reflect association with risk factors that negatively impact disease outcomes.


The higher economic status may be associated with protective factors (lower stress, more access to supports, better nutrition, cognitive factors) which either improve the outcome, or it may induce a pressure to give a more 'socially acceptable' diagnosis.

Stress is a big risk factor in initiating a psychotic episode. Refugees, for instance, have a much higher rate of psychosis than the normal population. This may be associated with stress induced elevations in dopamine.

Linkadge

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 11, 2017, at 9:24:53

In reply to Re: what's in a diagnosis?, posted by linkadge on November 11, 2017, at 9:03:18

interesting, linkadge. i like how you linked social status to possible physical factors that might contribute to psychosis.

i do prefer bipolar I as a diagnosis because its far less stigmatizing than either schizoaffective or schizophrenia.

i go to a public/community mental health clinic. i cannot help but think that if my parents were still "rinky dink middle class" (a lovely phrase I've borrowed from a former counselor, btw), I'd be on involuntary, long acting injections of Haldol, maybe risperidone, if I played nice.

as it is...I'm diagnosed w/ Bipolar I, get disability, and fill my prescriptions at a local pharmacy (low low copay, thank goodness).

Maybe my parents' social status isn't so much resulting in "special treatment" as it is...making the people of Mental Health, Inc. do (for once...) what they're -supposed- to do, namely listen to the person/patient, provide compassion and support, and give treatment in the "least restrictive setting" possible?

ugh. clearly, I'm not the biggest fan of Mental Health, Inc. I'm not nearly as bitter and nihilistic as I was in years past, but I am...disillusioned, I suppose.

oh well. at least --I-- get appropriate, hands off treatment, at long last...and disability covers it, which is a huge plus for my parents.

 

Re: what's in a diagnosis?

Posted by Lamdage22 on November 11, 2017, at 12:54:39

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 11, 2017, at 9:24:53

Personally i dont care what my psychiatrist calls me as long as he doesnt defame me in the community. I have that same inclination towards a feel of unease and paranoia.

I try to conquer that with CBT.

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 11, 2017, at 13:38:29

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 11, 2017, at 9:24:53

I've had shrinks and other 'professionals' go after me in years past. ugh. --not-- fun. lines up all too well with szasz and others' characterization of psychiatry as a form of social control, especially when dealing with low(er) status people.

but...now, as the locals like to say, 'his people have money,' and that buys me some "breathing room" in this situation.

I'm also fortunate that most of the state hospital is gone now. a lot of it was apparently on desirable real estate. the state made a cool couple hundred million$ shutting it down and selling it off to a real estate developer.

now...even the "not guilty by reason of insanity" cases are fast-tracked thru treatment ("recovery model" in action, it seems).

I -could- have been committed to the local state-funded hospital, at one point. I was lucid and clever enough to be able to go home, but again: social class played a role. if id been a poor, minority woman, I might have gone off to the hospital, and then been discharged on ongoing, involuntary treatment on an "outpatient" basis.

I just...don't know, sometimes. I'm one of the few "clients" the clinic in long-term, ongoing counseling. if they decide to taper that off, I may decide to just go to family doctor.

 

Re: what's in a diagnosis?

Posted by linkadge on November 11, 2017, at 17:57:30

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 11, 2017, at 9:24:53

Hey,

I come from 'rinky dink middle class' and am proud of it :) The difference for me is self-education. With the internet, and a willing brain almost any individual can arm themselves with the knowledge needed to help improve the accuracy of their diagnosis and outcome.

In my location, no income = free medications anyway. However, I have to pay cash because I do make some money.

However, I have seen free medications as a mixed blessing myself. I actually improved after I lost coverage under my parents. Because of the costs, I had to really think hard about which medications I really needed, and which effects could be replicated with alternatives.

Currently, I can get by with generic Effexor and lithium.

Linkadge


 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 11, 2017, at 18:51:19

In reply to Re: what's in a diagnosis?, posted by linkadge on November 11, 2017, at 17:57:30

LOL. I think its the private, for profit mental health system in the US that's especially elitist. Its...interesting...now my parents and I have reconciled, they're more "well-to-do" or whatever...and I'm --finally-- receiving proper treatment.

I'm prescribed --4-- drugs, most days I Just take 1 (the Abilify, now and then a bit of gabapentin). I don't know if its me, in particular, the public/community mental health clinics in general, or...what...but...whoa, they load people up on psych drugs.

I dropped the trileptal and low dose lamictal once psychosocial stuff in my life got better. I feel much better w/o the antiepileptics, that's for sure...my thinking is much less muddled.

at least I've been spared involuntary injections of the depot drugs. --not-- something I'm interested in.

again, sorry to get all Marxist and such. I -do- have psychiatric "issues" that (thankfully...) respond to standard treatment. that's not the issue. I think its Mental Health, Inc. that I have problems with.


 

Re: what's in a diagnosis? linkadge

Posted by pedr on November 12, 2017, at 8:03:33

In reply to Re: what's in a diagnosis? Christ_empowered, posted by linkadge on November 10, 2017, at 17:48:27

> I don't know if you remember lou. But, that's what I think of, when I think of schizophrenia.
>
> Linkadge
>

I was wondering where Lou was. I'm not intending to be mean but I found his incessant posting difficult :/

 

Re: what's in a diagnosis?

Posted by pedr on November 12, 2017, at 8:14:05

In reply to Re: what's in a diagnosis? linkadge, posted by pedr on November 12, 2017, at 8:03:33

this is a super interesting thread.

I'm from an uber middle class background too. However all of the non-state therapy (UK + US) I've received has been out of my own wallet. I frequently wonder/worry if I'd even be here (my dx is severe TRD) if I hadn't the money to go private. I also frequently lament the 10's of $K's I've spent on so-far ineffective treatment.

One senior state PDoc told me after my first TCA failed that "there's nothing else for you to try". Having internet access I knew he was wrong and in fact wrote to the health department to complain bitterly. He may be right but what if he tells that to some old/poorer person with no internet or the inclination to verify his statement? They'll believe him and suffer until they die. Horrific.

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 12, 2017, at 11:34:52

In reply to Re: what's in a diagnosis?, posted by pedr on November 12, 2017, at 8:14:05

my problem now is that I seem to "rub people the wrong way." I'm on disability, living with my parents who are now "genteel" or whatever. OK. So, on the one hand, I get more "breathing room" than many "mental patients," on the other hand, I am forever perceived as "uppity," etc. It doesn't help that I had -extreme- conflict with some treatment providers in the past (the medical board has been involved), so...yeah. Good times, lol.

Diagnosis can be used as a tool to invalidate and stigmatize people, obviously. A lady at the front desk at the clinic I go to said that I'm "really Schizophrenic," even though that's not my diagnosis. Obviously, "Schizophrenia" is a far more stigmatizing diagnosis than "Bipolar I" of any sort.

To be fair though, I've had better luck w/ community/public mental health. So far, they haven't pulled out the Freud on me (or the shock "treatments"), which is always a good thing.

I'm hoping to get into some sort of j-o-b and move away. I get the sense that as long as I live in this area, I'll always have some sort of stigmatizing label(s) applied to me. fun times.

 

Re: what's in a diagnosis?

Posted by Lamdage22 on November 13, 2017, at 2:14:51

In reply to Re: what's in a diagnosis?, posted by Christ_empowered on November 12, 2017, at 11:34:52

I am sorry that the community labels you like that. Are they bullying you?

 

Re: what's in a diagnosis?

Posted by Christ_empowered on November 13, 2017, at 11:17:58

In reply to Re: what's in a diagnosis?, posted by Lamdage22 on November 13, 2017, at 2:14:51

hi, lamdage.

there's...a lot going on in my community. labels, stigma, social class issues, etc. I'm not a member of this community, and I probably never will be. As much as I hate the label "schizophrenia"--not just for me, but for anyone, really (its so stigmatizing)--in my case, the label provides a bit of "breathing room."

Its like this...now, my parents have more resources and status. I'm thankful. When I was in private practice treatment, etc. they had high-ish prestige jobs, middle class resources. Now, I'm in state/community treatment (covered by disability, btw), and they have the high(er) prestige careers, plus more resources.

So...basically, I'm labeled 'Schizophrenic,' but the label doesn't have the same effect on me as it would if I was poor or if my parents were still "rinky dink middle class." a "mental patient" from a "good family" apparently gets more freedom (no hospitalization, involuntary treatment, etc.), although I still "get no respect," like Rodney Dangerfield or something, lol.

I guess its just the nature of being a "mental patient" anywhere, but especially in the US. social status (yours and/or your family's...) plays a -big- role in what sort of "treatment" is provided, right down the labels/diagnoses one ends up with.


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