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Mental Wellness Weekly Check-in Thread 10 July 2023

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  • Went to the hospital yesterday and saw a new psychiatrist who was more attentive of my feedback, and she was about to give me a different antidepressant, but forgot what I said that made her ask me more questions and she suspects that I have Bipolar disorder instead of ADHD.

    So we're going to try the Bipolar medication instead and see if it's effective. Taking these medicine isn't fun, you just feel so sleepy all the time, and it really messes up other things for you, like libido.

    • so the psychiatrist is OK with patients trying different medication to confirm diagnosis? that doesn't sound assuring...

      I've been trying to get ADHD diagnosed, but been told it's just regular depression/anxiety

      • Hi I can see that you have some concerns about mental health disorders and diagnosis, just to share some insights on this!

        For the diagnosis of mental health disorders, it can be quite a delicate process. Some people may think that the diagnosis for a mental disorder is a pretty straightforward process - like the doctors have a standard list of symptoms for a specific mental disorder, and if a person shows or experiences a certain number of symptoms on the list, the doctor will confirm that the person is having that particular mental disorder, and diagnose them with "(name) disorder". But this is not how the diagnosis process goes.

        (So taking this opportunity to make a PSA against self-diagnosis - many people hear or learn about the different symptoms for a certain mental disorder, and they may find themselves thinking "oh I also experience these symptoms!" and thus convinced that they are having that particular disorder or condition. This is not a healthy thing to do - if you suspect of having certain mental health condition, please talk to a qualified mental health practitioner.)

        In reality, the process of diagnosis is a more holistic one. While checking for symptoms is part of the process, the psychiatrist or clinical psychologist (the only specialists who can make diagnosis) has to be very careful in applying the symptoms - including to check if the exhibited symptoms may be related/attributed to other physical or mental illnesses, as well as to examine the context such as if the patient has recently experienced any significant life events that may cause these symptoms, the patient's and the family's medical history, the family and life background, and other factors - before deciding on a diagnosis. Some different disorders have very similar symptoms but vastly different diagnostic criteria, and the specialists have to be very careful in considering and eliminating different possible diagnoses. That is why you may seem to fit the criteria for certain diagnosis, but the doctor gave you a different one that you have in mind. Often the specialists would also want to observe the patient for a certain period of time, to see if there are any changes in the experienced symptoms, before making a diagnosis. So it takes time.

        In addition to that, there is also this thing called "comorbidity" within mental disorders - where a person may experience two or more distinct psychological disorders at the same time, and the specialists have to be very careful in making sure all the different disorders are addressed.

        On the issue of meds - it's not uncommon to see doctors trying different presriptions (including different kinds of meds and also the dosage) to see what works best. We see it in all kinds of medical situations from common flu to cancer, not a practice unique to psychological disorders, can certainly not a suspicious or shaddy medical practice. Because the drugs may work differently for different people, so even for a specific diagnosis, the doctor may try different meds to find out what is the best for the patient. What the doctors are not doing - in Wee's case and in general - is using different drugs to confirm diagnosis.

        Hopefully this helps you to clarify the diagnosis process for mental disorders.

        I can see that you're concern with the doctors giving you a different diagnosis that you have in mind, and I hope the above information helped you to see how could this be possible. I certainly would encourage you to talk to your doctor if this is a main concern for you, you may indeed ask them "how is it that you decided on depression and anxiety for my diagnosis, and not ADHD?", and see if they can help you to understand more about your condition, and perhaps to work towards a better treatment plan.

        All the best!

        • thank you for the information!

          i've never thought about posing doctors the question. I've never seen a proper psychiatrist, only shrinks and GP perhaps that's why my experiences were less than ideal and marred.

          I can also see how it's super delicate, usually the first question they ask is how I function on a day-to-day basis, ie. my grades at uni, my career, my childhood grades etc. usually that's where they brush it off, because when discovered i've been getting straight As and pretty good grades when i was younger they said no way i would have ADHD. But issue is I have never, ever, ever concentrated a single second in my life, unless i try. Concentrating does not come as second nature to me and i have to rely on fear (of disappointing, negative consequences of not meeting job quotas etc) to motivate me. And i do not blame them at all, it could very well just be general depression/anxiety... but it's been there for more than 2 dozen years but oh well, i don't want to self-diagnose as you've said.

          will have to come around to seeing a psychiatrist in the future so will definitely keep your advice in mind.

      • Hmm maybe I worded it wrongly, but she does suspect I have Bipolar, and since I requested to change medication because of the drowsiness, we agree to try the Bipolar medication to see if it works better for me.

        Same, I'm actually trying to get ADHD diagnosis.

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