Posted by Racer on April 25, 2006, at 18:40:03
In reply to My diagnosis...help, posted by curtm on April 24, 2006, at 12:02:31
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> I have a psychiatrist that has been prescribing meds based on my symptoms (depression, anxiety, mood swings, irritability, and more.) She said that she does not do the diagnosis. She can only treat symptoms I have with medication that will help make me feel better.Well, first of all, she *could* do a diagnosis. Pdocs and Ts can both make dxs, although if she's talking about a definitive, based on a battery of reliable and valid tests, then she probably *doesn't* do that herself. If she chose to, she could send you on to someone else to do just that.
BUT
Depression and Anxiety are dxs. They're not symptoms, they are the actual dx. I've appended the criteria for them both, from the DSM IV.
Don't get caught up in "Diagnosis" though -- the DSM categorizes sypmtom clusters, and gives those clusters names. That standardizes statistical studies, and insurance company payouts. That's pretty much all it does. It doesn't say that you have any specific biochemical abnormality, nor that any particular drug will be of use to you.
As proof, ask how many people here with a diagnosis of UNIpolar depression find relief with the use of mood stabilizers. Ask how many people here find their anxiety improves on antidepressants, or antipsychotics -- or even amphetamines! Yes, having an Offical Diagnosis might be helpful if it leads to more effective treatment. But truly, that's rarely the case.
And, for what it's worth, my dxs have always come from pdocs, usually after a short evaluation visit. How accurate can that be? (And my current pdoc said, at my first visit, "Well, we only have to list one dx, so I'll only put down the depression..." Dx is just not that important to most doctors.)
Hope something in here helps.
Criteria for Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either
(1) depressed mood or
(2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
(4) Insomnia or Hypersomnia nearly every day
(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
(6) fatigue or loss of energy nearly every day
(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicideB. The symptoms do not meet criteria for a Mixed Episode (see p. 335).
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
Diagnostic criteria for 300.02 Generalized Anxiety Disorder
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.
(1) restlessness or feeling keyed up or on edge
(2) being easily fatigued
(3) difficulty concentrating or mind going blank
(4) irritability
(5) muscle tension
(6) sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)D. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.
E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.
poster:Racer
thread:636477
URL: http://www.dr-bob.org/babble/20060423/msgs/637011.html