Posted by violette on August 26, 2010, at 19:25:49
In reply to Re: Is It Depression or Bipolar? » violette, posted by ed_uk2010 on August 26, 2010, at 15:37:00
"As well as the issues with insurance, there's also the tendency of some psychiatrists to only diagnose conditions which are treated with medication. Conditions which are not normally treated with medication are never the 'default' diagnosis."
I don't think it's about lack of diagnosing the problems, it's pretty much about ignoring emotional problems....Those same psychiatrists are not looking at emotional issues unless they are extreme manifestations. So mental illness does not just 'go away'. And if they do, they often come back or get worse over time.
And the trend to label more people with the catch all bipolar II diagnosis is another way to ignore emotional problems, while encouraging more drug usage.
Every patient in psychoanalytic therapy will have 'traits' of personality disorders discovered. It's not PD, it's about your defense mechanisms, object relations, inter states, all sorts of things that can form patterns-sometimes to a small degree, sometimes to a large degree. Sometimes those traits are actually adaptive and change from time to time, serving a useful purpose to avoid psychosis.
It would benefit patients to get over the term 'personality disorder' because people can really learn alot about themselves from reading about them. Glen Gabbard is an excellent source. It's just a very stigmitizing term that unfortunately is used when describing the concepts of how traits are formed, often describing more fully manifested personality patterns for the sake of attributing conceptual terms to a group of features.
But if you read case studies, they usually describe how someone's 'traits', as opposed to actual 'PDs' cause and interact with the axis I stuff. They are not 'seperate' concepts.
It might be more helpful to not seperate axis i and ii-because they are so intertwined. And some estimates are that 50% of the mental health population in treatment actually would qualify as having a 'personality disorder' at time of treatment. I recall the last psychodynamic study I read about suicide attempts-over 80% of those people met the criteria for PDs, but were diagnosed MDD. People are not tested or treated for emotional problems.
Every therapist in psychoanalytic training will identify their own 'PD' traits/tendencies whether they be avoidant, narcissistic, ocd, codependent or whatever. It's not about PDs as much as it is about recognizing and treating the psychological parts of illness or whatever obstructs you in daily life or prevents you from living the best you can. Traits of PDs or PDs themseles-which are basically larger defense patterns-actually cause certain symmptoms to emerge at certain times-the same symptoms people take drugs for. People with certain PDs are somewhat less likely to benefit from pharmacuetical treatments, but the Axis I problems are not seperate-they are dynamic with the Axis II.
A person with OCPD traits who loses their job will likely get MDD-because OCD is a defense mechanism to prevent painful emotions and your job success is intertwined with your 'self'. People with various PD traits will get MDD after losing a relationship...often the other half of the relationship serves a purpose in affirming a person's worth. Others can get MDD or other axis i when approaching 'success'-if you have a very low self worth-it can cause an inner conflict you are unaware of. Why do you think so many people get mental illness after losing jobs and relationships? It's really about object relations; your brain's neurotransmitters are triggered by emotions. If not, then more people would spontaneiously get MDD or anxiety. It can often be traced back to something that effected you emotionally, maybe not as noticable as a job loss.
The problem is, those traits can come and go, intensified with stress. Medications may treat you temporarily, but for those in the mental health system for extended periods, you will likely never be well without addressing those emotional issues-even if drugs will temporarily mask the pain. People can learn alot...
I feel like one of those confetti bombs used on new year's eve...where after the confetti might provoke some for but 1 second, it just floats aimlessly around people, landing on the ground with no purpose or effect. Maybe I should save my confetti for 'special occasions' only.
poster:violette
thread:959557
URL: http://www.dr-bob.org/babble/20100821/msgs/960056.html