Posted by Dinah on August 1, 2011, at 11:22:53
In reply to Thanks Phillipa » Phillipa, posted by floatingbridge on July 30, 2011, at 22:38:20
I wonder if it really matters, diagnosis. I mean, it's helpful to have a framework for the problem or ideas for treatment.
But mental health diagnosis is nebulous at best and often seems to be more of a descriptor than a definition of cause. Even major depression is unlikely to be one illness.
It's not as if you could find a mechanism that causes "cyclothymia" as opposed to "bipolar II". Or that once there is a definition there is a cure. Psychiatry/neurology just isn't there yet. They just treat symptoms at this point, in a rather hit or miss way.
Cyclothymia indicates more rapid mood swings than bipolar II. Which is helpful to know. But surely it's even more helpful to find a descriptor that more closely fits *you* rather than try to fit your symptoms into a diagnostic framework.
For example, while I don't have enough behaviors to meet the diagnosis for borderline personality disorder, I find the theory behind it *fits* very well. So I adopt some of the terminology for myself, even though the whole diagnosis doesn't fit. I say I have OCD, but in some ways it doesn't precisely fit. I'm likely somewhere on the borderline spectrum, but none of the diagnostic criteria fit me all that well. I even have some attention problems. I guess what fits best is old fashioned "neurosis" but that seriously downplays the physiological causes.
So I say I have easy arousal with slow return to baseline, a *lot* of anxiety and obsessive thinking, and difficulty in mentally switching gears. Under some circumstances, lack of sleep or certain medications or even extreme stress, I can get hypomanic, though never manic. At times I can become depressed, though that is by no means the major issue. I have health issues associated with the same chemicals that cause emotional/mental issues. IBS, migraines, etc. There's probably some problems caused by excessive stress hormones over an extended length of time.
Personally, I think whatever is wrong with me isn't all that much different from what's wrong with an overexcitable dog. There may be childhood factors, but if I weren't wired like an overly inbred cocker spaniel, my childhood factors would not have caused serious problems.
I treat symptoms, which is all anyone can do at this point, until they understand more about underlying causes. I think they've finally figured out that correlation does not equal causality. Through trial and error I've found that SSRI's give surface relief but overall just increase my agitation. Mood stabilizers are somewhat helpful. Tranquilizers can be occasionally helpful. Antipsychotics, or major tranquilizers, are very helpful on an as needed basis though I can't tolerate them on a continual basis.
I've grown to be aware of my body and what's going on, and to treat as needed. I know what situations cause problems and I try to avoid those situations.
I've given up on the psychiatric holy grail, the perfect medication or the "correct" diagnosis. I've given up thinking that the experts are all that expert at all, in comparison with most fields of medicine. Maybe in my lifetime they'll figure it out. But in the meantime, I'm not going to identify with any diagnosis. They're going to have to treat *me*.
Does cyclothymic or bipolar II or any other diagnosis really matter, if treatment doesn't change? Can't you just think of yourself as somewhere on the bipolar spectrum?
poster:Dinah
thread:992265
URL: http://www.dr-bob.org/babble/20110728/msgs/992480.html