Posted by bleauberry on April 15, 2012, at 15:17:36
In reply to New pdoc, more confused than ever, posted by Raisinb on April 14, 2012, at 22:33:33
I think humans instinctively want to understand things and be able categorize things. With psychiatry the mysteries are so profound that the best we can do is give names to certain clusters of symptoms. Just because we have a name for our symptoms isn't really very helpful. We still don't know what it is, what causes it, or how to fix it. No matter what the name of the cluster of symptoms is, that cluster overlaps with other clusters. It isn't clear cut. There is no objective way to determine what is what, so it is done subjectively....based on opinion. So if you went to 10 different doctors, you could possibly come home with 5 to 8 different diagnosis.
What really matters is to try stuff to find what helps you. The name of the symptoms is partially helpful in that it gives us a general starting point. If our starting point turns out unfruitful then we can start looking elsewhere, but at least we had some sort of attempted organization to it all.
I think basically in psychiatry we are winging it, because we don't know what will work in each person, or if anything will at all, so we are at the mercy of trial and error experimentation. As humans we try to make it as compartmentalized and understandable as we can, despite it is far beyond that for us at this time. Using experience and observation we have been able to basically isolate different clusters of symptoms and give each a name. While that is somewhat helpful, but not really, I think the whole process is an overglorified one. But it's the best we have right now.
I wouldn't worry too much about the names. If he thinks you have some adhd in there, fine, then ritalin and adderall should be on your radar screen. Depression is a problem so whatever meds you've already tried....don't go that direction...go a different direction with other antidepressants. If bipolar is in there, maybe a mood stabilizer and maybe not. I personally would address the most crippling symptom with the highest priority and deal with the others along the way.
In terms of actual med choices, I am of the belief that balanced norepinephrine vs serotonin strategies have the best outcomes. That means nortriptyline+zoloft, nort+prozac, savella, nardil, or parnate. Ritalin or Adderall might feel good, with or without the other meds.
Anyway, you've made a little step forward, so, cool! Next step.
> He had me fill out a raft of screening forms and it turns out I might have "soft" bipolar, or what he called "bipolar 3," borderline personality disorder (I've heard that one before, too), and a new thing: adult ADHD. No one has ever suggested I had ADHD before, but then again I don't think I've ever been screened for it. I am chronically disorganized, fidgety, impatient, and irresponsible. I do not pay bills, file taxes, or keep my house or car clean (they always look like landfills). But I thought that was the depression--or is the depression from being borderline, or--
>
> Dude! How do you know what you actually have?
poster:bleauberry
thread:1015611
URL: http://www.dr-bob.org/babble/20120411/msgs/1015655.html