Monday, July 19, 2004

The Hunt for a Diagnosis

A recent study by the American Psychiatric Association estimates that anywhere from 15 to 40 percent of patients with bipolar disorder are misdiagnosed. For some, it can take years before their psychiatrist finally fits the pieces together.

My own journey through the mental health system supports the APA's conclusions. My first diagnosis was delivered by the Student Counseling Center at USC. Their doctor told me I had an anxiety disorder, not otherwise specified. The translation? He couldn't tell me if I had a panic disorder, generalized anxiety disorder, social anxiety disorder or another, less common type of anxiety problem.

After three months, my counseling quota was exhausted and I was forced to hunt for another shrink. I landed on the office doorstep of Dr. Saul Niedorf. Dr. Niedorf was and is a compassionate doctor who cares very much about his patients and their lives. He opined that he preferred not to attach labels to his patients because they only served to limit his perceptions of what was wrong. Eventually, I bothered him often enough that he decided I might be cyclothymic. In layman's terms, that means he suspected that I had a touch of bipolar disorder--the most mild derivation. A deep, unrelenting depression forced him to hypothesize that I might be seasonal affective, meaning that the change in light prompts a depressive response. A mismanaged change of medications prompted a withdrawal so ugly and painful that despite my fondness for Dr. Niedorf, I decided to switch doctors after my departure from LA.

This decision shoved me through the money-saving doors of the ASU Student Health Center, where I met with Dr. Foran. She serves as the only psychiatrist for a student body of 60,000. She attempted to provide treatment, but seeing as how my illness is severe enough to require office visits more than every three months, I was prompted to again switch psychiatrists.

My newest psychiatrist is named Dr. Greenman. I'm not entirely sure what to make of him because we've only seen each other once. My gut reaction is that he's very qualified, though I've felt that way about all of my previous shrinks. I suppose I try to give every doctor the benefit of the doubt until they prove to me that they are unworthy of the opportunity to manipulate my brain chemistry. To me, "oops" is not a viable option.

Dr. Greenman provided me with the diagnosis of bipolar II--go here for more information on bipolar disorder. I suppose if two out of four psychiatrists agree, it must be true.

I suppose the part of my journey through the mental health system that angers me the most falls into the very first psychiatrist that I ever saw. I was having severe problems at home with my parents and we were getting to the point where we couldn't even talk to each other without fighting. My father started berating me about something and I was simply fed up with being blamed for familial problems that I started to smile at the horror of it all. My dad decided that I needed to see and shrink because of this response. I think he was done dealing with screaming fights between me and my mom. So, into the psychiatrist's office I went.

She didn't perform any kind of diagnostic tests, but merely tried to figure out why my mom and I were at each other's throats. She missed the fact that I was miserably depressed. She missed the fact that my mom was miserably depressed, that her SAD was in a severe stage, that part of our problem was that my mom was blaming me for a lot of her troubles and vice versa.

That was awful. It turned me away from the mental health system for years when I could have used help.

The subjectivity of psychiatry is disturbing. Patients die and years of people's lives are lost to the ravages to mental illness because of faulty diagnoses.

Makes me cranky.